Abstract

Aim: to investigate the violations of the interferon status and to evaluate the clinical and immunological efficacy of immunoactive drugs in patients with asthma with the justification of their use in persons with an immunocompromised viral background.Materials and methods. We examined 86 patients with atopic asthma, 67 patients with atopic BA of the lung, medium and moderate course during remission of the disease, and 19 patients with asthma exacerbation. Immunovac VP-4 was used in patients with BA in remission, interferon inducer (IFN) Cycloferon in patients with exacerbation of BA. The observation period of outpatients was 1 year, during which they monitored clinical, allergological and immunological parameters, including the assessment of interferon status with the determination of the biological activity of IFN type I and II, as well as the activity and quantitative content of type II IFN and IL-4 in the blood serum.Results. All patients with asthma, regardless of the severity of the disease, showed a pronounced decrease in the biological activity of IFN types I and II produced by the patients’ leukocytes, and a reduced potential of Th2 cells to synthesize IL-4 during remission, incomplete remission, and especially in period of exacerbation caused by ARVI.Conclusion. The inclusion of immunomodulating drugs Immunovac VP-4 and cycloferon in the complex therapy of patients with atopic asthma of light and moderate severity leads to an increase in leukocyte IFN-producing ability, a decrease in the incidence of ARVI and the number of exacerbations of the underlying disease. The use of synthetic and bacterial immunomodulators in patients with immunocompromised genesis of the disease will reduce the number of exacerbations of asthma and the frequency of respiratory viral infections.

Highlights

  • Aim: to investigate the violations of the interferon status and to evaluate the clinical and immunological efficacy of immunoactive drugs in patients with asthma with the justification of their use in persons with an immunocompromised viral background

  • Immunovac VP-4 was used in patients with BA in remission, interferon inducer (IFN) Cycloferon in patients with exacerbation of BA

  • Regardless of the severity of the disease, showed a pronounced decrease in the biological activity of IFN types I and II produced by the patients’ leukocytes, and a reduced potential of Th2 cells to synthesize IL-4 during remission, incomplete remission, and especially in period of exacerbation caused by ARVI

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Summary

МАТЕРИАЛЫ И МЕТОДЫ

Обследованы 86 пациентов с атопической БА в возрасте 41,06±1,87 лет. Диагноз БА устанавливали согласно рекомендациям ВОЗ (Глобальная стратегия лечения и профилактики БА, GINA). Период наблюдения амбулаторных пациентов составил 1 год, в ходе которого осуществляли мониторинг клинических, аллергологических и иммунологических показателей. Аллергологическое обследование: сбор аллергологического анамнеза, постановка кожных проб с неинфекционными аллергенами (при отсутствии данных в амбулаторной карте), определение уровня общего и специфического IgE. Определение уровня общего IgE и IgEспецифических антител к бытовым, пыльцевым аллергенам и аллергенам некоторых грибковых и условно патогенных микроорганизмов проводили с помощью непрямого твердофазного метода иммуноферментного анализа, разработанного в лаборатории аллергодиагностики НИИВС им. Для иммунокоррекции больных БА были применены отечественные иммуноактивные препараты: индуктор интерферона циклоферон и в рамках клинической апробации иммуномодулятор — вакцина Иммуновак ВП-4 [3]. Этот метод включал 3 интраназальных и 5-6 подкожных введений препарата согласно инструкции по применению. Оценку различия средних величин иммунологических показателей проводили с помощью непараметрических критериев: Вилкоксона — для зависимых выборок и Манна-Уитни — для независимых выборок.

РЕЗУЛ ЬТАТ ЫИОБСУЖДЕНИЕ
ИФН II
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