Nonspecific Inflammatory Diseases Research Articles

Review of the book “Practical issues of rational antibacterial therapy”

In 2023, the book “Practical Issues of Rational Antibacterial Therapy” under general ed. Yarovoy SK, Khokhlov AL, was published. This monograph is devoted to practical issues of empirical therapy for the most common nonspecific infectious and inflammatory diseases. The monograph presents the main provisions of antimicrobial therapy from the perspective of clinical pharmacology. The general patterns of prescription and distribution of antibacterial agents, the concepts of basic and reserve drugs, selection of hospital strains, natural and acquired resistance are explained. Antibacterial drugs are compared in pairs with each other based on an analysis of their spectra of antimicrobial activity. Combination (multicomponent) antibacterial therapy is being considered. Undesirable regimens of antimicrobial therapy are described, options with insufficient effectiveness and an unsatisfactory safety profile are analyzed.

Effect of screening colonoscopy frequency on colorectal cancer mortality in patients with a family history of colorectal cancer.

Colorectal cancer is a common malignant tumor in China, and its incidence in the elderly is increasing annually. Inflammatory bowel disease is a group of chronic non-specific intestinal inflammatory diseases, including ulcerative colitis and Crohn's disease. To assess the effect of screening colonoscopy frequency on colorectal cancer mortality. We included the clinicopathological and follow-up data of patients with colorectal cancer who underwent laparoscopic colectomy or open colectomy at our Gastrointestinal Department between January 2019 and December 2022. Surgical indicators, oncological indicators, and survival rates were compared between the groups. The results of 104 patients who met the above criteria were extracted from the database (laparoscopic colectomy group = 63, open colectomy group = 41), and there were no statistically significant differences in the baseline data or follow-up time between the two groups. Intraoperative blood loss, time to first ambulation, and time to first fluid intake were significantly lower in the laparoscopic colectomy group than in the open colectomy group. The differences in overall mortality, tumor-related mortality, and recurrence rates between the two groups were not statistically significant, and survival analysis showed that the differences in the cumulative overall survival, tumor-related survival, and cumulative recurrence-free rates between the two groups were not statistically significant. In elderly patients with colorectal cancer, laparoscopic colectomy has better short-term outcomes than open colectomy, and laparoscopic colectomy has superior long-term survival outcomes compared with open colectomy.

Особливості імунних порушень у дівчат із рецидивами хронічних неспецифічних запальних захворювань статевих органів

Nonspecific inflammatory diseases of the female genital organs (NIDFGO) affect women throughout their lives and are an important medical and social problem associated with a decrease in a woman's reproductive potential. Purpose - to study the immune status of girls with HCV in comparison with changes in adult women in order to improve algorithms for the diagnosis and treatment of inflammatory vaginal lesions depending on age. Materials and methods. In a prospective, single-center controlled and non-randomized study, 69 girls were involved: 55 patients with NIDFGO, who had a different frequency (from 1 to 4 or more) of disease recurrence during 1 year of observation, and 14 healthy girls of the control group. All study participants underwent a standard gynecological examination and laboratory screening. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the Bogomolets National Medical University. The informed consent of the children’s parents was obtained for the conducting the studies. Statistical analysis was performed using the IBM SPSS Statistics 23 package and the MedStat program. Results in groups were compared using Kruskal-Wallis, Dunn, or Mann-Whitney tests with Bonferroni correction. Results. Selective deficiencies of IgE and NKT-cells are the main immune disorders in patients with , NIDFGO of both age groups. Deficiencies of IgA, C3 component of the complement system and qualitative phagocytic disorders are registered only in girls, while in adult women, deficiency of C4 component of complement, CD8+ cytotoxic T-lymphocytes and NK cells predominate. Conclusions. The opposite direction of changes in the content of the IgE molecule and the number of NKT cells in the blood in patients with NIDFGO in different age groups, with the preservation of the ratio of results in subgroups with different frequency of relapses, indicates the need for a differentiated approach to the diagnosis, treatment and prevention of immune disorders in people with recurrent NIDFGO in different age groups. No conflict of interests was declared by the authors.

Informing of estimation of cytokine status at nonspecific infectious-inflammatory diseases of cervix and vagina

The objective: to estimate informing estimation of cytokine status at nonspecific infectious inflammatory diseases of the cervix and vagina. Materials and methods. 9 type groups are selected: I –conditionally healthy (42 women), II –candidacy (45 women), III – bacterial vaginosis (112 women), IV - a nonspecific vulvovaginitis (107women), V – acute vulvovaginal candidiasis (61 women), VI - chronic vulvovaginal candidiasis (76women), VII – bacterial vaginosis + candida infection (71 women), VIII - a nonspecific vulvovaginitis+ candida infection (84 women), IX – bacterial vaginosis + nonspecific vulvovaginitis (63 women). The complex of the conducted research included cytological, bacterioscopic, bacteriological, and immunological. Results. The set connection between clinical and laboratory by the features of the studied states and biological properties of stamps of C. albicans, selected from different patients. Together with the comparative analysis of morphological and cultural descriptions of mycotic cultures, the special interest was presented by the determination of their phospholipase activity, which is examined as basic, correlating with other, factors of pathogenicity of C. аlbicans. It is marked, that in those cases when it is possible it was to foresee the participation of C. аlbicansin an infectious process as a mono exciter or fellow member of parasitocenosis, registered the meaningful increase of the degree of their virulence for certain. The sizes of cages varied, but more frequently were below averages. The coefficient of virulence which correlates with the level of phospholipase activity hesitated within the limits of 0,3–0,9 and, as a rule, exceeded 0,5. Dependence is marked also on a temperature factor: the speed of growth of «virulent» variants at room temperature was considerably slowed, or growth absented in general, that typically for exciters infectious inflammatory diseases. In those cases, when candida was discovered for practically healthy women or as«casual», transient components on a background of nonspecific vaginitis or bacterial vaginosis, the coefficient of virulence of the selected stamps was always below the 0,3, a tendency was traced to thejumboizing of cages, here cultures identically well grew and at a room temperature, and at 37 °С. Obviously, at clarification of diagnosis, for differentiation of the states, C is related to infecting. аlbicans, and estimations of their contribution to the infectious process, together with traditional clinical-and laboratory by tests, expedient study of the transferred properties of microbial cultures which are selected. Conclusions. The results of the conducted research testify to the substantial role of cytokine status in the estimation of the state of local factors of defense for patients from infectious inflammatory diseases of the cervix and vagina. The got results must be taken into account in the development of an algorithm for diagnostic and treatment-and-prophylactic measures.

Immunomodulatory properties of plant polyphenols shown in an <i>in vitro</i> experimental model

Polyphenols exert a wide range of biological effects, including immunomodulatory action. Studying the effects of flavonoids on phagocytic activity of specialized phagocytic cells seems to be a rather promising direction for their further usage as pharmacological (therapeutic) agents. Quercetin and luteolin are the most commonly studied flavonoid substances with pleiotropic action. In-depth study and understanding of immunotropic mechanisms (e.g., regulation of phagocytosis) is a prerequisite for adequate pharmacotherapy in infectious conditions, nonspecific inflammatory diseases, autoimmune and oncological disorders. The aim of our work is to study the effect of flavonoids upon phagocytic activity of professional phagocytes (neutrophils) using an in vitro test system. The biological material (venous blood) from 30 practically healthy people (adults n = 15, children n = 15) was used in the present work. The study was carried out in accordance with established international regulations. 0.5 mg/L of Luteolin (basic substance content ≥ 98%) and Quercetin (basic substance content ≥ 95%) were added to experimental samples and incubated for 20 min at 37 °С. The percentage of phagocytosis, phagocytic number (mean number of formalin-treated sheep erythrocytes engulfed per one neutrophil) was determined in control and experimental samples using light microscopy. The unidirectional nature of phagocytosis inhibition by quercetin and luteolin was noted in the test experiments. A statistically significant (p < 0.05) decrease in the phagocytosis intensity by 10% was shown in experimental blood samples obtained from adult patients compared with control values. When quercetin and luteolin were added to blood samples obtained from children, a statistically significant (p < 0.05) decrease in phagocytosis by 30% was noted against control values. At the same time, the mean percentage of phagocytosis and phagocytic number in blood samples after the addition of flavonoids were found to be in the range of reference values, thus suggesting adequacy and physiological suppression of excessive activities of innate immunity compartments by quercetin and luteolin. At this concentration, the flavonoids were found to exert a more pronounced suppressive effect on phagocytic activity in children. Modeling of immune response using the phagocytosis indices assayed in experimental in vitro models with neutrophils from practically healthy adults and children enables us to expand the knowledge of mechanisms underlying the immunotropic effects of flavonoids (quercetin and luteolin), in order to correct immunopathological conditions.

Indicators of immune status in women with different recurrence rates of nonspecific inflammatory diseases of the genital organs

Non-specific inflammatory diseases of the female genital organs (NIDFGO) are an important problem of modern gynecology due to their high frequency in the population, the tendency to frequent recurrences, and many cases of resistance to recommended antimicrobial and anti-inflammatory drugs. Aim: to study indicators of immune status in women with different recurrence rates of NIDFGO and biomarkers of recurrences to improve potential therapeutic approaches and prevent recurrences in the further. Materials and methods. A prospective single-center controlled non-randomized clinical study was conducted with the participation of 98 adult women. Out of them, 80 patients with NIDFGO had one-year recurrence rate of 1, 2–3, 4 or more events, and 18 age-matched women without NIDFGO were assigned to the control group. Immunogram and hemogram were performed for all study participants using standardized methods. Statistical analysis of the results was performed using IBM SPSS 23 statistical package software. Results. The mean serum concentration of IgE in patients with frequent relapses was 3 times (p < 0.05) lower than that in women with only one recurrence, 2.6 times (p < 0.05) lower than that in patients with medium recurrence rate, and 3.4 times (p < 0.05) less than in the control. In women with frequent recurrences, the mean relative number of blood NKT cells was 3.5 times (p < 0.05) less than that in patients with only one recurrence, 2.3 times (p < 0.05) less than that in persons with medium recurrence rate, and 3 times (p < 0.05) less as compared to women of the control group. Conclusions. Selective deficiencies of IgE and NKT cells in women with NIDFGO are factors that lead to a higher frequency of disease exacerbations per year. T he development and clinical approval of immunotherapeutic approaches to compensate for deficiencies of IgE and NKT cells in women with NIDFGO will contribute to the imposition of immune control over the inflammatory process, increase the effectiveness of antimicrobial treatment, resulting in a decrease in the recurrence rate.

Features of the epidemiological situation with acute urogenital gonococcal infection in the Perm Region for the period from 2010 to 2021

BACKGROUND: According to WHO, more than 60 million people get sick with gonococcal infection every year. Recently, there has been a decrease in the incidence of gonorrhea in Russia. However, in addition to Neisseria gonorrhoeae, other microorganisms may also cause acute urethritis. However, there is no record of morbidity for them.
 AIM: This study analyzes the epidemiological situation of the incidence of аcute genital gonococcal infection and urethral nonspecific inflammatory diseases in the Perm Region for the period 20102021.
 MATERIALS AND METHODS: A comparative retrospective analysis of the incidence of аcute genital gonococcal infection and urogenital tract nonspecific inflammatory diseases among patients of the Perm Region was performed using the annually published data of official statistics. The data on the incidence of genital tract nonspecific inflammatory diseases were obtained from outpatient patient records of three clinics in the city of Perm. Epidemiological and statistical information processing methods were used in the work, and the Pearson coefficient was used for correlation analysis.
 RESULTS: The long-term dynamics of the incidence of аcute genital gonococcal infection among the population of the Perm Region was characterized by a pronounced downward trend. However, in recent years, the number of genital tract infections in women and men has increased. The decrease in the incidence of аcute genital gonococcal infection is most likely due to changes in the properties of N. gonorrhoeae, causing significantly more difficult laboratory diagnoses and often leading to false negative results. In addition, the high polymorphism of cultural, morphological, and biochemical properties of conditionally pathogenic microorganisms further complicates the identification stage of the isolated strains.
 CONCLUSION: As a result, against the background of a decrease in the incidence of аcute genital gonococcal infection, an increase in the incidence of genital tract nonspecific inflammatory diseases was revealed. The peculiarities of the epidemic process of аcute genital gonococcal infection and urogenital tract and the complexity of laboratory diagnostics of these conditions cause their untimely detection.

Combination therapy in inflammatory bowel disease: Current evidence and perspectives.

Inflammatory Bowel Diseases (IBD) are chronic nonspecific intestinal inflammatory diseases with a relapsing-remitting course, including Ulcerative Colitis (UC) and Crohn's Disease (CD). Combination therapy has been proposed as a strategy to enhance treatment efficacy in IBD. The aim of this study is to summarize current evidence and perspectives on combination therapies in IBD. Electronic databases such as PubMed, Ovid Embase, Medline, and Cochrane CENTRAL were searched to identify relevant studies. Current evidence supports that the combination of infliximab and thiopurines is more effective than monotherapy in inducing and maintaining remission in IBD. Data on the combination of other biological agents such as adalimumab, vedolizumab, ustekinumab, and immunosuppressors is lacking or showed conflicting results. Vedolizumab seems a potentially effective maintenance regimen after calcineurin inhibitors-based rescue therapy in acute severe ulcerative colitis (ASUC). Dual Targeted Therapy, which is the combination of two biological agents and/or small molecules, might be a reasonable choice in patients with concomitant IBD and extraintestinal manifestations, or in patients with medical-refractory IBD who lack valid alternatives. Some safety concerns such as adverse events (serious and opportunistic infections) and malignancies (lymphoma and nonmelanoma skin cancer) were raised in combination therapies. Combination therapies seem to be effective in some IBD patients such as refractory IBD patients or patients with extraintestinal manifestations, but it might be associated with an increased risk of adverse events and malignancies.

Innovative Technologies in Interpreting the Results of Traditional Clinical and Laboratory Examination of Patients with Nonspecific Inflammatory Lung Diseases and Purulent Inflammatory Diseases

Innovative Technologies in Interpreting the Results of Traditional Clinical and Laboratory Examination of Patients with Nonspecific Inflammatory Lung Diseases and Purulent Inflammatory Diseases

СЕЛЕКТИВНОЕ ПРОФИЛАКТИЧЕСКОЕ ФЛЮОРОГРАФИЧЕСКОЕ ОБСЛЕДОВАНИЕ СОЦИАЛЬНО-ДЕЗАДАПТИРОВАННОЙ ГРУППЫ НАСЕЛЕНИЯ г. ЯКУТСКА

The article analyzes the effectiveness of a selective preventive fluorographic examination of a socially maladjusted group of the population, conducted in Yakutsk in 2018-2021. The socially maladjusted groups of the population include persons without a fixed place of residence and work (homeless), suffering from alcohol addiction, persons released from places of the penitentiary system. The analysis of data from field fluorographic examinations of 667 persons from a socially maladjusted group who found themselves in difficult life situations was carried out. The examination revealed 114 fluoropositive individuals with various radiographic changes in the chest organs. As a result of additional examination of fluoropositive persons in the anti-tuberculosis dispensary, active tuberculosis of the chest organs was detected in 7 persons, metatuberculous changes in the lungs - in 28, oncological and non-specific inflammatory diseases, as well as post-inflammatory changes in the lungs - in 41. The group of the population amounted to 10.5 per 1,000 examinations, which is significantly higher than the similar indicator of mass continuous examination of the entire population of the republic for 2012-2019, which amounted to 0.57 per 1,000 examinations. Thus, persons from the socially maladjusted group of the population remain one of the main risk groups for tuberculosis. Tuberculosis remains largely a social disease and requires special attention not only from healthcare organizations, but also from social protection authorities, administrations of municipal institutions, public organizations, law enforcement and justice agencies.

COVID-19 and inflammatory bowel disease crosstalk: From emerging association to clinical proposal.

Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection can cause coronavirus disease 2019 (COVID‐19), an acute respiratory inflammation that has emerged worldwide since December 2019, and it quickly became a global epidemic. Inflammatory bowel disease (IBD) is a group of chronic nonspecific intestinal inflammatory diseases whose etiology has not been elucidated. The two have many overlapping symptoms in clinical presentation, such as abdominal pain, diarrhea, pneumonia, etc. Imbalance of the autoimmune system in IBD patients and long‐term use of immunosuppressive drugs may increase the risk of infection; and systemic symptoms caused by COVID‐19 may also induce or exacerbate intestinal inflammation. It has been found that the SARS‐CoV‐2 receptor angiotensin converting enzyme 2, which is highly expressed in the lung and intestine, is an inflammatory protective factor, and is downregulated and upregulated in COVID‐19 and IBD, respectively, suggesting that there may be a coregulatory pathway. In addition, the immune activation pattern of COVID‐19 and the cytokine storm in the inflammatory response have similar roles in IBD, indicating that the two diseases may influence each other. Therefore, this review aimed to address the following research questions: whether SARS‐CoV‐2 infection leads to the progression of IBD; whether IBD increases the risk of COVID‐19 infection and poor prognosis; possible common mechanisms and genetic cross‐linking between the two diseases; new treatment and care strategies for IBD patients, and the feasibility and risk of vaccination in the context of the COVID‐19 epidemic.

HucMSC-Ex alleviates inflammatory bowel disease via the lnc78583-mediated miR3202/HOXB13 pathway.

As a group of nonspecific inflammatory diseases affecting the intestine, inflammatory bowel disease (IBD) exhibits the characteristics of chronic recurring inflammation, and was proven to be increasing in incidence (Kaplan, 2015). IBD induced by genetic background, environmental changes, immune functions, microbial composition, and toxin exposures (Sasson et al., 2021) primarily includes ulcerative colitis (UC) and Crohn's disease (CD) with complicated clinical symptoms featured by abdominal pain, diarrhea, and even blood in stools (Fan et al., 2021; Huang et al., 2021). UC is mainly limited to the rectum and the colon, while CD usually impacts the terminal ileum and colon in a discontinuous manner (Ordás et al., 2012; Panés and Rimola, 2017). In recent years, many studies have suggested the lack of effective measures in the diagnosis and treatment of IBD, prompting an urgent need for new strategies to understand the mechanisms of and offer promising therapies for IBD.

Biological Clock and Inflammatory Bowel Disease Review: From the Standpoint of the Intestinal Barrier.

Inflammatory bowel disease is a group of chronic, recurrent, nonspecific inflammatory diseases of the intestine that severely affect the quality of life of patients. The pathogenesis of this disease is caused by complex and interactive neural networks composed of factors such as genetic susceptibility, external environment, immune disorders, and intestinal barrier dysfunction. It is well known that there is a strong link between environmental stressors (also known as circadian clocks) that can influence circadian changes and inflammatory bowel disease. Among them, the biological clock is involved in the pathogenesis of inflammatory bowel disease by affecting the function of the intestinal barrier. Therefore, this review is aimed at systematically summarizing the latest research progress on the role of the circadian clock in the pathogenesis of inflammatory bowel disease by affecting intestinal barrier functions (intestinal mechanical barrier, intestinal immune barrier, intestinal microecological barrier, and intestinal chemical barrier) and the potential clinical value of clock genes in the management of inflammatory bowel disease, for the application of circadian clock therapy in the management of inflammatory bowel disease and then the benefit to the majority of patients.

676 Study of immune status in women with non-specific chronic inflammatory diseases

Introduction: Often recurrent nonspecific inflammatory diseases of the female genital organs (NIDFGO) are understood to obe vulvovaginitis, vaginitis, cervicitis, most commonly caused by conditionally pathogenic flora, such as Escherichiae coli, Enterococcus faecalis, Streptcoccus agalactiae etc. We consider it important to study the state of the immune system of patients to improve the diagnostic algorithm and improve the effectiveness of treatment of this pathology by adding immunotherapy. Objective: To determine the association of frequently recurrent NIDFGO with the immunodeficiency of the body based on the patient’s immunogram parameters to further improve the diagnostic algorithm and therapeutic tactics.

Applications of a muscle relaxant (tolperizone) in clinical practice

Tolperizone is a central type of muscle relaxant that is widely used in clinical practice for the treatment of patients with acute and chronic nonspecific lower back pain(LBP), inflammatory and degenerative-dystrophic joint diseases, and is used in the treatment of myofascial pain syndrome (MPS).The Russian market widely used drug tolperizone, which is comparable in its clinical and anti-inflammatory activity with the original tolperizone, as well as with non-steroidal anti-inflammatory drugs (NSAIDs). Tolperizone is prescribed mainly in complex therapy, as well as as monotherapy.In some studies, based on the clinical efficacy of tolperizone (200 mg 3 times a day), it is concluded that tolperizone can be considered as a promising treatment for acute muscle spasm, without causing drowsiness. In the treatment of pain syndromes and osteoarthritis (OA) of various localization, the optimal dosage regimen of tolperizone is currently recommended: oral 150-300 mg per day for a course of 14 days, or according to a 2-stage scheme of administration, first intramuscularly 1.0 ml 2 times a day for 5 injections, then switching to oral administration of 150 mg 3 times a day; with MPS, a single local intramuscular injection of tolperizone is prescribed at the trigger point. The addition of tolperizone (150 mg/s) to the scheme of complex therapy allows to achieve an earlier clinical effect in OA of the hip and ankle joints, suppressing further progression of the disease. When included in the therapy regimen of tolperizone (150 mg/s, 14 days) OA of the ankle joint, with ultrasound examination, there is a statistically significant decrease in the signs of synovitis.

The use of Decasan in the local treatment of chronic inflammatory diseases of the tonsils

Chronic non-specific inflammatory diseases of the tonsils are predominantly asocialized with bacteria of Streptococcus pyogenes species. However, a mixed microflora, including fungal, is often growing, and tonsillitis can be associated with viral pathogens. Modern antiseptic drug Dekasan, due to its bactericidal, fungicidal, virucidal, sporocidal activity, is a highly effective means for the sanitization of the the palatine tonsils. It can reliably reduce the incidence of tonsillitis, thus reducing the need for systemic antibiotics and will slow the rate of antibiotic resistance.

CONTRADICTION TO CLINICAL IMMUNOLOGY. SUPPRESSION AND STIMULATION OF IMMUNE REACTIVITY IN PATHOLOGICAL PROCESSES

The analysis of literature data and our published results of examination of patients with a wide range of pathological processes was carried out. It has been established that polar changes in reactivity provoke the development of immune-dependent ones, which include primary and secondary immunodeficiencies, auto-aggressive and immunocomplex diseases, or immunoassociated purulent-inflammatory, nonspecific inflammatory lung diseases, cerebrovascular diseases, in which suppression and stimulation of reactivity is a pathogenetic mechanism for normalizing homeostasis, depending on the links of the immune system, doses of antigens, the initial state of protective functions, phases of the immune response, etc.
 Keywords: Stimulation. Suppression. Immunodeficiency

Do COVID-19 infection among patients increase the risk of Alzheimer’s disease?

The COVID-19 outbreak has occurred for more than ten months. Some COVID-19 complications are still unknown. Is there any long-term effect on the neurologic manifestations after COVID-19? Will the infected patient get a greater risk of Alzheimer’s disease? May the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have a long latency period in the Central Nervous System (CNS)? If this is possible, it has various non-specific inflammatory diseases that initiate and re-activate certain inflammatory or oxidative reactions in Alzheimer’s disease, but the neurological complications of COVID-19 are limited to individual cases or small case series according to several published papers. Recently, Varatharaj et al. reported the neurological and neuropsychiatric complications of COVID-19 in 153 patients who were divided into two groups, cerebrovascular and neuropsychiatric. 96% of patients with cerebrovascular events are also altered with mental status in the age range from 71 to 80. The results showed 43% of patients with neuropsychiatric disorders would have a new-onset psychosis such as neurocognitive, dementia, and Alzheimer’s disease. (To be continued)...

Use of a drug containing ornidazole-neomycin–prednisolone–econazole for the empirical treatment of vaginal infections

Relevance. Empirical treatment of vaginitis is indicated due to its polymicrobial etiology and limited microbiological analysis. The aim of the study was to study the combination of ornidazoleneomycinprednisoloneeconazole (ONPE, Elzhina) as a first-line drug for local treatment of patients with various forms of non-specific vaginitis.
 Materials and methods. The study included 55 non-pregnant women aged 18 to 50 years (381.5 years) who had clinical and laboratory signs of acute vaginitis.
 Results. All patients at the initial treatment complained of pathological discharge, 47 (85.5%) noted itching, burning, pain in the genital area of various degrees of severity, 17 (30.9%) discomfort when urinating, 9 (16.4%) unpleasant smell, 8 (14.5%) dyspareunia, 4 (2.2%) complained of sensations of a foreign body in the vagina. The clinical and laboratory effectiveness of treatment was 89.1% (49). In 6 (10.9%) patients, clinical improvement was noted, with the remaining laboratory signs of aerobic vaginitis.
 Conclusion. The new combination of ornidazoleneomycinprednisoloneeconazole (ONPE, Elzhina ) has a good efficacy and safety profile and can be used to initiate empirical treatment of non-specific inflammatory diseases of the lower genital tract.

Immune-metabolic genesis of pathological processes

This article deals with metabolic-immune processes at rest and under stress conditions, which, in turn, results in the development of immune-dependent and immune-associated disorders. The article analyzes study results and conclusions of various literature sources and experimental data in healthy individuals and patients suffering from non-specific inflammatory lung diseases; purulent-inflammatory diseases and their combinations, primary and secondary progressive multiple sclerosis in the acute stage and remission. Research studies investigated the impact of the type, stage, combination of diseases on the parameters of the immunologic and metabolic statuses, as well as their correlations. The authors also analyzed metabolic effects of immunomodulators. Based on the analysis of the literature and own clinical and experimental data, the authors identified the ability of metabolic factors to regulate immunological processes. A correlative analysis of examination results of the patients with various diseases helped detect the unity of the immune-metabolic mechanisms of pathology. The data on the therapeutic effect of various modulators through differentiated biochemical chains and vice versa – the metabolic effect through immunological mechanisms –were analyzed in the study. Thus, one can testify that there is the phenomenon of a mediated effect of some immunocorrectors on the reactivity through metabolic chains. The fact that a number of modulators and metabolics can simultaneously affect the biochemical and immunological parameters of patients proved the above phenomenon. There was revealed a significant correlation interaction of the immune-metabolic parameters with various types of purulent-inflammatory diseases, which proves the formation of a single mechanism of pathology.