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Relevance. In recent years, there has been a steady increase in the incidence of children morbidity, in the structure of which infectious pathology occupies a leading position. The development of minimal persistent inflammation of the upper respiratory tract mucosa is the basis for the persistence of microflora, the entrance gate for allergens and irritants, and creates conditions for the timing of the inflammation. The aim of the study: based on the study of the features of the immune system and interferon system in immunocompromised children of early age suffering from co-infections: return ARVI associated with atypical chronic herpes virus infections, to develop a new program of local and systemic interferon therapy and evaluate its effectiveness. Materials and methods: We observed 30 children aged 1-4 years, 16 boys and 14 girls suffering from recurrent ARVI associated with various atypical chronic active herpes virus infections (ACHA-HVI) (HSV I/II, EBV, CMV, HHV VI). The comparison group was 20 conditionally healthy children, comparable by sex and age. We used clinical and immunological methods: ELISA, PCR, cytofluorimetry. Results: A clinical and anamnestic investigation showed that young children had clinical features of immunocomprometization: a high rate of recurrent ARVI of 10-15 or more episodes per year, and the duration of these episodes ranged from 7 to 12 days, while in 100 % of cases there were recurrent monoand/or mixed ACHA-HVI. A study of the state of the immune system and the interferon system showed that children of the study group were deficient in T cytotoxic lymphocytes, natural killer cells, serum IFN, serum IgA, and various disorders of neutrophil granulocytes (NG). A new immunopathogenetically based program of local and systemic therapy with recombinant IFN2b in combination with antioxidants has been developed. This program demonstrated a high clinical-immunological effectiveness, providing in a significant reduction of ARVI episode rates, a reduction in the duration of IRVI, as well as the number of complicated ARVI, a decrease in the replicative activity of herpes viruses in a field of restoration of the interferon system, a significant improvement of antiviral and antibacterial immune response. Conclusions: A new immunopathogenetically based program of systemic and local IFNtherapy for immunocompromised young children has been created. The high clinical-immunological effectiveness and immunoprophylactic orientation of the developed local and systemic program of interferonotherapy have been demonstrated.

Background: Every year, a steady, progressive increase in the number of atypical, chronic, active forms of infections caused by herpesviruses (AHA-HVI) is recorded. The diagnosis and selection of adequate therapeutic strategies for the treatment of these forms of infections presents significant difficulties for physicians of therapeutic, neurological profile, immunologists, infectious disease specialists, due to the polysyndromicity and the presence of many clinical masks of these infections. Aims: determining the prevalence of AHA-HVI among patients infected with herpes virus infections, as well as studying the features of the etiological structure and clinical manifestations/criterion signs of atypically occurring chronic forms of herpes viral infections. Materials and methods: Under our supervision at the Medsi CDC in Belorusskaya (Moscow) there were 98 patients (SG) of both sexes aged 23 to 60 years suffering from AHA-HVI. The comparison group consisted of 30 conditionally healthy subjects comparable in sex and age to SG patients. In addition to traditional methods (history collection, physical examination methods, CBC, etc.), serodiagnosis methods with ELISA were used to detect herpes-viral infections; PCR method for detecting the genome of viruses in biomaterials. The study was approved by the ethics committee, and all patients received informed consent to participate in the study. Statistical analysis was performed using adequate methods of statistic studies. Results: The study of the etiological structure of herpes virus infections in patients with AHA-HVI, mixed HVI was shown to occur in 83.4% of patients, and mono-HVI in 16.6% of cases. It was shown that EBV was the dominant virus among patients with both mono and mixed GVI. A high rate of EBV DNA detection was demonstrated in saliva (84.2%), posterior pharyngeal wall scraping (73.5%) and tonsils (42.9%), urine (12.6%) and blood (8.3%) is a marker of high replicative activity of the virus. The main clinical syndromes associated with the course of mono and mixed AHA-HVI were identified. Conclusions: Identification and quantitative assessment of the viral load associated with the severity of the course and severity of clinical manifestations of ACA-HVI, as well as clarification of the features of clinical manifestations and syndromes in patients suffering from various mono-, mixed-herpesvirus infections, allow us to outline goals for the further development of an adequate diagnostic algorithm for these atypical forms of herpesvirus infections and the concept of targeted, personalized etio- and immunopathogenetic therapy.

Федеральное государственное бюджетное образовательное учреждение высшего образования Кубанский государственный медицинский университет, Краснодар, Россия 2 Федеральное государственное автономное образовательное учреждение высшего образования Первый Московский государственный медицинский университет имени И.

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Arterial hypertension (AH) is a leading risk factor for the development of cardiovascular, cerebrovascular, and renal diseases, which are among the top 10 most common causes of death in the world. The etiology of hypertension has not been fully elucidated, but it has been established that endothelial dysfunction is the most significant pathogenetic link in the formation and progression of the disease. The data obtained in the last 10-15 years on endothelial glycocalyx (eGC) studies indicate that endothelial dysfunction is preceded by destabilization and shedding of eGC with the appearance of its soluble components in the blood, which is equivalent to a process that can be designated as eGC dysfunction. Signs of eGC dysfunction are expressed in the development of hypertension, diseases of the cardiovascular system, and their complications. The purpose of this review is to analyze and substantiate the pathophysiological role of eGC dysfunction in hypertension and cardiovascular diseases and to describe approaches for its assessment and pharmacological correction. Abstracts and full-size articles of 425 publications in Pubmed/MEDLINE databases over 20 years were studied. The review discusses the role of eGC in the regulation of vascular tone, endothelial barrier function, and anti-adhesive properties of eGC. Modifications of eGC under the influence of pro-inflammatory stimuli, changes in eGC with age, and with increased salt load are considered. The aspect associated with eGC dysfunction in atherosclerosis, hyperglycemia and hypertension is covered. Assessment of eGC dysfunction is difficult but can be performed by indirect methods, in particular by detecting eGC components in blood. A brief description of the main approaches to pharmacoprevention and pharmacocorrection of hypertension is given from the position of exposure effects on eGC, which currently has more a fundamental than practical orientation. This opens up great opportunities for clinical studies of eGC dysfunction for the prevention and treatment of hypertension and justifies a new direction in the clinical pharmacology of antihypertensive drugs.