Background. According to current epidemiological studies, 94.9% of women suffering from sexually transmitted infections are diagnosed with the presence of human papillomavirus (HPV) DNA during the examination. Aims. The aim of the study was to study the effect of combined exposure to blue monochromatic polarized incoherent light and polychromatic visible and infrared polarized light in combination with imihimod 5% cream for external use on the state of systemic immunity in patients with HPV-associated cervicitis. Materials and methods. The study included 60 patients aged 2035 years with an HPV-associated cervicitis with a history of at least 1 year, who were randomly divided into 3 groups: in the main group (n=20), course effects of blue monochromatic polarized incoherent light on the projection of the carotid arteries and polychromatic visible and infrared polarized light on the cervix in combination with imihimod 5% cream for external use (complex 1); in the comparison group (n=20) exposure to polychromatic visible and infrared polarized light on the cervix in combination with imihimod cream for external use 5% (complex 2); in the control group (n=20) a course of local exposure to the cervix with imihimod cream 5%. The data of the survey of 20 healthy women of the same age were taken as the values of the norm. The state of systemic immunity in patients with HPV-associated cervicitis before treatment and after the course was evaluated by the indicators of mature T-lymphocytes (CD3+), CD4+, CD8+, immunoregulatory index (IRI = CD4+/CD8+), CD16+ (natural killer cells) and CD20+ (B-mature lymphocytes) in peripheral blood. Results. Before the start of treatment, the patients showed low levels of CD3+-lymphocytes and a decrease in the immunoregulatory index, which is the ratio of CD4+/CD8+ against the background of an increase in the relative content of CD16+ and CD20+, which indicates an imbalance in the cellular immunity. After the course of treatment, the most pronounced results were obtained under the influence of complex 1: a significant increase in the relative content of CD3+ and normalization of IRI against the background of a decrease to the reference values of the initially elevated levels of CD16 (%) and CD20 (%) in both the percentage and absolute ratio of these populations in peripheral blood. Patients treated with complex 2 also showed a positive, but less pronounced, trend towards an increase in CD3+ and IRI and a decrease in elevated CD16+ levels after the course of treatment. In the control group, there was no statistically significant difference between the indicators before and after treatment, and only a slight positive trend was observed for some of them. Conclusion. The combined use of blue monochromatic polarized incoherent light on the projection of the carotid arteries in combination with polychromatic visible and infrared polarized light and imihimod 5% cream for external use on the cervix in patients with chronic cervicitis associated with papillomavirus infection, to a greater extent than the local use of polarized light in combination with imihimod 5%, has a pronounced immunocorrective effect on the cellular link of immunity.
The article presents the data of clinical and experimental research of Russian and foreign scientists on the use of polychrome polarized incoherent radiation in clinical practice and the rationale for its use in gynecology.
Taking into account the literature data on the significance of the mucous membranes in providing an immune filter, and cervical mucus in providing an immune response due to the high content of the main mediators of the development of a local inflammatory response, i.e. anti-inflammatory cytokines, which play a major role in the regulation of the immune response and the formation of local antiviral and antitumor immunity, we studied the cytokine profile in patients with HPV-associated cervicitis and the effect of the combined use of polarized light and an immunomodulator on their content, depending on the viral load. The purpose of the work is to study the effect of the combined exposure to blue monochromatic polarized incoherent light and polychromatic visible and infrared polarized light in combination with Imiquimod 5% cream for external use on the state of the cytokine profile in the cervical mucus in patients with HPV-associated cervicitis. Material and methods. The study included 60 patients with an HPV-associated cervicitis with the history of at least 1 year, aged 20 to 35 years, who were randomly divided into three groups: the main group of 20 patients who underwent course exposure to blue monochromatic polarized incoherent light on the projection of the carotid arteries and polychromatic visible and infrared polarized light on the cervix in combination with Imiquimod 5% cream for external use (complex 1); a comparison group of 20 patients who underwent the exposure to polychromatic visible and infrared polarized light on the cervix in combination with the topical cream, Imiquimod 5% (complex 2); a control group of 20 patients who underwent a course of local effects on the cervix with the cream Imiquimod 5% and 20 healthy women of similar age, whose the survey data were taken as a norm. To assess the cytokine state in patients with HPV-associated cervicitis, the levels of IL-1β, IL-2, IL-10, IFNa, IFNy, and TNFa in the cervical mucus were studied before and after the course of treatment by the enzyme immunoassay method. The results of the research and the discussion. Prior to the treatment, certain differences were found depending on the viral load. In patients with a low viral load, interferon levels of IFNα and IFNγ were increased by 55% (p < 0.05) and 93%, respectively (p < 0.01), compared with those of healthy women, with a significant decrease in the content of IL-10 — by 85% (p < 0.01), IL-2 — by 53% (p < 0.05) and TNFα — by 56% (p < 0.05), the content of IL-1β was increased only by 8% (p > 0.05). When analyzing cytokine levels in patients with an increased viral load, IFNα was increased by 48% (p < 0.05) and IFNγ — by 62% (p < 0.05), as well as IL-1β — by 59% (p < 0.05), and TNFα — by 37% (p < 0.05), compared to healthy women, with a significant decrease in IL-10 and IL-2 — by 53% and 56%, respectively (p < 0.05). The increase in the concentration of TNFα and IFNγ with an increased viral load was slightly lower. In patients with a significant viral load, interferons IFNα and IFNγ were increased by 35% and 40%, accordingly (p < 0.05), IL-1β — by 17.9% (p < 0.05) and IL-10 — by 14.1% against the background of a slight decrease in the content of TNFα — by 14.5% (p >0.05) and a highly significant 2.26-fold decrease in IL-2 — (p < 0.05), which play an important role in the regulation of the Th1 immune response. After the treatment, in patients of the main group (complex 1) and a comparison group (complex 2) with no significant differences, the positive dynamics was observed, manifested in lowering the initially increased concentrations of TNFα and IFNγ, IL-1β and IL-10 approaching the level of healthy individuals; in the control group, the decrease of the initially increased IL-2 and TNFα was noted, and, although there was a positive dynamics of all the studied indicators, it was less pronounced. Conclusion. The obtained data indicate a pronounced immunocorrective effect of the combined use of blue monochromatic polarized incoherent light on the projection of the carotid arteries and polychromatic visible and infrared polarized light on the cervix in combination with Imiquimod 5% cream for external use in patients with chronic cervicitis associated with papillomavirus infection, which is confirmed by an improvement in the cytokine profile.
Insufficient nutrition is an urgent problem of modern healthcare. According to WHO, more than 2 billion people suffer from essential vitamin and mineral deficiencies, in particular vitamin A, iodine, iron and zinc [1]. The hypovitaminosis, as well as hypoelementosis pose the greatest threat to pregnancy and lactation, contributing to the development of miscarriages, intrauterine growth restriction, maternal mortality, labor complications, infectious pathology and adverse course of the neonatal period.Objective of the study: evaluation of the efficacy of the vitamin and mineral complex in correcting the nutritional status of patients during gestation.Materials and methods of the study: 33 pregnant women with threatened miscarriage of various genesis, who were admitted to the department of gynaecology, underwent a clinical and laboratory examination and treatment. In addition to the general clinical examination, all patients were assessed for plasma vitamin E and folic acid concentrations, which play a key role in embryogenesis. In addition to therapy aimed at prolonging pregnancy, all pregnant women received nutritional support in the form of a multivitamin drug.Results of the study: During the observation period, the condition of pregnant women improved significantly: signs of threatened miscarriage were eliminated, complaints of weakness, fatigue and sleep disturbance disappeared. All patients showed significantly higher plasma vitamin E and folic acid concentrations after the treatment.
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