Objective: to study the state of cytokine status in children with acute and chronic urticaria.Materials and methods: 264 children of both sexes aged from 6 to 16 years with different variants of urticaria were examined. Clinical research methods included analysis of anamnestic data, objective examination of the child to determine the severity of urticaria. Immunological research methods included determination of IL-4, IL-6, IL-17, and IFN-γ levels by the method of enzyme immunoassay of blood serum.Results: cytokine profile analysis revealed hyperproduction of IL-17, γ-IFN with reduced IL-4 synthesis in children with acute urticaria. In children with chronic urticaria, IL-6 hyperproduction is noted against the background of a significant decrease in IL-4 synthesis.Conclusion: there was a significant relationship between the development of severe acute urticaria and the levels of proinflammatory cytokines IL-6, IL-17, and between the formation of chronic urticaria and the level of IL-6.
Ростовский государственный медицинский университет Минздрава России, Ростов-на-Дону Высокая заболеваемость, частое развитие тяжелых форм осложнений, неблагоприятные отдаленные последствия для здоровья детей, недостаточная эффективность применяемых схем терапии острых респираторных инфекций диктуют необходимость совершенствования программы лечения этой группы заболеваний. Проведено комплексное клинико-лабораторное обследование 72 детей в возрасте от 3 до 6 лет с острыми ринофарингитами и бронхитами. Выявлена зависимость клинической формы заболевания, особенностей течения от состояния преморбидного фона и выраженности изменений иммунного статуса. Установлено, что включение инозина пранобекс в комплексное лечение острых респираторных инфекций у детей способствует быстрой положительной динамике клинической симптоматики и показателей иммунного статуса, не сопровождается развитием побочных эффектов. Таким образом, высокая эффективность и безопасность применения инозина пранобекс позволяют рекомендовать включение этого препарата в программу лечения детей старше трех лет жизни с острыми респираторными инфекциями, независимо от формы заболевания и состояния иммунного статуса. Ключевые слова: острые респираторные инфекции, дети, инозин пранобекс.
Lifetime use of IgG replacement therapy is the standard of CVID treatment. However, full control over stabilization of chronic infection loci is not always achieved, even if this therapy is continuously applied. The purpose of this study was to carry out comparative analysis of changes in cellular component of adaptive and innate immune response, depending on effectiveness of replacement therapy of patients with infectious CVID phenotype. The observation group consisted of 15 patients with CVID who were diagnosed since early childhood in 100% of cases. They had prolonged respiratory infections followed by the development of complications requiring continuous treatment with antibiotics.After reaching mean age of 15 years old, the intensity of infection-associated antibody deficiency was 6-8 times per year. After verification of the diagnosis, the patients received replacement therapy, first at the saturation dose, and, after stabilization of IgG at the level of 7-8 g/l, at the monthly maintenance dose. The clinical course of the disease was traced during a full year of replacement therapy, and the cellular immunity indices were evaluated. In all patients, after a year of therapy corresponding to clinical guidelines, there was an improvement in quality of life indices, decreased rates of recurrent bacterial infections. At the same time, 40% of them continued to suffer, on average, 5.4±1.1 times a year and required long-term courses of antibiotic therapy. Evaluation of immune status did not reveal statistically significant differences in IgG plasma saturation between the groups of patients with different treatment efficiency: 8.7 (8-9) g/l and 9.1 (8.5-10.5) g/l, at p = 0.5. The differences related to immune cell factors in cases of smaller effect of IVIG therapy are manifested in higher relative numbers of T effectors containing lytic Granzyme B granules and CD14+CD284+ monocytes, accompanied by lower spontaneous active oxygen forms produced by neutrophils, lesser contents of CD16+ natural killers in peripheral blood.The obtained data illustrate the value of monitoring, not only serum IgG level, but also the parameters of the cellular immune response. Such analysis may be essential as a prognostic criterion for efficacy of IVIG therapy. Reduced levels of some parameters of innate immunity cells serves a basis to formulate the concept of combined treatment and usage of tools that alter functions of immunocompetent cells.
Objective: to study the functional characteristics of innate immunity in the formation of postpericardial syndrome (PPS) in patients undergoing coronary artery bypass graft ing (CABG).Materials and methods: the study involved 60 people, 40 of them made up the main group of patients with coronary artery disease, which retrospectively aft er 1 month of observation was divided into 2 groups. Group I CABG and PPS, group II CABG without PPS. The control group consisted of 20 patients without IHD. Before surgery, aft er 5, 14 days and 1 month, the expression of toll-like receptors (TLRs) 2, 4, 9, the content of CD16+ and Granzyme B lymphocytes, the HCT test and serum α-defensin were evaluated in blood cells. Statistical analysis of the results of the study was carried out using the program Statistica 12.0 (StatSoft , USA). The difference in mean values between groups was evaluated by the Mann-Whitney test. Statistical signifi cance was considered signifi cant at p ≤ 0.05.Results: when comparing the initial indices of the main groups and the control group, an increase in the expression of TLRs 2, 4, 9 was revealed. An increase in the content of CD16+, as well as an increase in the cytotoxic activity of natural killers and an increase in the production of α-defensin.Conclusions: on the basis of the study, activation of the cellular link of innate immunity, an increase in the cytotoxic potential of natural killers and a signifi cantly high level of α-defensin both before and aft er CABG were revealed, which can play an important role in the development of PPS.
Objective:to study the clinical efficacy of re-PUVA therapy in patients with torpid forms of chronic true hand eczema.Materials and methods:the study involved 78 patients (47 women, 31 men) with severe and moderate forms of chronic true hand eczema. Clinical indices were used before and after treatment: HECSI, DLQI. The patients were randomly divided into 3 groups: 1 group (25 people) received standard therapy (antihistamines, external glucocorticosteroid drugs, emollients); 2 group (27 people) received the indicated standard therapy against the background of PUVA; Group 3 (26 people) -standard therapy on the background of re-PUVA (combination of PUVA with retinoids (isotretinoin)). The duration of therapy was about 3 months.Results:in group I, before treatment, the average value of the HECSI index was 76.0 ± 37.9, and after the treatment, 63.6 ± 30.2; in group II, before treatment, the average value of the HECSI index was 78.3 ± 34.2, and after treatment it decreased to 51.5 ± 24.0, in group III, respectively, before treatment, the average HECSI was 77.2 ± 35.3, and after course of therapy 28.7 ± 14.0. The duration of remission in the first group after a course of standard therapy was 2.52 ± 1.1 weeks, in the second group 15.7 ± 7.5 weeks, in the third group 61.7 ± 32.4 weeks.Conclusions:The re-PUVA method is most effective in the treatment of chronic eczema of the hands in comparison with the PUVA and standard therapy.
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