Backgraund: Allergic rhinitis (AR) is a common IgE-mediated disease. Multiple mechanisms are involved in the regulation of IgE synthesis, and cytokines produced by immune cells play an important role in this process. In addition, the study of the features of immunological reactivity in seasonal AR (SAR) is of interest both getting of new data about pathogenesis of the disease and optimization of the treatment.
Aims: To study the features of the cytokine status and hematological parameters in patients with SAR outside the period of exacerbation.
Materials and methods: 43 adult patients with SAR (stage of remission) have been included in the study, and 47 conditionally healthy patients have formed the comparison group; perennial symptoms and/or sensitization to perennial allergens were considered as exclusion criteria. Complete blood cell count and serum IL-4, IL-5, IL-6, IL-8, IL-10, IL-18, MCP-1, total IgE, eosinophil cationic protein levels were measured.
Results: The remission stage in patients with SAR is characterized by higher serum levels of total IgE and IL-8 compared with the group of healthy patients. Normal serum total IgE level in patients with SAR in remission is associated with activation of the monocyte-macrophage link (increased serum levels of MCP-1, IL-6, IL-8, absolute and relative numbers of monocytes). Increased serum total IgE level is associated with the predominant signs of the Th2-phenotype of the immune response (increased in the serum levels of IL-4, IL-5).
Conclusions: Immune reactivity of patients with natural remission of SAR is characterized by Th1-phenotype features if serum level of IgE is normal and Th2-ones if IgE is increased.
The aim of the study is to research the effects of immunostimulant Ribomunyl in virus-induced bronchial asthma (VBA) children.Materials and methods. 14 virus-induced bronchial asthma (VBA) children were agministrated with immunostimulant Ribomunyl as a part of complex therapy in a 18-month trial (3 cycles of treatment). The comparison group consisted of 16 patients who received only standard therapy for bronchial asthma. At the end of the study, against the background of basic BA therapy, the following parameters were estimated: the frequency of acute respiratory viral infections (ARVI), the need for antibacterial therapy, the frequency of IgG to respiratory-syncytial virus (RSV) prevalence, the serum level dynamics of total IgE, IFN-γ, interleukin-4 (IL-4), interferon gamma (IFN-γ).Results. The inclusion of Ribomunyl into the basic therapy complex in virus-induced bronchial asthma (VBA) children, made it possible to reduce the need for the VBA basic therapy complex by 50% and by 12,5% (р=0,0279). At the same time, as for the frequency of acute respiratory viral infections (ARVI), there was a comparable decrease in both groups, but in the main group the number of cases requiring antibiotic therapy decreased from 78.6% to 42.9% (p=0.0199). The inclusion of Ribomunyl into the basic therapy complex resulted in the decrease of the total IgE serum level; in the patients with the initial presence of IgG to the respiratory syncytial virus (RSV), the IL-4 level decreased and the IFN-γ level increased.Conclusion. Ribomunyl improves the treatment of virus-induced bronchial asthma (VBA) children, herewith the dynamics of immunological indicators is more in RSV-seropositive patients.
The goal of our study was to examine local and serum cytokine level involved in regulating inflammation in patients with chronic endometritis combined with endometrial hyperplastic processes. On admission, all patients underwent hysteroscopy with separate diagnostic curettage followed by histological examination of samples isolated from the uterine and cervical canal mucosa. Such manipulations were indicated due to abnormal uterine bleeding as well as suspected endometrial pathology based on ultrasound examination. According to the histological examination data of the endometrial samples, all patients were divided into two groups: Group I contained 45 women with CE combined with PEG without atypia; Group II - 38 patients with morphologically verified CEE combined with AEG without atypia. Level of IL-1β, IL-2, IL-6, γ-INF, TNF-α in biological fluids (aspirate from the uterus; serum) was measured by using enzyme-linked immunosorbent assay. We found that in both groups (91.1% and 89.6%, respectively) the vast majority of patients was hospitalized due to abnormal uterine bleeding. Oligomenorrhea alternated with intermenstrual bleeding (66.7% and 71.2%, respectively) and dominated in pattern of menstrual cycle disorders in the examined patients, whereas 11 (24.4%) and 7 (18.4%) patients from group I and II, respectively, were noted to suffer from severe menstrual bleeding.Overall, analyzing the data on cytokine level both in the uterine aspirate and serum evidences about ongoing inflammatory process found at examination time point. Upon that, such process was not only local, but also exhibited signs of a systemic inflammatory response. The data on cytokine level in the uterine aspirate from patients with CE coupled to PGE or CGE without atypia point at local inflammatory process characterized by significantly increased concentration of IL-1β, IL-2, IL-6, TNF-α and IFN-γ. At the same time, higher level of IL-1β and IFN-γ in patients from group II might indicates that degree of morphological changes in the endometrium could affect the level of local cytokine production. Thus, the data obtained evidence that immune changes in chronic endometritis combined with non-atypical endometrial hyperplastic processes mostly occur locally. In this regard, measuring cytokine concentration in the uterine aspirate is a diagnostic predictor and serves as a sign for monitoring therapeutic effectiveness of therapy in this cohort of patients.
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