Recurrent mixed urogenital infections in women: correction strategy of mucosal immunity

Shulzhenko, A E; Zuykova, Irina N.

doi:10.26442/2075-1753_2016.6.87-93

Cited by 4 publications

(4 citation statements)

References 7 publications

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“…В связи с этим Полиоксидоний ® можно рекомендовать как препарат выбора на первом этапе терапии при лечении инфекций [12,19]. Препарат активирует все факторы естественной резистентности: клетки моноцитарно-макрофагальной системы, нейтрофилы и NК-клетки, вызывая повышение их функциональной активности при исходно сниженных показателях [12,18,19]. Активация макрофагов ведет к усилению синтеза практически всех цитокинов, вырабатываемых этими клетками, следствием чего является усиление функциональной активности факторов как клеточного, так и гуморального иммунитета.…”

Section: клиническое наблюдение №unclassified

“…Активация макрофагов ведет к усилению синтеза практически всех цитокинов, вырабатываемых этими клетками, следствием чего является усиление функциональной активности факторов как клеточного, так и гуморального иммунитета. Исследования показали, что Полиоксидоний ® повышает иммунную резистентность организма в отношении заболеваний нижних отделов половых путей, вызванных самыми разными патогенными микроорганизмами [12,18,19]. заключение Микст-инфекции, ассоциированные с условно-патогенными микроорганизмами, свидетельствуют о дисбалансе в локальной противоинфекционной защите репродуктивного тракта.…”

Section: клиническое наблюдение №unclassified

“…Однако большинство лекарственных препаратов, применяемых в лечении урогенитальных инфекций, эффективны при неосложненных или острых процессах. В случае же хронического рецидивирующего процесса необходимы иные подходы, в частности, применение локальной иммунокоррекции является весьма обнадеживающим методом преодоления терапевтических неудач [18][19][20]. Использование локального иммунотропного препарата является оптимальным, так как основные события развиваются на слизистой оболочке влагалища [12,18,19] Лечение.…”

Section: Introductionunclassified

“…В случае же хронического рецидивирующего процесса необходимы иные подходы, в частности, применение локальной иммунокоррекции является весьма обнадеживающим методом преодоления терапевтических неудач [18][19][20]. Использование локального иммунотропного препарата является оптимальным, так как основные события развиваются на слизистой оболочке влагалища [12,18,19] Лечение. Принимая во внимание хроническое рецидивирующее течение воспалительного процесса, наличие микст-инфекции, неэффективность ранее проведенной этиотропной терапии, пациентке назначили терапию препаратом Полиоксидоний ® в свечах в дозировке 12 мг по схеме: 1 суппозиторий ежедневно интравагинально в течение 3 дней, затем 1 суппозиторий через день общим курсом 10 введений, флуконазол 150 мг в 1, 4, 7, 14-й дни терапии, наружно эпиген-гель для интимной гигиены.…”

Section: Introductionunclassified

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Pathogenic treatment of the inflammatory diseases of the urogenital tract in women of reproductive age

Letyaeva¹,

Зиганшин²

2021

Russian Journal of Woman and Child Health

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This paper discusses one of the important gynecological issues, inflammatory diseases of the urogenital tract caused by opportunistic microbes. The treatment and long-term control over these conditions are challenging and depend on their occurrence and high risk of complications. Impaired local anti-infectious protection is one of the risk factors of chronic inflammation. Since the disease may recur even after successful treatment, domestic and foreign authors increasingly focus on immunotherapy as a part of complex strategy and isolated entity. Local immunotherapy may prevent recurrences and activate host defense. This paper describes the management of two women with mixed infections. The first woman with chronic recurrent inflammation (cervicitis caused by U. urealyticum, vulvovaginal candidiasis, and aerobic vaginitis) in whom prior etiological therapy was ineffective received immunotherapy which resulted in long-term remission. The second woman with coexistent papillomavirus infection (genital warts) and bacterial vaginosis received immunotherapy and topical etiological treatment. As a result, clinical symptoms, the size and number of genital warts reduced which greatly facilitated their chemical destruction. KEYWORDS: genital tract, urogenital infections, papillomavirus infection, bacterial vaginosis, local immunity, biofilms. FOR CITATION: Letyaeva O.I., Ziganshin O.R. Pathogenic treatment of the inflammatory diseases of the urogenital tract in women of reproductive age. Russian Journal of Woman and Child Health. 2021;4(1):59–64. DOI: 10.32364/2618-8430-2021-4-1-59-64.

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Section: клиническое наблюдение №unclassified

Section: Introductionunclassified

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Pathogenic treatment of the inflammatory diseases of the urogenital tract in women of reproductive age

Letyaeva¹,

Зиганшин²

2021

Russian Journal of Woman and Child Health

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Immune-mediated mechanisms of the inflammatory response in women with combined infections of the lower genital tract

Dikke

Sukhanov

Kukarskaya

et al. 2021

Akušerstvo, ginekologiâ i reprodukciâ

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Aim: to increase the effectiveness of combination therapy and reduce frequency of recurrences of inflammatory diseases in the lower genital tract of combined etiology.Materials and Мethods. There was conducted a prospective, randomized, blind, comparative clinical study. 80 women with vaginal microbiota disorders were examined randomized into 2 groups: group I (n = 40) – antibiotic therapy was carried out in combination with the preparation Superlimph, group II (n = 40) – a standalone antibacterial therapy; group III consisted of 20 patients lacking gynecological diseases considered to provide with control laboratory parameters. Clinical and laboratory methods were used: microscopy of vaginal smears, detection of viruses and sexually transmitted infections, measurement of serum cytokine levels – interleukins (IL-1â, IL-2, IL-4, IL-6, IL-8, IL-10), tumor necrosis factor alpha, (TNF-á), interferon gamma (IFN-ã).Results. It was found that clinical recovery occurred in 90.0 and 70.0 % of patients in group I and group II (р = 0.02), respectively. Microbiological recovery was observed in 100.0 and 67.5 % of patients, respectively (р = 0.003). In group I, the isolation of herpes simplex virus type 2 was found in 80.0 and 45.2 % of patients before and after treatment (p < 0.001), respectively, whereas in group II – in 82.5 and 77.5 %, respectively (p = 0.58), between groups – p < 0.001. Before treatment the level of all cytokines, excepting IFN-ã, was higher than the reference values in both groups: in group I, their magnitude decreased after treatment (p < 0.001) and corresponded to the reference values; in group II no changes occurred. Three months after treatment, no relapses were observed in group I, whereas frequency of relapses in group II was 22.5 %, within 1 year – 0 and 35.1 %, respectively. Predictors of recurrent dysbiosis (IL-2, IL-6 and TNF-á in increased concentrations after a course of treatment) were identified.Conclusion. Treatment with a combined broad-spectrum antimicrobial drug along with topical immunomodulatory agent containing exogenous cytokines is an effective strategy for treating concomitant dysbiosis and preventing relapse.

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Vulvovaginal candidiasis in women of reproductive age: immunological aspects of modern algorithms for examination and treatment

Dobrokhotova

Каранашева

2022

Medicinskij sovet

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immunological defense complex is involved: the role of complement, T-lymphocytes, NK-cells is noted. Of particular importance among immune factors is interferon-γ, which is able to limit the reproduction of Candida fungi in the early stages of infection by stimulating the immune response. This is due to the fact that interferon-γ is the strongest stimulator of effector functions of macrophages (microbicidal activity, cytokine production), increases the expression of histocompatibility molecules MHCI and MHCII, as well as adhesion molecules on endothelial cells, increasing endothelial permeability. Thus, the rate of development and severity of the pathological process depend on the state of the body’s defenses. The use of antibiotics, glucocorticoids and cytostatics, as well as radiation therapy can enhance the adhesive properties of yeast fungi. The choice of treatment for VVC should be based on the results of a comprehensive diagnosis, taking into account the form and risk factors of the disease. Local immunity impairment due to the innate quality of the vaginal epitheliocytes is currently one of the most significant risk factors for the development of VVC. This also explains the availability of sufficient drugs for etiotropic therapy, which does not affect its recurrence rate. The use of topical immunomodulators is a very promising method of overcoming the therapeutic failures in the complex treatment of genital candidiasis.

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Recurrent mixed urogenital infections in women: correction strategy of mucosal immunity

Cited by 4 publications

References 7 publications

Pathogenic treatment of the inflammatory diseases of the urogenital tract in women of reproductive age

Pathogenic treatment of the inflammatory diseases of the urogenital tract in women of reproductive age

Immune-mediated mechanisms of the inflammatory response in women with combined infections of the lower genital tract

Vulvovaginal candidiasis in women of reproductive age: immunological aspects of modern algorithms for examination and treatment

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