Особливості порушень стану імунної системи та їх корекція у хворих на часто рецидивуючу герпетичну інфекцію

После проведенной комплексной терапии Ацикловиром и Кагоцелом у больных с тяжелой степенью заболевания (ІІ группа) наблюдалось уменьшение количества рецидивов с 7-13 до 3-5 в год, а длительность рецидивов снижалась с 2-3 недель до 5-7 дней. У больных І группы, с частотой рецидивов меньше 6 раз в год, после проведенной комплексной терапии препаратами Ацикловир и Кагоцел была достигнута длительная и стойкая ремиссия.

Ключевые слова: герпетическая инфекция, HLA, лимфоциты, натуральные киллеры, цитокины, Кагоцел.

ANNOTATION

Derkach M. I. Peculiarties of disorders in the state of the immune system and their correction in patients with frequently recurring herpetic infection. - Manuscript.

The dissertation is submitted for getting the scientific degree of the Candidate of Medical Sciences in speciality 14.03.08 - immunology and allergology. - SI «Institute of Urology AMS Ukraine», Kyiv, 2009.

In comparing the immunologic findings of peripheral blood with the common clinical picture in 120 patients with different stages of herpetic infection, it was proved that for the group I (the slight and middle stages of course, the number of relapses less them 6 for a year) the HSV-infection course unlike the group II (the severe stage, the number of relapses exceeded 7 times for a year) was characterized by the drop in the immunity activation at the systemic level. There was noted in recurrence and remission the distinct difference in the basic levels of cytokines IL-12, IL-15, IL-18 and IFN-y in peripheral blood in both groups of patients, in the group II in particular.

When the findings of in vitro spontaneous production of cytokines by mononuclear cells of peripheral blood in patients having HSV (groups I and II) were compared, there was found the low potential level of functional activity of cells in group II in the production of cytokines particularly IL-12, IL-15, IL- 18, IFN- . But most informative are the results of cytokine production by mononuclear blood cells under conditions of their in vitro stimulation by mitogen (induced production). The compared results of the induced production of cytokines of both groups show the distinct decrease in cells of relapses (above 7 times for a year). Most distinctly it was demonstrated in production of IL-12,
IL-15, IL-18, INF-.

The NK number and their qualitative ability to express Granzyme B in group II (patients with relapse about 7 times for a year) were statistically lower in comparison with group I.

Having analyzed the distribution of HLA -A, B, DR antigens in patients with different stages of HSV - infection, we received the statistical data indicating that HLA- A24, HLA- B7, HLA-B22, HLA-DR2 are antigen - provokers in the development of a severe course of recurrent simple herpes (group II under study). In patients with slight and middle recurrent simple herpes (group I) no distinct association with a certain HLA- phenotype was found.

After the complex Acyclovir and Kagocel therapy its effect was demonstrated in stimulation of production of cytokines IFN-, TNF-, IL-12, IL-15, IL-18 by mononuclears in peripheral blood and also by Granzyme B expression by NK cells.

When we completed the complex Acyclovir and Kagocel therapy, the patients with severe stage of disease (group II) decreased the number of relapses from 7-13 to 3-5 times for a year and the duration of relapses decreased from 2-3 weeks to 5-7 days. The patients of group I (the number of relapses less then 6 times for a year) after the above therapy reached the long and stable remission.

Key words: herpetic infection, HLA, lymphocytes, natural killers, cytokines, Kagocel.

ПЕРЕЛІК УМОВНИХ ПОЗНАЧЕНЬ ТА СКОРОЧЕНЬ

мкАТ - моноклональні антитіла

CD - кластери диференціювання

ELISA - твердофазний імуноферментний аналіз

ICAM-1 - міжклітинна молекул адгезії-1

IL - інтерлейкін

IFN-г - інтерферон-г

HLA - антигени гістосумісності

Th - Т-хелпери

NK - натуральні кілери

HSV - вірус простого герпесу

TNF- - фактор некрозу пухлин -

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