РЕЗУЛЬТАТЫ И ПЕРСПЕКТИВЫ ИСПОЛЬЗОВАНИЯ ИНДУКТОРОВ ИНТЕРФЕРОНА В ЛЕЧЕНИИ ИНФЕКЦИОННЫХ БОЛЕЗНЕЙ

There is represented  the current classification of interferon inducers of various chemical groups related to antiviral agents, described the mechanisms of synthesis of different types of endogenous interferon in blood serum. The effectiveness of methylglucamine acridonacetates  in integrated treatment of chronic hepatitis C, tuberculosis with  HIV infection background, chronic brucellosis, arboviral diseases, including West Nile fever , as well as influenza and acute respiratory infections are shown.  For successful treatment of acute and chronic diseases with  endogenous interferon inducers should be applied as early as possible, at an average level of viremia , to enhance the effect of drugs with the directed etiotropic action and immunomodulators , which achieves the optimal pharmacotherapeutic effect.Представлена современная  классификация  индукторов  интерферона различных химических групп, относящихся к противовирусным средствам, описаны механизмы синтеза разных типов эндогенного интерферона в сыворотке крови. Продемонстрирована эффективность метилглукамина акридонацетата в комплексном лечении хронического гепатита С, туберкулеза на фоне ВИЧ-инфекции, хронического бруцеллеза, арбовирусных заболеваний, включая лихорадку Западного Нила, а также гриппа и острых респираторных инфекций. Для успешного лечения острых и хронических заболеваний индукторы эндогенного интерферона следует применять как можно раньше, при среднем уровне  виремии,  для усиления эффекта  препаратов  направленного этиотропного действия и иммуномодуляторов, что обеспечивает  достижение оптимального фармакотерапевтического эффекта.

Clinical characteristics and mechanisms underlying the development of organ pathology in patients with chronic brucellosis

Objective. To analyze specific characteristics and mechanisms underlying the development of organ pathology in patients with chronic brucellosis (CB). Patients and methods. This study included more than 500 patients with CB treated in Saratov hospitals in 2003–2018. In addition to standard examination, all study participants have undergone the assessment of their lipid peroxidation/antioxidant defense system, levels of major cytokines, markers of endotoxicosis (ET), and tissue-specific autoreactive antibodies. Results and discussion. The vast majority of patients (98.2%) had their musculoskeletal system affected; lesions to the autonomic nervous system and peripheral nervous system were observed in 97.5% and 88.8% of patients, respectively; almost half of males (45%) had their reproductive organs affected; approximately one-third of participants (26.7–32.9%) had cardiovascular disorders with myocardial lesions. The severity of systemic inflammation, ET, and autoimmune reactions depended on the CB activity and determined the development of organ pathology. We found that vascular and mechanical factors were important for the development of lesions to the peripheral nervous system and reproductive organs in men. Patients, in whom the diagnosis of CB was verified 2 years following onset of symptoms, were more likely to develop exacerbations, had more organs and systems affected, and had higher risk of disability. Conclusion. Comprehensive examination revealed multiple organ lesions in all CB patients, associated not only with damage caused by the pathogen at the site of specific inflammation, but also with the involvement of vascular and mechanical factors, as well as the consequences of systemic inflammatory response, ET, and autoimmune reactions. Late diagnosis was associated with more severe clinical manifestations of CB. © 2021, Dynasty Publishing House. All rights reserved