Effect of vitamin D and interferon α-2b on cytokine profile in pregnant women with vaginal infections

A study was conducted to evaluate effectiveness of vitamin D and interferon α-2b preparations on cytokine profile in pregnant women with vaginal infections. It was shown that pregnant women with vs. without bacterial vaginosis were featured with low vitamin D level in 53.8–60.5% cases. Administration of vitamin D and interferon α-2b preparations in combination with antibacterial therapy in pregnant women with bacterial vaginosis conferred anti-inflammatory effect resulting in normalized IL-8 level corresponding to that one in healthy subjects. Use of vitamin D altered interferon status and augmented antimicrobial activity in pregnant women confirmed by reduced rate of ARI episodes

Application of bacterial therapeutic vaccine Immunovac-VP4 in the treatment of pollinosis

In-depth study of the function and structure of the lymphoid tissue of the gastrointestinal tract and respiratory tract opens wide opportunities for the use of mucosal vaccines to improve immunity to various infectious agents. One such drug is The immunovac-VP4 vaccine containing pathogen-associated molecular structures (PAMSs) of microorganisms. They are the antigens of Klebsiella pneumoniae, Proteus vulgaris, Escherichia coli, Staphylococcus aureus. Discovered in many studies and experiments, the ability of the vaccine to induce innate immunity provides opportunities for prevention and treatment of both infections and allergic diseases, because it promotes the switching of Th2 immune response to Th1. The aim of the study was to study the effectiveness of the complex use of bacterial therapeutic vaccine Immunovac-VP4 and allergen-specific immune therapy (ASIT) in pollinosis in children and adults. Materials and methods. Bacterial therapeutic vaccine Immunovac-VP4 was used annually, nasal and oral administration in patients before the course of ASIT standardized aqueous-salt solutions of allergens. Results. The therapeutic application of bacterial vaccines, Immunoac-ВП4 before the course ASIT has helped to reduce the frequency of acute respiratory infections in 8,5 times in comparison with the control group. Clinical efficacy of complex treatment according to the results of the survey of patients in 7 years after the start of therapy was 90%. There was a significant decrease In IgG4 to causally significant allergens, General immnunoglobulin E (IgE) and a tendency to decrease IgE. Conclusion. The use of bacterial therapeutic vaccine Immunovac-VP4, which is a natural ligand of toll-like receptors in combination with ASIT, seems to be an effective and promising direction in the treatment of allergic diseases

Measles vaccination of children born to HIV-infected mothers (clinical and immunological aspects)

Vaccination of children born to HIV-infected mothers in accordance with the national Calendar of preventive vaccinations represents an important issue. Upon that, measles incidence rate especially among unvaccinated children has been substantially elevated. Use of live measles vaccine in both HIV-infected children and mothers has some features primarily due to HIV-associated immunocompromised state that was poorly investigated. Here we monitored 212 children aged 12–36 months born to HIV-infected women, 184 HIV-negative children born to HIVinfected women who were included into the group with the diagnosis “Perinatal HIV contact” (R75) after verification. In addition, 28 children were included into the group” HIV infection “(B23), whereas 42 children — into the control group. Live measles vaccine was administered subcutaneously at a dose of 0.5 ml. All children were followed up for 36 weeks. HIV status, measles antibodies level by measured by ELISA and RPG methods, as well as total immunoglobulin A, M, G classes and CD3+, CD4+, CD8+, CD19+ lymphocyte counts were examined. No post-vaccination complications or severe vaccine-induced reactions were reported in HIV-infected patients group. A satisfactory course of the vaccine process in all children born to HIV-infected mothers was observed that did not significantly differ from that one in control group. Children with perinatal HIV contact are able to respond adequately to vaccination with live measles vaccine. The number of children with conditionally protective antibody levels, still remaining seronegative among children with perinatal HIV contact (R75) was comparable to that one in healthy control group. At the same time, children with perinatal HIV contact were shown to display protective antibody level after administering live measles vaccine only in 36.4% of cases, whereas the remainder (63.6%) demonstrated a conditionally protective antibody level or lack it (compared to 76% of children with perinatal HIV contact). Children with perinatal HIV infection who did not respond to the first administered live measles vaccine produced low amount of antibodies after re-vaccination. Seroconversion was observed in up to 68% of cases, whereas protective antibody level was found in up to 33.6% of child ren. On the contrary, children from the perinatal HIV contact group were shown to have protective antibody level in 69.6% of cases upon seroconversion rate reaching 91.3% that did not differ them from those in control group. In the post-vaccination period, suppressive modality of immune reaction tended to increase indirectly evidenced by increased percentage of CD8+ T cell subset

Comparative effect of immunomodulators on the contents of hydrolase inhibitors and lactoferrin in community-acquired pneumonia in adults

The  purpose  of our  study  was to  examine the  effect  of immunomodulators (broncho-vaxom, immunovac-VP4 vaccine  and polyoxidonium) upon  the kinetics  of serum hydrolase inhibitors and lactoferrin in the treatment of community-acquired pneumonia (CAP). The  study included 71 CAP  patients at the age of 18 to 70 years. The  patients were divided  into  4 groups:  Group I (15 people)  was a control group  treated with basic antibacterial and  symptomatic therapy, according to the standard treatment regimen, without use of immunomodulators; the  patients from  group  II  (19  patients) were  additionally administered bronchovaxom (the  drug was prescribed upon  admission: 1 course  over 30 days, then  2 rounds  for 10 days each,  with an interval  in 20 days); group III  (20 cases) contained the patients who additionally received  polyoxidonium (the drug was prescribed from the 1st day of hospitalization, 6 mg daily i/m  for 3 days, then  10 injections over 10 days); group IV (17 cases): Immunovac-VP4 vaccine  was administered orally 4 ml and intranasally 2 drops on days 1, 4, 7, 10, 13, 19, 25, 31, along  with antibacterial and  symptomatic therapy. This  vaccine  consists of  antigens   from  opportunistic microorganisms (a  multicomponent  mixture of  water-soluble antigens   of S. aureus, K. pneumoniae, P. vulgaris, E. coli). Serum  concentrations of α2-macroglobulin and α1-antitrypsin hydrolase inhibitors were determined by the method of quantitative immunoelectrophoresis using the research test systems; lactoferrin (LF)  levels were evaluated by enzyme-linked immunosorbent assay using commercial test systems. These  indicators were studied  in blood serum  before treatment, on the 2nd, 13th, and 60th   days of observation. It was shown that administration of immune modulators combined with antibiotic therapy  in patients with CAP can affect the kinetics of acute phase inflammatory proteins. The effect of broncho-vaxom corresponds to the classical pathway of the response to inflammatory process, i.e., activation of complex of positive acute phase reactants (α1-antitrypsin and  lactoferrin) and  inhibition (blocking) of negative  acute  phase  reactants (α2macroglobulin). Polyoxidonium has a noticeable effect only upon neutrophils secreting lactoferrin. ImmunovacVP4 promotes only short-term secretion of this protein. One may assume that activation of hydrolase inhibitors and lactoferrin after use of immunotropic drugs enhances clinical effect of therapy, with decreased severity and duration of symptoms, as well as lower exacerbation risk of chronic diseases and lesser volume  of drug intake. Antibacterial therapy  does not significantly  affect the kinetics of acute phase inflammation reactants in patients with CAP.  Administration of immunomodulators in combination with standard basic therapy  may affects the inflammatory process to different  degree,  thus, in turn,  leading to improved prognosis  in this disease

ROLE OF ANGIOGENIC FACTORS FOR TRANSPLACENTAL TRANSFER OF THE MEASLES ANTIBODIES

Angiogenesis factors (VEGF, Ang-1, TGF-β) influence production, development and functioning of vascular endothelium that are part of the placental barrier structure and are involved into transplacental transfer of different substances. The aim of this study was to study the relationship between VEGF, Ang-1, and TGF-β concentrations, and the levels of transplacental IgG-antibodies to the measles virus in cord blood of children born to mothers with placental insufficiency. Patients and methods: venous blood was taken from 32 women with uncomplicated pregnancies, and 34 samples from pregnant women with placental insufficiency, as well as umbilical blood of their newborns, the level of IgG-antibodies to measles and the concentration of some angiogenic factors (VEGF, Ang-1, TGF-β) examined by ELISA techniques. The following results were obtained: in a cord blood of infants seronegative for the measles virus, born to women with placental insufficiency, showed uniformly low VEGF levels, decreased Ang-1 concentration (1.6) and increased TGF-β concentration (2.7) as compared to seropositive newborns. In a similar group of children from mothers with physiological pregnancy, the level of these factors did not differ from those in newborns with protective antibodies to measles. Conclusion: in physiological pregnancy, transplacental transmission of IgG-antibodies to the measles virus is directly dependent on the presence of specific antibodies in a woman; in case of placental insufficiency, an imbalance in the system of angiogenic factors may promote disturbances of transmission mechanisms for IgG measles-specific antibodies from mother to the fetus

Новые возможности вакцинопрофилактики коклюша

The review provides information about the current features of the spread of whooping cough among children and adolescents. It is shown that there is a shift in morbidity to an older age group of the population, which is facilitated by changes in the properties of the pathogen and the widespread use of drugs based on cell-free technology as primary vaccination. Information is given about the possibility of preventing morbidity among schoolchildren and adults by introducing additional revaccinating doses against whooping cough with special drugs in the vaccination calendars. Information is given on effective protection of newborns against this infection by immunization of pregnant women. In our country, there is an opportunity to expand pertussis immunoprophylaxis among children of preschool-school age and adults within regional programs and individual vaccination with acellular pertussis-diphtheria-tetanus vaccines, which has a high profile of safety and immunological effectiveness.В обзоре обобщены данные о современных особенностях распространения коклюша среди детей и подростков. Показано, что происходит смещение заболеваемости в более старшую возрастную группу, чему способствуют изменения свойств возбудителя и повсеместное использование в качестве первичной вакцинации препаратов на основе бесклеточной технологии. Приведены сведения о возможности предотвращения заболеваемости среди школьников и взрослых путём введения в календари прививок дополнительных ревакцинирующих доз против коклюша бесклеточными вакцинами. Даётся информация по эффективной защите новорождённых против данной инфекции путём иммунизации беременных. В качестве ревакцинации против коклюша среди детей дошкольно-школьного возраста и взрослых в рамках региональных программ и индивидуальной вакцинопрофилактики возможно использовать бесклеточные АбКДС-М вакцины, которые имеют высокий профиль безопасности и иммунологической эффективности

Безопасность применения коклюшных вакцин у подростков

Aim: to investigate the safety of acellular pertussis vaccines for adolescents.Materials and methods. The clinical tolerability of revaccination against pertussis (cell-free component), diphtheria and tetanus was analyzed in 107 children aged 13,5–14 years. Group 1 consisted of children revaccinated with DTacP-IPV combined vaccine (Tetraxim), group 2 – vaccinated with Td and group 3 – children who received Tdap vaccine (Adacel).Results. Statistically significant differences in the frequency of local reactions between the group that received Tdap and the other two (DTacP-IPV and Td) were detected (p = 0.001and p = 0.04, respectively). Analysis of the structure of local reactions revealed a difference only in the occurrence of the hyperemia at the site of injection, with the most frequent registration in the groups of children vaccinated with DTacPIPV (29,4%) and Td (14,7%), whereas in patients vaccinated with Tdap – only in 5,9% (χ2 = 6,8 p = 0,03). Systemic reactions occurred with the same frequency in all studied groups and did not require medical correction, as well as local reactions. Thus, revaccination against pertussis, diphtheria and tetanus of adolescents using Tdap, containing the acellular pertussis component, does not exceed the frequency of systemic reactions and the number of local reactions is significantly lower in comparison with the vaccine with a reduced content of diphtheria and tetanus toxoids (Td) that is used in practice for a long time.Цель: изучение безопасности применения ацеллюлярных коклюшных вакцин у подростков.Материалы и методы. Проведен анализ клинической переносимости ревакцинации против коклюша (бесклеточный компонент), дифтерии и столбняка у 107 детей в возрасте 13,5–14 лет. 1 группу составили дети, ревакцинированные препаратом АбКДС-ИПВ (Тетраксим), 2 группу – привитые препаратом АДС-М и 3 группу – дети, получившие вакцину АбКДС-М (Адасель).Результаты. Выявлены статистически значимые различия по частоте встречаемости местных реакций между группой, получившей АбКДС-М, и двумя другими (АбКДС-ИПВ и АДС-М) (p=0,001 и p=0,04 соответственно). Анализ структуры местных реакций выявил различие показателей только по частоте возникновения гиперемии на месте инъекции, которая более часто отмечалась в группах детей, привитых АбКДС-ИПВ (29,4%) и АДС-М (14,7%), тогда как у пациентов, ревакцинированных АбКДС-М, регистрировалась только в 5,9% (χ2 =6,8 p=0,03). Системные реакции встречались с одинаковой частотой во всех исследуемых группах и не требовали медикаментозной коррекции, так же, как и местные реакции. Таким образом, ревакцинация против коклюша, дифтерии и столбняка подростков с использованием препарата АбКДС-М, содержащего бесклеточный коклюшный компонент, не вызывает повышения частоты системных реакций, а количество местных реакций достоверно ниже по сравнению с их встречаемостью при применении давно используемой на практике вакцины с уменьшенным содержанием дифтерийного и столбнячного анатоксинов АДС-М.

Вакцинация беременных против управляемых инфекций респираторного тракта

The review provides information on the importance of immunoprophylaxis of epidemic controlled infections in pregnant women. It is shown that the most severe complications of pregnancy occur when women are infected with respiratory pathogens, especially influenza virus in the late stages of gestation. Newborns also have a high risk of fatal disorders and an infant mortality rate in cases of maternal influenza. Modern inactivated vaccines used in pregnant women in many countries since the second period of gestation have high safety and immunological efficacy for both women and the fetus. The issues of expediency, safety and effectiveness of vaccination of pregnant women against pneumococcus, Hemophilus type-b and pertussis infection are actively discussed, which reflects the evolution of understanding of the importance of this area of preventive medicine in obstetricpractice.В обзоре приводятся сведения о значимости у беременных иммунопрофилактики эпидемических управляемых инфекций. Показано, что наиболее тяжёлые осложнения беременности случаются при инфицировании женщин респираторными патогенами, особенно вирусом гриппа на поздних сроках гестации. Новорождённые дети также имеют высокий риск фетальных нарушений и показатель младенческой смертности в случаях перенесенного материнского гриппа. Высокой безопасностью и иммунологической эффективностью как для женщины, так и для плода обладают современные инактивированные вакцины, применяемые у беременных во многих странах мира, начиная с второго периода гестации. Активно обсуждаются вопросы целесообразности, безопасности и эффективности вакцинации беременных против пневмококка, гемофильной типа b и коклюшной инфекции, что отражает эволюцию понимания важности этого направления профилактической медицины в акушерской практике

Перспективные данные применения пневмококковой 13-валентной конъюгированной вакцины у взрослых пациентов с хронической бронхолегочной патологией

Aim. The aim of this study was to investigate safety and clinical efficacy of 13valent conjugated pneumococcal vaccine (PCV13) and 23valent poly saccharide pneumococcal vaccine (PPV23) in patients with chronic obstructive pulmonary disease (COPD) and asthma and to assess impact of vaccination on quality on life. Methods. This was a prospective comparative study. Clinical efficacy and safety were evaluated using data on systemic and local adverse reactions during a month after vaccination, changes in lung function and quality of life (QoL in 6 months after vaccination. Lung function was assessed before and 1 and 6 months after vaccination. QoL was measured before and 6 months after vaccination using CAT test in COPD patients and ACQ ques tionnaire in asthma patients. Results. The study involved 58 patients with COPD and 59 patients with asthma. Of them, 33 and 34 patients, respectively, were vaccinated with PCV13 and 25 patients of each group were vaccinated with PPV23. A rate of systemic and local adverse reactions did not differ significantly between patients vaccinated with PCV13 or PPV23. Patients with both COPD and asthma vaccinated with PCV13 demonstrated more significant increase in FEV1. QoL improved in all vaccinated patients. Worsening of the disease was not noted in any patient.Conclusion. In patients with COPD and asthma, lung function tended to improvement and QoL significantly improved in 6 months after vaccina tion with PCV13 or PPV23. Both vaccines were well tolerated.Проблема вакцинации против пневмококковой инфекции пациентов с бронхолегочной патологией является актуальной, т. к. при данной инфекции обостряется течение основного заболевания, прогрессирует хронический процесс, ухудшается качество жизни (КЖ) больных. Проведено сравнительное исследование по оценке безопасности, клинического эффекта, влияния на показатели КЖ 13валентной конъюгированной (ПКВ-13) и 23валентной полисахаридной пневмококковых вакцин (ППВ-23) у пациентов с хронической бронхоле гочной патологией. Обследованы пациенты с хронической обструктивной болезнью легких (ХОБЛ) (n = 58) и бронхиальной астмой (БА) (n = 59). ПКВ-13 были вакцинированы пациенты с ХОБЛ (n = 33) и БА (n = 34), а ППВ-23 – по 25 больных ХОБЛ и БА. В проведенном исследовании не выявлено различий в частоте возникновения системных и местных реакций при введении конъюгированной и полисахаридной пневмококковых вакцин. У больных как ХОБЛ, так и БА была выявлена более выраженная тенденция к увеличению показателя объема форсированного выдоха за 1ю секунду в группах, вакцинированных ПКВ-13. После проведенной вакцинации было отмечено улучшение показателей КЖ пациентов во всех группах. Случаев ухудшения течения основного заболевания не зарегистрировано