Karaivanova, A.

Mavrodinova, T.

Odzhakova, Z.

Petkova, D.

Radkov, Y.

English

Varna Medical University Press: Journals

Scripta Scientifica Medica, vol.28, Suppl.1,pp.199-200 Copyright © Medical University, Varna, 1991 IMMUNOMODULATORS IN PULMOLOGIGAL P R A C T I C E D. Pe tkova , Z. Odzhakova , Y . Radkov , T . Mavrodinova, A. Kara i vanova Clinic of Allergology and Clinical Immunology, Varna Observing the basic requirements for prescribing immunomodu-lating therapy, i.e., therapy well grounded, differentiated, purposeful and individualizad, we set ourselvers a goal to make an attempt to assess the clinical effectiveness of some known and used in this country immunostimulating medicines and these medicines applied to patients with frequent chronic nonspecific pulmonary diseases. For the period 1983-1991 in the Clinic of Pulmology, Medical Univer-sity, Varna, 197 patients with frequent pushes of chronic nonspecific pulmonary diseases (CNPD) and protracted course of acute bacteri-al pneumonia and signs for immunodeficiency were checked up. Their immunodeficiency was determined on the basis of the results obtained from the examination of the following indexes: phagocyte activity of polymorphic nuclear leukocytes and alveolar macro-phages, lysozyme in serum and bronchial secretion, protease inhibi-tors, complement, Ig G,A,M, including specific antibodies in serum and bronchial secretion, circulating immune complexes, E-rosette-forming cells, intradermal test with purified protein derivative of tuberculine, candidine, trichophytin as a test for proving the cellular mediated immune deficiency. All the patients received immunomodu-lating medicines in correspondence with their immunity breaches: I. DECARIS (Levamisol) given to 63 patients by the following way: 2,5 mg/kg daily (on the average 150 mg) during 3-5 days and then one tablet (150 mg) weekly for the following month. II. GAMMA A - new Bulgarian medicine (enriched with IgA gamma globulin) for correction of IgA and IgG-deficit was given to patients with signs of deficiency of antibody synthesis. 17 of them received 0,3-0,5 ml/kg, followed by a dose of 0,3-0,55 ml/kg once in fortnight under observ-ance of their serum immunoglobulin levels. In some cases the bron-chial secretion was under control during the period of treatment. IN. ANTISTENOCARDIN (Dipiridamol) - interferon inductor was given to 91 patients with CNPD. The dose prescribed was 100 mg once a week for 3 months. 19 patients with frequent recurrences of CNPD and virus infections inhaled the newly invented Bulgarian leu-kocyte interferon 3-5 times - 50000 U each time. IV. RESPIVAX - new Bulgarian polymicrobial immunomodulator that proved to have 200 stimulating effect on antibody synthesis, phagocytosis and cellular immunity was applied to 62 patients with signs of dysfunction of the phagocytosis, humoral and cellular immunity in following dosage: basic course 1 tablet (50 mg) every morning for 30 days; after that 10 days monthly every morning 1 tablet (50 mg) for at least 3 months. V. ISOPRENASIN - immunomodulator was also included in the com-plex therapy of patients with non-bacterial pheumonia and unusually complicated course and with signs of cellular-mediated immunity deficiency. The dose was 50 mg/kg during a period of 7-10 days. To assess the effect of the treatment the following criteria were used -clinical and immunologic: correction of the deficiency and the dyss-function of a particular section of the immunity system. Our results are demonstrated on table 1. Table 1. Clinical effectiveness of the complex therapy combined with immunomodulaters and applied to patients with frequent recur-rence of CNPD. Immuno- Cases modula- n tors antirecurrent effect of treatment n % Parameters shortening terms of treatment n % reducing treatment Decaris 63 41 5,07 40 63,5 28 44,44 Respivax 62 41 66,02 51 82,25 19 30,60 GammaA 17 5 29,41 7 41,17 5 29,41 Antisteno- 19 12 63,20 3 15,78 3 15,78 cardin Levamisol (Decaris) and Respivax proved to have good antire-current effect for two thirds of the treated patients. Dipiridamol proved significant antirecurrent effect in patients with positive re-sponse to interferon after induction with it. Gamma A proved small antirecurrent effect and that is why we recommend its usage as an immunosubstitution in the complex therapy. Apart from the favour-able clinical effect and practically lack of side effects, usage of vari-ous immunomodulators improved some immunologic index without normalization. 

IMMUNOMODULATORS IN PULMOLOGIGAL PRACTICE

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IMMUNOMODULATORS IN PULMOLOGIGAL PRACTICE

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Varna Medical University Press: Journals