Актуальні інфекційні захворювання
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Актуальні інфекційні захворювання
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Журнал «Актуальная инфектология» Том 7, №2, 2019
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Changes in the immune status of patients with herpes infections under the influence of alokin-alpha
Авторы: M.O. Sokolenko, A.A. Sokolenko, I.V. Balaniuk
Bukovinian State Medical University, Chernivtsi, Ukraine
Рубрики: Инфекционные заболевания
Разделы: Медицинские форумы
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Background. One of the most common diseases of viral etiology is herpesvirus infection. With herpetic infections, immunodeficiency states can develop, both at the level of the cellular and humoral immune levels. That is, the weakened immune system becomes less capable of eliminating the virus from the body, although it retains its function of antibody synthesis throughout life, sometimes in fairly high titres. However, they only participate in the neutralization of certain antigens of the virus, but do not prevent relapses. The purpose of the study — to determine changes in the immune status of patients with herpetic infections under the influence of aloki-alpha.
Materials and methods. 84 patients were examined and treated for recurrent herpetic infections caused by herpes simplex viruses 1 and 2, as well as Herpez zoster. For a representative choice, patients were divided into two groups. The first included 40 patients with herpes infection, who against the background of basic therapy during the week (daily intake of etiotropic drug with the international unpatented name (INN) valacyclovir — 1.0 g orally 2 times a day for 7–10 days) were additionally prescribed 3 subcutaneous injections of the immunotropic drug “Allokin-alpha”, the active ingredient of which is alloferon at a dose of 1 mg every other day. The comparison group consisted of 44 patients who were prescribed only the above basic therapy during the week. For this study, patients were selected at random. The follow-up period consisted of the time of treatment and subsequent outpatient follow-up for 3 months. Patients were carried out immunological research, determination of lymphocyte subpopulations, proliferative activity of T-lymphocytes, activity of NK-cells. The study involved patients with a clinical picture of herpes infection during the exacerbation period, no more than 48 hours after the onset of rash. The test group of patients included 23 patients for recurrent labial herpes, 21 for genital herpes and 40 for herpes zoster. The average duration of the disease was 4–8 years, the average number of relapses per year — 12.
Results and discussion. Alokin-alpha supplemented treatment provided significant enhancement of functional activity of mature T-lymphocytes by 92.6 % with genital herpes (2703.4 ± 326.2) against (1403.4 ± 199.2) cells/μl before treatment and 112.1 % with herpes zoster (2618.1 ± 250.4) against (1234.6 ± 104.5) cells/μl before treatment (in all cases p < 0.05). Also, the treatment, supplemented with alloferon, ensured the normalization of the level of TCD4+-lymphocytes, which, with herpes zoster, statistically significantly exceeded the value in patients before treatment (1239.9 ± 130.6) against (1157.8 ± 146.3) cells/µl, respectively (р < 0.05). Negative influence of alloferon on the immune status indicators was not established, although it should be noted that the level of T-suppressors under the influence of combination therapy was characterized by a tendency to increase, and with herpes zoster significantly exceeded the corresponding figure in patients before treatment (616.9 ± 74.5) against (423.8 ± 41.1) cells/μl, respectively (р < 0.05). It can be assumed that the approved immunotropic drug has a certain stimulation of cytotoxic T-effectors (TCD8+-cells). The effect of alloferon was also characterized by a significant increase in the activity of TCD16+-cells, which are markers of natural killers and are responsible for antibody-independent specificity, that is, for cumulative specific and non-specific cytotoxicity. In patients with genital herpes, this indicator was (492.8 ± 43.9) cells/µL, which is 70.7 % more than at the height of the disease and 48.6 % after the traditional treatment with valacyclovir. For herpes zoster, this excess was 73.6 % and 52.6 %, respectively (in all cases р < 0.05). At the same time, the level of TCD16+-cells always remained within normal limits.
Conclusions. Thus, the data obtained confirm that Alokin-alfa has an antiviral and immunomodulatory effect and in combination with traditional anti-herpetic therapy provides significant improvement in cellular immunity in patients with herpesvirus infection, which distinguishes this treatment from traditional monoclonal therapy with valacyclovir.