PERSONALIZED APPROACH TO IMMUNE SYSTEM REHABILITATION IN PATIENTS WITH YEAR-ROUND ALLERGIC RHINITIS SUFFERING FROM RECURRENT ARVI AND RECURRENT HERPES VIRUS INFECTIONS.



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Abstract

Introduction The problem of treating patients with respiratory allergopathology associated with recurrent infectious diseases, such as rARVI, frequent exacerbations of rCHVI, is becoming urgent. The presence of persistent inflammation and co-infection significantly complicates the treatment of immunocompromised patients with year-round allergic rhinitis (YAR) and necessitates the development of personalized programs, with the inclusion of immunomodulatory for restoring disorders in the immune system (IS) and interferon system (IFN).

Materials and methods: The study group (SG) included 65 patients of both sexes aged 23-60 years, suffering from YAR associated with rARVI and rCHVI. The comparison group (CG) consisted of 50 healthy individuals, comparable in sex and age. All patients underwent standard physical, immunological and allergological examinations, including the use of serological (ELISA, ImmunoCUP), molecular genetic (PCR-RV) methods, FC, etc. Voluntary informed consent was obtained from all patients. The StatPlus computer program was used for statistic.

Results and discussion: In patients with YAR associated with rARVI and rCHVI, two variants of disorders in IS have been established, which are defined as pathological immunophenotypes (PIF).

The PIF1 is characterized by a deficiency in the induced production of IFNα, a decrease in CD3-CD16 + CD56 + EKKs, and a decrease in neutrophil granulocytes (NG).

In the PIF2, along with a shortage of IFNα production, a decrease in EKKs is observed in combination with a decrease in CTLs, as well as a decrease in NGs.

The clinical criteria for immunocompromising in this cohort of patients were studied. The severity of YAR symptoms was assessed by VAS.

In order to correct the identified disorders in the IS and IFN system, complex personified IFN- and immunotherapy programs have been developed for each PIF, including prolonged local and systemic therapy with rIFNα2b in combination with antioxidants, as well as GMDP for patients of SG1, and for patients of SG2 - GMDP and hexapeptide. The high immunological and clinical efficacy of IFN- and immunotherapy was shown, which was expressed in the tendency to restore existing disorders, as well as in achieving control over the symptoms of YAR, with the possibility of reducing the volume of basic antiallergic pharmacotherapy.

About the authors

Evgeniya Khalturina

I. M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia;
MEDSI Clinical Diagnostic Center at Belorusskaya, Moscow, Russia

Email: jane_k@inbox.ru
ORCID iD: 0000-0002-8948-8983
SPIN-code: 2813-4952
Scopus Author ID: 0000-0002-8948-8983

Grand PhD (Medicine), Associate Professor,  Department of Microbiology, Virology and Immunology,  I. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation;  allergist-immunologist in CDC «Medsi on Belorusskaya»

Russian Federation, 11 Mokhovaya St., bld. 10, 125009, Moscow (right wing, 1st, 2nd, 3rd and 5th floors)

Natalya Viktorovna Garskova

Academy of Postgraduate Education FSBI FNCC FMBA of Russia;
MEDSI Clinical Diagnostic Center at Belorusskaya, Moscow, Russia

Email: garskova@bk.ru

allergist-immunologist in CDC «Medsi on Belorusskaya» , post-graduate student, 3 years, Department of Immunopathology and Immunodiagnosis, Academy of Postgraduate Education, FSBI FNCC FMBA of Russia, Moscow, Russia

24 Kashirskoye shosse, Moscow, 115522

Arina Dmitrievna Shemetova

I. M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia

Author for correspondence.
Email: jane_k@inbox.ru

2nd year student of the Institute of Public Health named after F.F. Erisman

11 Mokhovaya St., bld. 10, 125009, Moscow (right wing, 1st, 2nd, 3rd and 5th floors)

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