OPTIMIZATION OF THE EFFECTIVENESS OF REPLACEMENT THERAPY IN COMMON VARIABLE IMMUNE DEFICIENCY

Introduction. Suppression of antibody production is a leading symptom of common variable immunodeficiency (CVID), but the causes of this disorder have not been fully elucidated. However, numerous studies confirm the involvement of the cellular compartment of the immune response in the pathogenesis of this variant of innate immune defects. In some cases, despite effective replacement therapy, patients with CVID continue to be ill. The development and implementation of combination therapy regimens through additional effects on the cellular link of immunogenesis is of interest. The purpose of the study: Clinical and immunological characteristics of the effectiveness of combined immunotropic therapy in patients with CVID. Materials and methods. The observation group consisted of 7 people. Inclusion criteria: established diagnosis of CVID, regular IVIG replacement therapy with confirmation of a pre-transfusion IgG level of at least 8.0 g/l, four or more episodes of exacerbation of foci of chronic infections during the year. Patients received monthly IVIG replacement therapy at a dose of 0.4 g/kg body weight and glucosaminylmuramyl dipeptide at a regimen of 1 mg in the morning and 1 mg in the evening sublingually for 10 days each month for three months. The course was repeated after six months. Immune system parameters were assessed before the start of combination therapy and one year later. Results. The frequency of complications of foci of chronic infection during the previous year was 5.1±1.1, the average number of days of antibiotic use was 38.3±12.4. The results of immunological testing showed suppression of the parameters of the cellular component of the innate immune response. During the year of combination therapy, the number of episodes of infectious manifestation was 2.1±1.3, the average number of days of antibiotic use to relieve infectious complications was 10.7±4.3. The results of the immunological examination confirmed that the clinical improvement in the course of CVID is associated with changes in the indicators that were identified before the start of the use of the immunotropic drug.Сonclusions. The use of licopid as an additional immunocorrective effect in patients with CVID leads to an increase in the effectiveness of replacement therapy with intravenous immunoglobulins