Local immunity and microflora of the reproductive tract of gynecological patients before and after immunomodulatory therapy

Immunomodulatory drugs are widely used as drugs for the treatment of inflammatory diseases of microbial etiology in clinical medicine. The authors evaluated the effectiveness of the therapeutic effect of the Cycloferon immunomodulator in the treatment of chronic purulent-inflammatory diseases of the reproductive tract using clinical, microbiological and immunological parameters. It was shown that under the influence of immunomodulatory therapy, the restoration of the qualitative and quantitative composition of the normoflora was observed with the elimination of etiologically significant microorganisms. The immunocorrective effect of therapy on the indices of local immunity was established: the concentration of lactoferrin increased in the cervical secretion, the level of cytokines IL-1β and γ-IFN normalized, the amount of secretory IgA increased significantly, which contributed to the enhancement of local protective reactions, as well as the clinical efficacy of therapy, which was manifested in the reduction and/or disappearance of pain syndrome and the absence of relapse for 2 or more years. Conducted researches allow us to speak of immunotropic drugs as a promising direction in the treatment of inflammatory processes of the reproductive tract, a significant advantage of which is rational immunomodulation directly in the focus of inflammation, the availability of treatment, the absence of side effects with adequate therapeutic regimens, which makes it relevant to further study this direction of immunocorrection and its implementation into wide clinical practice.

[Cycloferon in local immunotherapy in patients with virus-associated rhinitis]

Evaluation of the effectiveness of various schemes of local immunotherapy in immunocompromised patients with allergic rhinitis was carried out.

MATERIALS AND METHODS

A comparative analysis of the treatment of 72 patients with allergic rhinitis, divided into groups: I (main, n=21), which included immunocompromised patients who received sublingual allergen-specific immunotherapy with antipollin and inhaled immunotherapy with cycloferon (every other day, a course of 10 procedures, the total dose of Cycloferon per course is 1250 mg); II (comparison, n=22) - immunocompromised patients who received monotherapy with antipollinum and III (control, n=29) - patients with allergic rhinitis without signs of immunocompromise, who also received antipollinum. The effectiveness of therapy was assessed by the quality of life (RQLQ questionnaire), the severity of nasal symptoms (the patient's self-observation diary) and the need for drugs after a course of intranasal immunotherapy.

RESULTS

The inclusion of cycloferon in the treatment of immunocompromised patients with allergic rhinitis increased its effectiveness - the severity of nasal symptoms decreased: in terms of sneezing, a decrease of 53.5 times versus 1.82 - in the control, «nasal congestion» - 6.3 times versus 2.6 - in the control, «itching in the nose» - 4.9 and 4.2 times, respectively (p<0.05). The changes had a positive effect on the total indicator of the quality of life of patients - an increase of 6.2 times (by 83.7%) (p>0.05) and significantly reduced the need for cromones (18 times, versus 10.3 - in the group comparison), inhaled corticosteroids (10.4 times versus 8 times in the comparison group, and in decongestans - 8.1 times versus 6.1 - in the comparison group (p>0.05)).

CONCLUSIONS

The combined use of local immunotherapy with cycloferon and sublingual allergen-specific immunotherapy with antipollinum in immunocompromised patients with allergic rhinitis is the first-line method of choice that statistically significantly changes the quality of life of patients.

[Cycloferon efficacy in treatment of upper respiratory tract infections: systematic review and meta-analysis]

Medical scientific sources about randomized clinical trials of Cycloferon were studied as a single plot of 531 articles. AIM was to get the generalized cycloferon efficacy's assessment in comparison with basic therapies curing the otorhinolaryngologic diseases. Groups heterogeneity and responding parameters' variability were estimated also. Comparison groups were symmetric enough to annihilate end-point variabilities, so the results' interpretations were clear enough and vector of clinical effects was detectable. Comparison groups were integrated to increase statistical power of metaanalysis. In result, cycloferon additional administration in treatment of otorhinolaryngologic diseases added 25% to absolute and relative usefulness of medical intervention. Also cycloferon increased 3,5 times the chances of recovery and absence of recurrent exacerbation.