急性呼吸道病毒群体感染患者免疫反应特点及纠正免疫反应不适应的可能性

V. Akimkin, Z. Ponezheva, L. O. Ponezheva, T. S. Guseva, O. Parshina, A. N. Turapova
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引用次数: 0

摘要

本研究的目的是确定急性呼吸道病毒感染患者免疫反应适应不良障碍的严重程度及其纠正的可能性。材料和方法。从组织组中选取90例无并发症ARVI患者和一组条件健康患者(n = 30)进行检查。除了对症治疗外,患者还接受了直肠和鼻内重组IFN-α-2b的联合治疗。采用PCR法鉴定ARVI病原菌。ELISA法测定血清中IFN-α和IFN-γ的浓度,以及细胞在体外自发和受新城疫病毒或植物血凝素刺激时产生这些细胞因子的能力。采用流式细胞术分析外周血淋巴细胞亚群组成。采用酶免疫法检测各组血清IL-8、IgA、IL-8水平。结果。62.1%的ARVI患者病因明确,在发病结构中主要由流感(39.3%)和腺病毒(35.6%)引起。在看似健康的人组成有组织的团队的前3个月,发现t辅助细胞、自然杀伤细胞和干扰素系统抑制水平下降,这表明违反了适应机制,导致身体抵抗力下降。对细胞因子系统的分析表明,与一组实际健康的人相比,急性呼吸道病毒感染患者的分泌和血清IL-8浓度增加。在ARVI后1个月的免疫状态中,t淋巴细胞数量显著增加,辅助t淋巴细胞倾向于使携带IFN-α和-γ受体的t淋巴细胞正常化,而b淋巴细胞数量保持显著减少。与重组IFN-α-2b联合治疗的免疫调节效果表现为诱导的IFN-α在初始抑制期数量增加,而初始过量产生量减少。IFN-α初始诱导水平低于200 pg/ml时,分泌IL-8和IgA浓度升高。结论。在有条件健康的个体中,在有组织群体形成的前3个月,在34%的病例中发现免疫反应失调。观察重组IFN-α-2b联合治疗对干扰素的调节作用。
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Features of the Immune Response and the Possibility of Correcting the Maladaptation of the Immune Response in Patients with Acute Respiratory Viral Infections from Organized Groups
The purpose of the study was to determine the severity of maladaptation disorders of the immune response and the possibility of their correction in patients with acute respiratory viral infections from organized groups. Material and methods. 90 patients with uncomplicated forms of ARVI and a group of conditionally healthy (n = 30) from organized groups were examined. In addition to symptomatic therapy, patients received a combination of rectal and intranasal forms of recombinant IFN-α-2b. Identification of the ARVI pathogen was determined by PCR. ELISA was used to determine serum concentrations of IFN-α and IFN-γ and the ability of blood cells to produce these cytokines ex vivo spontaneously and when stimulated by Newcastle disease virus or phytohemagglutinin. Flow cytometry was used to analysis the subpopulation composition of peripheral blood lymphocytes. The study of the levels of secretory IL-8, IgA, serum IL-8 was carried out by enzyme immunoassay. Results. The etiology of ARVI was deciphered in 62.1% of patients, the main share in the morbidity structure was due to influenza (39.3%) and adenoviruses (35.6%). In the first 3 months of the formation of organized teams in apparently healthy people, a decrease in the level of T-helpers, natural killers and inhibition of the interferon system was revealed, which indicates a violation of adaptive mechanisms and contributes to a decrease in body resistance. An analysis of the cytokine system showed an increase in the concentration of secretory and serum IL-8 in patients with acute respiratory viral infections compared with a group of practically healthy people. In the immune status 1 month after ARVI, there was a significant increase in the number of T-lymphocytes, T-helpers with a tendency to normalize T-lymphocytes carrying IFN-α and -γ receptors, while maintaining a significantly reduced number of B-lymphocytes. The immunomodulatory efficacy of combination therapy with recombinant IFN-α-2b is characterized by an increase in the amount of induced IFN-α during its initial depression and a decrease in initial hyperproduction. Also, at the initial level of induced IFN-α less than 200 pg/ml, there was an increase in the concentration of secretory IL-8 and IgA. Conclusion. In conditionally healthy individuals, in the first 3 months of the formation of organized groups, maladjustment disorders in the immune response were detected in 34% of cases. The interferon-modulating effect of combination therapy with recombinant IFN-α-2b was shown.
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