Медицинский совет (Oct 2020)

Advanced therapy for eternal vulvovaginal candidiasis recurrences

  • I. A. Kulikov

DOI
https://doi.org/10.21518/2079-701X-2020-13-157-165
Journal volume & issue
Vol. 0, no. 13
pp. 157 – 165

Abstract

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Candidiasis is the most common fungal infection predominantly affecting the mucous membrane. The fungus Candida causes these lesions. There are strains resistant to modern antimycotic drugs among Candida spp. Due to the increase in candidiasis prevalence and the widespread use of antifungal agents, the issue of effective treatment is becoming increasingly important.Liability of C. albicans to antigenic mimicry and suppression of the immune response mediates the evasion of the fungus from the immune response and development of excessive inflammation. The evasion of the fungus Candida from the local nonspecific immunity factors contributes to the breakdown of the antibody response initiation and cellular reactions of the acquired immunity, which are of key importance for anti-candidiasis protection. Therefore, the lack of an adequate local immune response from the mucous membranes is a possible reason for the development of a recurrent vulvovaginal candidiasis.Modern treatment for recurrent candidiasis in the formed risk groups involves the use of prophylactic aggressive etiotropic therapy, but at a lower dose, and the pathogenetically substantiated treatment involves regulating the local immune response in the vagina through the use of immunomodulatory drugs that inhibit the growth of fungi by activating the innate and acquired components of mucosal immunity. In addition, local immunomodulators contribute to the recovery of damaged mucous membranes and additional lubrication of tissues in contrast to antimycotics, which tend to increase the clinical manifestations of infection and dryness of mucous membranes when applied topically in the early stages of treatment.

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