Медицинская иммунология (Jul 2014)
PATTERN OF LOCAL IMMUNE ALTERATIONS IN THE PATIENTS WITH CHRONIC ADENOIDITIS, AND AN OPPORTUNITY OF THEIR CORRECTION WITH IMUNOFAN
Abstract
Abstract. The issue of chronic adenoiditis, due to its medical and social significance, is in focus of attention for otolaryngologists, pediatricians, immunologists. According to various works, chronic adenoiditis in children comprise 20 to 56% of upper respiratory diseases. Chronic adenoiditis is characterized by relative resistance to conventional therapy, and, in pronounced cases, by low reversibility of pathological events. The studies performed have shown that the patients with chronic adenoiditis show some features of local and general immune deficiency that were exhibited as decreased serum IgA concentration and local sIgA secretion, as well as insufficient income of IgG from vascular system to the area of inflammation in patients with chronic adenoiditis. These local immune deficiencies were considered to be an indication for local immunotherapy. Dynamics of clinical symptoms and changes in immunoglobulin profile has shown that clinical efficiency of Imunofan therapy was dependent not solely on the initial clinical features of disease, but on the local immunity state. Analysis of initial immunoglobulin concentrations in nasopharyngeal lavage from the patients showing differential clinical response have demonstrated that therapeutic effect of Imunofan was most pronounced in the patients with initially moderate activity of inflammatory process, deficient IgG income from vascular system, decreased local IgA synthesis in the inflammatory foci. Certain clinical features of chronic adenoiditis, i.e., clinical course without hypertrophy of pharyngeal tonsils, local immune deficiency (decreased local IgA secretion and deficient IgG income from blood), with a background of moderate inflammatory events, may be used as a rationale for administration of local immunotherapy with Imunofan to these patients. (Med. Immunol., 2008, vol. 10, N 6, pp 551-562).
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