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Clinical and immunological efficacy of combination therapy of children with measles

Abstract

The aim of the study was to assess the clinical and immunological efficacy of recombinant interferon Alfa-2b. Examined 34 children aged from 1 year to 7 years carrying medium to heavy degree of measles. All patients were not vaccinated against measles. In the treatment of 18 people (Control group) were used only basic therapy (pathogenic, symptomatic). At 16 people (Study group) used a combination therapy (basic + Viferon). As an antiviral agent used and immunotropic preparation of human recombinant interferon alfa-2b in the form of rectal suppositories – Viferon (OOO «Feron», Russia). Immunological patient survey was conducted in the dynamics of the disease – during the height (in 1-6 days the rash) and in convalescence period (10-16 days rash). Indicators of cellular immunity (leukocytes, lymphocytes, CD3 +, CD3 + CD (16 + 56) +, CD3 + CD4 +, CD3 + CD8 +, CD4 + CD8 +, CD3-CD8 +, CD3-CD (16 + 56), CD19 +, CD25 +, CD3 + HLA DR +, CD (16 + 56) + HLA DR +, HLA DR +, CD95 +) were evaluated by flow cytometry. To assess the production of IFN-α and IFN-γ in the samples of peripheral blood were cultured in the CO2 incubator for 18 hours at 37 C and 4% CO2. The supernatants of cell culture were investigated with the purpose of studying spontaneous and induced production of interferon alpha and gamma. The concentrations of interferon α and γ (IFNα, IFNγ) in the blood serum, as well as levels of spontaneous and induced cytokine production data of blood cells of sick children was determined by ELISA. All the children at the peak of the disease found a dramatic inhibition of cellular immunity and the production of cytokines, which is consistent with the concept of «measles anergy» accepted in the scientific literature. The period of convalescence oppression immunity indices remained, but it was less pronounced in the group of children treated with the drug of human recombinant interferon alfa-2b -Viferon. Clinical efficacy of Viferon in the treatment of patients with measles children characterized by rapid positive dynamics of symptoms of acute period (normalization of body temperature, reducing intoxication, catarrhal symptoms and severity of the syndrome exanthema). It was also found reduction in the incidence of complications, reduction in the average bedday and smooth during the period of convalescence later.

About the Authors

V. N. Timchenko
Saint Petersburg State Pediatric Medical University, Saint-Petersburg, Russia
Russian Federation


N. M. Kalinina
All-Union Center of Emergency and Radiation Medicine named after A.M. Nikiforov, Saint-Petersburg, Russia
Russian Federation


E. B. Pavlova
Saint Petersburg State Pediatric Medical University, Saint-Petersburg, Russia
Russian Federation


O. V. Bulina
Saint Petersburg State Pediatric Medical University, Saint-Petersburg, Russia
Russian Federation


T. A. Kaplina
Saint Petersburg State Pediatric Medical University, Saint-Petersburg, Russia
Russian Federation


O. A. Leonicheva
Saint Petersburg State Pediatric Medical University, Saint-Petersburg, Russia
Russian Federation


E. N. Vyzhlova
Federal Science Research Centre of Epidemiology and Microbiology named after N.F. Gamalei, Moscow, Russia
Russian Federation


References

1. Lobzin Ju.V. Kliniko-laboratornaja diagnostika infekcionnyh boleznej: rukovodstvo dlja vrachej / Ju.V. Lobzin. – SPb.: Foliant. – 2001. – 384-385 s.

2. Lobzin Ju.V. Spravochnik po infekcionnym boleznjam u detej / Ju.V. Lobzin – SPb.: SpecLit . – 2013. – 254-258s.

3. Timchenko V.N. Kliniko-jepidemiologicheskaja jevoljucija i sovremennaja terapija kori u detej / V.N Timchenko, E.B Pavlov, O.V. Bulina, A.N. Nazarova, A.N. Leonicheva, E.V Timofeeva // Zhurnal Infektologii. – 2015. – T.7,№1. – S. 39-46.

4. Timchenko V.N. Kor’ u detej v sovremennyh uslovijah / V.N. Timchenko, E.B. Pavlova, O.O. Fedjuchek, R.A. Ivanova, N.V.Pavlova, S.I. Minchenko // Pediatricheskaja farmakologija. –2012. – T. 9, №6. – S.12-15.

5. Informacionnyj bjulleten’ VOZ№ 286. Aprel’ 2012 g. URL: http://www.who.int/mediacentre/factsheets/fs286/ru/index.html

6. Timchenko V.N. Vozdushno-kapel’nye infekcii v praktike pediatra i semejnogo vracha: rukovodstvo dlja vrachej vseh special’nostej / V.N. Timchenko. – SPb.: SpecLit, 2007. – 644s.

7. Timchenko V.N. Kor’ u detej rannego vozrasta / V.N Timchenko, T.M. Chernova, O.V. Bulina, E.B Pavlova, A.N. Nazarova, A.N. Leonicheva, E.V. Timofeeva // Detskie infekcii. – 2015. T. 14, №2. – S. 52-58.

8. Toptygina A.P. Osobennosti specificheskogo gumoral’nogo immunnogo otveta protiv virusa kori / A.P.Toptygina, T.A.Mamaeva, V.A.Aleshkin// Infekcija i immunitet. – 2013. – T.3, №3. – S. 243–250.

9. Hickman, CJ. Laboratory characterization of measles virus infection in previously vaccinated and unvaccinated individuals / CJ. Hickman, TB. Hyde, SB. Sowers, S. Mercader, M. McGrew, et al. // J. Infect. Dis. – 2011. – V. 204. – Suppl 1. – P. 549–558.

10. Ob jepidemiologicheskoj obstanovke v Sankt-Peterburge. URL: http://www.78.rospotrebnadzor.ru/

11. Goodbourn , S., Randall ,RE. The regulation of type I interferon production by paramyxoviruses / S. Goodbourn, RE. Randall // J. Interferon Cytokine Res. – 2009. V. 29. – R. 539–547.

12. Rory D. de Vries Measles Immune Supression: Functional Impairment or Numbers Game? / Rory D. de Vries, Rik L. de Swart // PLOS Pathogens. – 2014. – V.10. – Issue 12. – e1004482 – P.1-4.

13. Sato H., Yonder M., Honda T., Kai C. Morbillivirus receptors and tropism: multiple pathways for infection / H. Sato, M. Yonder , T. Honda , C. Kai // Frontiers in Microbiology. – 2012. – V. 3. – Article 75. – P.1-9.

14. Yu, XL. Measles virus infection in adults induces production of IL-10 and is associated with increased CD4+ CD25+regulatory T cells./ Yu XL, YM Cheng, BS Shi, FX Qian, FB Wang , [et al] // J. Immunol. – 2008. – V. 181. – R. 7356– 7366.

15. Caignard G. Measles virus V protein blocks Jak1-mediated phosphorylation of STAT1 to escape IFN-alpha/beta signaling./ G. Caignard, M. Guerbois, JL. Labernardiere, Y. Jacob, [et al] // Virology. – 2007. – V. 3 – 368. – R.351–362.

16. Chinnakannan S. K. Morbillivirus V Proteins Exhibit Multiple Mechanisms to Block Type 1 and Type 2 Interferon Signalling Pathways / S. K. Chinnakannan, S. K. Nanda, M. D. Baron // PLOS ONE. – 2013. – V. 8. – Issue 2. –e57063. – R. 1-14.

17. Malinovskaja V.V. Novyj otechestvennyj kompleksnyj preparat Viferon i ego primenenie v perinatologii i pediatrii pri infekcionnoj patologii / V.V. Malinovskaja // Rossijskij vestnik perinatologii i pediatrii. – 1999. – T. 44, № 3. – S.36-43.


Review

For citations:


Timchenko V.N., Kalinina N.M., Pavlova E.B., Bulina O.V., Kaplina T.A., Leonicheva O.A., Vyzhlova E.N. Clinical and immunological efficacy of combination therapy of children with measles. Journal Infectology. 2016;8(3):46-52. (In Russ.)

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ISSN 2072-6732 (Print)