Научная статья на тему 'Immunological effectiveness of “immun-5” in various forms brucellosis'

Immunological effectiveness of “immun-5” in various forms brucellosis Текст научной статьи по специальности «Клиническая медицина»

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BRUCELLOSIS / IMMUN-5 / T AND B LYMPHOCYTES / TREATMENT / PREVENTION

Аннотация научной статьи по клинической медицине, автор научной работы — Mamatkulov Ibrokhim Homidovish, Ahmedova Mubarahon Dgalilovna, Kosimov Odiljon Shodiyevish

Ellular immunity was studied in patients with acute, subacute, primary and secondary chronic forms of brucellosis was studied before and after therapy including domestic preparation “Immunе-5” and in healthy persons (as a control group). Effect was not observed in the treatment of acute and subacute brucellosis, but positive immunologic and clinical dynamics was observed in patients with chronic forms of brucellosis.

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Текст научной работы на тему «Immunological effectiveness of “immun-5” in various forms brucellosis»

At the same time the part of the veterinary and administrative services area has been a significant economic impact in the livestock sector. For example, as a result of events in the 20-25 % increased safety of young animals increased their weight gain and fatness, and wool clip in the public sector (where, there were activities) increased by 50 % (from 0.8 to 1.2 kg. per head).

Based on the preliminary results it can make number of conclusions:

1. Preparation "Imnamak" has immunostimulatory effects and gives a pronounced protective effect in experimental animals (P < 0.05).

2. The proposed method is simple in execution in practice, and well suited to the conditions of the Republic of Uzbekistan.

3. The effectiveness of this method is very high; it can be used in the most disadvantaged regions of the country.

4. The recommended method of epidemiological and environmentally safe, it can be used without any restrictions.

5. Implementation of this method further entails obtaining a positive economic impact for the owners of farm animals.

6. It is appropriate to recognize the application of this method in the form of a comprehensive "Program" in all brucellosis outbreaks with a maximum coverage of events of all livestock small ruminants. It is hoped that this approach will allow for a few (2-3) years, to reduce the incidence of brucellosis in the country to the individual sporadic cases.

References:

1. Ahmedova M. D., Mamatkulov I. H. Immunostimulation infections with the phenomenon of incomplete phagocytosis//Seminar on bruccelosis in humans and animals. - Almaty, 2004.

2. Amanfu William, Al-Idrisi Ahmed. Observation of brucellosis and its control: role of FAO//Seminar on brucellosis in human and animals. - Almaty, 2004.

3. Imomaliyev U. N., Ignatov P. Y., Mamatkulov I. H., Federov A. I., Kasimov O. Sh., Bektemirov A. M. Improving control activities of brucellosis in the Republic of Uzbekistan. Post I and II. Topical issues of infectious diseases, secondary immunodeficiencies and their correction. - Tashkent, 2001. - P. 140-151.

4. Interdisciplinary program of Republic Uzbekistan to combat human and animal brucellosis. - Tashkent, 2003. - 15 p.

5. Mirzayeva M. A., Atahodjayeva D. R. Epidemiological features ofbrucellosis in Republic of Uzbekistan//Infection, immunity and immunology. - Tashkent, 2014. - No. 3. - P. 285-290.

6. Mustanov A. N., Ganiyev M. M. Clinic and laboratory diagnosis of brucellosis in a professional and non-professional groups of population/Bulletin of association of doctors of Uzbekistan. - 2000. - No. 1. - P. 62-64.

7. Otamuradova N. H., Kasimov I. A., Shomansurova Sh. Sh. Current epidemiological features of brucellosis in Uzbekistan//Actual. probl. of diagnosis, treatment and prevention of infectious and parasitic diseases: V International Scientific and Practical Conference. -Tashkent, 2009. - P. 75.

8. Ruzumuradov M. A., Nematov A. S. Brucellosis as nature-foci infection in Uzbekistan//Actual problems of infectious diseases: Materials of international Eurasian Congress on Infectious Diseases. - Vitebsk, 2008. - V. 1. - P. 64.

Mamatkulov Ibrokhim Homidovish, Research Institute of Epidemiology, Microbiology and Infectious Diseases, doctor of medical sciences, professor

E-mail: bibinor@list.ru

Ahmedova Mubarahon Dgalilovna, Tashkent Medical Academy, doctor of medical sciences, professor

Kosimov Odiljon Shodiyevish, Research Institute of Epidemiology, Microbiology and Infectious Diseases, candidate of Medical Science

E-mail: Saodat.us@mail.ru

Immunological effectiveness of "Immun-5" in various forms brucellosis

Abstract: Cellular immunity was studied in patients with acute, subacute, primary and secondary chronic forms of brucellosis was studied before and after therapy including domestic preparation "Immune-5" and in healthy persons (as a control group). Effect was not observed in the treatment of acute and subacute brucellosis, but positive immunologic and clinical dynamics was observed in patients with chronic forms of brucellosis.

Keywords: brucellosis, immun-5, T and B lymphocytes, treatment, prevention.

Object of the study to assess the effectiveness of domestic im- hepatitis of various etiologies, gynecological diseases and chronic mune stimulator in various forms of brucellosis. A natural prod- diseases of the urogenital tract. Prophylactic courses of immuno-5 uct "immun-5" was chosen (production of research and practice are recommended twice a year in spring and autumn. In brucel-firm «Bibinor». The drug is a balanced mixture of natural active losis the preparation is applierd for the first time [1], we suppose biological substances, activating immune system. A capsule daily that the pathogenic features of brucellosis are corresponded above-for 30 days ius recommended for patients with gastritis, colitis, mentioned parameters of the properties "immun-5".

Immunological effectiveness of "Immun-5" in various forms brucellosis

Materials and methods. 86 patients at the age of19 to 52 years were examined. They were divided into 4 groups: the 1st included 19 patients with acute brucellosis; the 2nd group — 21 patients with subacute brucellosis; the 3rd group — 23 patients with secondary chronic brucellosis; the 4th group — 23 patients with primary chronic brucellosis (n = 23). The control group consisted of 23 clinically healthy subjects (donors) at the age from 20 to 58 years old.

Lymphocytes ofperipheral blood were studied by the method of indirect rosettes formation by F. Y. Garib et al. method [3; 4]. Erythrocytes, loaded with monoclonal antibodies to the surface antigens (markers of lymphocytes according to the system CD (Claster Differentiation) were used as diagnosticum. We used conjugates

of Research Institute of Immunology of the Ministry of Public Health of Russia production (Moscow, "Sorbent"): CD3, CD4, CD8 and CD20 (total pool of T-lymphocytes, T-helpers/inducers, T-cytotoxic cells and B-lymphocytes, respectively). Immunoregula-tory index (IRI) (the ratio of CD4/CD8) was calculated. Isolation of lymphocytes from peripheral blood was performed by cells sedimentation by A. Boyum method [2; 5; 6; 7].

Statistical analysis of the results was carried out on the computer IBM PC using the program EXCEL.

Results and discussion. The results obtained in study of cellular immunity parameters in groups ofpatients with acute and subacute brucellosis are presented in Table 1.

Table 1. - Parameters of cellular immunity factors in healthy persons and patients with brucellosis (before treatment)

Patameters Groups under examination

Healthy (n = 23) Acute brucellosis (n = 19) Subacute brucellosis (n = 21)

Leukocytes 7.3 ± 0.6 10.3 ± 1.8* 8.63 ± 2.44

Lymphocytes 29.9 ± 1.5 12.8 ± 1.2* 17.7 ± 7.42

CD 3+ 59.3 ± 2.8 49.95 ± 0.64* 45.24 ± 0.59**

CD 4+ 38.0 ± 2.6 22.37 ± 0.40* 19.62 ± 0.43**

CD 8+ 26.14 ± 0.35 17.58 ± 0.33* 15.62 ± 0.27

Immune regulatory index 1.46 ± 0.03 1.21 ± 0.02 1.22 ± 0.02

CD 20+ 20.26 ± 2.10 15.53 ± 0.14* 15.62 ± 0.11**

Note: * — significant difference between patients with acute brucellosis and healthy individuals; ** — significant difference between patients with subacute brucellosis and healthy individuals.

The table shows, that a number of statistically significant changes were found in patients with acute brucellosis compared with the group clinically healthy individuals (against the background of modersate leukocytosis): decrease in the relative content of total T lymphocytes (CD3 +) B-lymphocytes (CD20 +), T cytotoxic (CD8 +) and helper T (CD 4+) subpopulations of T lymphocytes (about 1.2 times). In the analysis of the results obtained in the group of patients with subacute brucellosis, compared with the group clinically healthy persons, against statistically significant lymphopenia increase of immunoregulatory index was

observed: IRI 2.64 in the group of patients compared with 1.9 IRI healthy persons, indicating the imbalance in the composition of im-munoregulatory subpopulation of T cells.

Parameters of cellular immunity factors in donors and patients with acute brucellosis after complex therapy are presented in Table 2.

As Table2 shows, the specific improvement after the treatment wuth immune-5 in the acute phase of the disease was not observed. A similar phenomenon we observed in patients with subacute brucellosis (Table 3). Apparently, this is due to pathogenic features of the brucellosis course in acute and subacute forms.

Table 2. - Parameters of cellular immunity in patients with acute brucellosis (after treatment with immune-5)

Indicators Groups under examination

Healthy (n = 23) Patients with acute brucellosis

Before treatment After treatment

Leukocytes 7.3 ± 0.6 10.3 ± 1.8* 9.1 ± 2.6

Lymphocytes 29.9 ± 1.5 12.8 ± 1.2* 16.4 ± 1.2**

CD 3 + 59.3 ± 2.8 49.95 ± 0.64* 46.47 ± 0.41***

CD 4 + 38.0 ± 2.6 22.37 ± 0.40 20.21 ± 0.16

CD 8 + 26.14 ± 0.35 17.58 ± 0.33* 16.32 ± 0.25

IRI 1.46 ± 0.03 1.21 ± 0.02 1.20 ± 0.02

CD 20 + 20.26 ± 2.10 15.53 ± 0.14* 15.89 ± 0.07*

Table 3. - Parameters of cellular immunity in health persons and patients with subacute brucellosis (after complex treatment with immun -5)

Indicators Examined group

Healthy (n = 23) Before treatment After treatment

1 2 3 4

Leukocytes 7.3 ± 0.6 8.63 ± 2.44* 8.46 ± 2.26

Lymphocytes 29.9 ± 1.5 17.7 ± 7.42* 16.8 ± 7.24**

CD 3+ 59.3 ± 2.8 45.24 ± 0.59* 45.48 ± 0.60***

CD 4 + 38.8 ± 2.6 19.62 ± 0.43 19.62 ± 0.40

Note: * — significant difference between patients with acute brucellosis before treatment and healthy individual; ** — significant difference in patients after treatment to healthy in dividuals; *** — significant difference in patients before and after treatment.

1 2 3 4

CD 8 + 26.14 ± 0.35 15.62 ± 0.27* 15.86 ± 0.32

IRI 1.46 ± 0.03 1.22 ± 0.02 1.21 ± 0.02

CD 20 + 20.26 ± 2.10 15.62 ± 0.11* 15.95 ± 0.08*

Note: * — isignificant differences between parameters before treatment and in health individuals; ** — isignificant differences between parameters before treatment and in health individuals; *** — significantdifference in parameters before and after treatment in patients.

of T helper (CD4 +) lymphocytes, a sharp decline of the number

In the analysis of lymphocyte phenotype in patients with secondary-chronic brucellosis (table 4) revealed significant changes in the content ofwhite blood cells, lymphocytes (total CD3+, CD72+). However, the dynamics of such parameters as in helpers/inducers (CD4 +) and suppressors (CD8 +) are not significantly differed from control values.

Table 4 also shows the comparative results of the data of the group with primary chronic brucellosis and a group of donors. A number of statistically significant changes was found: an increase of the relative content of total CD3+ cells and relative values

of B-cells (CD20 +). Statistically significant changes in content of T-suppressor cells immunity have not been identified.

In secondary chronic brucellosis after complex pathogenetic therapy with "immun-5" addition, we noted positive shifts in leukocytosis and lymphopenia to normalization; restoration to normal levels of values of CD3 +, CD4 +, CD8 +, CD20 +, lymphocytes in comparison with patameters before treatment. Similar results we observed in patients with primary chronic form of the disease (Table. 5, 6).

Table 4. - Parameters of cellular immunity factors in healthy and patients with chronic brucellosis (before treatment)

Parameters Groups under examination

Healthy (n = 23) Primary chronic (n = 23) Secondary chronic (n = 23)

Leukocytes 7.3 ± 0.6 7.17 ± 1.02 9.94 ± 0.98** '***

Lymphocytes 29.9 ± 1.5 26.9 ± 4.0 13.0 ± 1.4** '***

CD 3 + 59.3 ± 2.8 48.04 ± 0.55* 46.13 ± 0.78** '***

CD 4 + 38.0 ± 2.6 21.22 ± 0.38* 19.83 ± 0.41** '***

CD 8 + 26.14 ± 0.35 17.48 ± 0.47 16.48 ± 0.37

IRI 1.46 ± 0.03 1.22 ± 0.02 1.21 ± 0.01

CD 20+ 20.26 ± 2.10 15.52 ± 0.46* 15.65 ± 0.10** '***

Note: * — significant of differences in parameters of patients with primary chronic form and healthy persons; ** — significant of differences in parameters of patients with secondary chronic form to healthy persons; *** — significant difference in parameters of patients with secondary and primary chronic forms.

Table 5. - Parameters of cellular immunity factors in health and disease is primary chronic brucellosis (after complex treatment with immun-5)

Parameters Groups under examination

Healthy (n = 23) Before treatment After treatment

Leukocytes 7.3 ± 0.6 7.17 ± 1.02* 8.16 ± 1.24

Lymphocytes 29.9 ± 1.5 26.9 ± 4.0* 28.4 ± 4.8**

CD 3+ 59.3 ± 2.8 48.04 ± 0.55* 51.09 ± 0.48***

CD 4+ 38.0 ± 2.6 21.22 ± 0.38 23.39 ± 0.30

CD 8+ 26.14 ± 0.35 17.48 ± 0.47* 18.22 ± 0.39

IRI 1.46 ± 0.03 1.22 ± 0.02 1.29 ± 0.03

CD 20+ 20.26 ± 2.10 15.52 ± 0.46* 17.17 ± 0.40*

Note:* — significant differences of parameters in patients before treatment and healthy persons; ** — significant differences of parameters in patients after treatment to healthy persons; *** — significant differences of parameters in patients before and after treatment.

Table 6. - Parameters of cellular immunity in healthy individuals and secondary chronic brucellosis (after complex treatment with immun -5)

Parameters Groups under examination

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Healthy individuals Before treatment After treatment

Leukocytes 7.3 ± 0.6 9.94 ± 0.98* 8.42 ± 0.8

Lymphocytes 29.9 ± 1.5 13.8 ± 1.4* 26.6 ± 1.6**

CD 3+ 59.6 ± 2.8 46.13 ± 0.78* 49.65 ± 0.46***

CD 4 + 38.0 ± 2.6 19.83 ± 0.41 1.52 ± 0.43

CD 8+ 26.14 ± 0.35 16.48 ± 0.35* 16.48 ± 0.37

IRI 1.46 ± 0.03 1.21 ± 0.01 1.31 ± 0.02

CD 20+ 20.26 ± 2.10 15.65 ± 0.10* 15.65 ± 0.10*

Note:* — significant differences between parameters before treatment and healthy individuals; ** — significant differences between parameters after treatment and healthy individuals; *** — significant differences between parameters before and after treatment.

Evaluating the effectiveness of fructose-1,6-diphosphate in treating of ocular ischemic syndrome

Thus, use of biological active food additives (activators of the immune system) in acute and subacute forms of brucellosis was ineffective, on the other hand, it resulted in positive dynamics of immunological parameters in patients with chronic (primary and secondary chronic) forms of the disease.

Subpopulations of lymphocytes in patients with various forms of brucellosis disease in an endemic region before and after the standard treatment, in combination with immun-5 were studied. It was found that before treatment significant differences in cellular immunity parameters were obtained. In the acute form a significant reduction of T and B lymphocytes was observed. Most prolonged changes concerned CD3 +, CD4 +, CD8 +, CD20 +, lymphocytes. We can assume that deep depression of T-cell immunity contributes to development of complications, mainly due to a helper T cells.

The fact that the state of the B-cell immunity is not significantly differed in patients with primary subacute and chronic forms of brucellosis, confirms the viewpoint that the greatest susceptibility of B cells to the action of Brucella toxins compared to other immune cells. This study points to the highest sensitivity of B cells to damaging factors, taking place at the brucellosis infection. However, it is not excluded that the reduction of B cells is mediated by the combined effects of toxins Brucella on the immune system in total.

Conclusions:

1. The use of immune stimulator immun-5 in the complex treatment of acute and subacute brucellosis is inappropriate.

2. Positive immunological effect is observed in immun-5 inclusion in a complex therapy of chronic forms of the disease.

References:

1. Akhmedova M. D., Akhadova G. Effect of immune-5 on the dynamics of cellular immunity in chronic brucellosis in women of reproductive age//Infection, Immunity and Pharmacology. - 2005. - No 1. - P. 31-34.

2. Boyum//Soand. J. Clin. Lab.Invest. - 1968. - Vol. 21, suppl. 97. - P. 77-89.

3. Garib F. Y., Zalyalieva M. V. Methods of studying human lymphocyte subpopulations in pathology: Method. recommendations. -Tashkent, 1989. - 25 p.

4. Garib F. Y., Gurarii N. I., Gharib V. F. et al. Method of lymphocyte subpopulations determining//Rasmiy Ahborotnoma. - Tashkent, 1995. - № 1. - P. 90.

5. Maletskaya O. V. Influence of immunomodulatory drugs on the effectiveness etiotropic treatment in experimental chronic brucel-losis//Immunologiya. - 2003. - t. 24. - P. 182-184.

6. Zhukova L. I. Immunity and immunocorrecting therapy in treatment of brucellosis: Avroreferat. dis. ... - Alma-Ata, 1990. - P. 14.

7. Zhukova L. I., Kolos E. N. Dynamics of some immunological parameters in brucellosis against the background of the therapy//Health of Kazahstan. - 1989. - № 8. - P. 34-36.

Makhkamova Dilbar, Tashkent Institute of Postgraduate Medical Education, Department of Ophthalmology, Uzbekistan, Tashkent E-mail: dilbarmk@gmail.com

Evaluating the effectiveness of fructose-1,6-diphosphate in treating of ocular ischemic syndrome

Abstract: The purpose of this study was to evaluate the efficacy and safety of FDP in patients with ocular ischemic syndrome.

Material and methods. The material for this study is based on results of a comprehensive examination and treatment of 53 patients with a diagnosis OIS. The average age of the patients was 57.8 ± 6.82 year. 19 of them women, 34 men. 27 patients entered to the main group (1) which received standard therapy in combination with intravenous FDP (fructose-1,6-bisphosphate). 26 patients in the control group (2) received standard treatment.

Results. In applying the FDP combined with comprehensive therapy in the main group resulted in increased of visual acuity by 32.8 %, parameters of retinal sensitivity by 17.8 %, reducing the area of scotomas compared with patients of the control group. Optical coherence tomography registered significant changes in the dynamics in patients of the main group — reducing the edema and restoration of RNFL and ONH. Recovery of visual function may have contributed neuroprotective activity of the drug FDP by a protective effect on nerve tissue, reducing the effects of hypoxic stress.

Conclusions. The use of standard therapy in combination with FDP in the treatment of ocular ischemic syndrome has a positive effect on the course of the disease, thereby, increase of visual acuity, a decrease in sectoral loss in vision fields, the positive dynamics OCT parameters, improving hemodynamic parameters at Doppler imaging in dynamics.

Keywords: ocular ischemic syndrome, the treatment of ischemic diseases of the eye, FDP, metabolic therapy of ocular isch-emic syndrome.

Introduction

Ocular ischemic syndrome is a rare condition, which is caused by ocular hypoperfusion due to stenosis or occlusion of the common or internal carotid arteries. Atherosclerosis is the major cause of changes in the carotid arteries Kearns & Hollenhorst [4]. OIS occurs

mostly in patients with poor collateral circulation between the internal and external carotid arteries or between the two internal carotid arteries Mendrinos, Machinie & Pournaras [6], Mizener, Podha-jsky & Hayreh [7]. Since OIS is associated with atherosclerosis, patients usually have other related co-morbidities. Hypertension is

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