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PF = 2.83) that demonstrates protective participation of it allele in pathogenesis of CD.
At an atypical form the frequency of occurrence of alleles of DRB1 * 12, was higher, than at healthy. In the analysis of polymorphism of groups of alleles of a gene of DRB1 at children with a refractory current of CD the frequency of occurrence of an allele of DRB1 * 16 considerably exceeded control indicators. The high risk of development of a refractory course of a disease is established at DQA1 * 0501 and DRB1 * 16 carriers.
Thus, at our patients the positive association CD with genes of HLA DQA1 * 0501, HLA DQB1 * 0201, HLA-DRB1 * 07 and * 13 is established. For the children having an allele of DRB1 * 16 and DQA1 * 0501 the high risk of development of a refractory course of a disease, for carriers of alleles DRB1 * 12 — high risk of development of an atypical form of a disease is established. We regarded existence of HLA DRB1 * 12 as ethnic feature of the Uzbek population and the evidence of her participation in pathogenesis of development of an atypical form of a disease.
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Abdushukurov Abdurashid, Research Institute of Epidemiology, Microbiology and Infectious Diseases, candidate of medical sciences Gulyamov Nariman, doctor of medical sciences, professor Ruzmetov Dilshod, candidate of medical sciences Akhmedova Khalida, doctor of medical sciences E-mail: akhmedova1957@mail.ru
The influence of immonumoduline on the effectiveness of vaccination of typhoid fever
Abstract: In 162 male volunteers aged 18-22 years, studied the efficacy of typhoid vaccines adsorbed liquid chemical production of "Uzbiofarm" Immunomodulin and influence on the process of antibody production.
Vaccinated receiving typhoid vaccine the formation of a protective level of antibodies was observed in 61.6 %, whereas 38.4 % of the vaccine did not contribute to the formation of protective antibody titers and was not effective. In the group vaccinated and received simultaneously Immunomodulin formation of a protective antibody titer was observed in 95.2 % of those with a lack of protective antibody titers — at 4.8 %. Immunomodulin contributed to the intensification of antibody production and a significant increase in the effectiveness of typhoid vaccine.
Low efficiency of typhoid vaccine was due to low levels of neutrophils in the blood additional activation NBT-test. The intensification of the process of antibody production under the influence of Immunomodulin was mediated through its effect on inducing functionally metabolic activity of blood neutrophils in response to a vaccine antigen.
Keywords: typhoid fever, typhoid vaccines, Immunomodulin, NBT-test, functionally metabolic activity ofblood neutrophils.
The influence of immonumoduline on the effectiveness of vaccination of typhoid fever
Typhoid fever is one of the most serious intestinal infections in many developing countries, including in Asia. In endemic areas, the infection most commonly affects school children and youth, as well as widespread asymptomatic intestinal carriers of Salmonella typhi, which are the main source of infection. The most effective strategy to control the incidence of typhoid fever seems vaccination of people at risk [7].
The most objective assessment of immunological effectiveness of the vaccine can be obtained by studying the antibody response after vaccination in humans. Evaluation of immunogenicity of the vaccine preparation is carried out on the basis of determining the ratio of the number of persons classified as post-vaccination in seropositive and seronegative groups (BRIC).
An important indicator for the development of resistance of the organism is a functional state of neutrophilic granulocytes responsible for the process of phagocytosis and intracellular digestion of different antigens [8; 9]. The study of functional and metabolic activity of neutrophils (FMAN) in NBT-test reflects the intensity of phagocytosis process and reveals its biochemical basis [1]. With this test, you can identify the natural enzymatic neutrophil defects and defects after stimulation [3]. The difference between spontaneous and stimulated NBT test shows neutrophil reserve, available for sale on the impact of antigenic response [11].
The new major challenges of modern medical science in the field of immunization are specific study of the nature and mechanisms of realization of the non-specific and specific parts of the immune reaction, the solution of problems to increase the efficiency of typhoid vaccination [5]. The most realistic and cost-effective solution for this problem is to stimulate the immune response after vaccination with the help of modern means of immunomodulation which is the domestic product Immunomodulin.
The purpose of the study. To study the effect on phagocytic Immunomodulin level of antibody activity and processes with typhoid vaccine preventable.
Materials and methods
During the routine vaccination against typhoid by epidemiological indications in 162 male volunteers aged 18-22 years used a typhoid sorbed liquid chemical vaccine production of "Uzbiofarm" (hereinafter TSLCV). The first group included 99 individuals who has taken the typhoid vaccine. The second group consisted of 63 volunteers of the same age have taken the typhoid vaccine and 0.01 % Immunomodulin solution at a dose of 1.5 ml/m.
Table. 1. - Effect of Immunomodulin on the rising of the
On the 4th day after typhoid vaccine inoculation the rate of group-1 the activation of neutrophils in response to a vaccine antigen accounted for 15.4 % (Table. 1). In group-2 taken the vaccine and Immunomodulin the activation of neutrophils rate made up 26.3 %. That is, under the influence of the degree Immunomodulin additional activation of neutrophils in response to typhoid vaccine antigen was 1.7 times higher than in the group without Immunomodulin.
The immunological efficacy was assessed in determining the serum titers of specific antibodies against O-antigen of S. typhi by PHA [10]. In assessing the severity of the immune response we took into account the order of increase titers of specific antibodies in paired sera: before vaccination and 30 days after vaccination. According to the degree of increase in specific antibody titers vaccinated were distributed as follows: 0 degree — no rise in antibody titer (seronegative); 1st degree — rise in antibody titer to 1 order (seronegative); 2nd degree — the growth of antibody titers 2 orders, 3rd degree — an increase in antibody titer to 3 orders of magnitude, 4th degree — increase in antibody titer of 4 order, 5th degree — an increase in antibody titer to 5 orders of magnitude (Table 1).
Dynamics of changes in the functional-metabolic activity of neutrophils (FMAN) blood prior to vaccination and on the 4th day after vaccination was evaluated in a spontaneous and stimulated NBT-test [12]. In setting the stimulated NBT-test, we used an inductor (opsonized zymosan). The results have read on the screen-reader at a wavelength of 620 nm. and have expressed as extinction units. Stimulated NBT-test — shows the maximum potential to be activated; The spontaneous NBT-test — indicates the extent to which the feature Hf at the time of the study; The rate of increase of the activity of Hf ( %) with the antigenic exposure — further implementation of the functional capabilities in response to antigenic exposure due to intracellular reserve.
Processing of statistical results were carried out using the program on the PC Sigmastat®.
Research results
The research results revealed that after vaccination TSLCV of 1 group the average rise in antibody titer reached 2.06 order (Tab. 1). Moreover, people with a lack of protective antibody titers (0 and 1 degree, seronegative) amounted to 38.4 % (Fig. 1). A person with a protective level of antibodies to PHA (2; 3; 4, and 5 degree — seropositive) were 61.6 %. That is, of the vaccination efficacy TSLCV "UZBIOFARM" was 61.6 %, whereas 38.4 % of the vaccine did not contribute to the formation ofprotective antibody titers and was not effective.
In the group vaccinated TSLCV and taken simultaneously Immunomodulin average rise in antibody titer was about 3.21 (Tab. 1). Moreover, person with a lack of protective antibodies (0 and 1 degree, seronegative) of 4.8 %. While persons with protective antibody levels (2, 3, 4, and 5 degree — seropositive) amounted to 95.2 %. Therefore, the use among inoculated persons Immunomodulin facilitated the efficiency of typhoid vaccine by 33.6 % (Fig. 1). titer antibodies in vaccination «TSLCV» of "Uzbiofarm"
Thus, the low efficiency of the immunization typhoid vaccine was due to low levels of additional neutrophil activation in blood. Use in vaccines Immunomodulin contributed to significant intensification of antibody production and a significant increase in the effectiveness ofvaccination typhoid. The intensification of the process of antibody production under the influence of Immunomodulin mediated through its effect on inducing functionally metabolic activity of blood neutrophils.
НСТ-test indications
Average rise of antibody titers Before vaccination After vaccination
Stimulation with Zimozan (optical density) Spontaneous (optical density) Difference between Spontan. and Stimul. ( %) Spontaneous (optical density) Difference between Spontan. and Stimul. ( %) Rate of the rise HF activation ( %)
"TSLCV" 2.06 0.584 ± 0.005 0.213 ± 0.003 36.5 0.303 ± 0.003 51.9 15.4
"TSLCV" + Immunomodulin 3.21 0.620 ± 0.005 0.200 ± 0.002 32.3 0.363 ± 0.005 58.5 26.3
Fig. 1. The rate of increase of specific antibodies in vivo vaccination typhoid chemical sorbed liquid vaccine «TSLCV» produced by "UZBIOFARM" and Immunomodulin introduction simultaneously
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