Evaluation of safety and pharmacotherapeutic efficacy of cycloferon in treatment of Astrakhan rickettsial fever

Clinicopathogenetic impact of cycloferon, an endogenous interferon inductor, on the process of Astrakhan rikettsial fever, its complications and outcomes was analysed. The treatment scheme with addition of cycloferon to the complex therapy was optimized. The specificity of the disease clinical process and the level of the interferon status in the patients treated with cycloferon alone or with combination of the standard therapy and cycloferon was shown. It was observed that in the patients with moderate severity of the disease the combined use of the standard therapy and cycloferon was in favour of arresting the disease clinical signs (fever, headache, weakness, eruption, hepatomegaly, arthralgia and myalgia, lymphatic gland inflammation, primary affect) and lowered the hospitalization term vs. the standard therapy alone. In the patients with moderate severity of the disease the levels of the serous interferon-alpha before the treatment were found lower, while those of interferon-gamma were higher. The use of cycloferon in the treatment scheme resulted in increase of the interferon-alpha levels and decrease of the higher levels of interferon-gamma. The standard therapy in combination with cycloferon in the patients with moderate severity of the disease provided changes in the immune status: increase of the relative content of T- and B-lymphocytes and normalization of their absolute number. Normalization of the phagocytic activity and the coefficient of the active phagocytes, as well as increase of the phagocytic index, the levels of immunoglobulins G, A and M and the number of the circulating immune cells were stated. The standard therapy with addition of cycloferon resulted in normalization of the levels not only of succinic denydrogenase, lactate dehydrogenase and glucose-6-dehydrogenase but also of alpha-naphthylacetate esterase and alpha-naphthylbutirate esterase in the neutrophils, as well as of the whole spectrum of the monocyte enzymes, except NAD-diaphorase. The adverse reactions were observed in 2.5% of the cases (9 subjects). All of them were mild and did not require discontinuation of the drugs use.     

Improvement of herpetic stomatitis therapy in patients with chronic tonsillitis

To determine the clinicopathogenetic efficacy of cycloferon liniment in combined therapy of herpetic stomatitis, 60 patients with herpetic stomatitis and chronic tonsillitis were examined and treated. It was shown that the use of cycloferon liniment in the combined therapy of herpetic stomatitis in the patients with chronic tonsillitis allowed to lower the infection load in the parodontal recesses and the local inflammation, to normalize the immunity indices and to reduce the level of the endogenous intoxication, that provided acceleration of the recuperation processes and decreased the frequency of stomatitis backsets.     

Rational pharmacotherapy and correction of immunity disorders in children with chronic hepatitis (clinical review)

The data on the efficacy of antivirals and their impact on the virologic and immunologic indices in HCV- and HBV-infected children are presented. The best therapeutic effect in the management of children with chronic virus hepatitis was provided by combined antiviral therapy of different action. In the treatment of babies the drugs of choice could be viferon or cycloferon, for the 2-year older children with chronic hepatitis B the combination of viferon + cycloferon should be recommended and for those with chronic hepatitis C the combination of interal + cycloferon could be used. The cycloferon combination with interferons-a makes it possible to generate the Th1 cellular immune response, to minimize the side effects of interferons and chemotherapeutics and to improve their tolerability. The complex therapy of patients with chronic hepatitis B and lambliasis, using cycloferon and macmiror, provided stable effect, less frequent relapses oflambliasis and minimum side effects of the specific therapy. The repeated isolation of lamblia within a 1-year observation period was recorded only in 16.6% of the children treated with cycloferon vs. the control (40.0%).     

Cycloferon efficacy of therapy of chronic hepatitis B (results of randomized multicentre study)

The best therapeutic effect in the treatment of patients with chronic hepatitis B was observed with the use of cycloferon in the scheme of the antiviral therapy. The combination of cycloferon with lamivudine provided complete stable remission in 54.1% of the patients, whereas the use of a-interferon in combination with cycloferon provided remission in 44.1% of the lamivudine-resistant patients. The use of cycloferon in the therapy of chronic hepatitis B made it possible to lower the frequency and manifestation level of the side effects and prevented the lamivudine resistance development and generation of the virus mutants.     

Apoptosis of the hypothalamus neurosecretory cells in stress and ageing: the role of immune modulators

There is assumption about active role of immune modulators in cell death process. The involvement of interferon-alpha and cycloferon in apoptosis regulation of hypothalamic neurons of mice during stress and aging was studied. We determined the expression of apoptosis markers (Bcl-2, Mcl-1, Bax) in comparison with apoptosis level. We have found that immune modulators suppress activity of nonapeptidergic neurons. Thus, interferon-alpha treatment reduces synthesis of Bcl-2; cycloferon treatment inhibits expression of Bax and Bcl-2. So the role of immune modulators in neuron apoptosis depends on the stage of ontogenesis and type of immune modulator. Cycloferon is able to reduce the level of age-dependent apoptosis of neurons in aging, but under stress condition both interferon-alpha and cycloferon act as protectors of cell death.     

Therapeutic efficacy of various formulations of cycloferon in the treatment of infectious mononucleosis in children

One hundred twenty six children at the age of 4 to 7 years with infectious mononucleosis were observed. The subjects under the complex therapy were treated with cycloferon suppositoria (1st group), intramuscular cycloferon (2nd group) or placebo (3rd group). The results demonstrated similar therapeutic efficacy of the parenteral cycloferon and rectal suppositoria (a novel cycloferon formulation).     

Cycloferon efficacy in viral and bacterial diseases of children (clinical review)

The authors' findings and literature data on the pharmacotherapeut efficacy of cycloferon, an interferon inductor (immunomodulators) are described. The drug effect in the treatment of various socially significant children' diseases, including acute respiratory tract viral infection, bronchial asthma, allergic conditions with infection protection disturbances, mycoplasmic infection, bronchopulmonary complications of acute respiratory tract viral infection with low intensity of free radical oxidation is indicated. The use of cycloferon at the background of vaccination was shown to provide inhibition of the autoimmune processes causing postvaccinal complications in frequently ill children. The results of the use of cycloferon in the treatment of gastrointestinal tract and intestinal infections of both the viral and bacterial genesis are discussed. Cycferon is recommended to be used for correction of the intestine dysbiosis (the microflora level came to normal in 95% of the children). The use of the drug in surgical pathology and in particular in appendicular peritonitis for decreasing the postoperative complications and correction of the immune disturbances due to chronic viral hepatitis C and B in children under the complex therapy is described. The cycloferon safety and efficacy were confirmed by the postmarketing randomized trials.     

Clinical efficacy of cycloferon in complex therapy of infectious mononucleosis in pediatrics

The results of the cycloferon use in therapy of 80 children at the age of 1 to 15 years with infectious mononucleosis are presented. The children were divided by chance sampling into two comparable groups of 40 subjects each. In the first group the children in addition to the standard therapy were treated with cycloferon for 10 days, intramuscularly or orally depending on the age. The reference group included the patients under the standard therapy alone. The efficacy of the drug was evaluated by reduction and more rapid disappearance of the main clinical symptoms of the disease. The improvement of certain laboratory indices, including those of the liver protein synthesis function were recorded, that allowed to reduce the hospitalization term. No side effects of the cycloferon use were observed.     

Cytokinin inducing and antiviral activity of cycloferon on experimental herpetic infection

Experimental data on the protective activity and the capacity for inducing the biosynthesis of some cytokins, the low molecular inductors of cycloferon, endogenic interferon of the acridanon group, in herpetic infection are presented. The herpes infection was modelled by intraperitoneal injection of herpes simplex virus, type 1 into BALB/c mice. In the animals with normal immune status cycloferon induced the formation of serum interferon (INF) in high titers (up to 1:20,000) with the peak achieved 4-8 hours after the injection of the preparation. In addition, cycloferon stimulated the synthesis of IL-2 and gamma INF, but decreased the concentration of IL-1b. Following immunosuppression caused by gamma-radiation or cyclophosphamide the titers of serum interferon decreased 4-8 times. In generalized herpes infection in non-inbred white mice with undamaged immune status cycloferon increased survival rate by 30-100% in comparison with the controls (untreated mice), while in case of immunosuppression the protective effect of this preparation was considerably lower. In infected mice the concentrations of gamma INF, IL-2, IL-1b were found to be elevated in comparison with their concentrations in healthy animals. In the course of the infectious process cycloferon suppressed the production of IL-2 and IL-1b, but did not influence the synthesis of gamma INF.     

Combined therapy of patients with recurring anogenital herpes infection

Up-to-date conceptions of etiology and epidemiology of anogenital herpetic infection are described. The main mechanisms of immunological shifts in subjects with anogenital Herpes infection are discussed. The efficacy and safety of cycloferon in the combined treatment of patients with recurring anogenital herptic infection were estimated. The clinical efficacy of the combined therapy (acyclovir in a dose of 200 mg 5 times a day for 5 days + cycloferon liniment applied topically on the eruptions twice a day for 5 days) was 85% or 25% higher vs. the control.     

Kidney cell death in inflammation: The role of oxidative stress and mitochondria

Pyelonephritis is an infectious disease, and common treatment strategy is based on antibiotic therapy directed at the elimination of a pathogen. However, urinary tract infections are accompanied by inflammation and oxidative stress, which are major damaging factors, and therefore can serve as a target for therapeutic intervention. The goal of this study was to clarify the role of the mitochondrial reactive oxygen species (ROS) in kidney cell damage under experimental pyelonephritis. We investigated the mechanisms of inflammation and the role of mitochondria and oxidative stress in inflammation in kidney tissue using in vivo and in vitro models of pyelonephritis. We observed the development of oxidative stress in renal tubular epithelium in vitro, and resulting apoptotic cell death. This oxidative damage was caused by the leukocytes producing ROS after interaction with bacterial antigens. The essential role of mitochondria-mediated oxidative stress was confirmed using an experimental model of pyelonephritis in vivo. We revealed increased levels of malonic dialdehyde in kidneys of rats with experimental pyelonephritis that pointed to lipid peroxidation. Besides, high ROS levels were observed in blood leukocytes from rats with pyelonephritis. The mitochondria-targeted antioxidant SkQ1 significantly reduced the signs of kidney inflammatory injury, in particular the infiltration of neutrophils. Summarizing the data obtained, we assume the importance of mitochondrial ROS in different phases of acute pyelonephritis onset. Protection of kidney cells from infection-mediated damage can be attained by the induction of tolerance mechanisms and by antioxidant treatment.     

Interferon inductors in treatment of associative forms of tick-borne infection in children

Thirty three children with associative forms of thick-borne infection (thick-borne encephalitis with ixodic borreliosis) were clinically observed. The disease was characterized by subfebrile temperature, moderate intoxication, rare erythema (39.5%) and frequent cardiovascular disorders with development of Lyme carditis (32.6 +/- 7.2%) and further rise of hepatomegalia in the diseases dynamics and development of meningeal symptoms. There were observed changes in the cytokine spectrum, characterized by INF-gamma high levels, and hypersecretion of the whole spectrum cytokines in the dynamics, that provided the Th2 type immune response. High clinicoimmunological efficacy of the complex therapy with cycloferon as an immunomodulator providing more balanced production of pro- and anti-inflammatory cytokines (IL-1alpha, INF-gamma and IL-10) was shown.     

Mild hypobaric hypoxia influences splenic proliferation during the later phase of stress erythropoiesis

Tissue trauma and hemorrhagic shock are common battlefield injuries that can induce hypoxia, inflammation, and/or anemia. Inflammation and hypoxia can initiate adaptive mechanisms, such as stress erythropoiesis in the spleen, to produce red blood cells and restore the oxygen supply. In a military context, mild hypobaric hypoxia—part of the environmental milieu during aeromedical evacuation or en route care—may influence adaptive mechanisms, such as stress erythropoiesis, and host defense. In the present study, healthy (control), muscle trauma, and polytrauma (muscle trauma and hemorrhagic shock) mice were exposed to normobaric normoxia or hypobaric hypoxia for ∼17.5 h to test the hypothesis that hypobaric hypoxia exposure influences splenic erythropoiesis and splenic inflammation after polytrauma. This hypothesis was partially supported. The polytrauma + hypobaric hypoxia group exhibited more splenic neutrophils, fewer total spleen cells, and fewer splenic proliferating cells than the polytrauma+normobaric normoxia group; however, no splenic erythroid cell differences were detected between the two polytrauma groups. We also compared splenic erythropoiesis and myeloid cell numbers among control, muscle trauma, and polytrauma groups. More reticulocytes at 1.7 days (40 h) post-trauma (dpt) and neutrophils at 4 dpt were produced in the muscle trauma mice than corresponding control mice. In contrast to muscle trauma, polytrauma led to a reduced red blood cell count and elevated serum erythropoietin levels at 1.7 dpt. There were more erythroid subsets and apoptotic reticulocytes in the polytrauma mice than muscle trauma mice at 4 and 8 dpt. At 14 dpt, the red blood cell count of the polytrauma + normobaric normoxia mice was 12% lower than that of the control + normobaric normoxia mice; however, no difference was observed between polytrauma + hypobaric hypoxia and control + hypobaric hypoxia mice. Our findings suggest muscle trauma alone induces stress erythropoiesis; in a polytrauma model, hypobaric hypoxia exposure may result in the dysregulation of splenic cells, requiring a treatment plan to ensure adequate immune functioning.     

Clinicoimmunological monitoring of therapy in patients with associated forms of yersiniosis

Characteristics of the clinical process and immunological profile in children with yersiniosis as a monoinfection or in association with acute intenstinal infections and virus hepatitis A are presented. The efficacy of the immunotropic therapy with cycloferon, an interferon inductor, and recombinant interferon in the patients with the viral and bacterial association of the disease (yersiniosis + hepatitis A) and initial disbalance of the serum cytokines was estimated. Dependence of the interferon clinicolaboratory efficacy on the initial levels of serum y-interferon, IL2 and IIA, promoting shorter terms of hyperthermia, diarrhea syndrome and cytolysis syndrome was shown. It allowed to optimize the scheme of the pathogenetic therapy of Yersinia mixed infection.     

The use of cycloferon in the therapy of experimental herpetic keratitis]

The cycloferon efficacy was investigated in the treatment of experimental herpesvirus kerato-conjunctivitis in rabbits. The model was demonstrated to reflect the main aspects of herpesvirus eye lesions in humans. Cycloferon application similarly to that of known interferon inducer poludan has been shown to enhance processes of inflammation and subsequent regeneration of eye tissues as well as to decrease mortality of animals due to the generalization of infection.     

Current radiation diagnosis of pyelonephritis

The paper deals with the current diagnosis of nonspecific and specific (tuberculosis) acute and chronic pyelonephritis. Having rather ample materials (308 patients with different forms of acute and chronic pyelonephritis), the authors compared different introscopic techniques (plain X-ray study, excretory urography, retrograde pyelography, ultrasonography, computed tomography and angiography) used in the diagnosis and monitoring of patients with pyelonephritis. Based on their own findings and on the data available in the literature, the authors described the symptomatology of pyelonephritis in detail by using a great variety of diagnostic techniques. The paper shows the place and potentialities of conventional X-ray in a variety of current diagnostic studies and the potentialities of imaging techniques in recognizing pyelonephritis, assessing their extent and the reserve potentialities of the diseased kidney. The authors show that the rational use of routine and current radiographic techniques is of great diagnostic and prognostic value, enhances the efficiency of therapy for pyelonephritis, shortens treatment periods, reduces the number of radical nephrectomies by using organ-sparing operations more widely, and decreases mortality rates.     

Activation of the Immune System in Acute Inflammatory Disease

Any inflammation, infectious or noninfectious, is characterized by consecutive changes in the parameters of the total blood counts, including subpopulations of lymphocytes. The magnitude of these changes is determined by the intensity and extent of the inflammation. In patients with active inflammation (without a history of immune insufficiency) an active antibacterial therapy by surgical treatment of abscesses and by antibiotics or sulfanilamides results in a normal development and termination of the inflammation. Under intoxication of the body, the inflammation course is decelerated; and detoxification activates the immune system, normalizes the inflammation course, and promotes its termination. In these cases the use of nonspecific immunity modifiers fails to optimize the course of inflammation. On the contrary, the use of nonspecific immunity modifiers in patients with a history of immune insufficiency often activates the inflammation and promotes its effective termination.     

Increase in NK-activity using superlow doses of the immunomodulator cycloferon

A possibility of rising the antitumor activity of natural killers using various doses of the immunomodulator cycloferon was evaluated. A direct correlation has been revealed between the killer activity and the cycloferon dose. However, on a decrease in cycloferon concentrations by several orders, as compared with commonly accepted doses, this correlation changed for inverse. A possible mechanism of this effect is discussed in addition to practical significance of the obtained results.     

Vaccination of children under immunosuppressive therapy with ADS-m anatoxin

The effectiveness and safety of the immunization of children with adsorbed DT toxoid with reduced component with disturbances in the reactivity of the body, caused by immunosuppressive therapy, are evaluated. The group under study included 53 children with glomerulonephritis, malignant tumors and acute lymphoblast leucosis, formerly receiving immunosuppressive drugs. The control group consisted of 24 patients with pyelonephritis who had not received such therapy. In the postvaccinal period no exacerbation of the main disease was registered in children. The manifestation and frequence of postvaccinal reactions did not differ from those observed in healthy children after the injection of adsorbed DT toxoid with reduced antigen content. Control serological testing demonstrated the presence of pronounced immune response in the vaccinees.