Immunostimulating agents. Review and application

35.2. Immunostimulating agents (immunityimulators)

The means that stimulate immunity processes (immunostimulators) are used in immunodeficiency states, chronic sluggish current infections, as well as in some cancer diseases.

3 5.2.1. Endogenous origin polypeptides and their analogues

Timalin, Tabuti, Melopid, Imunofane

Timalin and the storage faction is a complex of polypeptide fractions from thymus (forks of the gland) of cattle. Are the first generation preparations from this group. Preparations restore the number and function of T-lymphocytes, normalize the ratio of T-and B-lymphocytes, their subpopulations and the reaction of cellular immunity, increase the activity of natural killers, amplify phagocytosis and lymphokinov products.

Indications for the use of drugs: Complex therapy of diseases accompanied by a decrease in cellular immunity - acute and chronic purulent and inflammatory processes, burn disease, trophic ulcers, inhibition of blood formation and immunity after radiation and chemotherapy. When using drugs, allergic reactions may occur.

Myelopid is obtained from the culture of mammalian bone marrow cells (calves, pigs). It consists of 6 myelopeptides (MP), each of which has certain biological functions. So, MP-1 enhances the Ak-Tienity of T-Helpers, MP-3 stimulates phagocytic immunity link. The mechanism of action of the drug is associated with stimulation of proliferation and functional activity of V- and T-cells. Produced in the form of a sterile powder for 3 mg in vials. Myelopid is used in complex therapy of secondary immunodeficiency states with preferably lesions of humoral immunity, for the prevention of infectious complications after surgical interventions, injuries transferred to osteomyelitis, in non-specific pulmonary diseases, chronic pyroders. Side effects of the drug - dizziness, weakness, nausea, hyperemia and pain in the place of administration.

Imunofane is a synthetic hexapeptide (Arginyl-aspa-Ragil-Lisil-Valil-Tyirosyl-Arginine). The drug stimulates the formation of IL-2 immunocompetent cells, increases the sensitivity of lymphoid cells to this lymphokine, reduces the products of the FULL NAME, has a regulating effect on the development of mediators of immunity (inflammation) and immunoglobulins.

Available in 0.005% solution. It is used in the treatment of immunodeficiency states.

All drugs of this group are contraindicated pregnant, myelopid and Ima-Nofan are contraindicated in the presence of a reserves-conflict of mother and fetus.

35.2.2. Synthetic preparations

Levamizol, polyoxidonium

Levamizol is an imidazole derivative, used as an anti-shine and immunomodulatory agent. The drug regulates T-lymphocyte differentiation. Levamizol increases the reaction of T-lymphocytes on antigens and mitogen, increases lymphokinov products, enhances the cytotoxicity of T cells, cooperation of T cells with in lymphocytes, which contributes to the synthesis of immunoglobulins.

Polyoxidonium - synthetic water-soluble polymer compound. The drug has an immunostimulating and detoxifying effect, increases the body's immune resistance in relation to local and generalized infections. The polyoxidonium activates all the factors of natural resistance: the cells of the monocytic-macrophage system, neutrophy-lies and natural killers, increasing their functional activity at initially reduced indicators.

35.2.3. Microbial Preparations and their analogues

Immunostimulators of microbial origin are the purified bacterial lysates (bronchomunals), bacterial ribosomes (bronchomunal), bacterial ribosomes and their combinations with membrane fractions (ribomuynyl), lipopolysaccharide complexes (Prodigiosan), bacterial cell membrane fractions (lycopid).

Bronchomunal is a lyophilized lysate of bacteria that most often causing respiratory tract infection. The drug stimulates humoral and cellular immunity. Increases the number and activity of T-lymphocytes (T-helpers), natural killers, increases the concentration of IgA, IgG and IgM in the mucous membrane of the respiratory tract, enhances the production of cytokines: gamma interferon, FNF, IL-2. Bronchomunal is used in infectious diseases of the respiratory tract resistant to antibiotic therapy.

Ribomunyl is a ribosomal proteoglycan complex of the most common pathogens of ENT infections and respiratory tract (Klebsiella. pneumoniae., Streptococcus. pneumoniae., Streptococcus. pyogenes, Hae.­ mophilus. influenzae.). Stimulates cell and humoral immunity. The ribosomes contained in the drug contain antigens identical to surface antigens of bacteria, and cause the formation of specific antibodies to these pathogens in the body. Membrane proteoglycans stimulate

cephic immunity by enhancing phagocytic activity and stimulation of non-specific resistance factors. Ribominyl is applied with recurrent respiratory tract infections (chronic bronchitis, tracheitis, pneumonia) and ENT organs (otitis, rhinitis, sinusitis, pharyngitis, angina, etc.) from side effects is possible hypersion.

Prodigiosan is a high-polymer lipopolisha-reader highlighted from a microorganism You.prodigiosum.. The drug enhances the non-specific and specific resistance of the body, preferably stimulates in lymphocytes, increasing their proliferation and diffe-renovation into plasma cells producing antibodies. Activates phagocytosis and killer activity of macrophages. Enhances the products of humoral factors of immunity - interferonov, lysozyme, complement, especially when local intended purpose in inhalations. It is used in complex therapy of diseases accompanied by a decrease in immunological reactivity: in chronic inflammatory processes, in the postoperative period, in the treatment of chronic diseases, with sluggishly healing wounds, radiation therapy. The drug is used intramuscularly and inhalation.

Licopid in the chemical structure is an analogue of a microbial origin product - a semi-synthetic glucosamemmuramildepeptide - the main structural component of the cell wall of bacteria. It has an imaging effect.

35.2.4. Interferons

Interferon preparations are classified by type of active component

a) Natural:

Interferon Alpha, interferon beta, interferon alpha-nl;

b) recombinant:

Interferon Alfa-2a, Interferon Alpha-2, interferon beta-lb.

Natural interferons are obtained in the culture of the cells of donor blood leukocytes (in the culture of lymphoblastoid and other cells) under the influence of the inductor virus.

Recombinant interferons are obtained by a genetic engineering method - the cultivation of bacterial strains containing in their genetic apparatus the built-in recombinant plasmid of the human interferon gene.

Interferons have antiviral, antitumor and immuno-dulging effect.

As antiviral drugs, interferon drugs are most active in the treatment of herpetic eye diseases (locally in the form of droplets, subconjuncti-valctual), simpleness, with localization on the skin, mucous membranes and genitalia, sliding listeners (locally in the form of ointments on a hydrogel basis), acute and chronic Viral hepatitis B and C (parenterally, rectally in suppositories), in the treatment and prevention of influenza and ARVI (intranasally in the form of droplets). In HIV infection, the preparations of recombinant interferon normalize immunological parameters, reduce the sharpness of the course of the disease in more than 50% of cases, cause a decrease in the level of viremia and the content of serum markers of the disease. The AIDS is carried out combined therapy with azidothimidine.

The antitumor effect of interferon preparations is associated with the antiprols-faratic effect and stimulation of natural killer activity. As antitumor agents, interferon alpha, interferon alpha 2a, interferon alpha -2, interferon alpha n1, interferon beta is used.

The interferon beta-lb is used as an immunomodulator with multiple sclerosis.

Interferon Alpha is one of three types of interfero-new, which is produced mainly by leukocytes. The maximum plasma concentration is determined after 1-6 hours, then the level in the blood gradually drops to its complete disappearance after 18-36 hours. With intravenous administration, the concentration gradually decreases below the minimum for 24 hours. Hematocol penetrates through the hematorecephalic barrier. Excreted by the kidneys.

Interferon Alfa-2A- recombinant consumer-separable protein containing 165 amino acids is identical to the human leukocyte interferon alpha-2a. It has antiviral, antitumor and immunomodulatory effect. After intramuscular administration, the maximum concentration is observed after 3.8 hours, after subcutaneous administration - after 7.3 hours. It is excluded mainly by the kidneys, ^ is 5.1 hours.

Interferon Alfa-2r - human recombinant interferon. As a stabilizer contains human albumin. It has antiviral, antitumor and immunomodulatory effect. When local use is not found in the blood. When spraying in the respiratory tract is determined in the pulmonary fabric and in a small amount of blood. With intramuscular administration, 70% enters systemic blood flow. The body bio-transforms is mainly in the kidneys and to a slight degree in the liver, is excreted by the kidneys.

Interferon Alfa-NL - Natural Interferon, is a mixture of various subtypes of human interferon alpha. After intramuscular administration, maximum concentrations are determined in plasma after 4-8 hours. Biotransformed in the kidneys, \ g. in intravenous administration is

about 8 hours. The drug is used in high-meal leukemia, chronic hepatitis V.

Interferon beta natural human fibroblast interferon. It is a species-specific glycoprotein with a molecular weight of about 20,000 daltons. It has antiviral, antitumor and immunomodulatory effect. With intramuscular administration, the maximum concentration is achieved after 3-15 hours, then decreases at a constant speed. T% is 10 hours.

Interferon Beta-LB is a challenge shape of the human interferon beta. It is a sterile lyophilized protein product obtained by a recombinant method. Bioavailability at subcutaneous administration is 50%, the maximum concentration is achieved after 1-8 hours with the introduction of 0.5 mg of the drug. T W 5 h.

Interferon beta-LB is used to treat multiple sclerosis. The drug brakes the replication of viruses, reduces the formation of gamma interferon and activates the function of T-suppressors, weakening the effect of antibodies against the main components of myelin. Prevents the development of inflammatory and destructive processes in myeline.

Interferon preparations cause similar side effects. Characteristic - influencing syndrome; Changes on the part of the central nervous system: dizziness, visual impairment, confusion, depression, insomnia, parrestzia, tremor. From the gastrointestinal tract: loss of appetite, nausea; From the cardiovascular system, the symptoms of heart failure are possible; from the urinary system - proteinuria; From the side of the blood formation - transient leukopenia. It may also be rashed, itching, alopecia, temporary impotence, nose bleeding.

35.2.5. Interferon Inductors (Interferonogens)

Interferon inductors are preparations that enhance the synthesis of endogenous interferon. These drugs have a number of advantages compared to recombion-natal interferons. They do not have antigenic activity. Stimulated synthesis of endogenous interferon does not cause hyperintertherminemia.

Amixine refers to low molecular weight synthetic compounds, is an oral inductor interferon. It has a wide spectrum of antiviral activity against DNA and RNA-containing viruses. As an antiviral and immunomodulatory agent is used for the prevention and treatment of influenza, ARVI, hepatitis A, for the treatment of viral hepatitis, herpes of simple (including urogenital) and conjunction, with complex therapy for chlamydial infections, neuroviral and infectious-allers -anic diseases, during secondary immunodeficiency. The drug is well tolerated. Dyspeptic phenomena, short-term chills, increase the total tone, which does not require the cancellation of the drug.

The halfdan is a biosynthetic polyyribonucleotide polyadenyl and polyuridyl acid complex (in equimolar ratios). The drug has a pronounced inhibitory effect on the viruses of simple herpes. It is used in the form of eye drops and injections under the conjunctival. The drug is prescribed to adults for the treatment of viral eye diseases: herpetic and adenoviral conjunctivitis, keratoconjunctivitis, keratitis and

keratoiridocyclites (keratowets), iridocyclites, chorioretinites, neurites of the optic nerve.

Side effects rarely occur and manifest themselves with the development of allergic reactions: itching and the feeling of the foreign body in the eye.

Cycloferon - low molecular weight inductor interferon. It has antiviral, immunomodulatory and anti-inflammatory effect. Cycloferon is effective for viruses of tick-borne encephalitis, herpes, cytomegalovirus, HIV, etc. has an anthylamydial effect. Effective with systemic diseases of the connective tissue. Installed radio protection and anti-inflammatory effect of the drug.

35.2.6. Interleukins

Aldesleikin is a recombinant non-tagged analog of In-Terleikina-2 (IL-2). It has an immunomodulatory and antitumor effect. Activates cell immunity. Enhances the proliferation of T-Lim-Focytes and IL-2-dependent cell populations. Increases the cytotoxicity of lymphocytes and cells - killers, which recognize and destroy tumor cells. Enhances the products of Gamma Interferon, FULL NAME, IL-1. It is used for kidney cancer.

Betalekin - recombinant human interleukin-1 beta. Stimulates leukopoese and immune protection.

35.2.7. Colonsessulating factors (see also Section 26.2)

MRRAGRAPHES (LEKOMAKS) is a recombinant drug of the human granulocytaric-macrophageal colonystimulating factor. It is a highly purified water-soluble peptide consisting of 127 amino acid residues. Stimulates leukeopoese, has immunotropic activity. Enhances the proliferation and differentiation of precursors, increases the content of mature cells in peripheral blood, the growth of granulo-quotes, monocytes, macrophages. Increases the functional activity of mature neutrophils, enhances phagocytosis and oxidative metabolism, providing phagocytosis mechanisms, increases cytotoxicity for malignant cells.

Philgrantim (neapogen) is a recombinant drug of the human non-glycosylated granulocyte colonistimulating factor. Philgrantim regulates the products of neutrophils and their flow into the blood of bone marrow.

Lenograntim is a recombinant drug of the human glycosylated granulocyte colonistimulating factor. It is a highly purified protein. It is an immunomodulator and a leukeopoese stimulator.

35.2.8. Immunoglobulin preparations for intravenous administration

Preparations of this group can be classified according to the predominant content of certain immunoglobulins:

Preparations containing predominantly class IgG antibodies (immunoglobulin normal person for intravenous administration, etc.);

Preparations containing IGG class antibodies enriched with glutes
ca IGM and IGA (Pentaglobin);

Preparations containing significantly higher antibody concentrations
igG class against certain pathogens - specific hyperimmun
immunoglobulins (cytotect, hepattack).

Immunoglobulin Normal person for intravenous administration is an immunoglobulin preparation containing mainly an IGG antibody. The drug is shown in primary and immunopathological diseases acquired by immunochetological diseases (thrombocytopenic purpura, Kawasaki disease).

Pentaglobin - a polyclonal and polyvalent immunoglobulin of a person enriched with IGM antibodies to contain antibodies of all the most important circulating classes of immunoglobulins (IGM - 12%, IgA - 12%, IgG -76%). The drug is shown for combined therapy of severe bacterial infections (in combination. With antibiotics), sepsis, the prevention of infections in patients with immunodeficiency states and the high risk of the development of purulent-septic diseases; For substitution therapy in primary and secondary immunodeficiency syndromes.

The cytotect is a specific hyperimmune immunoglobulin for intravenous administration, used in cytomegalovirus infection.

Hepatject - specific immunoglobulin for intravenous administration against hepatitis V. is used for passive immunization. It is shown for emergency prevention of hepatitis in after injured by infected medical instruments or direct contact of the mucous membranes with infected biological fluids (blood, plasma, serum, saliva, urine, etc.); For the prevention of hepatitis B in newborns, born from Mothers of HBSAG media; For the prevention of infection of the liver transplant in the HBsag-positive patient; In persons with increased risk of infection with the hepatitis V. virus

Interaction of immunostimulating agents with other drugs

Immunostimulating funds	Interactive drug (group of drugs)	Result of interaction
Levamizol	Preparations of glucocorticoid cytostatics immunosuppressants Nonsteroidal anti-inflammatory means
Interferon preparations	Immunosuppressants cytostatics	Increased hematotoxicity (leukopenia, agranulocytosis)
	Cimetidine Phenytoin Warfarin Teophyllin Diazepam Propranolol	Slowing of the metabolism of drugs, an increase in their concentration and toxicity
	Sleeping, sedatives, opioid analgesics	Strengthening neurotoxic action on the central nervous system

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	Glucocorticoid drugs Nonteroid anti-inflammatory means	Weakening of the biological activity of interferon beta due to the oppression of the synthesis of prostaglandins
Aldeslakin	Beta adrenoblocators	Strengthening arterial hypotension
	Glucocorticoids	Reducing the effect of Aldeslakin
MRRAGRAPHES.	Drugs with high (over 85%) percentage of bond plasma proteins	The arrangements reduce the level of albumin in the blood, which can increase the free concentration of drugs appointed with it (it is necessary to reduce their dose)
Immunoglobulin normal human	Live vaccines	It can reduce the effectiveness of active immunization. Live viral vaccines for parenteral applications should not be used within 30 days after the administration of immunoglobulin

Main preparations

International non-proprietary title	Patented (trade) names	Forms of release	Information for the patient
Timalin (Thymalinum)			Adults are introduced at 5-20 mg 1 time per day, a course of 5-6 injections, if necessary, the course is repeated after 1-6 months. Keep refrigerated
Melopid (Myelopidum)	Melopid		Enter subcutaneously at 3-6 mg 1 time per day or every other day, the course of 3-5 injections. Keep refrigerated
Imunofan (imunofanum)	Imunofan.	0.005% solution for injections in ampoules 1 ml	They are injected subcutaneously or intramuscularly at 0.05 mg (1 ml of 0.005% solution) 1 time per day, course 3-5 injections. Keep refrigerated
Levamisolum		Tablets at 0.05 and	As an immunostimulating agent is usually prescribed at a dose of 150 mg per day for 30-40 minutes before eating for 3 days every 2 weeks. Assign under the control of blood tests (at least 1 time in 3 weeks) to detect leukopenia and agranulocytosis. Missed dose: Do not take a missed dose on this day, do not take double doses, you must consult with your doctor.

Table continuation

Bronchomunal (Bronchomunal)	Bronchomunal II.	3.5 mg capsules (bronchomunal II for children), and 7 mg	Take inside in the morning on an empty stomach of 7 mg, the rate is 10-30 days. In order to prevent 7 mg per day for 10 days in a row per month, the course 3 months (it is advisable to start therapy every month in the same day)
Ribomunyl (Ribomunyl)	Ribominyl	Tablets with a single dose of ribosomal fractions (0.25 mg); Tablets with a triple dose of ribosomal fractions (0.75 mg); Packets granulate with a triple dose of ribosomal fractions (0.75 mg) for the preparation of a solution for intake	Take inside in the morning on an empty stomach of 3 tablets with a single dose, or 1 tablet (sachet) with a triple dose. The contents of the bag are dissolved in a glass of water. Take 4 days a week for 1 month, then 4 days each month for 5 months. Missed dose: Do not take a missed dose on this day, do not take double doses, you must consult with your doctor
Likopid (Licopidum)		Tablets 1 and 10 mg	Inside (10 mg tablet), subling-valillary (1 mg tablets) 30 minutes before meals, on an empty stomach. Increased body temperature up to 38 "; with no cancellation of the drug. Missed dose: Do not take a missed dose on this day, do not take double doses, you must consult with a doctor
Interferon Alfa (Interferon Alfa)	Alphaeferon	A solution for injection in 1 ml ampoules containing 1; 3 or 6 million me	Apply individually taking into account the nosological form and severity of the disease. More often injected intramuscularly and subcutaneously (from 3 times a week before daily destination). The duration of the course is established individually. For the treatment of influenza, ARVI is used intranasally: in the first hours of the disease, the diseases are injected into each nasal stroke of 3-4 drops every 15-20 minutes for 3-4 hours, then 4-5 times a day for 3-4 days. For the prevention of influenza and ARVI - 5 drops 2 times a day until the danger of infection is maintained.

Table continuation

			Caution data should be taken into account when treating any interferon drugs. Therapy is carried out under the control of blood tests (leukocyte formula), the level of hepatic enzymes and creatinine in the blood plasma. With the appearance of fever and headaches, paracetamol (0.5-1 g) is effective, its preventive use is 30 minutes before injection. In the event of serious adverse reactions, you should immediately consult a doctor. At the beginning of therapy should be abandoned from potentially dangerous activities (driving a car, etc.) requiring increased attention and rapid psychomotor reactions
	Referon	Ampoules with dry substance for injections containing 0.5; one; 3 or 5 million me.	Enter subcutaneously, intramuscularly, intravenously and subconjunctivative. Apply individually, depending on the testimony and treatment regimen. Solutions are stable when stored in the refrigerator for 1 day
Interferon Alfa-2B (Interferon Alfa-2B)		Flakes with lyophilic powder for injections containing 3; five; 10 million me.
Interferon Beta (Interferon Beta)		Viophiles with lyophilic powder for injections containing 3 million meters with solvent (saline); ampoules 2 ml	Apply individually, depending on the testimony and treatment regimen
Tiloronum (Tiloronum)		Tablets at 0.125 g	In order to prevent viral infections, 1 tablet (0.125 g) are used 1 time per week for 4-6 weeks. For treatment, they are taken after eating 1-2 tablets (0.125-0.250 g) per day for 2 days, then 1 tablet after 48 hours (standard diagram). The duration of the course (from 1 to 4 weeks) depends on the disease. The drug is compatible with all groups

Table continuation

			antimicrobial and antiviral agents. Missed dose: Do not take a missed dose on this day, do not take double doses, you must consult with your doctor
POLUDANUM		Flakes with powder for the preparation of the injection and instillations containing 0.0002 g (200 μg), which corresponds to 100	The solution intended for instillations (instillation) into the eye is prepared by dissolving the contents of the vial (200 μg of powder) in 2 ml of distilled water. Ready solution can be used within 7 days. The solution is buried in the conjunctival bag of the patient's eyes 6-8 times a day, then as the inflammatory phenomena is elected 3-4 times a day. In the absence of effect, within 7 days, you must consult with your doctor. The dry drug in the bottles is stored in the refrigerator. The instillation solution is stored in the refrigerator not more than 1 week.
Cycloferonum (Cycloferonum)	Cycloferon	2 ml ampoules containing 12.5% \u200b\u200bsolution; bottles or ampoules containing 0.25 g of lyophilized powder; Tablets coated with a Ki-shchno-soluble shell of 0.15 g; 5% 5 ml liniment	Apply intramuscularly and / or intravenous, one-time dose 0.25-0.5 g, tablets - inside 30 minutes before the meal is not chewing at 0.3-0.6 g, 1 time per day according to the standard scheme 1, 2, 4, 6, 8, 11, 14, 17, 20, 23 days depending on the disease. The treatment diagram and course are determined by the testimony to the appointment. The drug is stored in the place protected from light at room temperature. Treatment of influenza and ARVI - 2-4 tablets 1 time per day for 2 days, then every other day. Course -0.75-1.5 g (10-20 tablets). Treatment begin at the first symptoms of the disease. Liniment (with genital herpes, urethritis, vaginites) intra-urethral, \u200b\u200bintravaginal 5-10 ml per day, course 10-15 days
Aldesleikin (Aldesleukin)	Prolekin		Apply in the form of continuous intravenous infusion within 5 days. The treatment diagram is determined individually. Apply under the careful control of the doctor.

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			The drug is incompatible with a 0.9% sodium chloride solution; For intravenous infusions, 5% glucose solution is used. Persons in both sexes during the treatment period should be used by reliable methods of contraception
MRRAGRAPHES.	Leuckeax	Flakes with lyophilic powder containing 50, 150, 400, 500, 700 and 1500 μg	Enter subcutaneously and intravenously. During treatment, peripheral blood pattern is required.
Immunoglobulin Normal human for intravenous administration (Immuno-globulinum Human Normal)	Intraglo-Binf.	Ampoules with a 5% injection solution of 10 ml and 20 ml, comprising 0.5 g and 1.0 g. Flakes with a 5% injection solution for 50 ml and 100 ml, containing 2.5 g and 5, respectively, 0 g	Assign intravenously drip. The dosing mode and course are established individually, depending on the indications, the severity of the disease, the state of the immune system, individual tolerance. The lyophilized powder for infusions is dissolved in a 0.9% solution of sodium chloride, water for injection, 5% glucose solution immediately before use
	Sandoglobu-Lin.	Flakes with lyophilic powder for infusions containing 1; 3; 6 and 12 g

The state of immune deficit in many children requires, as a rule, corrected specially selected drugs.

However, before proceeding with the treatment of immunostimulating drugs, you must first determine the presence of immunodeficiency in the body, for which you need to contact the children's doctor.

Determine when it makes sense to talk about the problems with the immune system in a child:
a.) If your child is sick more than six times during the year,
b.) If the flow of any infectious diseases in the baby is very severe with various complications,
c.) If the Krochi organism is sufficiently poorly reacts to the treatment carried out, and the disease itself lasts lasts,
d.) If no traditional methods of increasing immunity, such as hardening, receiving multivitamine complexes, power correction, as well as various folk remedies practically do not help.

So, you showed a child to the doctor. After all necessary analyzes, the doctor will determine what to do next. If there is a need, the doctor will prescribe an immunogram to determine the immune status, as well as a number of additional analyzes. And only on the basis of all the data, your child will be appointed by an immuno corrective treatment.

It is necessary to strictly observe the dosage of all immunostimulating drugs according to age and the treatment regimen appointed by the doctor.

Immunostimulating drugs for children (as well as for adults) are divided into the following groups.

1. Preparations of plant origin to increase immunity (they are released without a recipe)

Immunal
The drug that contains grass Echinacea purple. Most often used as a preventive means of influenza and colds. The greatest effect is noted in infectious uncomplicated diseases and in susceptibility to constant colds to increase immunity.

It should be taken inside, diluted with a small amount of water. For adults and children (from 12 years) - enough 20 drops 3 times a day. At the same time, the initial dose of up to 40 drops is allowed. The acute stage of the disease - 20 drops every two hours during the first two days.
Children from one to 6 years old - 3 times a day, 5 or 10 drops.
Children from 6 to 12 years old - 3 times a day at 10 or 15 drops.

Tablets are stuffed with water (small babies of tablets can be missed and mix with a small amount of water, juice or tea).
Adults, as well as adolescents from 12 years old - 3 or 4 times a day on one tablet.
Children from 6 to 12 - one tablet 1-3 times a day.
For children from 4 to 6 years old one tablet one twice a day.
The duration of the course is from one week, but not more than 8 weeks.

Echinacea is also part of the following drugs:
1 ) Tincture Echinacea Dr. Tussa,
2 ) Tincture Echinacea of \u200b\u200bdomestic production.

In addition to the above, the following drugs can be attributed to the preparations of vegetable origin that have an immunostimulating and adaptogenic effect.

Eleutherococcus extract
Dosage: adults 2 or 3 times a year 20-40 drops per day, children - twice a day on one drop for every year of the child's life. The drug is accepted before meals, inward, preferably in the first half of the day. The course of treatment is from 25 to 30 days.

Tincture ginseng
It takes 2-3 times daily by 30-50 drops for 30 or 40 minutes before meals. The course is 25-30 days.

Tincture of chinese lemongrass
It is accepted at 20-30 drops of tincture dissolved in water (small quantity) for half an hour before meals 2 or 3 times a day.

2. Preparations for improving the immunity of bacterial origin

These drugs contain enzymes of those bacteria that cause infections such as pneumococcus, staphylococcus, streptococcus and others. They do not pose a danger, but have a fairly strong immunostimulating effect.

Ribominyl
It is used as a prophylactic agent, as well as for the treatment of infectious diseases, which are repeated quite often. These are various sinusitis and rhinitis, otitis and angina, as well as some other diseases of ENT organs. Available as tablets or granules for the preparation of solutions. Prescribed it already from the six-month age.

Broncho-Munal
This means for the prevention and treatment of various infections of the upper respiratory tract, repeating very often. These are rhinitis, bronchitis, sinusitis, etc. Produced in the form of capsules 3, 5 and 7 mg. It is often prescribed to children.

Likopid
Included in the complex therapy in the treatment of secondary immunodeficiency, which manifest themselves in the form of various sluggish, chronic and recurrent inflammatory-infectious processes, regardless of their localization. Tablets are available at 1 or 10 mg.

Imudon
This is a local application with inflammatory infectious diseases of the throat, as well as the oral cavity in dentistry and otorinolaryngology. Produced in the form of tablets for resorption. Prescribe children since 3 years of age.

IRS-19
For the treatment and further prevention of infectious and inflammatory diseases, both respiratory tract and LOR organs: bronchial asthma, rhinitis, tonsillitis, rinofaring, pharyngitis, otitis, bronchitis, rhinitis of allergic origin, etc. Produced in the form of a nasal spray. It is assigned to children from 3 months of age.

3. Preparations containing nucleic acids improving immunity

Sodium Nucleicate (Derinat)
Regenerating, immunomodulating, wound-heating, reparative agent stimulating hemopoies, with a wide range of its action. Produced in the form of a solution, both for injections and for outdoor use.

4. Preparations Immunity of Interferon Group

It is possible to immediately note that they achieve the greatest effect at the initial stages of the disease. They make no sense to use for the prevention of diseases of infectious origin.

The preparations from the interferon group include Bav (biologically active substances) that are able to slow down and even block the development of many infections.

Leiccitarian interferon
In the form of ampoules with dry mortar for the preparation of the finished solution.

Viferon
In the form of rectal candles of different dosages and ointments.

Infpopheron
Highly efficient immunode-generating, antiviral, antimicrobial and anti-inflammatory agent. Produced in drops for intranasal use.

Indicators of endogenous interferon stimulate the production of their own interferon, which has a pronounced immunostimulating anti-infectious effect.

Arbidol.
Immunomodulating and antiviral agent. Produced in capsules of 50 and 100 mg. It is assigned to children from a biennium.

Anaferon
Antiviral immunomodulatory agent. Sublingual pills for children and adults. Can be assigned to kids from one month.

Cycloferon
Tablets stimulating an increase in immunity with a wide range of antiviral activity.

Amixin
Tablets with immunomodulatory action. It has antiviral properties.

5. Timus or fork gland preparations

Used for active immunotherapy. Appointed only by a doctor: Timalin, stubble, Vilozen, Teiburamulin, as well as some others.

6. Various biogenic stimulants: Aloe in ampoules, calangean juice, fibs and others.

7. Non-specific stimulants (mixed or synthetic origin): vitamins, leucogen, pentoxyl, etc.

Vitamins
Are coenzymes of numerous biochemical reactions occurring in our body. Provide stimulation of immunity generation and significantly increase overall reactivity in the body.

Apply them as immunostimulating drugs for children and adults. Treatment with such drugs is carried out only under the supervision of the doctor.

Strong immunity to you and your kids!

Immunity in the life of each person plays one of the main roles. If it were not, people would regularly suffered from various diseases. In the season of colds, many think about how to strengthen the immune function. For such purposes there are immunostimulating drugs.

Immunostimulating drugs allow you to increase the body's protective forces, thanks to which the person begins to hurt less. They are recommended to accept children, adults, women in the period of to wear and breastfeeding.

Immune preparations are divided:

1. to interferons. This group of funds contains proteins that are able to block a viral infection;
2. on the inductors of interferon. These medicines do not contain protective proteins. But they help the body independently produce immune cells;
3. on immunostimulating drugs of bacterial nature. The effect of such a group of medicines resembles the effect of vaccines. When introducing bacteria into the body, the body begins to synthesize antibodies independently;
4. on immunostimulating drugs, which include nucleic acid. Such medicines allow you to activate the struggle of leukocytes with infection;
5. on immunoglobulins. The effect of such funds is aimed at neutralizing the action of many pathogens. Protein production occurs blood cells;
6. for drugs from thymus. They are made from pets of domestic animals. The action of drugs is directed to the activation of cellular immunity. They are prescribed for diseases of severe;
7. on synthetic medicines. The main components are chemical compounds that are made artificially. They increase immunity in both adults and children;
8. on biogenic stimulants. Such a group of drugs has vegetable and animal origin. Their impact is aimed at stimulating metabolic processes, an increase in the activity of the domestic secretion glands;
9. on vitamin complexes. They are able to strengthen the immune system with the help of normalization of processes in the body;
10. for medicines that have vegetable origins. Their action is aimed at stimulating immune bodies at the cellular level. Phagocytosis is also increased.

Immunostimulating preparations of vegetable origin

Medicine for immunity of plant origin belongs to the group of secure funds. They have natural composition, due to which they practically do not have contraindications and do not cause side symptoms.

The main property of such funds is to strengthen immunity and increase resilience to infections. But in some situations they can cause an allergic reaction.

The greatest popularity is the means in the form of:

• tincture Echinacea, Ginseng, Eleutherococcus, Lemongrass;
• Immunal, Immunorm, Estifana. Preparations are available in the form of tablets, and in its composition they have echinacea;
• Dr. Tais. These funds in their composition have calendula, echinacea, socket.

Although they have a small cost, but have a number of restrictions in the form of children up to two years, increased susceptibility to the components of the drug and the presence of allergies.

Preparations Interferons and their inductors

Often, doctors prescribe immunostimulating drugs with a cold and flu, which includes interferons. They have high efficiency, but only if their reception has begun when the first signs of cold have been manifested. Also, they are often used to implement preventive measures.

Preparations that are in their composition interferon do not have contraindications. And therefore allowed to use in children from birth, adults, women in the period of tooling and breastfeeding.

This group of funds belong.

1. Infpopheron. Produced in the form of droplets. There is an analogue in the form of interferon in drops, which costs two or three times cheaper.
2. Viferon. Sold in the form of candles and ointments. Candles instantly affect the viral infection, thereby speeding up the process of recovery during cold. Ointment is used as prevention for lubrication of nasal strokes.
3. Anaferon and Ergoferon. Sold in the form of tablets. Anaferon is allowed to children from the first month of life, and Ergoferon recommend to give children from six months.

Also on sale there are drugs that belong to the group of inductors of Interferon. They have high activity in viral infections. Their action is directed to the urgency of the body independently produce protective proteins.

The immunization with a cold has a minimum of side manifestations, but has a number of contraindications. It is prohibited during pregnancy and increased susceptibility to the components of the drug.

To such a group of funds can be attributed:

• Amixin;
• Arbidol;
• Cycloferon.

They are produced in the form of tablets. To get the effect of medicines, they need to start taking at the first signs of a cold.
One of the effective tools of this group is considered to be Kagocel. It can be taken to children from three years. At the same time, it is discharged during late treatment.

Immunostimulating drugs of bacterial origin

Many patients believe that such medicines are harmful to the body, but it is not. They are written by adults and children. The effects of drugs are directed to the natural lift of immunity when the bacterial cells are administered.

In such a group of funds include:

• Imudon. Sold in the form of tablets for resorption. Effectively cope with infection in the oral cavity.
• Bronchoymunal. Sold in the form of capsules. Shows efficiency with regular inflammatory processes in the upper respiratory tract.
• Ribominyl. Sold in the form of tablets and capsules for the preparation of the solution.

It is prohibited for use in pregnant women and lactating women, as well as children under two years.

Immunostimulating medicines with nucleic acid

Such a group of drugs include Derinat and Ridostin.
Derinat is produced in the form of a solution for injection, spray and droplets. Displays both adults and children. It has only the only contraindication in the form of individual intolerance.

Ridostin is also available in the solution for injections. It is considered an effective immunostimulating agent in the treatment of viral and bacterial injections.

Immunoglobulins and vitamin complexes

Immunoglobulins have a high price, but in contrast to the vitamin complexes in their composition there are still antibodies to pathogens of various diseases. If the patient has no allergic reactions, such medications will be simply indispensable to increase the immune function.

Immunoglobulins include intraglobin, Hamimun N, Humaglobin.

Vitamins and minerals are needed by the body for the implementation of many processes. If their level falls, immunity is sharply weakened.
Vitamin complexes that are sold in pharmacies, usually in their composition have several vitamins and minerals at once.
In childhood, doctors prescribe peaks, multi tabs, complivit, alphabet.

For children under three years, drugs are produced in the form of syrups. This can include peaks, calcium d3.
Often, fishe fat in drops are discharged as prevention and lack of vitamins. It is relevant for those parents whose children are very rarely eating fish.
Adults can be taken alphabet, complivit, Vitrum, Supradin, Center.

Many doctors at weakening the immune function are prescribed immunostimulating agents. But they do not always help patients. Some believe that they have a placebo effect, others argue that they are completely inactive, the third praise them.

But the immunity does not weaken, you need to comply with simple rules.

• First of all, it is worth thinking about nutrition. If you eat alone semi-finished products and fast foods, then natural immunity will fall. On the table there should be fruits and vegetables daily. At the same time, you need to exercise exercise and hardening.
• No need to forget about regular washing of hands and face after the street and before meals.
• You also need to walk more often. After all, experts have been established, those who walk more than two hours a day with any weather, suffer from infections less often.
• Another rule to maintain the immune function is to ventilate the room and the humidification of the air in it.

First of all, it should be determined that they understand the term "immunotropic drugs". Ppm Mashkovsky divides drugs, corrective processes of immunity (immunocormers), on immunostimulating and immunosuppressive (immunosuppressors). A third group of immume-nominulators can be distinguished, that is, substances that provide their effect on the immune system depending on its initial state. Such drugs increase low and reduce increased indicators of immune status. Thus, according to the action on the immune system, immunotropic drugs can be divided into immunosuppressors, immunostimulants and immunomodulators.

This section is dedicated only to two recent drugs and mainly immunostimulants.

Characteristics of immunomodulators

Preparations of bacterial and fungal origin

Immunomodulators vaccines Vaccines from conditionally pathogenic bacteria not only increase resistance to a specific microbe, but also have a powerful non-specific immunomodulatory and stimulating effect. This is explained by the presence in their composition of lipopolysaccharides, proteins A, M and other substances of the strongest activators of immunity acting as advisuances. An indispensable condition for the appointment of immunomodulating therapy with lipopolysaccharides should be a sufficient level of target cells (i.e., an absolute number of neutrophils, monocytes and lymphocytes).

Bronchomunal ( Broncho. - Munal ) - lyophilized lysate bacteria { Str.. pneumoniae., H.. influence, Str.. vindans., Str.. pyogenes, moraxella catarrhalts., S.. aureus., K.. pneumoniae. and Kozaenae.). Increases the number of T-lymphocytes and IgG, IgM, CLGA antibodies, IL-2, FNF; Used in the treatment of infectious diseases of the upper respiratory tract (bronchitis, rhinitis, tonsillites). The capsule contains 0.007 g of lyophilized bacteria, 10 per pack. Assign 1 capsule a day for 10 days a month for 3 months. Children are prescribed bronchomunal II, which contains 0.0035 g of bacteria in the capsule. Used in the morning on an empty stomach. Dyspeptic phenomena, diarrhea, epigastric pain.

Ribominyl ( Ribomunyl ) - contains immunomodulatory substances represented by a combination of bacterial ribosomes (Klebsiella. pneumoniae. - 35 dollars Streptococcus. pneumoniae. - 30 fractions, Streptococcus. pyogenes - 30 fractions Haemophilia. influenzae. - 5 shares) and membrane proteoglycans Kpneumoniae.. It is assigned to 1 tablet 3 times a day or 3 tablets on the reception in the morning, an empty stomach, in the first month - 4 days a week for 3 weeks, and in the next 5 months. - 4 days at the beginning of each month. Forms immunity to infectious agents, provides a long-term remission in chronic bronchitis, rhinitis, angins, otitis.

Polycomplete vaccine (VP-4 - Immunomak) it is antigenic complexes isolated from staphylococcus, a protest, Klebsiellas of pneumonia and intestinal chopsticks K-100; It causes antibodies to these bacteria. In addition, the drug is a stimulator of non-specific resistance, increasing the body's stability to conventionally pathogenic bacteria. Correals the level of T-lymphocytes, enhances the synthesis of IGA and IgG in the blood and SLGA in saliva, stimulates the formation of IL-2 and interferon. The vaccine is designed for immunotherapy of patients (age 16-55 years) with chronic inflammatory and obstructive diseases of respiratory organs (chronic bronchitis, chronic obstructive lung disease, infectious-dependent and mixed form of bronchial asthma). Intranasally introduced: 1 day - 1 drop into one nasal stroke; 2 days - 1 drop in each nasal stroke; 3 days - 2 drops in each nasal stroke. Starting from the 4th day after the start of immunotherapy, the drug is administered under the skin of the subband region 5 times with an interval of 3-5 days, alternately changing the direction of administration. 1st injection - 0.05 ml; 2nd injection 0.1 ml; 3rd injection - 0.2 ml; 4 Injection - 0.4 ml; 5 Injection - 0.8 ml. With an oral method of using a vaccine after 1-2 day after the end of intranasal administration, the drug is taken orally 5 times with an interval of 3-5 days. 1 reception - 2.0 ml; 2 reception - 4.0 ml; 3 reception - 4.0 ml; 5 Reception - 4.0 ml.

Staphylococcus vaccine contains a complex of thermostable antigens. It is used to create anti-stilococcal immunity, as well as to increase overall resistance. It is introduced subcutaneously at a dose of 0.1-1 ml daily for 5-10 days.

Imudon ( Imudon. ) - tablet contains a veil mixture of bacteria (lactobacia-terrium, streptococci, enterococci, staphylococci, Klebsiella, Corinbacteria pseudiferic, fusiform bacteria, candida Albikans); Used in dentistry in periodontitis, stomatitis, gingules and other inflammatory processes of the oral mucosa. Assign 8 tab / day (1-2 in 2-3 hours); The tablet is kept in the mouth until complete dissolution.

IRS-19 ( IRS. -19) - dosage aerosol for intranasal use (60 doses, 20 ml) contains lysate bacteria (diplococci pneumonia, streptococci, staphylococci, neasery, Klebsiella, Morachella, influenza wand, etc.) . Stimulates phagocytosis, increases the level of lysozyme, CLGA. We use by rhinitis, pharyngitis, tonsillites, bronchitis, bronchial asthma with rhinitis, otitis. Make 2-5 injection per day in each nostril before the disappearance of infection.

Bacterialand yeast substances

Sodium nucleicate The drug in the form of a nucleic acid sodium salt is obtained by hydrolysis of yeast cells with subsequent purification. It is an unstable mixture of 5-25 types of nucleotides. It has polypotent stimulating activity against immunity cells: Increases the phagocytic activity of micro and macrophages, the formation of these cells of active acid radicals, which leads to an increase in the bactericidal action of phagocytes, increases the titles of antitoxic antibodies. It is prescribed inside in tablets in the following doses of 1 reception: children of the 1st year of life - at 0.005-0.01 g, from 2 to 5 years - at 0.015-002 g, from 6 to 12 years - 0.05-0 , 1 g. The daily dose consists of two or three one-time doses, designed for the age of the patient. Adults receive no more than 0.1 g per reception 4 times a day.

Pirohenal The drug is derived from culture Pseudomonas. aeroginosa.. Malotoxic, but causes a fever, short-term leukopenia, which is roughly leukocytosis. Especially effective effect on the system of cells of the phagocytic system, therefore is often used in the complex therapy of protracted and chronic inflammatory diseases of the respiratory tract and other localizations. Introduced intramuscularly. Children under 3 years of injection are not recommended. Children over 3 years old, dose from 3 to 25 μg (5-15 MPD - minimum pyrogenic doses) on the injection, depending on age, but not more than 250-500 MPD. For adults, the usual dose is 30-150 mg (25-50 MPD) per injection, the maximum is 1000 meters. The course of therapy includes from 10 to 20 injections, while the indicators of peripheral blood and immune status are necessary.

Pirogenal test - test for leukening states to stimulate emergency emissions from cellular depot of immature shapes of granulocytes. The drug is introduced at a dose of 15 MPD to 1 m 2 of the area of \u200b\u200bthe body. Another calculation formula is 0.03 μg per 1 kg of body weight. Contraindicated during pregnancy, acute fever, leukopenia of autoimmune genesis.

Preparations of yeast contain nucleic acids, a complex of natural vitamins and enzymes. They are long used in bronchitis, furunculosis, deductive ulcers and wounds, anemia, in the period of recovery after severe diseases. By 5 - 10 g of yeast add 30 - 50 ml of warm water, they are triturated and maintained for 15-20 minutes in a warm place until the formation of foam. The mixture is shaking and drink 15-20 minutes before eating 2-3 times a day for 3-4 weeks. The clinical effect appears in a week, immunological - later. To reduce dyspepsia, the drug is diluted with milk or tea.

Synthetic immunomodulators

Likopid The semi-synthetic drug belongs to Muramildepeptides close to bacterial. It is a fragment of the cell wall of bacteria. Obtained from the cell wall M.. lysodeicticus..

The drug increases the overall resistance to the body to the pathogenic factor primarily due to the activation of the cells of the phagocytic immunity system (neutrophils and macrophages). With oppressed blood formation, for example, caused by chemotherapy or irradiation, the use of liquid leads to the restoration of the number of neutrophils. Licopid activates T- and B-lymphocytes.

Indications: acute and chronic purulent inflammatory diseases; acute and chronic respiratory diseases; Defeasure of the cervix with a human papilloma virus; vaginitis; Acute and chronic viral infections: ophthalmokerpes, herpetic infections, sliding; pulmonary tuberculosis; trophic ulcers; psoriasis; Immunoprophylaxiscent of colds.

Prescribe courses depending on the disease. In chronic respiratory tract infections (bronchitis) in the aggravation stage of 1-2 table (1-2 mg) under the tongue - 10 days. With protracted recurrent infections of 1 tab (10 mg), 1 time per day for 10 days. Lung tuberculosis: 1 Table (10 mg) - 1 time under the 3rd cycle of 7 days at intervals of 2 weeks. Herpes (light shapes) - 2 tabs (1 mg x 2) 3 times a day for 6 days; With severe - 1 tab (10 mg) 1-2 times a day inside - 6 days. Children assign 1 mg tablets.

Contraindicated during pregnancy. Increased body temperature up to 38 ° C, sometimes occurred after taking the drug, is not contraindicated.

Reosorbilact. - Used for disintellation. Apparently, it has an immunomodulatory effect in the treatment of chronic obstructive diseases of lungs, rheumatism, intestinal infections. An adult is introduced 100-200 ml, 2.5 ml / kg children, intravenously drip (40-80 drops of 1 min) in a day.

Dibazol ( Dibazolum. ) - vasodinating, hypotensive agent. The drug has adaptogenic and interferogenic effects, enhances proteins and nucleic acid synthesis, IL-2 expression, receptors on N-helpers. Used in acute infections (bacterial and viral). Optimal, apparently, the combination of dibazole with a lycopeid should be considered. Assigned to tablets of 0.02 (one-time dose - 0.15 g), ampoules 1; 2; 5 ml 0.5 ° /, or 1% solution for 7-10 days. Early children - 0.001 g / day, to] year - 0.003 g / day, preschool age 0,0042 g / day.

Arterial pressure should be monitored, especially in children of adolescence, in which dibazole may cause violations of the regulation of the tone of the vessels.

Dimexide (dimethyl sulfoxide) The bottles of 100 ml are produced in bottles, a fluid with a specific smell, has a unique penetrating ability in tissue, pH 11. It has anti-inflammatory, anti-ethnic, bactericidal and immunomodulating effects. Stimulates phagocytes and lymphocytes. In rheumatology, a 15% solution is used in the form of appliques for joints with rheumatoid arthritis. Used with purulent and septic and bronchopal diseases. Course 5-10 applications.

Equipment (Groprin azin ) - a mixture of 1 part of the inosine and 3 parts of p-aceto amidobenzoic acid. Stimulates the cells of phagocytic series and lymphocytes. Stimulates the production of cytokines, IL-2, which significantly changes the functional activity of peripheral blood lymphocytes and their specific immunological functions: the differentiation of 0 cells in T-lymphocytes is induced, the activity of cytotoxic lymphocytes is enhanced. Almost not toxic and well tolerated patients. Side effects and complications are not described. With a pronounced interferonogenic effect, it is used in the treatment of sharp and protracted viral infections (herpetic infection, measles, hepatitis A and B, etc.). Stimulates mature B cells. It is accepted inward in the form of tablets (1 tab. 500 mg) at a dose of 50-100 mg per 1 kg of body weight per day. The daily dose is divided into 4-6 receptions. Course duration 5-7 days. Indications: Secondary immunodeficiency diseases, especially with herpetic infections.

Imunofan ( Imunofan. ) - Hexapeptide (arginyl-alpha-aspartil-lysyl-valine-Tyirosyl-arginine) has an immunoregulating, detoxification, hepatopro-tequet effect and causes the inactivation of free radical and peroxidant compounds. The effect of the drug is developing within 2-3 hours and continues up to 4 months; Normalizes lipid peroxidation, inhibits arachidonic acid synthesis, followed by a decrease in cholesterol levels in the blood and products of inflammation mediators. After 2-3 days, phagocytosis enhances. The immuno-corrective effect of the drug is manifested in 7-10 days, enhances the proliferation of T-lymphocytes, increases the products of interleukin-2, antibody synthesis, interferon. Ampoules contain 1 ml 0.005% solution of the drug (packing 5 ampoules). Assign subcutaneously, per / m daily or 1-4 days 1 rate of 5-15 injections. For herpetic infection, cytomegalovirus, toxoplasmosis, chlamydia, pneumocystosis 1 injection in two days, the course of treatment 10-15 injections.

Galavit ( Galavit. ) - derivative of aminophtharthydroside with anti-inflammatory and immunomodulatory activity. It is recommended for secondary immune failure and chronic recurrent, sluggish infections of various organs and localizations. Prescribed intramuscularly to 200 mg 1 dose, then 100 mg 2-3 times a day to reduce intoxication or ending inflammation. Supporting course in 2-3 days. Tested for furunculese, intestinal infections, adnexites, herpes, cancer chemotherapy; In inhalations in chronic bronchitis.

Polyoxidonium - synthetic immunomodulator of a new generation, N-oxidized polyethylene pee derivative, which has a wide range of pharmacological action and high immunostimulating activity. It has been established its preferential effect on phagocytic immunity.

The main pharmacological properties: activation of phagocytes and the digestive ability of macrophages against pathogenic microorganisms; Stimulation of the reticulosendothelial system cells (capture, phagocytic and remove alien microparticles from circulating blood); an increase in the adhesion of blood leukocytes and their ability to produce active forms of oxygen when contacting the spacious fragments of microorganisms; stimulation of cooperative T- and cellular interaction; increasing the natural resistance of the body to infections, the normalization of the immune system in secondary IDF; Antitumor action. Polyoxide are prescribed patients once a day in / m, using doses from 6 to 12 mg. The course of administration of polyoxide - from 5 to 7 injections, every other day or according to the scheme: 1-2-5-8-11-14 days of administration of the drug.

Methyluracyl Stimulates the leukopoesez, enhances the proliferation and differentiation of cells, the production of antibodies. Prescribed inside by 1 reception: children from 1-3 years - 0.08 g, from 3-8 years - 0.1 - 0.2 g; From 8-12 years old and adults - at 0.3-0.5 g. The patient is injected with 2-3 one-time doses. The course lasts 2-3 weeks. In secondary immunological failure, it is used in patients with moderate cytopenic states.

Teophyllin Stimulates the suppressor T cells at a dose of 0.15 mg 3 times a day for 3 weeks. In this case, not only a decrease in the number of B cells, but also the suppression of their functional activity is noted. It can be used in the therapy of autoimmune diseases and autoimmune syndrome during immunodeficiency. However, the main purpose of the drug is the treatment of bronchial asthma, as it has a bronchology effect.

Famotidin - Blocators H2 histamine receptors, inhibit T-suppressors, stimulate T-helpers, expression of IL-2 receptors and immunoglobulin synthesis.

Inductor interferon Stimulate the production of endogenous interferon.

Amixin - Stimulates the formation of α, β, and gamma interferons, enhances the antibody formation, has an antibacterial and antiviral effect to treat hepatitis A and enteroviral infections (1 Table - 0.125 for adults and 0.06 - for children for 2 days , then take a break of 4-5 days, a course of treatment for 2-3 weeks), for the prevention of viral infections (flu, ORZ, ORVI) - 1 table. 1 time per week, 3-4 weeks. Contraindicated during pregnancy, liver diseases, kidneys.

Arbidol. - Antiviral drug. It has an inhibitory effect on influenza viruses A and V. has interferoninducing activity and stimulates humoral and cellular immunity reactions. Release form: Tablets of 0.1 g. For the treatment of viral infections are prescribed 0.1 g three times a day before meals for 3-5 days, then 0.1 g 1 time per week, within 3-4 weeks . Children 6-12 years old 0.1 g every 3-4 days 3 weeks prophylactically during the flu epidemic. In the treatment: Children - 0.1 g 3-4 times a day 3-5 days. Contraindicated patients with cardiovascular diseases, diseases of the liver and kidneys.

Neovir - induces the synthesis of alpha interferon, activates stem cells, NK cells, T-lymphocytes, macrophages, reduces the FNO-α level. In the acute period of herpes-infection, 3 - injections of 250 mg per interval of 16-24 hours and another 3 injections with an interval of 48 hours are prescribed. In the intercreed period 1 injection per week at a dose of 250 mg for a month. In the urogenital chlamydia 5-7 of injections of 250 mg at an interval of 48 hours. Antibiotics are prescribed on the day of the second injection. Available in a sterile solution for injections in 2 ml ampoules containing 250 mg of active substance in 2 ml of physiologically compatible buffer. Packaging of 5 ampoules.

Cycloferon - 12.5% \u200b\u200binjection solution - 2 ml, tablets of 0.15 g, ointment 5% 5 ml. Stimulates the formation of α, β, and γ-interferon (up to 80 units / ml), increases the level of CD4 + and CD4 + -T-lymphocytes in HIV infection. It is recommended for herpes, cytomegalovirus infection, hepatitis, HIV infection, sclerosis, ulcerative gastric ulcer, rheumatoid arthritis. One-time dose 0.25-0.5 g per / m or V / v per 1, 2, 4, 6, 8, 11, 14, 17, 20, 23, 26, 29 days. Children at 6-10 mg / kg / day - in / in or in / m. Tablets 0.3 - 0.6 g 1 time per day. Prescribed with flu and respiratory infections; Ointment - with herpes, vaginites, urethritis.

Kagelin - Synthetic preparation based on carboxymethylcellulose and polyphenol - Gossetol. Induces synthesis α and β-interferon. Already after one-time reception, they are produced during the week. 12 mg tablets. For the treatment of influenza and ORVI, adults are appointed in the first two days - 2 tablets 3 times a day, in the next two days - on one tablet 3 times a day. A total of 18 tablets, the duration of the course - 4 days. Prevention of respiratory and viral infections in adults is carried out by 7-day cycles: two days - 2 tablets 1 time per day, 5 days break, then cycle repeat. The duration of the preventive course - from one week to several months. For the treatment of herpes in adults, 2 tablets are prescribed 3 times a day for 5 days. A total of 30 tablets, the course duration - 5 days. For the treatment of influenza and ORVI, children aged 6 are prescribed in the first two days - 1 tablet 3 times a day, in the next two days - one tablet 2 times a day. A total of 10 tablets, the duration of the course - 4 days.

Immunofan and dibazole - (See above) are also interferonogens.

Dipyridamol. (Kuraltil) - A vasodulating drug, applied to 0.05 g 2 times a day with an interell 2 hours once a week increases the level of gamma interferon, stops viral infections.

Anaferon - Contains low doses of antibodies to gamma interferon, therefore it has immunomodulatory properties. Used in viral infections of the upper respiratory tract (flu, ORVI) for 5-8 tablets in the 1st day and 3 on the 2nd - 5th day. For prophylaxis - 0.3 g - 1 tablet for 1-3 months.

Preparations obtained from cells and organs of the immunity system

Timic peptides and hormones The most important feature of the tyamic peptides (taking place from epitheliodic, stromal cells, the Gassale Taurus, Timocytes, etc.) as hormones is the short-term and short-circuit of their action on target cells. This largely determines the therapeutic tactics. Therapeutic preparations are obtained by various ways of animal thymus extracts.

Timus peptides have a property common to the entire group, the differentiation of the cells of the lymphoid system, changing not only the functional activity of lymphocytes, but also causing the secretion of cytokines, for example IL-2.

Indications for the purpose of the drugs of this group are clinical and laboratory signs of insufficiency of T-cell immunity: infectious or other syndromes associated with immunological failure; Lymphopenia, decrease in the absolute number of T-lymphocytes, index of the ratio CD4 + / CD8 + lymphocytes, proliferative response to mitogens, depression of the reactions of increased sensitivity of a slow-type type in skin tests, etc. .

Timic failure can be acuteand chronic.Acute thymotic insufficiency is formed with intoxications, physical or psycho-emotional stress, against the background of severe acute infectious processes. Chronic characterizes T-cell and combined form of immunodeficiency. Timus failure should not be corrected by immunostimulating effects, it should be replaced by the drugs of thymus peptides-hormones.

Replacement therapy of acute thymus deficiency usually requires a short course in the saturation mode of thymus peptides against the background of symptomatic therapy. Chronic thymus failure is replaced by regular thymus peptide courses. Usually the first 3-7 days are injected in saturation mode, and then continue as supportive therapy.

Congenital forms of immunological failure T-cell typealsomely cannot be corrected by the thymic factors, as a rule, due to genetically deterministic defects of target cells or products of mediators (for example, IL-2 and IL-3). The acquired immunodeficiency are well corrected by the thymomic factors, if the genesis of the immunodeficiency is due to the thymus deficiency and, as a consequence, the immaturity of T-cells. However, thymus peptides are not corrected by other T-lymphocyte defects (enzyme, etc.).

Timalin - Complex of the peptide of Timus calves. The lyophilized powder in 10 mg bottles is dissolved in 1-2 ml of isotonic sodium chloride solution. Introduced in / m adults at 5-20 mg (30-100 mg per course), children up to 1 g of 1 mg; 4-6 years 2-3 mg; 4-14 years - 3.5 mg for 3-10 days. It is recommended for acute and chronic viral and bacterial infections, burns, ulcers, infectious bronchial asthma; Diseases associated with immunodeficiency.

Tabuti - Complex of Timus Timus polypeptides. Available in bottles of 1 ml - 0.01% solution. In case of chronic nonspecific diseases of the lungs, the optimal dose of the clinic is 1-2 μg / kg. The drug is introduced 1 ml (100 μg) subcutaneously for 5 days, then 1 time per week for 1 month. Further, 5-day monthly re-courses are held. It is recommended for purulent-septic processes, lympholoicosis, ophthalmokerpes, tumors, psoriasis, sclerosis and diseases associated with immunodeficiency.

Thorusulin - The complex of polypetides of thymus of cattle is introduced in a dose of 1 mg per 1 kg of mass for 7 days, then 2-3 times a week. Such a mode of administration was used in therapy of combined forms of primary immunological failure. The best clinical effect is observed in patients with defects of the functional activity of cellular immunity effectors. Allergic reactions to the drug are possible.

Blood and Immunoglobulin PreparationsPassive, replacement immunotherapy includes a group of methods based on the introduction of a patient from the outside of ready-made factors. In clinical practice, three types of human immunoglobulin preparations are used: native plasma, immunoglobulin for intramuscular administration and immunoglobulin for intravenous administration.

Autohemotransfusion serves as an alternative to allogeneic hemotransfusion. When planned operations, it is recommended (Chander, 1999) an advance workpiece of autocrets with the introduction of erythropoietin 1 time per week at a dose of 400 units / kg 3 weeks, as well as recombinant leukeopoese stimulants (GM-KSF), IL-11, stimulating thrombocytopoes.

Leukocyte mass Used as a means of substitution therapy in immunodeficiency states by phagocytic system. The dose of lekomassa is 3-5 ml per 1 kg of body weight.

Stem cells - autologous and allogeneic, bone marrow and isolated from blood are able to restore the functions of organs and tissues due to differentiation into mature cells.

Native blood plasma (liquid, frozen) contains at least 6 g of a total protein in 100 ml, incl. Albumin 50% (40-45 g / l), alpha 1-globulin - 45%; Alpha 2-globulin - 8.5% (9-10 g / l), beta globulin 12% (11-12 g / l), gamma globulin - 18% (12-15 N / l). It may contain cytokines, ABO-antigens, soluble receptors. Available in bottles or plastic bags of 50-250 ml. The plasma is native to apply on its production day (no later than 2-3 hours after separation from the blood). Frozen plasma can be stored at a temperature of -25 ° C and below for 90 days. At a temperature of -10 ° from the shelf life of up to 30 days.

Plasma transfusion is carried out with compatibility in blood groups (AVO). At the beginning of the transfusion, it is necessary to carry out a biological sample and when the reaction features are found to stop transfusion.

Dry (lyophilized) plasma In view of the decrease in therapeutic fullness due to the denaturation of a part of unstable protein components, a significant content of polymeric and aggregated IgG, highty pieces, it is impractical to apply for immunotherapy of antibody deficiency syndromes.

Immunoglobulin human normal intramuscular Preparations are made of a mixture of more than 1000 donor serums, due to which contain a wide range of antibodies of different specificity, reflecting the state of collective immunity of the contingent of donors. Assigned to prevent infectious diseases: hepatitis, measles, cough, meningococcal infection, poliomyelitis. However, they are unsuitable for substitution therapy of antibody deficiency syndromes during primary and secondary immunodeficiencies. Most of the immunoglobulin destroys at the injection site, which, at best, can cause useful immunostimulation.

The release of hyperimmous intramuscular immunoglobulins, such as anti-stilococcal, anti-infamous, anti-beaded, anti-tunic, applied for specific immunotherapy, has been established.

Intravenous Immunoglobulins (Vig) Secure in terms of transfer of viral infections, contain a sufficient amount of IgG3 responsible for the neutralization of viruses, the activity of the FC fragment. Indications for use:

1. Diseases in which the effect of Vig is convincingly proven:

- pjervic immunodeficiencies(H-bound by agammaglobulinemia; total variable immunodeficiency; transient hypogammaglobulinemia of children; immunodeficiency with hypergobulinemiam M; deficiency of immunoglobulin g; deficiency of antibodies with normal levels of immunoglobulins; heavy combined immunodeficies of all types; Syndrome Viscott-Aldrich; ataxia-teleangioectasia; dwarfishness with selectively short limbs; X-bound lymphoproliferative syndrome.

- secondary immunodeficiency: hypogammaglobulinemia; prevention of infections in chronic lympholes; Prevention of cytomegalovirus infection with an allogeneic bone marrow transplant and other organs; rejection syndrome with an allogeneous bone marrow transplant; Kawasaki disease; AIDS in pediatric practice; Disease is housing Bar; chronic demyelinizing inflammatory polyneuropathy; acute and chronic immunion thrombocytopenic purpura, including children and a related HIV infection; Autoimmune neurophenia.

2. Diseases in which Vig is probably effective:malignant neoplasms with antibody deficiency; Prevention of infections during myeloma disease; enteropathy, accompanied by loss of protein and hypogammaglobulinemia; nephrotic syndrome with hypogammaglobulinemia; neonatal sepsis; severe miastic; Bullese pemphigoid; coagulopathy with the presence of an inhibitor to factor VIII; autoimmune hemolytic anemia; neonatal auto or iso immune thrombocytopenic purple; post-infectious thrombocytopenic purpura; Anticardolypin antibody syndrome; Multifocal neuropathy; hemoly-tico-uremic syndrome; Systemic juvenile arthritis, spontaneous abortion (An-Tiffospholipin syndrome); Shenlein-Genochi disease; Heavy IgA-neuropathy; Steroid dependent bronchial asthma; chronic sinusitis; Viral infections (Epstein-Barr, respiratory synzyti-aple, parvos, adeno, cytomegalovirus, etc.); bacterial infections; sclerosis; hemolytic anemia; viral gastritis; Evans syndrome.

4. Diseases in which the use of Vig may be effectivenon-coming convulsive seizures; System red lupus; dermatomyosis, eczema; rheumatoid arthritis, burn disease; Muscular atrophy Duceda; diabetes; Thrombocytopenic purpura, associated with the introduction of heparin; necrotic enterocolitis; retinopathy; Crohn's disease; Multiple injury, recurring average otitis; psoriasis; peritonitis; meningitis; Meningoencephalitis

Features of clinical use of Vig.

There are several options for therapeutic and prophylactic use of immunoglobulins: replacement therapy for immunodeficiency, complicated by infection; immunotherapy of patients with severe infection (sepsis); The overwhelming IT with autoamellergic and allergic diseases.

Hypogamaglobulinemia is usually found in children with active bacterial infections. In such cases, immunotherapy should be carried out in saturation mode, simultaneously with active antimicrobial chemotherapy. The transfusion of native (fresh or cryopreserved) plasma in a single dose of 15-20 ml / kg of body weight is carried out.

The Vig is administered in a daily dose of 400 mg / kg intravenously drip or infusion of 1 ml / kg / hour premature and 4-5 ml / kg / hour to docking children. Premature children with a body weight of less than 1500 g and the level of IgG 3 g / l and below the Vig is introduced for the prevention of infections. In immunodeficiencies with a low level of IgG in Blood, the VIG is administered until the concentration of IgG in the blood is not lower than 4-6 g / l. With severe purulent-inflammatory diseases, they are introduced daily 3-5 injections or every other day to 1-2.5 g / kg. In the initial period, the intervals between the injections can be 1-2 days, at the end of up to 7 days. 4 - 5 administrations are sufficient, so for 2 to 3 weeks the patient, an average of 60-80 ml of plasma or 0.8-1.0 g of Vig per 1 kg of body weight is obtained. For a month, no more than 100 ml of plasma is transfused or 1.2 g of Vig per 1 kg of body weight of the patient.

After recruiting the exacerbations of infectious manifestations in a child with hypogammaglobulinemia, as well as to achieve levels not lower than 400-600 mg / for the mode of supporting replacement immunotherapy. The clinically effective preservation of the child outside the exacerbation of the foci of infection correlates with the prestrange levels above 200 mg / dl (respectively, the post-transfusion level the next day after plasma transfusion - above 400 mg / dl). This requires a monthly administration of 15-20 ml / kg of body weight of native plasma or 0.3-0.4 g / kg of Vig. For the best clinical effect of non-privileged and regular substitution therapy. For 3-6 months after the completion of the course of immunotherapy, there is a gradual increase in the completeness of the sanitation of chronic infection foci. The maximum effect is manifested by 6-12 months of continuous replacement immunotherapy.

Intraglobin - Vig Contains 1 ml of 50 mg of IgG and about 2.5 mg of IgA, used in immunodeficiency, infections, autoimmune diseases.

Pentaglobin - Vig IgM is enriched and contains: IgM - 6 mg, IgG - 38 mg, IgA -6 mg per 1 ml. Apply under sepsis, other infections, immunodeficiency: newborn 1 ml / kg / hour, 5 ml / kg daily - 3 days; adults 0.4 ml / kg / hour, then 0.4 ml / kg / h, then continuously 0.2 ml / kg to 15 ml / kg / hour for 72 hours - 5 ml / kg 3 days, if necessary - Repeated course.

Octagam - Vig Contains 1 ml of 50 mg of plasma proteins, of which 95% IgG; less than 100 μg IGA, and less than 100 μg IGM. Close to native IGG blood plasma, there are all IgG subclasses. Indications Congenital Agamaglobulinemia, variable and combined immunodeficiency, thrombocytopenic purpura, Kawasaki disease, bone marrow transplant.

In immunodeficiency, it is introduced to the IgG level in the blood plasma 4-6 g / l. The initial dose of 400-800 mg / kg, followed by the introduction of 200 mg / kg every 3 weeks. To achieve the level of IgG 6 g / l, it is necessary to introduce 200-800 mg / kg per month. To control determine the level of IgG in the blood.

For the treatment and prevention of dose infections, VIG depend on the type of infectious process. As a rule, it is introduced as early as possible. With a cytomegalovirus infection (CMV), the dose should be 500 mg / kg weekly for 12 weeks, because the half-life of the IgG3 subclass responsible for the neutralization of the virus is 7 days, and the clinically infection is manifested between the 4-12 weeks after infection. At the same time, synergistic acting antiviral drugs are prescribed.

For preventing neonatal sepsis in premature children weighing from 500 to 1750 grams, it is recommended to introduce from 500 to 900 mg / kg / day of IgG to maintain its concentration of at least 800 mg / kg under the control of the IgG level in the blood. Increased IGG levels remain an average of 8-11 days after administration. IgG introduction Pregnant after 32 weeks reduced the risk of infection in newborns.

Vig preparations are used for the treatment of sepsis especially in combination with antibiotics. The recommended level in the blood is more than 800 mg / kg.

After allogenic bone marrow transplantation for the prevention of CMV and other Vig infections are introduced weekly within 3 months, and then 500 mg / kg every 3 weeks for 9 months.

In the treatment of autoimmune doses, 250-1000 mg / kg is 2-5 days every 3 weeks. Children with autoimmune thrombocytopenic purple introduced 400 mg / kg 2 days, adults - 1 g / kg for 2 or 5 days.

The mechanism of action of immunoglobulins depends on the stateFC.Leukocyte -Rsceptors: binding to them, immunoglobulins enhance functions in infection, and, on the contrary, inhibit during allergies.

Anti-immunoglobulinsuppests from a Rh-negative woman a synthesis of antibodies against a rhesus-positive fetus by the type of feedback.

Mechanism of actionIgG. It consists in a specific and nonspecific effect. Specific associated with the action of a small amount of antibodies present. Nonspecific - with immunomodulatory effect. Both effects are usually mediated throughFC.-receptors leukocytes. Binding S.FC.-receptors leukocytes, immunoglobulins activate them, in particular phagocytosis. If there are antibodies among immunoglobulin molecules, then they can be aspided by bacteria or neutralize viruses.

Novikov D.K. and Novikova V.I. (2004) developed a method for predicting the effectiveness of immunoglobulin drugs. It was found that the therapeutic effect of immunoglobulin preparations depended on the presence of FC receptors on the leukocytes of patients. The method is that in the blood of patients before treatment, the number of leukocytes carrying receptors for FC fragments of immunoglobulins, and the ability of leukocytes to sensitizing with antistaphococcal immunopreparations is determined. If there are 8% and more lymphocytes and 10% and more granulocytes in the amount of more than 100 in 1 μl of blood having Fc receptors, and the positive reaction to the transfer of sensitization predict the effectiveness of immunotherapy.

The results on the transfer of the immunopreparation of sensitization lymphocytes are estimated in the reaction of suppressing the migration of leukocytes using antigens, corresponding to antibodies in the antiserum, for example, staphylococcal antigens. If staphylococcal antigens suppress the migration of leukocytes treated with antistaphococcal plasma, but do not suppress the migration of leukocytes treated with normal plasma, the reaction is considered positive.

The proposed method allows to predict the effectiveness of both specific (using immune drugs) and non-specific (for FC receptors) immunotherapy with immunoglobulin.

Monoclonal antibodies Mice against lymphocytes and human cytokines are used to suppress autoimmune reactions, transplant immunity. Below are some options for using monoclonal antibodies:

Antibodies against CD20 B-lymphocytes for immunosuppression ( Mabter )

Antibodies against receptors to interleukin 2 - in the threat of rejection of the kidney al-lotlanplant;

Antibodies against IgE - with severe allergic reactions ( Xollarm ).

Bone marrow preparations, leukocytes and spleen

Melopid Get from the culture of bone marrow cells of pigs. It contains the immuno-modulators of bone marrow origin - myelopeptides. Myelopid stimulates antitumor immunity, phagocytosis, antibody cells, pranthelocyte proliferation and macrophages in the bone marrow. Myelopid is used in the treatment of septic, protracted and chronic infectious diseases of bacterial nature, secondary immunodeficiency, since it has the ability to strengthen antibody synthesis in the presence of antigens. Myelopid (5 mg bottle) is introduced per / m daily or every other day. One-time dose 0.04-0.06 mg / kg. The course of therapy consists of 3-10 injections performed in a day.

Leukocytarial transfer factor ("Transfer factor") A group of biologically active substances extracted from leukocytes of healthy or immunized donors with the help of multiple consecutive freezing and defrosts. Transfer factors in strengthening slow motion-type hypersensitivity to specific antigens. The drug prevents the development of immunological tolerance, enhances the differentiation of T-cells, chemotaxis neutrophils, the formation of interferons, synthesis of immunoglobulins (mainly class M). One-time dose is for adults 1-3 units of dry matter. It is used in the treatment of primary immunodeficiency, especially macrophagum type and therapy of secondary immunodeficiency lymphoid type (with defects of differentiation and proliferation of T-cells, hemotaxis violation and presentation of antigens).

Cytokines- A group of biologically active glycopeptide-mediators, isolated by immunocompetent cells, as well as fibroblasts, endothelium cells, epithelium. The main directions of cytokinotherapy:

Inhibition of products of inflammation cytokines (IL-1, TNF-α) with anti-inflammatory agents and monoclonal antibodies;

Correction of immunoreactivity cytokines (IL-2, IL-1, interferons);

Strengthening cytokines of the immunostimulating effect of vaccines;

Stimulation by cytokines of antitumor immunity.

Betalekin - recombinant IL-Lβ, produced in ampoules of 0.001; 0.005 or 0.0005 mg (5 ampoules). Stimulates leukeopoese with leukopenia caused by cytostatics and irradiation, differentiation of immunocompetent cells. Apply in oncology, with postoperative complications, protracted, purulent-septic infections. Introduced in / in drip at a dose of 5 ng / kg for immunostimulation; 15-20 ng / kg For the stimulation of leukopopower daily by 500 ml of 0.9% sodium solution of chlorad for 1 - 2 hours. Course - 5 infusions.

Roncolekin - recombinant IL-2. Indications: signs of immunodeficiency, purulent-inflammatory diseases, sepsis, peritonitis, abscesses and phlegmon, pyodermia, tuberculosis, hepatitis, AIDS, oncological diseases. At sepsis, 0.25 - 1 mg (25000 - 1000000 meters) in 400 ml of 0.9% solution of sodium chloride in / in drip at a rate of 1-2 ml / min for 4-6 hours, during cancer - 1-2 million units 2-5 times at intervals of 1-3 days, 25,000 meters in 5 ml of physiological solution are injected with sinusitis in a maxillary or frontal sinus; installations in the urethra in chlamydia daily at 50000 me (14-20 days); Orally under the heersineoses and diarices of 500,000 - 2500,000 in 15-30 ml of distilled water on an empty stomach daily 2-3 days. Ampoules of 0.5 mg (500000 me), 1 mg (1000000 me).

Neapogen (Philgrantim) - A recombinant granulocyte colony positive factor (M-KSF) stimulates the formation of functionally active neutrophils and partly monocytes already in the first 24 hours after administration, activates hemopohees (for the fence of autocardies and bone marrow for transplanting). Used in chemotherapeutic neutropenia, for the prevention of infections in a dose of 5 μg / kg / day V / V or P / k 24 hours after the treatment cycle within 10-14 days with congenital neutropenia 12 μg / kg per day.

Lekukax (arrangements) - recombinant granulocytarial macrophageal colonystimulating factor (GM KSF). Applied with leukopenia at a dose of 1-10 μg / kg / day, subcutaneously according to indications.

Granocyte (Lenograstim) - a granulocytic colonystimulating factor, stimulates the proliferation of granulocyte precursors, neutrophils. Applied with neutropenia 2-10 μg / kg / day for 6 days.

Leucinferon - is a complex of cytokines of the first phase of the immune response and includes IFN-α, IL-1, IL-6, IL-12, TNF-α, MIF. In case of bacterial infections, the course of treatment should be intense (every other day one AMP, V / m) and only when restoring immunity supporting (2 times a week 1 AMP, V / m).

InterferonsThe classification of interferons by their origin is presented in Table 1.

Table 1. Interferon classification

Source of interferon	A drug	Cell-target
Leukocytes	α-interferon (Egifeon, Gelferon)
Fibroblasts	β-interferon (fibloferon, betaferon)	Infected cell virus, macrophages, nk, epithelium	Anti-virus, antiproliferative
T-, B cells or NK	γ-interferon (gamma farmer, immunofoferon)	T-cells and NK	Strengthening of cytotoxicity, antivirus
Biotechnology	recombinant α 2-Interferon (Refaferon, intron a)
Biotechnology	Ω interferon		Antoviral, antitumorian

The mechanism of the immunomodulatory action of interferon is implemented through an increase in the expression of receptors on cell membranes and through the involvement in differentiation. They activate NK, macrophages, granulocytes, inhibit tumor cells. The effects of different interferons differ. The interferons I type - α and β focus expression on MHC I class cells, and also activate macrophages, fibroblasts. Interferon-type II type increases the functions of macrophages, the expression of the MHC II class, the cytotoxicity of NK and T-coilers. The biological significance of interferon is not limited to a pronounced antiviral effect, they exhibit antibacterial and immunomodulating activity.

The interferon status of an immunocompetent person is determined by the trace amounts of these glycoproteins in the blood (< 4 МЕ/мл) и на слизистых оболочках, но лейкоциты здоровых людей при антигенном раздражении обладают выраженной способностью синтезировать интерфероны. При хронических вирусных заболеваниях (герпес, гепатит и др.) способность к выработке интерферонов у больных снижена. Наблюдается синдром дефецита интерферона. В то же время у детей в случаях первичных иммунодефицитов лимфоидного типа интерферонная функция лейкоцитов сохранена. При антигенном стимуле в норме вырабатываются все типы интерферонов, однако наибольшее значение для местного противовирусного иммунного статуса имеет титр α-интерферона.

Interferons in doses up to 2 millionMe. have an immunostimulating effect, and their high doses (10 millionMe.) Call immunosuppression.

It must be remembered that all interferon drugs can cause fever, influenza-like syndrome, neutropenia and thrombocytopenia, alopecia, dermatitis, disorders of the liver and kidney function and a number of other complications.

Leiccitarian α-interferon (Egifeon, Valiferon) It is used as a prophylactic drug in the form of local appliqués on the mucous membrane in epidemic periods and in the treatment of early stages of sharp respiratory and other viral diseases. With viral rhinitis, it is necessary to introduce an intranasally sufficiently large dose (3x10 b ME) 3 times a day in an early period of the disease. The drug is rapidly excreted by sausages and is inactivated by its enzymes. Applying it for more than a week can cause inflammation. Eye interferon drops are used with viral eye lesions.

Interferon-β (Betaferon) Apply for the treatment of sclerosis, it slows down the replication of viruses in the cerebral tissue, activates the suppressors of the immune response.

Human immune γ-interferon (gammaferon) It has cytotoxic effects, modulates the activity of T-lymphocytes and activates B cells. At the same time, the drug can cause the oppression of antibody formation, phagocytosis and modify the answer of lymphocytes. The effect of γ-interferon on T cells is saved for 4 weeks. Used in psoriasis, HIV infection, atopic dermatitis, tumors.

Doses of interferon preparations for parenteral administration are selected individually: from several thousand units per 1 kg of body weight to several million units per 1 injection. Course 3-10 injections. Adverse reactions: flu-like syndrome.

Recombinant interferon alpha-2β (intron a) prescribed for the following diseases:

multiple myeloma- p / k 3 r. per week, 2 x10 5 IU / m 2.

sarcoma Kaloshi.- 50 x 10 5 IU / m 2 subcutaneously daily for 5 days, then a break of 9 days, after which the course is repeated;

malignant melanoma- 10 x 10 6 me p / k 3 times a week every other day at least 2 months;

hairy cell leukemia- p / k 2 x 10 b i / m 2 3 p. in week 1-2 months;

papilomatosis, viral hepatitis- the initial dose of 3 x 10 b m / m 3 times a week for 6 months in the first case (after surgical removal by papillom) and 3-4 months - in the second case.

Laferon (Larquet) Recombinant alpha-2BET Interferon is used in the therapy of adults and children with: acute and chronic viral hepatitis; acute viral and viral-bacterial diseases, rino- and coronavirus, paraganizer infections, ARVI; under meningoencephalitis; under herpetic diseases: disintegrating, lesions of the skin, genitals, keratitis; acute and chronic septic diseases (sepsis, septicemia, osteomyelite, destructive pneumonia, purulent mediacenitis); scarmed sclerosis (injecting at least one year); kidney cancer, breast, ovary, bladder, melanoma (including in dicimic form); Hemoblastosis: Hairy Melting Lakekosis; chronic myelolomicosis, acute lymphoblastic leukemia, lymphoblastic lymphosarcoma, T-cell lymphoma, multiple myeloma, sarcoma capos; As a means that removes intoxication during irradiation and chemotherapy of oncological patients. Laferon is manufactured by: 100 thousand meters, 1 million meters, 3 million meters, 5 million meters, 6 million meters of 9 million and 18 million meters. Prescribe with: herpes-Zoster They smoke in the course of the nerve near the rash of 2-3 million IU in 5 ml of physical. R-ra and applying Laferon Papula mixed with a cosmetic emulsion of La Kos (or children's cream) in the ratio of 1 million meters of Laferon by 1-2 cm 3 cream; acute viral hepatitis in per / m 1 - 2 million meters 2 r. per day 10 days; H. ronic viral hepatitis in per / m 5 million meters 3 r. per week 4-6 weeks (with a hypertermic reaction 20-30 minutes before the introduction of Laferon, take 0.5 g of paracetamol, if necessary, the reception of anti-infires can be repeated 2-3 hours after the injection of Laferon); at x. ronic viral hepatitis with v / m at a dose of 3 million meters 3 r. per week for 6 months; for ORVI and flu : in / m 1-2 million meters 1-2 p. On the day, together with intranasal administration (1 million mete, in 5 ml of physical fis. R-ra, pour into each nasal stroke of 0.4-0.5 ml 3-6 r. per day, r-p to warm up to 30- 35 ° C); with postgrippose meningoencephalite Entering in / at 2-3 million meters 2 r. per day (under the protection of antipirectrics); under sepsis in / m (drip on physiological) introduction at a dose of 5 million and 5 days and more; at D. breeds of the epithelium of the cervix, papilloma of viral and herpetic genesis, in chlamydia per / m 3 million meters 10 days and locally: 1 million metera of Laferon mixed with 3-5 cm 3 cosmetic emulsion of La Kos (or children's cream), to introduce the uterus with an aplikator every day (preferably before bedtime); with K. yeratitis, keratoconjunctivitis, keratowest parabulbarno 0.25-0.5 million meters 3 - 10 days and Laferon in Installations: 250-500 thousand IU per 1 ml of physical. rr 8-10 times a day; with warts per / m 1 million meters of 30 days; with multiple sclerosis per / m 1 million meters 2-3 times a day 10 days, then 1 million meters 2-3 times a week for 6 months; when cancer different localization per / m 3 million meters 5 days before surgical intervention, then courses of 3 million meters 10 days after 1.5-2 months; with primary-limited melanoblastoma Endolymphatic administration of 6 million me / m 2 in combination with cytostatics, supporting therapy by weekly courses: 2 million me / m 2 Laferon in a day, 4 times (course - 8 million meters 2) monthly; with multiple myelome - per / m daily at a dose of 7 million me / m 2 for 10 days (course - 70 million IU / m 2) after the course of chemat and gamma therapy, supporting therapy by weekly courses at a dose of 2 million me / m 2 V / m, 4 administration every other day (course - 8 million me / m 2), within 6 months, the interval between courses 4 weeks; from archoma Caposhi per / m 3 million me / m 2 10 days after cytostatic therapy supporting therapy by weekly courses, p / k 2 million me / m 2 4 times a day (course - 8 million me / m 2), 6 courses with interval 4 weeks; B. azalo-cell cancer P / k Introduction to the tumor zone 3 million meters in 1-2 ml of water for injection, 10 days, repeated course in 5-6 weeks.

Roiferon-A. - recombinant interferon - alpha 2a is introduced in / m (up to 36 million me) or p / k (up to 18 million me). With hairy cell leukemia - 3 million and a day in / m 16-24 weeks; myeloma disease - 3 million me 3 times a week in / m; The sarcoma of Kalosh and the kidnotee Cartzen - 18-36 million me per day; Viral hepatitis B - 4.5 million ME / m 3 times a week 6 months.

Viferon - The recombinant interferon alpha-2β is used in the form of candles (150 thousand me, 500 thousand ME, 1 million me), ointment (40 thousand meters in 1 g). Prescribe with infectious and inflammatory diseases (ORVI, pneumonia, meningitis, sepsis, etc.), with hepatitis, during herpes of the skin and mucous membranes - 1 time per day or every other day in candles; With herpes - additionally lubricate the affected areas of the skin by ointment 2-3 times a day. Children candles for 150 thousand me 3 times a day after 8 hours 5 days. In hepatitis - 500 thousand me.

Reaffeferon (Interal) Recombinant interferon α2 is prescribed when hepay in, virus meningoencephalitis V / m to 1-2x10 b ME 2 times a day 5-10 days, then the dose is reduced. In case of influenza, intranasal-king can be used; In the genital herpes - ointment (0.5x10 b me / g), zooming - intramuscularly to 1x10 6 me per day for 3-10 days. Use also for the treatment of tumors.

Bostimulators of various originMany signals bonding the CNS and the immune system are transmitted by biologically active substances that perform neutromediators and neuromodulators in the CNS, and in peripheral tissues - hormone functions. These include: hormones, biogenic amines and peptides.Neuro-regulatory biological mediators and hormones affect the differentiation of lymphocytes and their functional activity. For example, adenogipophysis secrete such immunotropic mediators as somatotropin, adreno-corticotropic hormone, gonadotropic hormones, a group of thyrotropic hormones, as well as a special hormone - timocyte growth factor.

Heparin - Mukopolisaccharide with M.M. 16-20 kda, stimulates hemopoiesis, reinforces the yield of leukocytes from the bone marrow depot and increases the functional activity of cells, enhances the proliferation of lymphocytes in lymph nodes, increases the resistance of erythrocytes of peripheral blood to hemolysis. In doses of 5 - 10 thousand, it has fibrinolytic, disaggregating platelets and a weak immunosuppressive effect, strengthens the effect of steroids and cytostatics. With intradermal use in patients in several points in small doses of 200 to 500, it has an immunoregulating effect - normalizes a reduced level of lymphocytes, their subpopulation spectrum; It has a stimulating effect on neutrophils.

VitaminsUnder the influence of vitamins, the activity of biochemical processes in cells, including immunological ones changes. Some forms of immunological failure are associated with a shortage of certain vitamins. For example, the primary form of the defect phagocytosis can be - Chadiacon Higashi syndrome. In case of echoing the disease, the reception of vitamin C at a dose of 1 gram per day for several weeks, enzyme redox phagocyte systems (neutrophils and macrophages) is activated for several weeks) to the stage of compensation for their bactericidal function.

Vitamin C normalizes the activity of T-lymphocytes and neutrophils in patients with initially reduced indicators. However, high doses (10 g) cause immunosuppression.

Vitamin E - (tocopherol acetate, α-tocopherol) It is contained in sunflower, corn, soybean, sea buckthorn oil, in eggs, milk, meat. It has antioxidant and immunostimulating properties, used with muscle dystrophy, sexual impairment, during chemotherapy. Prescribed inside and intramuscularly at 0.05-0.1 g per day 1-2 months. The appointment of vitamin E in the daily dose of 300 me 6-7 days orally increases the number of leukocytes, T- and in-lymphocytes. In combination with selenium, Vitamin E gained the amount of antibody cells. It is believed that vitamin E changes the activity of lipo and cyclooxygenases, enhances IL-2 products and immunity, inhibits the growth of tumors. The tocopherol at a dose of 500 mg daily normalized the indicators of the immune status.

Zinc acetate (10 mg 2 times a day, 5 mg to 1 month) is a stimulator of antibody and slow-type hypersensitivity. Zinc-Timulin is considered one of the main hormones of Timus. Zinc drugs increase resistance to respiratory infections. With a deficiency of this trace element, the quantitative deficiency of antibody-producing cells is determined, the synthesis defects of the IgG 2 and IgA synthesis. A separate form of primary immunological failure is described - "enteropathic accodimatitis with combined immunological failure", which is almost entirely corrected by the reception of zinc drugs, for example, zinc sulfate. Reception of the drug is carried out constantly. Zinc oxide is prescribed in powder after eating with milk, juices. With Akrodmetmatitis - 200-400 mg per day, then 50 mg / day. Dudews, for infants 10-15 mg / day, adolescents and adults - 15-20 mg / day. Prectuctively - 0.15 mg / kg / day.

Lithium it has an immunotropic effect. Lithium chloride at a dose of 100 mg / kg or lithium carbonate in the age dose to receive is caused by an immuno-modulating effect in immunological failure caused by the deficit of this trace element. Lithium enhances granulocytopoesees, the products of a colony-stimulating factor with bone marrow cells, which is used in therapy of the hypoplastic states of blood formation, neutropenia and lymphopies. Activates phagocytosis. The use of the drug: the dose is gradually increased from 100 mg to 800 mg / day, and then reduced to the initial one.

Phytoemmunomodulators Infusions, grave decoctions have immunomodulatory (immunostimulating) activity.

Eleuthorokokk With normal immune status, immunity indicators do not change. It has interferonogenic activity. When the number of T cells deficiency normalizes the indicators, enhances the functional activity of T cells, phagocytosis activates, nonspecific immunity reactions. Apply 2 ml of alcohol extract 30 minutes before meals 3 times a day 3-4 weeks. In children for the prevention of recurrence of ARZ 1 drop / 1 year of life 1-3 times a day 3-4 weeks.

Ginseng Increases the health and overall resistance to the body to diseases and adverse effects, do not cause harmful side effects and can be used for a long time. Ginseng root is a strong causative agent of CNS, does not have negative effects, does not break sleep. Ginseng preparations stimulate tissue respiration, increase gas exchange, improve the composition of the blood, normalize heart rhythm, increase eye sensitivity, accelerate the healing processes, suppress the vital activity of some bacteria, increase radiation resistance. Preparations of it are recommended to be used in the autumn-winter period. The most stimulating effect is observed when using a ginseng powder and a 4-degree alcohol tincture. A single dosage is 15-25 drops of alcohol tincture (1:10) or 0.15-0.3 g of ginseng powder. Take 2-3 times a day before eating courses for 30-40 days, after which take a break.

Infusion Inflorescences Chamomile Pharmacy It contains essential oils, azulene, an-thimine acid, heteropolisaccharides with immunostimulating ability. Use the chamomile infusion to increase the activity of the immune system after hypothermia, with long-term stressful situations, in the autumn-spring period for the prevention of colds. Infusion is taken inward at 30-50 ml 3 times a day for 5-15 days.

Echinacea ( Echinacea. purpurea. ) It has an immunostimulating, anti-inflammatory effect, activates macrophages, secretion of cytokines, interferons, stimulate T cells. Used for the prevention of colds in the autumn-spring period, as well as for the treatment of viral and bacterial infections of the upper respiratory tract, the urinary tract, etc. It is recommended to 40 drops 3 times a day diluted with water. Supporting doses - 20 drops 3 times a day orally for 8 weeks.

Immunal - 80% of the juice of Echinacea Purple, 20% ethanol. Assign 20 drops inside every 2-3 hours at Orz, flu, then 3 times a day. Course 1-8 weeks.

Bostimulators are adaptaged: a tincture of lemongrass, decoction and infusions of a turn, cleanliness, calendulas, violet tricolor, licorice root and dandelion possess an immunocorrorizing effect. There are preparations: glycers, Liquimiton, annexian chest, Caleflon, calendula tincture.

BacterioimmunotherapyDysbiosis of mucous membranes plays an important role in pathology. Antibiotic therapy, cytostatic and radiation therapy cause a violation of biocenosis of mucous membranes, primarily intestinal, and then dysbacteriosis occurs. Probiotic lactobacillias and bifidobacteria, colibacteria, highlighting coliols, inhibit the growth of pathogenic bacteria. However, it is important not only to suppress pathogenic bacteria and mushrooms, but also the fact that under dysbiosis arises insufficiently produced by normal flora of the necessary biologically active substances: vitamins (B 12, folic acid), lipopolysaccharides of intestinal sticks, stimulating the activity of the immunity system, etc. as a result Dysbacteriosis is accompanied by immunodeficiency. Therefore, natural flora preparations are used to restore the normal bowelosis biocenosis, which plays an important role in stimulating the functions of the immune system.

Gram-positive lactobacillias and bifidobacteria stimulate utteid-military and antitumor immunity, induce tolerance in allergic reactions. They directly cause moderate selection of cytokines by immunocompetent cells. As a result, the synthesis of secretory IGA is enhanced. On the other hand, lactobacillia, penetrating through the mucous membrane, may be the cause of infection and induce the systemic immune response, so probiotic bacteria serve as strong immunomodulators, especially in the immunodeficiency organism. Preparations of living bacteria do not apply simultaneously with antibiotics and chemotherapy products that oppress them.

Lactobacilli - antagonists of pathogenic microbes, excrete enzymes and vitamins. It is recommended to assign together with specific bacteriophages that overwhelming the pathogenic flora. It is impractical to use them in candidoses, since their acids increase the growth of mushrooms.

Bifidumbacterin Sukhoi - dried live bifidobacteria. Adults 5 tablets 2-3 times a day 20 minutes before meals. Course up to 1 month. Children - in vials, diluted with warm boiled water (1 tablet: 1 teaspoon) 1-2 doses 2 times a day.

Used in dysbacteriosis, enteropathy, artificial feeding of children, treatment of premature, acute intestinal infections (dysentery, salmonellosis, etc.), chronic intestinal diseases (gastritis, duodenitis, colitis), radiation and chemotherapy of tumors, candidal vaginites, intolerance to food and food allergies, dermatitis, eczema, normalization of microflora mucous membranes of the oral cavity during stomatitis, paradontitis, diabetes, chronic liver diseases and pancreas, work in harmful and extreme conditions.

Bificha Dry - Live dried bifidobacteria and intestinal wand VRT7. Adults and children over 3 years old - 20-30 minutes before meals 3-5 Table 2 times a day, drink water. Course 2-6 weeks.

Bifiform Contains at least 10 7 Bifidobacterium. lOBGUM., as well as 10 7 Epo-fGrococcus. faecium. in capsules. With the I-II I-II dysbacteriosis, 1 capsule 3 times a day, a course of 10 days, with dysbacteriosis II-III degree increasing the course to 2-2.5 weeks

Linex. - The combined drug contains three components of natural microflora from different departments of the intestines: in one capsule - 1.2x10 7 lively lyophilized bacteria Bifidobacterium. infantis, Lactobacillus., Cl.. dophilus. and Str.. faecium. antibiotic resistant and chemotherapy products. Microbiocenosis is maintained in all intestinal deposits - from the small intestine to the straight. Appoint: adults 2 capsules 3 times a day floating with boiled water, milk; Children up to 2 years old - 1 capsule 3 times a day, drinking liquid or mixing the contents of the capsule with it.

Kolibacterin Sukhoi - Dried live intestinal wand, M-L7 strain, which is an antagonist for pathogenic microbes, stimulates immunity, as well as enzymes and vitamins. Adults 3-5 Table 2 times a day for 30-40 minutes before meals, washed with alkaline mineral water. Course 3 weeks -1.5 months

Bificik - Combined drug.

Bakskyubtil - APPAKETERY OF CULTURE GR-5832 (ATCC 14893) 35 mg-10 9 dispute, applied with diarrhea, dysbios 1 cap 3-10 times a day 1 hour before meals.

Enterol-250. Unlike bacteria-containing drugs, has the Saccharomycetes BoulardII, which serve as antagonists of pathogenic bacteria and mushrooms. It is recommended for diarrhea, dysbiosis, can be used in combination with antibacterial therapy. Appoint children to 3 years old 1 capsule 1-2 times a day for 5 days, children over 3 years old and adults 1 capsule 2 times a day for 7-10 days.

Hilak Forte Contains products of metabolic activity of probiotic strains of lactobacilli and normal intestinal microorganisms - intestinal sticks and fecal streptococcus: lactic acid, amino acids, short-chain fatty acids, lactose. Compatible with taking antibiotics. The simultaneous use of antacid drugs is not recommended due to the possible neutralization of lactic acid, which is part of the hilak forte. Assign in a dose of 20-40 drops 3 times a day for 2-3 weeks (breast-age children is 15-30 drops 3 times a day), adopted in a small amount of fluid before or during meals, excluding milk and dairy products.

Gastropharm. - Live lyophilized cells Lactobacillus. bulgaricus. 51 and their livelihood metabolites (dairy and malic acid, nucleic acids, a number of amino acids, polypeptides, polysaccharides). Inside, 3 times a day, chewing with a small amount of water. One-time dose for children is a tablet, for adults - 1-2 tablets.

Immunomodulating effects of antibioticsConditional pathogenic microbes (staphylococci, streptococci, intestinal wand, etc.) are etiological factors as well as pathogens of most diseases that have infectious-inflammatory character. Therefore, antibiotic therapy, in particular, the use of antibiotics is served by the main medical unit. Attempts to "sterilize" a patient with antibacterial agents lead to dysbacteriosis, mikozam, creating new problems.

Conditional pathogenic microbes do not cause diseases in most people and are normal inhabitants of the skin and mucous membranes. The cause of their activation is the insufficient resistance of the body - immunodeficiency.Therefore, congenital or acquired, acute and chronic immunodeficiency, which create favorable conditions for reproduction of microbes, is the basis of infectious and inflammatory diseases, which create favorable conditions for microbes, is normalized by immunity factors. An example of a common acute immunodeficiency is a cold syndrome, when a natural resistance to conditionally pathogenic microbes is oppressed against the background of the organism hypothermia.

From the above, it follows that without the restoration of the organism reactivity, the suppression of microflora is often insufficient for complete recovery. Moreover, many antibacterial agents depress immunity, create conditions for the contamination of the organism resistant to antibiotics strains. Even more aggravates the problem of the common "prophylactic" use of antibacterial agents in viral infections. The main ways to solve the problem: the simultaneous use of antibiotics and funds normalizing the oppressed links of the immunity system; Additional use of immunorelabating tools; Maximum preservation and restoration of the endoecology of the body. Two types of influence of antibiotics on the immune response are possible: lisis associated with bacteria and damage to bacteria and caused by direct influence on the cells of the immune system.

1. Effects mediated by damaged bacteria:

- inhibition of the synthesis of the cell wall (penicillin, clindacimine, cephalosporins, carbapenes, etc.) - reduces the stability of bacterial cells to the action of bactericidal leukocyte factors and macrophages;

inhibition of protein synthesis (macrolides, rifampicin, tetracyclines, fluoroquinolones, etc.) causes changes in the cell membrane of microorganisms and can enhance phagocytosis by reducing expression on the surface of bacterial cells of proteins with anti-phakocyte function, at the same time these antibiotics suppress the immune response due to violations protein synthesis in immunity system cells;

the disintegration of the gram-negative bacteria membrane and an increase in its permeability (aminoglycosides, polymixin c) increases the sensitivity of microorganisms to the action of bactericidal factors.

2. Effects of antibiotics due to liberation from microorganisms in their destruction of biologically active substances:endotoxins, exotoxins, glycopeptides, etc. Small doses of endotoxins are necessary for normal development of immunity, have a beneficial effect, stimulate non-specific resistance to bacterial and viral infections, as well as to cancer. This is visible on the example of an intestinal stick, which is a normal inhabitant of the intestine. With its destruction, a small amount of endotoxin, stimulating local and general immunity, is distinguished. Therefore, with such protracted infections, preparations of bacterial lipopolysaccharides are often effective - Prodigiosan, Pyrohenal and Likopid. However, with severe infection and isolating a large amount of endotoxin in blood flow, induced by the cytokines (IL-1, TNF-α) can cause phagocytosis inhibition, expressed toxicosis up to toxic-septic shock with a drop of cardiovascular activity. On the other hand, the intensive lysis of a large amount of bacteria and the release of endotoxins can lead to side reactions, such as Jarisha-Gersheimer.

Effects caused by the direct influence of antibiotics on the immunity system:

Beta-lactam antibiotics enhance phagocytosis and chemotaxis leukocytes, but in large doses, antibody and bloodcactericidality of blood can coal;

Cephalosporins, binding to neutrophils, increases their bactericidity, chemotaxis and oxidative metabolism in patients with immunodeficiency.

Gentamicin reduces phagocytosis and chemotaxis granulocytes and RBTL.

Macrolids (erythromycin, roxitromycin and azithromycin) stimulate the functions of phagocytes, bactericidity, chemotaxis, synthesis of cytokines (IL-1, etc.).

Fluoroquinolones enhance the proliferation of cells of the immune system, the synthesis of IL-2, phagocytosis and bactericidality increase.

Tetracycline, doxycycline press the phagocytes and synthesis of antibodies.

Immunomodulating effects of antibiotics on the immunity system lead to the development of allergic reactions. The basis is the interaction of antibiotics as hapten with cells of the immunity system and the activation of a specific immune response.

Introduction
Immunomodulators.
Classification of immunomodulators
Pharmacological effect of immunomodulators.
Clinical application of immunomodulators.
Characteristics of some immunomodulators
Application of IMD with viral infections
Application of IMD with bacterial infections
Conclusion.
List of reference sources

Introduction

The emergence of new physical (radiation), chemical (hormones, antibiotics, pesticides, dioxins) and biological (HIV infection, prions) factors, including anthropogenic nature that influence both the pathogenicity of microorganisms (stimulating or relaxing it) and Resistance to humans and animals (stimulating or relaxing natural resistance and specific immunity), often leads to the modifications of the immune system, causing immunodeficient, autoimmune and allergic reactions.

With immunobiological positions, the condition of animals in modern conditions is characterized by a decrease in the immunological reactivity of the body. According to some data, more than 80% of animals have various deviations in the activities of the immune system, which increases the risk of incidence of acute diseases caused by opportunistic microorganisms.

The development of immune-deficient states and other violations of the immune system contributes to the content of a large number of animals on limited areas, a late organization and conducting veterinary and sanitary, preventive and anti-episotic measures, a lack or lack of insolation, active municipality, full nutrition. Also, in the process of the prevention and treatment of various animal diseases, there is often a low efficiency of chemotherapeutic preparations and other traditional methods, which is most often associated with low immunological reactivity of the body.

In this regard, the interest of doctors to immunotherapy and immunopylaxis increases.

To increase the resistance of animals, genetic (species, breed and individual depens on the genotype of manifestation of natural resistance, dependence on the genotype of intensive immune response to various antigens) and phenotypic (modification change in immune reactivity under the influence of external environmental factors) factors. However, the use of only these factors does not always give full protection of animals from affecting their immune system of physical, chemical and biological factors, which is why there is a need for continuous search for new ways to effectively protect against real infectious diseases, including through the impact on the immune system.

Immunomodulators.

Immunomodulators are medicinal preparations of animal, microbial, yeast and synthetic origin, affecting the immune system.

Some immunomodulators affect the immune system towards its strengthening (immunostimulants), others - in the direction of weakening (immunosuppressors); The first are used in the treatment of immunodeficiency states, the second - with autoimmune pathology and transplantation of allogeneic tissues. The effect of immunomodulators depends on the dose, as well as on the initial state of the immune system.

A variation of immunomodulation is immunocorrection - bringing to the norm of initially modified activity of the immune system or its components.

Classification of immunomodulators.

Currently, 6 major groups of immunomodulators are identified by origin:

immunomodulators microbial;

immunomodulators are tyamic;

armnotodulators bone marrow;

cytokines;

nucleic acids;

chemically clean.

Immunomodulators of microbial origin can be divided into three generations. The first drug allowed for medical use as an immunostimulator was a BCG vaccine, which has a pronounced ability to strengthen the factors of both congenital and acquired immunity.

Microbial preparations of the first generation include such drugs such as Pyrohenal and Prodigiosis, which are polysaccharides of bacterial origin. Currently, due to pyrcy and other side effects, they are rarely applied.

The microbial second-generation drugs include lysates (bronchomunal, IPC-19, IMUDON, relatively recently appeared at the Russian pharmaceutical market of the Swiss-produced Broncho-Vax) and Ribosomes (Ribominyl) bacteria, relating mainly to the number of causative agents of respiratory infections Klebsiella. pneumoniae., Streptococcus. pneumoniae., Streptococcus. pyogenes, Haemophilus. influezae. et al. These drugs have a double appointment specific (vaccinating) and non-specific (immunostimulating).

Licopid, which can be attributed to the microbial preparations of the third generation, consists of a natural disaccharide - glucosaminemilane and an attached synthetic dipeptide - L-alanyl-d-isa-bellum.

The two-generation of the first-generation thymic drugs in Russia became a tactual, which is a complex of peptides extracted from thymus of cattle. Timalin, Timoptin et al., And Timus, and Vilozen, also include drugs containing complex peptides.

The clinical efficacy of the Timic preparations of the first generation is no doubt, but they have one drawback - they are an unrequited mixture of biologically active peptides, quite difficult to standardization.

Progress in the field of drugs of thymic origin went through the creation of preparations II and III generations - synthetic analogues of natural hormones of thymus or fragments of these hormones with biological activity. The last direction turned out to be the most productive. Based on one of the fragments, which includes the amino acid residues of the active center of tymopoietin, a synthetic hexapeptide of immunophane was created.

The priest of bone marrow preparations is myelopid, which includes a complex of bioregulatory peptide mediators - myelopeptides (MP). It was found that various MPs affect the different links of the immune system: some increase the functional activity of T-helpers; Others suppress the proliferation of malignant cells and significantly reduce the ability of tumor cells to produce toxic substances; Third stimulate the phagocytic activity of leukocytes.

Regulation of a developed immune response is carried out by cytokines - a complex complex of endogenous immunoregulatory molecules, which are still the basis for creating a large group of both natural and recombinant immunomodulating drugs. The first group includes leucinferon and superlimph, to the second - beta-leukein, Roncolekin and leuckesax (arrangements).

A group of chemically pure immunomodulators can be divided into two subgroups: low molecular weight and high molecular weight. The first one includes a number of known drugs that are additionally possessing immunotropic activity. They were levamizole (decaris) - phenylimidothiazole, a known anti-shine, which subsequently identified pronounced immunostimulating properties. Another promising drug from the subgroup of low molecular weight immunomodulators is Galavit - a derivative of fluhydrazide. The peculiarity of this drug lies in the presence of not only immunomodulating, but also pronounced anti-inflammatory properties. The subgroup of low molecular weight immunomodulators also includes three synthetic oligopeptide: hepon, wildlux and alloferon.

To high molecular weight, chemically pure immunomodulators obtained by the directional chemical synthesis include the drug of polyoxidonium. It is a N-oxidized polyegylene derivative with a molecular weight of about 100 kd. The drug has a pharmacological effect of a wide spectrum on the body: immunomodulating, detoxifying, antioxidant and membranecture.

Drugs characterized by expressed immunomodulatory properties include interferons and inductors of interferon. Interferons As an integral part of the common cytokine network of the body are immunoregulatory molecules that have an effect on all cells of the immune system.

Pharmacological effect of immunomodulators.

Immunomodulators of microbial origin.

In the body of the main target for immunomodulators of microbial origin are phagocytic cells. Under the influence of these drugs, the functional properties of phagocytes (phagocytosis and intracellular killing of absorbed bacteria increase), the products of pro-inflammatory cytokines needed to initiate humoral and cellular immunity increase. As a result, antibody products may increase, the formation of antigensificant T-helpers and T-killers can be activated.

Immunomodulators of thymic origin.

Naturally, in accordance with the title of the main target for the immunomodulators of thymic origin are T-lymphocytes. With initially reduced indicators, the preparations of this series increase the number of T cells and their functional activity. The pharmacological effect of the synthetic thymus dipeptide of thymogen consists in an increase in the level of cyclic nucleotides by analogy with the effect of thymus hormone thymopoietin, which leads to the stimulation of differentiation and proliferation of T-cell precursors to ripe lymphocytes.

Armnotodulators of bone marrow origin.

The immunomodulators obtained by their bone marrow mammals (pigs or calves) belongs to myelopid. The composition of myelopid includes six immune response mediators specific to the bone marrow, called myelopeptides (MP). These substances have the ability to stimulate various immune response units, especially humoral immunity. Each myelopeptide has a certain biological action, the aggregate of which is determined by its clinical effect. MP-1 restores the normal balance of activity of T-helpers and T-suppressors. MP-2 suppresses the proliferation of malignant cells and significantly reduces the ability of tumor cells to produce toxic substances, overwhelming the functional activity of T-lymphocytes. MP-3 stimulates the activity of phagocytic immunity and, therefore, increases anti-infective immunity. MP-4 affects the differentiation of hematopoietic cells, contributing to their faster maturation, i.e. it has a leukopoietic effect. . In immunodeficiency states, the drug restores the indicators of the V- and T-systems of immunity, stimulates the products of antibodies and the functional activity of immunocompetent cells, contributes to the restoration of a number of other hyumoral levels of immunity.

Cytokines.

Cytokines are low molecular weight hormone-like biomletes produced by activated immunocompetent cells and are regulators of intercellular interactions. There are several groups of interleukins, growth factors (epidermal, nerve growth factor), colony positive factors, chemotactic factors, tumor necrosis factor. Interleukins are the main participants in the development of an immune response to the introduction of microorganisms, the formation of an inflammatory reaction, the implementation of antitumor immunity, etc.

Chemically clean immunomodulators

The mechanisms of action of these drugs are best viewed on the example of polyoxide. This high-molecular weight immunomodulator is characterized by a wide range of pharmacological effects on the body, including immunomodulating, antioxidant, detoxifying and membrane protector effects.

Interferons and inductors of interferon.

Interferons - protein-protective substances, which are produced by cells in response to penetration of viruses, as well as on the impact of a number of other natural or synthetic compounds (interferon inductors). Interferons are factors of non-specific protection of the organism from viruses, bacteria, chlamydia, pathogenic fungi, tumor cells, but at the same time they can also act as regulators of intercellular interactions of the immunity system. From this position, they belong to immunomodulators of endogenous origin.

Three types of human interferons are isolated: A-interferon (leukocytar), B-interferon (fibroblast) and G-interferon (immune). The interferon has fewer antiviral activity, but performs a more important immunoregulatory role. Schematically, the mechanism of action of interferon can be represented as follows: interferons bind to a cell with a specific receptor, which leads to a synthesis of about thirty proteins to the cell, which provide the above interferon effects. In particular, regulatory peptides are synthesized, which prevent the penetration of the virus into the cell, the synthesis of new viruses in the cell, stimulate the activity of cytotoxic T-lymphocytes and macrophages.

In Russia, the history of the creation of interferon drugs begins in 1967, the year was first created and introduced into clinical practice for the prevention and treatment of influenza and ORVI. Human leukocytar interferon. Currently, several contemporary alpha interferon drugs are produced in Russia, which according to the production technology are divided into natural and recombinant.

Interferon inductors are synthetic immunomodulators. Interferon inductors are heterogeneous in the composition of the family high-low-molecular synthetic and natural compounds combined by the formation of the formation of its own (endogenous) interferon in the body. Interferon inductors have antiviral, immunomodulatory and other effects characteristic of interferon.

The halfdan (complex of polyadenyl and polyuridine acids) is one of the very first inducers of interferon, used since the 70s. Its interferoninducing activity is low. The halfdan is used in the form of eye drops and injections under the conjunct with herpes keratitis and keraticonunctivitis, as well as in the form of applications for herpetic vulvovaginites and colpites.

Amixin is a low molecular weight inductor interferon related to the class of fluorons. Amicin stimulates the formation of all types of interferon in the body: a, b and g. The maximum level of interferon in the blood is achieved by about 24 hours after administration of amaxine, increasing compared to its initial values \u200b\u200bof tens of times. An important feature of amaxine is long-term circulation (up to 8 weeks) of the therapeutic concentration of interferon after the course reception of the drug. Significant and long-term stimulation of amixin production of endogenous interferon, provides its universally wide range of antiviral activity. Amixin also stimulates a humoral immune response, increasing IGM and IgG products, restores the T-helper / T-suppressor ratio. Amixin is used for the prevention of influenza and other ORVI, the treatment of heavy forms of influenza, acute and chronic hepatitis B and C, recurrent genital herpes, cytomegalovirus infection, chlamydia, multiple sclerosis.

Neovir - low molecular weight inductor interferon (carboxymethylacridone derivative). Novir induces high titers of endogenous interferon in the body, especially early Interferon Alpha. The drug has immunomodulatory, antiviral and antitumor activity. Neovir is used in viral hepatitis B and C, as well as for urethritis, cervicitis, chlamydial etiology salpintingitis, viral encephalitis.

Clinical application of immunomodulators.

The most reasonable use of immunomodulators is represented in immunodeficiencies that manifest themselves increased infectious incidence. The main target of immunomodulatory drugs remains secondary immunodeficiency, which are manifested by frequent recurrent, difficult to treat infectious inflammatory diseases of all localizations and any etiology. At the heart of each chronic infectious inflammatory process, there are changes in the immune system, which are one of the causes of the persistence of this process. The study of the parameters of the immune system can not always reveal these changes. Therefore, in the presence of a chronic infectious inflammatory process, immunomodulating drugs can be prescribed even if the immunodiagnostic study does not reveal significant deviations in immune status.

As a rule, with such processes, depending on the type of pathogen, the doctor prescribes antibiotics, antifungal, antiviral or other chemotherapeutic drugs. According to experts, in all cases when antimicrobial means are used in phenomena of secondary immunological failure, it is advisable to prescribe immunomodulatory drugs.

The main requirements imposed on immunotropic drugs are:

immunomodulatory properties;

high efficiency;

natural origin;

safety, harmlessness;

absence of contraindications;

lack of addiction;

no side effects;

lack of carcinogenic effects;

lack of induction immunopathological reactions;

do not cause excessive sensitization and not potentiate it

from other medicines;

easily metabolized and derived from the body;

do not engage in cooperation with other drugs and

have high compatibility with them;

unpastener routes of administration.

Currently developed and approved the basic principles of immunotherapy:

1. Mandatory definition of immune status before immunotherapy;

2. determining the level and degree of damage to the immune system;

3. Control of the dynamics of immune status in the process of immunotherapy;

4. The use of immunomodulators only in the presence of characteristic clinical signs and changes in immune status indicators

5. Appointment of immunomodulators in preventive purposes for maintaining immune status (oncology, operational interventions, stress, environmental, professional, etc. impact).

Determining the level and degree of damage to the immune system is one of the most important steps in the selection of the drug for immunomodulating therapy. The point of application of the drug should correspond to the level of violation of the activity of a certain level of the immune system in order to ensure maximum effectiveness of the therapy.

Characteristics of some immunomodulators

As mentioned above, the IMD is classified depending on their composition, origin (for example, exogenous and endogenous, natural, synthetic, complex, etc.), the targets of the application and the action mechanism. The table provides information on the composition and biological activity of the IMD, the most widely used in veterinary practice. These are drugs of natural origin - Gamaprene (Moraprenyl phosphate), reaches, nucleicate sodium (more often - in the composition of Hamavit), Ribotan, Salmozan and Fospmenil; Synthetic - Anandin, Halavet, Glycopin, Immunofan, Gamenon, Maxidin and Roncolecin; Comprehensive - Hamavit, Mastim-OL and the Cynov.

Name		Spectrum of activity	Application
Preparations of natural origin
Gamapren.	Phosphorylated polyesoprenoids isolated from mulberry leaves	Activation of MF (enhancing bactericidal activity and phagocytosis), induction of early production of IL-12, IFN γ, adjuvant properties, direct antiviral effect in vitro and in vivo against herpesviruses due to suppression of the synthesis of viral proteins and stimulation of IFN products and other cytokines.	In the treatment and prevention of herpesvirus, calicivirus, adenoviral, paramixes, infections
	Purified bacterial glycan and polysaccharide complex	Activation of MF, CTL, strengthening the detoxistant liver function (activation of the kravel cells), induction of endogenous IF, complement activation, increasing the phagocytic activity of neutrophils and serum lysozyme concentration	In infectious and gynecological diseases
Sodium nucleicate	Sodium salt of nucleic acid yeast cells	Immunomodulation is due to purin (inhibition) and pyrimidine (stimulation) nucleotides, induction of IF, IL-1, detoxistant properties (in the composition of the Hamavit)	Almost does not apply in itself; Usually - in the composition of Hamavit
	Complex of low molecular weight polypeptides of thymus and RNA fragments, yeast hydrolysis product	Stimulation of T-, and B cells, activation of MF, amplification of the synthesis of IF and a number of other cytokines, adjuvant properties	To reduce the frequency of congenital and acquired immunodeficiency, especially on the background of bacterial and viral infections
Salmosan	Purified bacterial polysaccharide	Activation of MF, B-cells, stem cells, induction of IF, adjuvant properties, stimulation of natural resistance to bacterial infections
Fosprenil	Phosphorylated polyprenols isolated from environmentally friendly pine needles	Activation of MF (enhancing bactericidal activity and phagocytosis), EC, improving IL-1 production, induction of early production of IL-12, IFγ, FNF-α, IL-4, IL-6, adjuvant properties, antiviral effect, detoxicant properties, hepatoprotection, Protection of IF from death, inhibition of lipoxygenase	In the treatment and prevention of viral infections, to improve the efficiency and safety of vaccines
Synthetic preparations
	Acredonacetic acid derivative -Glucoaminopropylcaridone	Stimulation of IFα synthesis, induction of synthesis and secretion of the TH-1 series of cytokines	With acute and chronic viral and bacterial infections, to accelerate regenerative processes
Glycopin	Glucosaminemuldipeptide - analogue of Muramildepeptide, component of the cell wall of bacteria	Activation of neutrophils and MF, IL-1 synthesis stimulation, FNF, XF, specific antibodies, dendritic cell maturation	In the treatment and prevention of bacterial and viral infections, to increase overall resistance, enhancing vaccination efficiency
Roncolekin	Recombinant Interleukin-2 from yeast cells S.cerevisiae	strengthening the proliferation of T-lymphocytes and IL-2 synthesis, activation of T- and B cells, CTL, EC, MF, raising the synthesis of IF	With tumor growth, with infections
Immunofan	Synthetic Timus hexapeptide, fragment derivative Timopoettin molecule	T-cells, stimulation of thymulin products, IL-2, FNF, immunoglobulins, adjuvant properties	For the correction of immunodeficiency, for the prevention and treatment of intestinal and respiratory diseases
Kamenon (Neovir)	Sodium salt 10-methylene carboxylate-9-acryon	Superinductor IFα and β	In the treatment and prevention of viral infections
Maxidin	Bis (pyridine-2,6-dicarboxylate) Germany	Activation of MF (phagocytosis, chemotaxis, oxidative metabolism, lysosomal activity), EK, stimulation of the synthesis of IFα / β and IFγ	For the treatment and prevention of viral infections, correction of immunodeficiency, dermatitis and alopecia
ombrexic drugs
	Balanced solution containing sodium nucleicate, denatured placenta extract, vitamins, amino acids, minerals	it has disintellation, immunomodulatory, antioxidant, biotonic, adaptogenic and hepatoprotective effect, stimulates growth hormone products
	biogenic stimulants of fabric origin and biologically active substances	preferably acts on B cells, activates regeneration processes, stimulates the growth and development of animals.	In the treatment of bacterial and viral infections, skin diseases
	lyophilized blend of leukocyte interferon proteins, as well as cytokines produced by peripheral blood leukocytes	stimulates the activity of immunocompetent cells, increases the nonspecific resistance of the organism of dogs, increases the effect of vaccines	in the treatment and prevention of viral infections in dogs

Application of IMD with viral infections

Since viral infections are almost always accompanied by immunosuppression, the search and application of those IMDs that are capable of not only increase the natural resistance of the body (stimulating the phagocytosis and the production of antibodies, reinforcing the cytotoxic activity of lymphocytes, inducing the synthesis of IF and other cytokines), but also - to provide direct antiviral effect . Mostly these requirements are satisfied with Fospmenil and Hamaprene. Such drugs that combine the properties of the img and antivirus can be recommended for the treatment and prevention of viral infections accompanied by an immunodeficiency state.

A favorable outcome with almost any viral infection directly depends on the early stimulation of cytokine synthesis, providing the formation of both a cellular and humoral immune response (5). Thus, during the first two days of a clinically pronounced disease, the use of IMDs stimulating interferon products (IFN) is shown, as well as capable of restoring the early cytokine reactions suppressed by viruses. On the contrary, in the later stages of the viral disease, excessive stimulation of cytokines can lead to the development of a number of immunopathological reactions and significantly worsening the condition of the body and even cause shock and death. In such cases, the use of drugs directly affecting the reproduction of viruses in target cells (for example, fosprenyl and gamperene), or by systemic influence (fosprenyl).

Thus, in the incubation period and in the first 1-2 days of the clinical stage of the viral disease, it is advisable to assign IMD, stimulating the products of the IFN, as well as other factors of the organism's natural resistance (for example, IL-12, FNF, IL-1). An objective criterion for the effectiveness of these IMDs can be the restoration of early cytokines, the synthesis of which is suppressed by viruses (6). Thus, fursed after administration to the body in a viral infection, it stimulates the early products of IF-γ, TNNα and IL-6 and IL-12 in serum (12, 13), which, apparently, is one of the key mechanisms of antiviral activity of the drug when it use as a prophylactic agent or in the earliest stages of the infectious process. Viruses have the ability to violate the balanced development of TH1 / TH 2 immune response required to form effective antiviral immunity, and fursed, apparently, is able to restore this necessary balance, in particular, due to the stimulation of products of key cytokines, providing a balanced formation TH1 (IL-12 , IF-?,) And TH2 (IL-4, IL-5, IL-6) of an immune response in a viral infectious process (13.15). This property of fospreyl combined with direct antiviral action, apparently, and ensures the protection of animals from viral infection.

In the treatment of severe infections, imaging of natural origin should be given preference (from thymus, yeast, bacterial cells, plants), which, as a rule, do not have side effects. Currently, inductors of IFN - interferonogens are often recommended, and not drugs themselves, including recombinant (now from the drugs based on IFN, in the treatment of viral infections, it is still used except for the cynoron, more efficient in the early stages of the disease). This is due, in particular, with the fact that, firstly, exogenous IFN after administration to the body is able to suppress the synthesis of endogenous IFN on the principle of feedback mechanism and cause imbalance in the IFN system. Secondly, recombinant IFNs are antigens and are quickly inactivated. On the contrary, the inductors of the IFN (Maxidin, Fosprenyl, reaches, ribotan, coma station, Salmosan, etc.) stimulate the synthesis of endogenous IFN (which is physiologically, and the activity of endogenous IFN is preserved longer), as well as, in most cases, launch synthesis and products of other cytokines. First of all, it is Th1 rows. In addition, nonspecific natural killers (ECC) are actively involved in the early antiviral process. These cells after activation and proliferation are synthesized and secreted by pro-inflammatory cytokines, which run the cascade of signals that promote the interruption of the virus reproduction cycle in an infected cell. In view of this, in the treatment of viral infections, it is advisable to use IMDs stimulating EKK - Fosprenyl, MaxiDin, Roncolekin (its activity naturally increases in combination with fospance). Unfortunately, a very effective IMD is seized from veterinary practice, which is capable of inducing the secretion of IFN all types. On the contrary, it should be welcomed that veterinary specialists almost ceased to use as an img levamizol (decaris), which is not only quite toxic, but also (when used in small doses) selectively stimulates suppressor (regulatory) T cells (4).

The IMD based on cytokines (including recombinant) with the introduction to the body is able to fill the deficit of soluble immunoregulatory factors, which is especially important in severe damage to the immune system, when its compensatory capabilities are violated. On the other hand, the unreasonable purpose of such drugs (in the absence of serious indications) can lead to an imbalance in the immune system by blocking the synthesis of homologous endogenous molecules on the principle of feedback mechanism. The combination of IMD based on recombinant cytokines with other drugs is of great importance. Obviously, for example, the effectiveness of Roncakekin (recombinant IL-2) increases if it is in addition to its introduction to the body to increase the expression of the corresponding receptors with the help of drugs that enhance the secretion of IL-1. This is confirmed in practice in experiments on the integrated use of Roncolecin with fosprenyl or with hamavit (the latter includes nucleicate sodium, an effective inductor IL-1 and IFN) - these IMDs significantly increase the activity of Roncolekin.

The possibility of combined use of IMDs differing from each other by the spectrum of impact on lymphoid cells targets. In particular, the combination is reacted or salmozana (more actively acting on B-cells than on T cells) with antiviral IMDs (for example, with fosprenyl or hampera) can, with a timely manner, initiated, prevent the development of secondary infections and, therefore, reduce the need In antibiotic therapy. In a series of experimental studies on a model of an acute clinically pronounced infection caused by the mice of the mice encephalitis (CE) in mice, the effect of mutual enhancement of the activity of FP and Maxidin (12) was revealed. As a result of the simultaneous joint administration of the mice of these two IMD, the protest effect increased by 2-2.5 times, compared with the effect of the introduction of any one drug. These data was based on clinical trials in the treatment of dogs with a diagnosis of carnivorous and cats with a diagnosis of punching. As a result, it turned out that in the difficult course of the plague of carnivorous, as well as with viral infections of cats, the combined use of FP and Maxinosis gives a positive effect: both drugs, having different mechanisms of antiviral action, complement each other; Their joint use accelerates the treatment time and prevents recurrences of the disease, and also allows for significantly (more than twice) to reduce one-time doses of drugs, thereby reducing the cost of treating animals (21).

At the same time, there are many situations in which IMD is contraindicated. In particular, the administration of liquid (glycopine) mice leads to the activation of the infectious process caused by the Langat virus. This effect, apparently, is associated with an img-caused population of macrophage target cells, in which the virus is multiplied (2). With severe viral infection, for example, the plaid of carnivorous, against the background of an already developed immunodeficiency, a branch, which achieves a fragile balance between immunostimulation and immunosuppression during the selection of therapeutic agents accounts for literally on the blade of the knife. That is why in the plague of the carnivorous, first of all, the IMDs can directly affect the causative agent. With the acute nervous form of the plague, when the virus, multiplying in neurons and glial cells, causes demyelinization, many branches prescribe glucocorticoid hormones, since the use of immunostamulators in this stage (T-activin, etc.) is able to kill the dog in 1-2 days, and Before the death, the clinical condition of the animals deteriorates sharply (1). For example, IFN? Promotes damage to nerve cells, activating cytotoxic T-lymphocytes. Therefore, it is also reached by other IMDs that increase the synthesis of IFNs?, Contraindicated with the nervous form of the plague of dogs, as a result of their use, the development of the disease can accelerate and exacerbate its current. Contraindicated in the nervous stage of the plague of carnivorous and mastim (according to the instructions). In contrast, mastim-ol, mainly acting on B cells, is effective in the nervous form of plague in dogs. At this stage, it is also possible to apply IMD with a strong systemic action. In particular, Fospmenil gives a good therapeutic effect when introduced into liquor dogs, patients of the nervous form of the plague.

The experimental data obtained scientifically justify the use of IMD at various stages of the infectious viral process. At the same time, it was shown that Fosprenyl - IMD of a comprehensive action - can be used not only in the early, but also at later clinically pronounced stages of viral infection, as it has a direct antiviral effect and the ability to disrupt the vigion life cycle in cells. Moreover, in contrast to most other antiviral drugs that violate certain stages of the replication of viruses (and, consequently, having a limited range of applications), the mechanism of action of fospinalil is more diverse and includes as a direct impact on viruses, for example - inhibition of the synthesis of key proteins, leading to a change in the structure Virion and violation of viruse replication indirectly, through the change in the metabolism of the infected cell, and, finally, the system action.

Application of IMD with bacterial infections

The literature has long established the view that infectious diseases are monoethological diseases. At one time, such representations undoubtedly had a positive effect and contributed to the study of the problems of pathogenesis, immunity, diagnosis, prevention and etiotropic treatment of viral or bacterial infections. However, in practice, viral diseases in small pets rarely proceed in the form of monoinfection. As a rule, against the background of an already existing immunodeficiency accompanying viral infection, secondary (secondar) infections are developing, which are also often polyethological. In addition to the state of the immune system of the host, the biological properties and activity of pathogens, as well as external stress factors, are of great importance in the development of secondar infections. Thus, respiratory viruses increase the susceptibility of the mucous membranes of the respiratory tract to staphylococci, streptococci and other microorganisms, enteroviruses have a similar effect on the sensitivity of the intestinal tract to Salmonellam and Schigellams. However, in small pets there are pure bacterial infections.

With the latter, the connection has proved to be connected to a complex treatment of Salmosan - IMD bacterial origin. Salmosan, obtained and comprehensively studied in NIIEM NIIM. Gamalei Ramna, is a purified polysaccharide from an o-antigen of the abdominal bacteria. The drug increases the formation of antibodies, the phagocytic activity of leukocytes and macrophages, the titer of lysozyme in the blood stimulates nonspecific resistance to infections caused by salmonellas, sheets, chlebseylallas, ascensions, staphylococci, brucella, rickettsies, tularemia causative agents and some other diseases (23). According to clinical trials conducted by specialists of 10 different clinics of the Russian Federation, with bacterial infections (salmonellosis, colibacteriosis and staphylococcosis, confirmed by laboratory diagnostics), respiratory diseases (bronchitis, pneumonia), enteritis of various etiology and enterocolites of dogs and cats The use of salmozana has significantly reduced the treatment time and increase the effectiveness of therapy. The conclusion about the feasibility of the use of salmosan as a preparation of the first choice, stimulating immunity and nonspecific resistance. In the treatment of purulent and torn wounds, the use of Salmosan made it possible to significantly reduce the term of treatment, a decrease in swelling was noted, a decrease in purulent exudate in the first 2-3 days, recovery occurred one and a half times faster.

The ability of salmosan to activate macrophages and stimulate the products of specific antibodies in lymphocytes and causes the fact that the combination of salmosan with IMDs with antiviral activity may, with a timely manner, begins to prevent the development of secondary infections. It has been shown that the use of salmozana in combination with such IMD as fursenil, MaxiDin, Hamaprene, Hamavit, Immunofan, Cynon, and others- not only significantly increases the effectiveness of the treatment of panlasting, herpesvirus infections and catsivirosis of cats, plague of carnivorous and parvivirous enterita dogs, as well as skin , respiratory, purulent and some other diseases, but also reduces the doses of antibiotics and reduce the course of antibiotic therapy (21). At the same time, it was noted that ampiox, benzylpenicillin and other antibiotics when using salmozana act much more efficiently, which allows, if necessary, reducing the cost of treatment, refuse to apply expensive antibiotics of the last generation.

When choosing preparations for the treatment of bacterial, viral and mixed infections, other, auxiliary functions of the IMD are important. In particular, with infections accompanied by the lesion of the gastrointestinal tract (salmonellosis, enteritis of various etiology, infectious hepatitis, punching, etc.) is of great importance to neutralization of toxins, ridiculously entering the body due to intestinal dysfunction. It is obvious that with such diseases such drugs are shown, such as fardhell, reaches, as well as sodium nucleicate or gamavit.

In the treatment of chlamydia, good results were obtained when used in conjunction with antibiotics of IMDs such as Maxidin, Fosprenyl or immunophane in combination with Hamavit (9). Apparently, this is explained by the IMD data mechanisms described above, since the decisive role in the recovery from chlamydial infection belongs to the TH1-immune response, the activation products of which are IL-2, FNF? and produced by TH1-IFN?, which not only inhibits the reproduction of chlamydia, but also stimulates the production of IL-1 and IL-2.