Shcherbakova Y. Diagnostics, treatment and preventive maintenance of the latent syphilis on the basis of studying epidemiology, serology and the cytokins' status

The dissertation is devoted to studying immunopathogenesis, clinically-epidemiological and serological features of the latent syphilis and to research of their dynamics at use a complex method of therapy. Some clinical and epidemiological features of the latent syphilis at the present stage are determined. In addition, important epidemiological differences of the early or late form of syphilis take place. For the almost 30 % of cases of latent syphilis slightly positive, controversial and, partly negative serologic tests for syphilis are typical. The new features of the immune answer of patients with the latent syphilis is established: the misbalance of interleukin-1beta, -4, -6, interferon-gamma, tumor necrosis factor-alpha is revealed, more expression of, which are produced Тh-1-lymphocytes - interleukin-1beta, interferon-gamma, tumor necrosis factor-alpha takes place. The misbalance of interleukin-4, -6 was revealed in latent syphilis in comparison with active syphilis. The deviation of the cytokinelevels from statistical norm in patients with late syphilis is more pronounced. The developed method of late latent syphilis treatment by penicillin G sodium salt and doxycyclin monohydrate in a combination with inductor of cytokines tiloron and an infra-red laser irradiation of blood has provided positive results in 85,7±5,9 % patients. The treatment allows reducing terms of patients follow-up considerably. Practical recommendations for preventions of serological resistance after treatment of latent syphilis are developed. Some additional laboratory tests offered which improve diagnostics and rationalize management of patients with latent syphilis.