Panchenko T. Clinical - immunological substantion of application of immunomodulators in external otitis

Dissertation is devoted to developing immunodiagnostic approaches in inflammatory lesions of the external ear and validity applying of locally - systemic immunotherapy and immunoprophylaxy. Infectious-inflammatory process in the external ear canal, as well as furunculosis of skin of the neck , leads to characteristic shifts in the indicators of reactivity due to the levels of CRP and proinflammatory cytokines 1 and 8. The increase quantitative indicators of cytokines in the 6 - 16 times proves the engagement of inflammatory and immune cells in processes adaptation and protection. Bacteriological studies in the patients with external otitis in the acute stage proved that most of the pathological material was stood out Staf. aureus. In 102 patients (100%) stood out microbiological association: in 2 patients (1.9%) bacterial - fungal, in 100 patients (98.1 %) bacterial. Of representatives of the bacterial flora more often in association was attended in Gram-positive cocci: Staphylococcus and Streptococcus spp. For external otitis in earwax authentically increased the quantity of ? - interferon, IL-8, PNP-? that IL-1?, that is, all the proinflammatory cytokines. During acute stage of recurrent external otitis, patients have an increased concentration of antibodies to microbial antigens, pro-inflammatory cytokines - interleukin 1? and and two types of interferons, phagocytic and cytolytic activity of blood cells, the amount of immunoglobulin class M. Clinical and immunological surveillance of patients with external otitis in remission, found deviations in comparison to controls: - conservation high levels of IgM; - reduced level of phagocytic activity; - low levels of interferon-gamma in the earwax. The most effective drug for the sum of positive influences on the expression of a variety of antigens, and the normalization of the immunocompetent blood cells functions are Licopid, ehinatseya compositum, then thiotriazolin and timogen. The clinical observations of patients with recurrent external otitis and immunological tests, suggest that the additional application to the basic therapy the locall and immunomodulation therapy provides significantly better clinical and immunological parameters in the short and long periods after treatment: - Reduction of quantity of relapses; - reducing the frequency ARI; - "normalization" of the local (secretory IgA, interlekiny IL-8 and the PNP, SILP and gamma-interferon) and systemic IgM and antibodies to microbial antigens) humoral immunity. The list of conditional reductions: EO - an external otitis, ARI - sharp respiratory disease, PNP - the factor nekrosis tumours.