Shuliak M. Immunopathogenesis of polypous rhinosinusitis on the background of perennial allergic rhinitis, immunotherapy and immunorehabilitation of patients

Thesis studies peculiarities of sensitization of patients ill with polypous rhinosinusitis with perennial allergic rhinitis (PR with PAR) to home and fungal allergens, state of the immune system, cytokine status (TNF-alfa, IL-1beta, IL-4, IFN-gamma), and immune-compensation capabilities due to allergen-specific immunotherapy (ASI) and immodin immune-compensation. The pursued research allowed us to identify the peculiarities of sensitization to home and fungal allergens by means of finding specific IgE to major and minor allergen-components in blood serum, the components of combined sensitization in patients affected by PR with PAR. High levels of T-helpers of type 2, low-molecular and medium-molecular circulating immune complexes, specific IgE, B-lymphocytes, eosinophilic cationic protein have been revealed in PR with PAR patients. Decrease of absolute values of CD4 + CD25 + FoxP3-Т-reg-lymphocytes and increase of absolute values of CD3 + CD4 + CD294 + Т-helpers of type 2, levels of TNF-alfa, IL-1beta, IL-4, and reduction of IFN-gamma level that causes a humoral and cellular links disbalance towards activation of humoral link have been observed in such patients. Application of ASI / sublingual immunotherapy (SI) to PR with PAR patients led to decrease of absolute proportion of T-helpers of type 2 and increase of absolute values of T-reg lymphocytes. Extra immodin prescription to ASI / SI diminished activation of humoral link of immunity, increased phagocytic activity of neutrophils and cellular link ratio. It has been revealed, that immodin treatment in combination with basic therapy applied to PR with PAR patients and sensitization to minor allergens leads to increase of phagocytic activity of neutrophils, decrease of humoral ratio, increase of cellular link ratio of immunity, considerable level reduction of pro-inflammatory cytokines TNF-alfa, IL-1beta, IL-4, level normalization of IFN-gamma, and thus, diminishes their stimulating impact on the degree of allergic and infectious inflammation, that helps achieve a clinical effect.