Sorokina O. Characteristics of immune disorders in patients with chronic EBV-infection and optimization of therapy by differentiated immunocorrection

Object of research: chronic EBV-infection. Goal of research: define immune disorders characteristic in adult patients with chronic EBV-infection and propose clinic-immunologic approaches to therapy optimization with differentiated immunity correction. Methods of research: general clinical (chronic EBV-infection screening), immunologic (investigation of the humoral, cellular and phagocytic chains of immunity, cytokines level), immunoenzyme (antibodies to EBV-antigenes level) and molecular genetic (EBV-DNA evaluation, IL28-B) examibation methods of patents with chronic EBV-infection, statistical. Equipment: chemiluminescence immunoassay systems Immulite 2000 EBV – VCA IgG and Immulite 2000 EBV - EBNA IgG, Siemens (Germany); amplifier DT-96, DNA-Technology (Russia); FACS-Calibur (USA); immunoassay analyzer Tecan (Austria); analyzer Cobas 6000 Roche Diagnostics (Switzerland). The dissertation studies the nature and grade of the immune disorders in patients with chronic EBV-infection and development of the effective differentiated immunity correction therapy. A complex clinic-immunologic characteristic of chronic EBV-infection course in combination with specific antibodies level and viral load is represented for the first time. The comparative research of the blood cytokines level and cell potential for the production of IL-2, IL-12, IFN-α and IFN-γ allowed to evaluate their differential diagnostic significance in disease course prediction. In addition, IL-28B Gene polymorphism was studied and the association of its alleles with the course of disease and therapy effectiveness in patients with chronic EBV-infection was revealed. For the first time, formulas of immune disorders in patients with chronic EBV infection, the ratio between the effectiveness of therapy and the nature and degree of immune disorders, as well as the viral load were revealed. The monitoring and prognostic system of therapy efficiency is proposed, the criteria for the appointment of differentiated immunity correction. The differentiated approach in the immune disorders correction with sodium oxodihydroacridinylacetate (Neovir) and recombinant interferon-α2β (Alpharekin) in patients with chronic EBV infection, taking into account the immunoreactivity in accordance with the immune disorders formula, was scientifically substantiated and proved for the first time. The immune-diagnostic algorithm that allows to provide individualized immunity correction, predict the efficiency of treatment optimize therapy on initial visit is proposed. The application of this immune-diagnostic algorithm allows to predict unfavorable course of chronic EBV infection and prescribe timely adequate etiotropic and immunity correction therapy. It was revealed that the use of a differentiated approach in the immune disorders correction with valacyclovir and sodium oxodihydroacridinylacetate (Neovir) or valacyclovir and recombinant interferon-α2β (Alpharekin) contributes to positive dynamics of clinical and laboratory data, immunoreactivity recover, suppresses the replicative activity and prevents the occurrence of relapses during the year. Degree of implementation: 18 acts of implementation, 1 patent. Area (specialty) of use: health (medicine: immunology, infectious diseases).