Object of research: immunological factors responsible for the formation of an insufficient specific immune response in 6-7 year-old children with chronic VEB infection (CVEBІ), the efficacy of pre-vaccine complex therapy for the development of strong, resistant vaccine immunity against measles, mumps and rubella (MMR). The purpose of the study: to determine the nature of immune disorders in children 6-7 years old with CVEBІ and to propose clinical and immunological approaches to increase the effectiveness of their vaccination against MMR by differentiated immunocorrection. Methods of research: general clinical (examination of children with CVEBІ), immunological (study of the state of phagocytic, humoral and cellular immunity), cytological and cultural (determining the proliferative activity of lymphocytes and the cytokine producing mononuclear in culture in vitro) immune enzymes (determination of antibody levels for vaccine antigens and levels of cytokines) in patients with CVEBІ, statistical. Equipment: Amplifier BIS; FACS-Calibur (USA); Immunoassay Analyzer Lisa Scan (Czech Republic), optical microscope Primo Star Zeiss (Germany).
The dissertation is devoted to the study of the features of general immunity and its relationship with the formation of specific vaccine immunity in 6-7 year old children with CVEBІ for the revaccination against the MMR and the development of approaches to pre-vaccination differentiated immunocorrection to improve the effectiveness of vaccination. It has been shown for the first time that a weak immune response to vaccination against MMR in children with CVEBІ is associated with an imbalance in the subpopulations of lymphocytes, a decrease in the relative amount of CD4 +, CD25 + CD4 +, cytotoxic cells - CD8 + CD11b-, Th1 (IFNγ +) cells , increase in suppressor cells - CD8 + CD11b +, decrease in the proliferative capacity of lymphocytes, low absorption, biocidal and metabolic activity of leukocytes, increase in the content of proinflammatory cytokines (TNFα, IL-1β, IL-2), decrease in levels of IL-4, IFNα, IL-15 and IL-21; reduction of spontaneous and induced products of IL-4, IL-15 and IL-21, decrease of T and B-lymphocytes of memory (CCR + CD45RA-), (CCR-CD45RA-, CCR-CD45RA+), (CD22 + CD27-). The study of these indicators allowed to establish their differential diagnostic value for predicting the possibility of developing tense and long-term humoral specific immunity after the MMR's revaccination. Efficiency is proved for the correction of immune disorders in children with CVEBІ before revaccination of the combination of inosin pranobex (Normomed), IFNα-2b (Viferon), Deschampsia caespitosa L. and Calamagrostis epigeios L. extracts (protefaside), citrulline malate (Stimol). Conduction of therapy has a pronounced normalizing effect on the changed immunological parameters of children with CVEBІ and after the extracts MMR revaccination promotes intensive production of specific antibodies and prolonged preservation of their protective level. Degree of implementation: 7 acts of implementation, 1 patent. Sphere (industry) of use: health (medicine: immunology, infectious diseases).
