Lupyr A. Pathogenetic substantiation of bacterial autovaccine use in anti-relapse therapy of patients with polypous rhinosinusitis

The dissertation is dedicated to pathogenetic grounding of bacterial autovaccine use as novel scientific direction for optimization of anti-relapse therapy of polypous rhinosinusitis. Modern tendencies of scientific researches have been studied in the direction of treatment of patients with polipous rhinosinusitis and the necessity of development and introduction of new forms of anti-relapse treatment in rhinosinusitis was proved. Clinico-experimental research of peculiarities of the course of polipous rhinosinusitis has been conducted in patients with infectious-inflammatory variant of the disease. Using immunomorphohistochemical and microbiological investigations, a leading role of microbe associations has been stated in the pathogenesis of polipous rhinosinusitis. During formation of immunological inflammation the influence of them on the nasal mucous membrane and paramenters of local and general immunity has been revealed. In comparison with known treatment methods the efficacy of bacterial autovaccine has been studied and the significance of nasal microflore structure in the development of productive chronic process in polipous rhinosinusitis has been stated. The hyposensibilization action of autovaccine against microbial antigens has been revealed (with decrease in titers of antibodies and specific immunoglobulin E). The original author method of combined treatment of patiens with polipous rhinosinusists has been created with use of bacterial autovaccine with proving of its efficacy comparing with antibacterial therapy and treatment with topical corticosteroid praparation basing on complex evaluation of clinical, physiological, instrumental, microbiological, immunological parameters and absence of relapses in catamnesis. The exceptional efficacy of the method has been proved in primary-revealed patients. The developed prognostic protocol allowes to objectivise the prognosis of efficacy of abacterial autovaccine. Thus, the dissertation includes the theoretical basics aimed on the solvation of the problem of treatment efficacy improvement for patiens with polipous rhinosinusitis by grounding the new perspective method of anti-relapse treatment.