The dissertation is devoted to deepening existing and obtaining new data on the role of humoral immune factors in the development of measles infection of varying severity and their prognostic significance in the occurrence of complications. The aim of the dissertation is to determine the nature of immune rearrangements in patients with measles infection of varying severity, their prognostic significance in the severity of the clinical course of measles infection and the development of complications, and the relationship of immune changes with the level of expression of Toll-like receptors type 9. Changes in the indicators of leukocyte indices of cellular reactivity, pro- and anti-inflammatory cytokines, interferons alpha and gamma, general and virus-specific immunoglobulins IgE, IgA, IgM, IgG with the determination of avidity of the latter, autoantibodies to native DNA (ADNA-2), microsomes of the liver and kidneys (anti LKM-1) and antibodies to phospholipids of cell membranes, the activity of the complement system and its C-3 component, small, medium and large circulating immune complexes, and expression levels of Toll-like receptors type 9 on peripheral blood immunocompetent cells. A correlation was established between the levels of pro- and anti-inflammatory cytokines and the level of expression of Toll-like receptors type 9. Based on the results obtained, a diagnostic algorithm has been developed and proposed for implementation in healthcare practice, which, taking into account clinical and immunological data at the beginning of the disease, makes it possible to predict the severity of measles infection with high probability. In severe cases of measles, to prevent the development of autoimmune pathology, it is recommended to study the level of autoantibodies to phospholipids of cell membranes, IgG to microsomes of the liver and kidneys (anti-LKM-1) and IgG to native DNA (ADNA-2).
Mathematical prediction of the length of hospital stay of patients based on the nature of their immunoreactivity is proposed.
In order to prevent severe measles and identify risks of complications, patients are recommended to conduct a screening study to detect the titer of protective anti-measles antibodies and their avidity. Individuals with a low titer of protective anti-measles IgG antibodies and their low avidity are recommended to be vaccinated.
