The effectiveness of immunomodulatory therapy with a synthetic analogue of the active center of the hormone thymus thymopoietin in the complex treatment of immunocompromised women with chronic infectious and inflammatory diseases of the pelvic organs

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Abstract

Chronic inflammatory diseases of the pelvic organs (pelvic inflammatory disease, PID) in women is among the main understudied problems in gynecology worldwide with adverse medical and socio-economic consequences, thus justifying the need for further study of immunopathogenesis and development of new approaches to treatment. Our objective was to develop new immunotherapeutic approaches to correction of combined disorders of the immune system functioning in immunocompromised women with PID and to evaluate their clinical and immunological efficacy.

55 women aged 20-40 years were examined, i.e., 35 patients with exacerbation of sluggish or recurrent PID, resistant to conventional therapy. Testiung was performed before complex treatment (study group 1 – GI- 1) and after the course (study group 2 – GI-2). Contents of T and B lymphocytes, natural killer cells (NK) (CYTOMICS FC500, USA), phagocytic and microbicidal functions of neutrophilic granulocytes (NG) were assessed in SG-1 and SG-2 before and 2-3 days after complex treatment with addition of an immunotherapeutic drug based on hexapeptide (HP) at a daily dose of 45 mg/ml intramuscularly for 10 days.

In patients from SG-1, a decrease in T cells (CD3+CD19- ) and B cells (CD3-CD19+), a 2-fold increase in the content of NK CD3-CD16+CD56+ was found, along with altered functioning of NG (deficiency of actively phagocytizing NG, a decrease in their digestive function and NADPH-oxidase activity). In SG-2 patients, the treatment was followed by restoration of the T (CD3+CD19-) and B cells (CD3-CD19+), NK cells (CD3-CD16+CD56+), like as an increase in effector functions, i.e., microbial capture by NG and their killing ability due to activation of NADPH oxidases and normalization of microbicidal reserve capacity in the NG cell population. Positive clinical effect included reduction of clinical symptoms in acute period, absence of PID exacerbations over follow-up for 6 months (85.6% of cases). Occasional exacerbations of PID were associated with medical manipulations (5.7%) and unprotected sexual contacts (5.7%).

The immunopathogenetically proven approach to correction of combined functional impairment of immune system in the women with PID shows a positive clinical and immunological effect.

About the authors

Svetlana V. Kovaleva

Kuban State Medical University

Author for correspondence.
Email: 3483335@mail.ru
ORCID iD: 0000-0002-9604-5806

Doctor of Medical Sciences (MD), Associate Professor, senior researcher of the department of clinical and experimental immunology and molecular biology of the Central Scientific Research Laboratory, Associate Professor of the Department of Clinical Immunology, Allergology and Laboratory Diagnostics of FAT and PRS

Russian Federation, 4, st. Mitrofan Sedin, Krasnodar, 350063

Irina V. Nesterova

Kuban State Medical University; P. Lumumba Peoples’ Friendship University

Email: inesterova1@yandex.ru
ORCID iD: 0000-0001-6071-4409

Doctor of Medical Sciences (MD), Professor, Chief Researcher, Department of Clinical and Experimental Immunology and Molecular Biology, Central Scientific Research Laboratory, Professor of the Department of Clinical Immunology, Allergology and Adaptology Faculty of Continuing Medical Education of the Medical Institute

Russian Federation, 4, st. Mitrofan Sedin, Krasnodar, 350063; 6 st. Miklukho-Maclay, Moscow, 117198

Svetlana N. Pikturno

Kuban State Medical University

Email: spikturno@yandex.ru
ORCID iD: 0000-0001-9376-3397

Postgraduate Student, Department of Clinical Immunology, Allergology and Laboratory Diagnostics of FAT and PRS

Russian Federation, 4, st. Mitrofan Sedin, Krasnodar, 350063

Galina A. Chudilova

Kuban State Medical University

Email: chudilova2015@yandex.ru
ORCID iD: 0000-0001-8005-9325

Doctor of Biological Sciences, Associate Professor, head of the department of clinical and experimental immunology and molecular biology of the Central Scientific Research Laboratory, Professor of the Department of Clinical Immunology, Allergology and Laboratory Diagnostics of the Faculty of Professional Development and Professional Retraining of Specialists

Russian Federation, 4, st. Mitrofan Sedin, Krasnodar, 350063

Lyudmila V. Lomtatidze

Kuban State Medical University

Email: llomtatidze@mail.ru
ORCID iD: 0000-0002-7041-7106

PhD in Biology, head of the department of clinical and experimental immunology and molecular biology of the Central Scientific Research Laboratory, Associate Professor of the Department of Clinical Immunology, Allergology and Laboratory Diagnostics of FAT and PRS

Russian Federation, 4, st. Mitrofan Sedin, Krasnodar, 350063

Yuri V. Teterin

Kuban State Medical University

Email: yura.teterin.1989@mail.ru
ORCID iD: 0000-0002-3073-5070

Postgraduate Student, Department of Clinical Immunology, Allergology and Laboratory Diagnostics of FAT and PRS

Russian Federation, 4, st. Mitrofan Sedin, Krasnodar, 350063

Anna I. Pirogova

Kuban State Medical University

Email: AnP1998@yandex.ru

Resident Department of Clinical Immunology, Allergology and Laboratory Diagnostics of FAT and PRS

Russian Federation, 4, st. Mitrofan Sedin, Krasnodar, 350063

Natalia S. Prosolypova

Kuban State Medical University

Email: NatalyPro87@yandex.ru

Head of the Consultative and Diagnostic Department of the Clinic

Russian Federation, 4, st. Mitrofan Sedin, Krasnodar, 350063

Аlla M. Chulkova

Kuban State Medical University

Email: achulkova@bagk-med.ru

PhD (Medical Sciences), Head of the Day Hospital Clinic

Russian Federation, 4, st. Mitrofan Sedin, Krasnodar, 350063

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Copyright (c) 2023 Kovaleva S.V., Nesterova I.V., Pikturno S.N., Chudilova G.A., Lomtatidze L.V., Teterin Y.V., Pirogova A.I., Prosolypova N.S., Chulkova А.M.

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