From theory to practice: immunotherapy of purulent-inflammatory diseases and purulent-septic complications
- Authors: Alekseeva N.Y.1, Dyumnikov D.A.2, Solovyev I.A.2, Kalyuzhin O.V.3
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Affiliations:
- Penza Institute for Further Training of Physicians – Branch Campus of Russian Medical Academy of Continuous Professional Education
- S.M. Kirov Military Medical Academy
- I.M. Sechenov First Moscow State Medical University
- Issue: Vol 40, No 3 (2021)
- Pages: 19-26
- Section: Original articles
- URL: https://journals.rcsi.science/RMMArep/article/view/77298
- DOI: https://doi.org/10.17816/rmmar77298
- ID: 77298
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Abstract
Lack of anti-infective protection is one of the reasons for the occurrence of purulent-inflammatory diseases of the skin, soft tissues and purulent-septic complications in the postoperative period. Immunocorrective therapy is extremely relevant in surgical practice, and it can be used both for the prevention and treatment of postoperative complications. In this regard, special attention should be paid to low molecular weight fragments of peptidoglycan of cellular bacteria – muramyl peptides.
The study included 65 patients with purulent inflammatory diseases, of which 35 men aged 23–55 years with chronic recurrent pyoderma (ostiofolliculitis, folliculitis, sycosis, furunculosis), and 30 patients aged 18 to 65 years with purulent inflammatory diseases of soft tissues, mainly abscesses and phlegmons of various localization without pronounced concomitant pathology. The examination included 26 patients with purulent-septic complications in the postoperative period. The patients included in the study were divided into 2 equal groups: 1 is the main group, in which patients received intramuscularly Polimuramil 200 mg daily for 5 days in addition to treatment; Comparison group 2, in which patients received only standard treatment. The clinical symptoms of pyoderma were assessed from day 0 to day 7, then on day 14, after 1 and 6 months of the study. Blood samples were taken from all patients for hematological and immunological studies. The timing of the appearance of granulations was monitored daily.
The inclusion of Polimuramil in the complex treatment of pyoderma accelerated the regression of the main clinical manifestations of the disease and promoted the induction of stable remission. In patients with soft tissue infections, Polimuramil increased the degree of regression of the depth and area of the wound and accelerated the appearance of granulations. The clinical efficacy of Polimuramil in patients with purulent-septic complications in the postoperative period correlated with a decrease in CRP and procalcitonin levels. The study confirms the effectiveness of Polimuramil in the treatment of purulent-inflammatory diseases and purulent-septic complications in the postoperative period and its high immunomodulatory potential (8 figs, 2 tables, bibliography: 5 refs).
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##article.viewOnOriginalSite##About the authors
Nataliya Yu. Alekseeva
Penza Institute for Further Training of Physicians – Branch Campus of Russian Medical Academy of Continuous Professional Education
Author for correspondence.
Email: alex-69Nat@mail.ru
SPIN-code: 7980-3666
Scopus Author ID: 603200
M.D., Ph.D. (Medicine), Associate Professor
Russian Federation, 8A, Stasova str., Penza, 440060Denis A. Dyumnikov
S.M. Kirov Military Medical Academy
Email: dym82@mail.ru
SPIN-code: 6945-7148
Scopus Author ID: 918201
M.D., Ph.D. (Medicine)
Russian Federation, Saint PetersburgIvan A. Solovyev
S.M. Kirov Military Medical Academy
Email: ivsolov@yandex.ru
SPIN-code: 6703-4852
Scopus Author ID: 440352
M.D., D.Sc. (Medicine)
Russian Federation, Saint PetersburgOleg V. Kalyuzhin
I.M. Sechenov First Moscow State Medical University
Email: kalyuzhi@list.ru
SPIN-code: 5067-6554
M.D., D.Sc. (Medicine)
Russian Federation, MoscowReferences
- Vinnik YS, Markelova NM, Tyuryumin VS. Modern methods of septic wounds treatment. Sibirskoe meditsinskoye obozreniye. 2013;1(79):18–24. (In Russ.)
- Shablovskaya TA, Panchenkov DN. Modern approaches to the complex treatment of purulent-necrotic soft tissue diseases. Bulletin of Experimental and Clinical Surgery. 2013;6(4):498–517. (In Russ.)
- Nesterenko AN. Immune distress аs pathogenetic аnd thanatogenetic relevant syndrome in severe sepsis and septic shock: clinical and pathomorphological substantiation of early replacement immunocorrection. Emergency medicine. 2013;6(53):94–112. (In Russ.)
- Karaulov AV, Kalyuzhin OV. Sphere of muramyl dipeptide application within the major approaches to immunotherapy/prophylaxis of infectious diseases. Fiziologiya i patologiya immunnoy sistemy. 2013;17(5):3–15. (In Russ.)
- Pashenkov MV, Budikhina AS, Golubeva NM, et al. Results of a phase II/III clinical trial of an immunomodulator polymuramyl in patients with purulent surgical infections. Immunologiya. 2012;33(4):199–203. (In Russ.)
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