Vol 5, No 2 (2015)

LECTURES

ETHICAL AND LEGAL ASPECTS OF INFECTIONS DISEASES AND VACCINATION Part 4. The balance between universal ethical and ecoethics principles on zooanthroponosis

Kubar O.I., Tokarevich N.K.

Abstract

The current paper continued the presentation of the data on ethical, legal and social aspects of the problems connected with the study for prevention infections diseases, additionally including the wide list of infections diseases and increasing the specter of ethical problems in the science in comparision with previous publications in this aria. The investigation of the balance universal ethical principles and ecoethics in the field of zooanthroponosis has been done first time in this paper. Data of the paper are based on the scientific and professional experience of the authors both in infections diseases and bioethics and give the analysis of main international UNESCO documents on bioethics and ecoethics. The principal element that has been used by authors for analysis was the view on epidemiology of zooanthroponosis as ecological process for integration between ethiological agents of infections diseases on the real population of different animals including human beings. Such approach became the base for including the biological, social, economical, topographic and environmental factors for investigation the principals of control and prevention in the aria of zooanthroponosis. In the paper has been presented the set of both environmental principles: common and practical. Theoretical picture of the application the philosophical standards of environmental ethics has been done in real conditions of ethiology, patogenics, epidemiology, clinic, treatment and prevention such kinds of zooanthroponosis as: eastern equine encephalitis, tick borne encephalitis, leptospirosis, Q-fever, tularemia, hemolytic uremic syndrome, listeriosis, West Nile fever, pseudo-tuberculosis and others. In the frame of the understanding ideology and principless of environmental ethics such as “respect for all life forms, human and non-human” and “respect for biodiversity” in the practical situation of zooanthroponosis the priority of prevention human being and responsibility for protection the rights of future generations was shown. The same time the value of bioethical and environmental ethics for control of zooanthroponosis was demonstrated with the justice of such principals as: “safeguarding the sustainability of the biosphere”, “environmental justice”, “precautionary principle” and “Earth as global commons”. In general it was contributed substantially for understanding the necessarily of the balance in using the base principals of bioethics and environmental ethics with the priority of surveillance and control in health care.
Russian Journal of Infection and Immunity. 2015;5(2):103-112
pages 103-112 views

REVIEW ARTICLES

ACCEPTIVE IMMUNITY — A BASIS FOR SYMBIOTIC RELATIONSHIPS

Kisseleva E.P.

Abstract

Review covers modern data on relationships of normal intestinal microbiota and immune system. Possibility to maintain the residence of large numbers of symbiotic bateria at mucosal surfaces of the body is regarded as a separate and independent immunological function named acceptive immunity. Basic effector arms of protective (defense against pathogens) and acceptive immunity (symbiotic relationships) are compared. Acceptive immunity differs from protective one in the absence of inflammation where all complex of immune reactions occurs in the context of physiological process. Several homeostatic mechanisms that provide crosstalk with symbiotic bacteria at the epithelial surfaces, innate and adaptive immunity are described. The main immunological strategies towards symbiotic bacteria are support of microbial community from one hand, and providing of host defense, from the other hand. The key step of this interaction is sensing of soluble microbial products via pattern-recognition receptors on the host cells. Basic innate immune response consists of mucus production and synthesis of antimicrobial peptides by barrier epithelial cells as well as maintenance of specific anti-inflammatory microenvironment. The main adaptive response is synthesis of secretory immunoglobulin A that is produced to the intestinal lumen and interacts with bacteria. At the same time, immunoglobulin A does not make any damage for commensals. Moreover this factor plays important role in symbiotic relationships. The following promicrobial functions of immunoglobulin A are suggested: participation in biofilm formation, discrimination of intestinal bacteria for fixed and free-living populations as well as facilitation of microbial transport through M cells. Mucosal homeostasis is supported by the development of immunological tolerance with participation of T regulatory cells. Main mechanisms of the development and maintenance of specific tolerance towards antigens of normal microbiota are discussed. Modern data on the participation of two main populations of T-regulatory cells are cited — thymic cells and cells induced in periphery. It is now accepted, that development of specific tolerance to microbial and food antigens plays important role in prevention of autoimmune and allergic diseases.
Russian Journal of Infection and Immunity. 2015;5(2):113-130
pages 113-130 views

IMMUNOLOGICAL ASPECTS OF NEUROSYPHILIS

Chuhlovina M.L., Bichun E.A.

Abstract

Reduced incidence of syphilis was reported in Russia over last years, along with increased prevalence of neurosyphilis. The issues of the mechanisms of the damage of nervous system and the immune response to syphilis are actual. Origin of syphilis antibodies from cerebrospinal fluid of patients with neurosyphilis is considered. The role of intrathecal immunoglobulin production and dysfunction of blood-brain barrier in patients infected with syphilis is of special importance. The aim of the research was to analyze the immunological aspects of neurosyphilis. Polymorphonuclear leukocytes have been shown to play an important role in infection with Treponema pallidium during clearance of the pathogenes. Potential virulence factors of Treponema pallidium have been discovered. It has been found that cell-mediated immune response is very important for defense against Treponema pallidium, while the key importance in bacterial clearance is put on Th1. Evidence has shown that the level of cytokines which are secreted by Th1 (IL-2, interferon gamma and tumor necrosis factor) and Th2 (IL-6 and IL-10) — lymphocytes, correlates with syphilis progression. The role of IL-10 in immune response regulation in patients infected with syphilis has been examined: this cytokine can inhibit the activity of immunocompetent cells. Some data has been produced concerning intrathecal production of immunoglobulins in neurosyphilis patients’ cerebrospinal fluid. The research of immunological parameters and composition of liquor in the patients with syphilis has revealed, that lymphocytes of peripheral blood are sensitized to antigens of the brain. It indicates the violation of permeability of patients’ blood-brain barrier. Nervous system becomes involved into the pathological process during the first weeks or months after syphilis infection. Cerebrospinal fluid changes can be detected at seronegative stage of the primary infection. The most expressed changes were found in the cerebrospinal fluid of patients with secondary recurrent syphilis It was established that high titers of treponemas specific antibodies in the cerebrospinal fluid of patients are the consequence of inflammation of the central nervous system. According to our data, cytosis and protein levels in the cerebrospinal fluid of patients with meningovascular syphilis were significantly higher than these in individuals with a history of syphilis and negative serological results in the research of the cerebrospinal fluid. Thus, advances in the study of the immunological aspects of syphilis promote early diagnosis of neurosyphilis and development of vaccines against syphilis.
Russian Journal of Infection and Immunity. 2015;5(2):131-136
pages 131-136 views

ORIGINAL ARTICLES

OPPORTUNITIES AND CHALLENGE OF SHIGELLOSIS AND SALMONELLOSIS VERIFICATION IN ADULT ACUTE DIARRHEA CASES

Kozhukhova E.A., Ivaschenko V.D.

Abstract

The paper suggests the frequency of enteropathogenic agents detected by different lab methods in feces of 262 adult acute diarrhea cases. The compared is the frequency results of Shigella spp. and Salmonella spp.detection by standard methods (culture and specific sera antibody finding) and PCR method. The calculated is some operational characteristics of PCR test (compared to culture test). The shown is that the frequency results of Salmonella spp. detected by standard and PCR methods are comparable, with high figures of all operational characteristics of PCR method. As to Shigella spp. detection the positive result by PCR method were obtained in 2,5 times more cases than that by standard method. However such PCR test characteristic as “positive predictive value” was quite low with the lowest figures in cases without colitis syndrome.
Russian Journal of Infection and Immunity. 2015;5(2):137-142
pages 137-142 views

THE CLINICAL AND LABORATORY EFFECTIVENESS OF OSELTAMIVIR FOR TREATMENT OF INFLUENZA IN HOSPITALIZED PATIENTS

Voloschcuk L.V., Golovacheva E.G., Go A.A., Mushkatina A.L., Zarishnuk P.V., Dnieprovskay G.L., Tumina T.L.

Abstract

The goal of our study was to estimate the efficacy of antiviral drug Oseltamivir for influenza treatment. We assessed the effect of Oseltamivir on the immune status of the 75 patients. It was formed 2 groups of observations with confirmed diagnosis of influenza: 38 received therapy Oseltamivir and 37 people receiving pathogenetic treatment. Treatment Oseltamivir contributes to a significant reduction in the duration of the catarrhal and intoxication syndromes and prevents the development of complications and exacerbations of chronic disease in persons with modified backdrop premorbid, which indicates for its high antiviral activity. We can assume the effect of Oseltamivir for restore the disturbed balance of cytokines, on assessing the dynamics of IL-1β, IL-8, IFNα, IFNγ in the serum.
Russian Journal of Infection and Immunity. 2015;5(2):143-147
pages 143-147 views

FEATURES OF THE IMMUNE RESPONSE DURING VIRAL INFECTION

Borisov G.A., Savchenko A.A., Kudryavtsev I.V.

Abstract

The aim of the investigation was to select using cluster analysis and comparatively characterize immune disorders types in acute and chronic viral infections. Patients with acute and chronic viral infections (n = 896) were examined: 77 patients with acute viral hepatitis B, 94 — chronic viral hepatitis B, 119 — chronic hepatitis C, 531 — recurrent herpes, 75 — human papillomavirus infection. Healthy persons (n = 466) were examined as control. The research of blood lymphocyte phenotype was performed by flow cytometry. Four-color immunophenotyping were used in the following panels: Т-lymphocytes (CD3+CD19–CD16/56–CD45+), Т-helpers (CD3+CD4+CD45+), cytotoxic Т-cells (CD3+CD8+CD45+), NKcells (CD3–CD16/56+CD45+), B-lymphocytes (CD3–CD19+CD16/56+CD45+). Absolute values were obtained on a dualplatform technology using the results of haematological analysis. The immunoglobulin concentrations were determined by ELISA. The clustering was performed by a single linkage method. The number of clusters was determined on the basis of calculating the values of the Euclidean distance between the mean group values. It was found that the parameters, characterizing the functional state of the various parts of the immune system in acute and chronic viral infections, considerable diversity values. Custer analysis allows to allocate 6 immunotypes defined different states of innate and adaptive immunity: characterized by activation of the innate (increasing the number of neutrophils and NK-cells) and adaptive immunity humoral response (increasing the concentration of IgG), characterized by hyperreaction of adaptive immunity (a significant increase in the concentration of IgG), discoordinated (multidirectional changes in the values of immunological parameters), immunodeficiency and unresponsiveness (did not differ from the control parameters) immunotypes. It is proved that in patients with viral infections most often determined by the “unresponsiveness” immunotype (40,5%), as well as humoral immunodeficiency (24,9%) and adaptive immune reaction (24,5%). A group of patients with chronic viral hepatitis B and C is allocated separately in which more than 10% of the detected adaptive immunity overreaction that is probably due to the development of chronic hepatitis. These immunotypes can be regarded as different pathogenetic variants of the course of acute and chronic viral infections. Healthy people often had unresponsiveness or immunodeficiency immunotypes, that is their immune system is out of activation. Stratification of patients with viral infections by immunotypes will increase the effectiveness of treatment and implement personalized approaches to diagnosis and treatment of functional disorders of the immune system.
Russian Journal of Infection and Immunity. 2015;5(2):148-156
pages 148-156 views

SENSITIZATION TO STREPTOCOCCUS PYOGENES AT CHILDREN OF EARLY AND PRESCHOOL AGE WITH RECURRENT RESPIRATORY INFECTIONS — PREDICTORS OF RHEUMATIC PATHOLOGY

Shabaldina E.V., Shabaldin A.V., Tyumenev A.V., Ryazantsev S.V., Simbirtsev A.S.

Abstract

Streptococcus pyogenes is the reason of rheumatism and a post-streptococcal glomerulonephritis. Primary colonization of mucosal with this microorganism develops in the period of early ontogenesis. It was confirmed that at a carriage of this microorganism children at them activate immunopathological reactions. Clinic and immune features of the children with recurrent respiratory infections of early and preschool age having the immune response to S. pyogenes were studied. Position of risk of formation of rheumatic diseases at these children was studied. 771 children, in an age interval of 2–6 years are examined. Immune and clinical indicators in two groups of the children having the immune response to S. pyogenes (n = 306) and not having it (n = 465) were analyzed. It was shown that in group of the children with immune response to S. pyogenes were authentically higher: point of an hereditary predisposition, expressiveness of placental insufficiency and a fetal hypoxia during the real pregnancy, and in the post-natal period degree of a thymomegaly, a pharyngeal lymphoid ring hypertrophy, skin manifestations of food allergy on the first year of life, the frequency of sharp respiratory infections within one year — in comparison with control. The group of the children having the immune response to S. pyogenes had a high level in a nasal secret of TNFα, IL-4, IFNα, and in blood — ASL-O, ASG, RF, CRP and immunoglobulin E. It was shown that at the children with a sensitization to S. pyogenes were lowered in peripheral blood: the general leukocytes, lymphocytes, T-lymphocytes (CD3 positive), T-helpery (CD3 and CD4 positive), an immunoregulatory index (the relation of CD4 of positive lymphocytes to CD8 to positive lymphocytes), phagocytosis (in test with nitro blue tetrazolium chloride — NBT) and immunoglobulin A — in comparison with control. The atopic immune response to S. pyogenes, S. pneumoniae, S. aureus, P. vulgaris, K. pneumoniae, H. influenzae took place in the main group. The average logarithmic cultivation titer of these microorganisms was also authentically higher at children of the main group. The conducted research showed that hyper productive immune reactions mainly on humoral type which can provide induction of rheumatic pathology are associated with the immune response to S. pyogenes; and detection of IgG antibodies to S. pyogenes can be screening for identification of group of risk on formation of rheumatic diseases among children with recurrent respiratory infections and a pharyngeal lymphoid ring hypertrophy.
Russian Journal of Infection and Immunity. 2015;5(2):157-164
pages 157-164 views

SHORT COMMUNICATIONS

THE LEVEL OF INTENSITY OF IMMUNITY TO DIPHTHERIA AND TETANUS AMONG THE POPULATION OF THE REPUBLIC OF CRIMEA

Karimov I.Z., Gorovenko M.V., Penkovskaya N.A., Midikari A.S., Shmoylov D.K., Kozlovsky O.A., Los-Yatsenko N.G.

Abstract

Investigation of state and assessment of population immunity to diphtheria and tetanus play important role in the study of the existing epidemic situation, development of preventive measures and the prognosis of tendencies of development of epidemic process. The aim of this work was the studying of level and estimation of intensity of immunity to diphtheria and tetanus in the population of the Crimean Republic. The concentration of antibodies measured in IU/ml was accepted to the main indicator of antidiphtherial and antitetanic immunity. In 2013, in total, there were observed 525 persons, 239 of them — city dwellers and 286 — from the rural area. Indicators of concentration of anti-toxin in examined serums were determined by the RPHA method with using of the standardized erythrocyte diphtheritic and tetanic diagnosticums. The assessment of immunity level was performed according to WHO recommendations on following criterias: concentration of antibodies within 0,015–0,06 IU/ml — conditional protection, 0,1–0,5 IU/ml — moderate protection; more than 1,0 IU/ml — high immunity. Antibodies concentration 0,1 IU/ml was taken as minimal protective level for both antidiphtherial and antitetanic antibodies. Research of intensity of antidiphtherial and antitetanic immunity in the population of Crimea allowed to reveal some decrease in level of immune protection in 2013 in comparison with 2012. The highest number of the seronegative and conditionally protected persons against tetanus in 2013 were noted among pregnant women and newborns — 31,8% and 27,8% respectively. The quantity of unprotected and conditionally protected population among children is 11,1%, among teenagers — 10,5%. The greatest layer of the seronegative persons among adults revealed in age group from 58 and older (15%), and conditionally protected — in the 48 to 57 age group (19,2%). The total number of the seronegative population in relation to diphtheria increased for 5,7%, to tetanus — for 1,7%. Decrease in number of highly immune persons was noted. However sufficient level of antidiphtherial immunity have 77,2% of observed population, antitetanic immunity — 88,2%. Thus, providing of immunobiological preparations of treatment and prophylactic establishments, activity of antivaccinal campaign, the level of sanitary and educational work have affected on condition of antidiphtherial and antitetanic collective immunity in the Republic of Crimea.
Russian Journal of Infection and Immunity. 2015;5(2):165-170
pages 165-170 views

A SCREENING RESEARCH OF PLASMA BLOOD DONORS FOR MARKERS PARVOVIRUS INFECTION

Antipova A.Y., Nikishov O.N., Khamitova I.V., Semenov A.V., Bichurina M.A., Kuzin A.A., Lavrentieva I.N.

Abstract

Parvovirus B19 (PV B19) replicates predominantly in progenitor cells of human erythrocytes and is transmitted by an airborne, vertical through and through blood or infected tissues. At-risk are pregnant women, people with immunodeficiency of different nature and individuals who need blood transfusions or organ transplantation. The available data indicate a high risk of infection through transfusion of blood containing the DNA of parvovirus B19, with viral load 105 copies/ml and above (Hourfar M.K. et al., 2011). According to the requirements of national regulations, the production of therapeutic drugs from plasma assumes the use of raw materials, free from viruses or with minimal viral load (Filatova E.C. et al., 2011). In some foreign countries a study of donor blood for the presence of DNA PV B19 is required; in our country the need for such screening is discussed (Giburt E.B. et al., 2013). Due to the fact that parvovirus is resistant to the methods of blood products desinfection, it is especially important to assess the quality of donor blood. Objective: To investigate the prevalence of the two markers parvovirus infection (IgG and PV B19 DNA) in blood samples from one of the blood centers at St. Petersburg. Plasma samples from 100 blood donors from Military Medical Academy blood centre were tested by ELISA for the presence of IgG antibodies of parvovirus B19. Positive samples were tested by PCR for the DNA of parvovirus B19. ELISA test system recomWell Parvovirus B19 IgG (Microgen GmbH, Germany) and diagnostic kits of Federal State Institution of Science «Central research Institute for epidemiology» of Rospotrebnadzor (Moscow, Russia) which are approved for use in RF was used according to the manufacturers instructions. It was shown that 78 out of 100 donors aged 18 to 58 years had IgG-antibodies.76 positive blood plasma samples were investigated by PCR, with the 19 donors have found DNA of parvovirus B19 (25%). Viral load of one donor was 106 copies/ml. In this case, there is the high risk of infection for the recipient. Results obtained are consistent with literature data. Obviously, it is need to investigate donor blood for parvovirus B19 presence. Obvious that quantification of the DNA of parvovirus B19 in blood products is need.
Russian Journal of Infection and Immunity. 2015;5(2):171-174
pages 171-174 views

CHRONICLE

ACTIVITY OF THE PARASITIC INFECTIONS DEPARTMENT DURING THE GREAT PATRIOTIC WAR

Tokarevich N.K., Stoyanova N.A.

Abstract

ACTIVITY OF THE PARASITIC INFECTIONS DEPARTMENT DURING THE GREAT PATRIOTIC WAR
Russian Journal of Infection and Immunity. 2015;5(2):175-182
pages 175-182 views

PASTEUR INSTITUTE WORKERS ACTIVITY DURING THE GREAT PATRIOTIC WAR AND THE SIEGE OF LENINGRAD ON THE PROBLEM OF ACUTE INTESTINAL INFECTIONS

Kaftyreva L.A., Voytenkova E.V., Matveeva Z.N.

Abstract

Прошло семь десятилетий со дня исторической Победы над гитлеровским фашизмом, но мы свято храним память о беспримерном подвиге защитников Ленинграда, среди которых были не только воинские части, народное ополчение, но также ученые осажденного города. Достойное место среди них заняли сотрудники Ленинградского НИИ эпидемиологии и микробиологии имени Пастера, которые за весь период блокады ни на один день не прекратили своей работы. Материалы, публикуемые в данной статье, посвящены деятельности сотрудников отдела кишечных инфекций в военные годы.
Russian Journal of Infection and Immunity. 2015;5(2):183-188
pages 183-188 views

OBITUARY

IN MEMORY OF SERGEI L. MUKOMOLOV

Abstract

1 июня 2015 года отечественная наука и практическое здравоохранение понесли тяжелую утрату. На 58 году жизни скончался Сергей Леонидович Мукомолов — доктор медицинских наук, профессор, заведующий отделом эпидемиологии и лабораторией вирусных гепатитов Санкт-Петербургского научно-исследовательского института эпидемиологии и микробиологии имени Пастера.
Russian Journal of Infection and Immunity. 2015;5(2):189-190
pages 189-190 views

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