Vol 5, No 2 (2015)

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.

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.

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.

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.

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.

ACTIVITY OF THE PARASITIC INFECTIONS DEPARTMENT DURING THE GREAT PATRIOTIC WAR

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.