Vol 14, No 3 (2024)

Cover Page

Full Issue

SHORT COMMUNICATIONS

IL-6 and IL-18 cytokine traps in COVID-19

Korotaeva A.A., Samoilova E.V., Chepurnova D.A., Pogosova N.V., Kuchiev D.T., Paleev F.N.

Abstract

Cytokines are mediators of immunity that regulate inflammation. Intensity of inflammatory process is strongly dependent on the cytokine type and duration of its effect. Interleukin 6 (IL-6) and interleukin 18 (IL-18) play an important role in the initiation and progression of inflammation. Cytokines regulate the inflammatory process in different ways by inducing or inhibiting inflammatory reactions. Functional activity of cytokines is limited by trap molecules whose levels determine initiation of protective or pathological effects of interleukins. Soluble glycoprotein sgp130 functions as a trap for IL-6, while IL-18 is controlled by IL-18 binding protein (IL-18BP). High IL-6 and IL-18 levels were recorded in COVID-19 patients, being associated with unfavorable outcome of the disease. Our objective was to compare sgp130 and IL-18BP levels in patients with different degrees of COVID-19. Retrospective study included 74 COVID-19 patients (40 men and 34 women) aged 63±14 years. The patients were assigned to groups according to severity of lung damage. Group 1 included patients without lung damage; group 2, patients with moderate pneumonia (< 50% lung damage); group 3, patients with severe pneumonia (> 50% lung damage). Plasma levels of cytokines and their trap molecules were determined by quantitative immunoenzyme assay. IL-6 and IL-18 plasma concentrations increased with COVID-19 severity. Ambiguous changes were recorded for their traps. Plasma levels of sgp130 were lower in patients with moderate pneumonia than in patients without lung damage. In patients with severe pneumonia sgp130 plasma concentrations were higher than those in patients with mild pneumonia, being similar to those in patients without lung damage. In contrast to sgp130, IL-18BP levels decreased with COVID-19 severity. Thus, an increase in IL-6 and IL-18 levels parallel to COVID-19 severity is accompanied by ambiguous changes in the levels of their trap molecules. The ratio between the levels of IL-6 and IL-18 and their traps reflects the degree of COVID-19 severity.

Russian Journal of Infection and Immunity. 2024;14(3):411-415
pages 411-415 views

Comparative assessment of interferon activity in influenza and COVID-19

Ospelnikova T.P., Svitich O.A., Ershov F.I.

Abstract

Among respiratory viruses, the most serious complications are caused by influenza A and B viruses, as well as coronaviruses. Most studies determined the absolute content of interferons (IFNs) of different types in blood serum. However, serum IFN protein concentrations do not always reflect the level of antiviral protection. The purpose of this study was a comparative assessment of interferon status in patients with ARVI: influenza and the acute stage of COVID-19. Materials and methods. We used biomaterial in the form of whole blood samples from 113 patients with influenza and 110 patients in the acute phase of moderate COVID-19. The body’s antiviral defense during ARVI was assessed by determining the activity of type I and II interferons produced by blood leukocytes using the “Interferon status” method in a cell-virus system simulated in vitro. Results. This work reveals a statistically significant decrease in the biological activity of interferons produced by blood leukocytes in influenza and a deficiency of IFN activity in COVID-19, compared with reference values, and also shows possible prospects for the treatment of these nosologies with such immunoactive drugs as IFN inducers (cycloferon, Kagocel) and immunomodulators (ingavirin, multicomponent vaccine Immunovac-VP-4). Conclusion. The results of IFN activity are necessary to assess the antiviral potential of the body, especially with COVID-19, given the “novelty” of the infection, the severity and variety of its clinical manifestations. Today it is known that the SARS-CoV-2 virus is capable of penetrating not only into the epithelial cells of the upper respiratory tract, epithelial cells of the stomach and intestines, but also into the cells of the esophagus, heart, adrenal glands, bladder, brain, as well as into the vascular endothelium and macrophages. Coronavirus SARS-CoV-2 inhibits the expression of cellular genes, including innate immune genes, and has a negative effect on the IFN system. The use of IFN inducers and immunomodulators for influenza and COVID-19 has shown immunological feasibility and clinical promise.

Russian Journal of Infection and Immunity. 2024;14(3):416-422
pages 416-422 views

Expression of pro-inflammatory cytokines (IL-18, IL-33) at the level of the mucous membrane, the entry point of infection, in persons who have experienced COVID-19 disease

Rasskazova N.D., Abramova N.D., Soshchenko T.D., Kalyuzhnaya N.O., Meremianina E.A., Shatokhin M.N., Zaitseva T.A.

Abstract

Introduction. The mucous membrane of the upper respiratory tract is the entrance gate for a large number of infections, including the SARS-CoV-2 virus. That is why the main task of the immune system of the mucous membranes of the entrance gate of infection is to maintain respiratory function. High production of proinflammatory cytokines, which play a key role in the development of severe COVID-19 infection, leads to detrimental consequences for all body systems. Their long-term influence can not only aggravate chronic pathologies, but also significantly increase the recovery period, leading to a decrease in the quality of life of patients. Therefore, the purpose of this work is to study the expression of IL-18 and IL-33 genes at the level of the mucous membranes of the upper respiratory tract in patients who have had COVID-19 disease. Materials and methods. The present study involved patients who had moderate or severe COVID-19. The control group consisted of relatively healthy individuals. The expression levels of IL-18 and IL-33 were detected using RT-PCR. Results. During the entire period of rehabilitation after suffering from COVID-19, patients showed a tendency to increase the level of IL-18 expression at the level of the mucous membranes of the nasopharynx and oropharynx. The level of IL-33 production was also increased, but varied depending on the location and period of sample collection. Conclusion. This increase in the level of IL-18 during the rehabilitation period of patients after COVID-19 may be explained by the fact that the virus, by activating glia through olfactory receptor neurons, triggers a powerful immune response and promotes the production of a large number of pro-inflammatory cytokines. On the contrary, overexpression of IL-33 in the late stages of rehabilitation is most likely associated with its ability to restore barrier tissues of the mucous membranes of the upper respiratory tract. Thus, we can conclude that the virus promotes excessive production of pro-inflammatory cytokines, the amount of which increases maximally at the 6th month of rehabilitation after suffering from COVID-19.

Russian Journal of Infection and Immunity. 2024;14(3):423-428
pages 423-428 views

Laboratory blood markers in COVID-19 and their connection to Viral variant

Korobova Z.R., Liubimova N.E., Arsentieva N.A., Zhebeleva M.S., Chernykh E.I., Davletshina V.V., Kashchenko V.A., Totolian A.A.

Abstract

Morality rates in COVID-19 are dependent on timely diagnosis. Therefore, studying the relationship between laboratory markers and the severity of disease is important. The first wave of COVID-19 associated with the spread of the original strain of SARS-CoV-2, showed higher mortality rates caused by cytokine storm. As the viral variant changed, a change in the disease course towards a less pronounced inflammatory reaction was observed. These changes affected major players of inflammation, cytokines. However, cytokines are not the only markers in the inflammatory response. The purpose of this work was to determine the significance of laboratory markers in inflammation: WBC, C-reactive protein, ferritin, fibrinogen, and D-dimer. The study included 227 patients with acute COVID-19 in the first 5–7 days from the onset of the disease from January 2021 to March 2022. When compared with reference, all groups were characterized by reduced absolute values of lymphocytes. Correlation analysis between the absolute value of lymphocytes and plasma cytokine concentrations also revealed statistically significant strong relationships with the level of the chemokine CCL22/MDC. Given that CCL22/MDC is an important component of lymphopoiesis, its low concentrations may indicate dysregulation of this process in COVID-19. In addition, we noted a positive correlation between the level of C-reactive protein and IL-6 in peripheral blood. IL-6 is a proinflammatory cytokine, and its elevated levels have been associated with the development of severe COVID-19. One of its functions is the induction of C-reactive protein, and this trend persists regardless of which variant causes COVID-19. We also noted positive correlations between the concentrations of fibrinogen and IL-18, ferritin and IL-6, IL-18. Both of these proteins are involved in inflammation along with cytokines. The literature provides data on the significance of these markers for determining the severity of COVID-19. There is evidence of a synergistic effect of ferritin and IL-18 against viral pathogens. Of interest was the negative correlation between plasma D-dimer levels and IFNα. At the same time, data on the role of the latter in thrombus formation processes are increasingly appearing in the literature.

Russian Journal of Infection and Immunity. 2024;14(3):429-436
pages 429-436 views

Blood cytokines as potential predictors of the development of SARS-CoV-2 associated pneumonia in patients with stage II ESSENTIAL hypertension

Radaeva O.A., Simbirtsev A.S., Iskandyarova M.S., Negodnova E.V., Kulyapkin V.V., Krasnoglazova K.A., Eremeev V.V.

Abstract

The search for predictors of the severe course of COVID-19 was relevant both during the pandemic and at the present time. The aim of the study was to analyze the relationship of cytokine levels in patients with EН before SARS-CoV-2 infection with the incidence of coronavirus pneumonia. Materials and methods. From the database of 290 patients with stage II EAG who have been under observation for 8–12 years with annual blood sampling to determine cytokine levels, COVID-19 survivors were selected (mild without pneumonia and moderate to severe, pneumonia CT 1–2, CT-3). Anamnestic levels of IL-1β, IL-1α, IL-1ra, IL-18, IL-18 BP, IL-37, IL-6, sIL-6r, M-CSF, VEGF-A, IL-34 and HMGB1) in the blood serum of patients with stage II EH were analyzed (method ELISA). The analysis of the obtained results was carried out using Stat Soft Statistica 13.5. Results and discussion. Patients with EH and COVID-19 with pneumonia (CT I-II) after SARS-CoV-2 infection 2–6 months before the infectious disease had significantly higher serum levels: IL-1α (p < 0.05) and a decrease in IL-37 (p < 0.001). During multivariate correlation analysis, a statistically independent relationship between an increase in the incidence of viral pneumonia in patients with stage II EН was confirmed only for IL-37 with a blood level of less than 60.2 pg/ml (regression coefficient — 2.21, standard error — 0.28, t criterion — 6.12, relative risk — 2.52, criterion Walda — 7.92, p = 0.006). When studying circadian rhythms of cytokine content in blood serum in patients of the analyzed groups, calculating the strength of correlations of anamnestic evening IL-37 levels in patients with stage II EР at 19.00–20.00 with the frequency of pneumonia against the background of SARS-CoV-2 infection, it has greater specificity and sensitivity (specificity — 0.75, sensitivity — 0.82) than morning concentrations. Considering that data on circadian rhythms were obtained in a limited number of patients, further monitoring is necessary, which is carried out by our scientific group. It should be noted that patients with essential hypertension are pathogenetically heterogeneous, including in terms of cytokine regulation. The study of this area will make it possible to personalize cytokine phenotypes of the disease and develop new methods for calculating the prognosis of both cardiovascular complications and features of the course of infectious diseases.

Russian Journal of Infection and Immunity. 2024;14(3):437-442
pages 437-442 views

Characteristics of virus-specific immunological reactions following COVID-19 vaccination in heart transplant recipients

Zafranskaya M.M., Nizheharodava D.B., Shatova O.G., Russkih I.I., Velichko A.V., Vanslau M.I., Novitskaya S.F., Denisevich T.L., Kolyadko M.G., Kurlyanskaya E.K.

Abstract

Heart transplant patients are at an increased risk of COVID-19 infection adverse outcomes because of underlying immunosuppression and concomitant comorbidities. To date, all large-scale randomized controlled trials for various COVID-19 vaccines have excluded solid organ transplant recipients. Therefore, the efficacy and safety of coronavirus infection prevention using COVID-19 vaccines in transplant heart patients has not been sufficiently studied. In this research, the evaluation of virus-specific immunological reactions after vaccination (double Vero Cell vaccination and Sputnik Light booster vaccination) in heart transplant patients has been carried out. In vaccinated heart transplant individuals who did not have a history of COVID-19, starting from 4–6 months after the 2nd dose of the vaccine, an increase in antibodies to S protein level of was observed, while maintaining statistically significant differences for 9–12 months after vaccination (regardless of whether with or without booster vaccination). However, the concentration of antibodies remained low, and 37% of patients detected no antibodies. In vaccinated heart transplant individuals following the previous COVID-19 infection, as compared to seronegative patients, post-vaccination immunity is accompanied by maintaining a high level of virus-specific IgG antibodies to the S protein of the SARS-CoV-2 virus in the dynamics of the post-vaccination period with a statistically significant increase of these antibodies by 9–12 months after booster vaccination. The specific cellular response (according to the assessment of CD3⁺154⁺ and CD3⁺IFNγ⁺ TNFα⁺ cells) to the S protein of the SARS-CoV-2 virus remained low throughout the entire follow-up period, was recorded in 5–40% of heart transplant patients and statistically significant changes in the number of spikereactive lymphocytes were observed in patients with a history of COVID-19 by 4–6 months after administration of the 2nd dose of the vaccine. This, together with the results of the assessment of the humoral response, indicates a more pronounced post-vaccination immunity in patients with a hybrid immunity. While developing a methodology for assessing the risk and benefit of a vaccination strategy for individual heart transplant patients, clinical efficacy, ongoing monitoring of rare serious adverse events, and data on vaccine immunogenicity should be taken into account.

Russian Journal of Infection and Immunity. 2024;14(3):443-450
pages 443-450 views

Algorithm for assessing the level of T cell immune response against SARS-CoV-2 and the results of its application in unvaccinated and vaccinated people who have been infected with COVID-19

Blyakher M.S., Fedorova I.M., Koteleva S.I., Kapustin I.V., Tulskaya E.A., Ramazanova Z.K., Odintsov E.E., Sandalova S.V., Novikova L.I., Bochkareva S.S.

Abstract

Antigen (AG)-specific T cell activity was compared in two groups of patients: those who underwent COVID-19 in 2021 during the circulation of the SARS-CoV-2 delta virus strain (43 individuals); and those who underwent COVID-19 in 2022 (Omicron strain, 23 individuals). The diagnosis was confirmed by PCR analysis of nasopharyngeal and oropharyngeal swabs. The 23 individuals following COVID-19 caused by SARS-CoV-2 (omicron) were part of a cohort of 41 volunteers who were examined multiple times during 2021–2023: during vaccination, after vaccination, before revaccination, and subsequently after illness (6–8 times in total). Due to this, it was possible to compare the indices of specific humoral and cellular immunity in the same patients 1–2 months before and after breakthrough infection. Detection of AG-specific T cells and assessment of their activity by AG-stimulated IFNγ production was carried out by our own previously developed method (Patent RU № 2780369 C1). For stimulation of memory T effectors in vitro, the same antigens were used to determine the concentration of antibodies against SARS-CoV-2 by ELISA method. A total of about 300 blood samples from healthy subjects and patients after COVID-19 were analyzed. Each sample was tested against 3 SARS-CoV-2 antigens and in 2 stimulation modes. A qualitative assessment algorithm for AG-specific T cell activity has been proposed that can be used to monitor the state of cellular immunity in a population in which SARS-CoV-2 virus continues to circulate and to create insights into what level of T cell activation is sufficient to prevent or reduce the severity of SARS-CoV-2 infection. Unvaccinated COVID-19 (SARS-CoV-2, Delta) survivors lacked AG-specific T cells to RBD SARS-CoV-2, but T cell specificity to full-length S glycoprotein at the same level, qualitatively assessed as low in 52% of the group, persisted for up to six months. In previously unvaccinated COVID-19 vaccinees, this duration of persistence of AG-specific T cells in circulating blood was achieved only after revaccination. Hybrid immunity, which we traced as a result of vaccination after COVID-19 (Delta strain) or as a breakthrough infection (SARS-CoV-2, Omicron), is characterized by the highest indices of memory T cell activity (43–46% of the group — normal activity of AG-specific cells, 30–43% — high activity) to all used antigens and the longest duration of preservation of indices at this level. Further investigation of the level of antiviral immunity after COVID-19 may be important for predicting the outcome of new waves of SARS-CoV-2 infection.

Russian Journal of Infection and Immunity. 2024;14(3):451-458
pages 451-458 views

Balance of pro- and anti-inflammatory cytokines in young patients who passed active Immunization against SARS-CoV-2 during the COVID-19 Pandemic

Li Y.A., Dmitrachenko M.N., Markelova E.V., Korolev I.B., Kostinov M.P., Bondar L.I.

Abstract

In 2019, the COVID-19 pandemic began and changed the world. Coronavirus SARS-CoV-2 has caused widespread illness and death around the world. In this regard, vaccination become the most important tool for creating herd immunity. Our study analyzed the dynamics of pro- and anti-inflammatory cytokines and antibodies to SARS-CoV-2 in the blood serum of young patients before and after vaccination against COVID-19. The study group included 76 young men. Determination of IL-1β, IL-4, IL-6, IL-8, IL-10, IL-17, IFNγ, TNFα and IgM and IgG antibodies to COVID-19 in venous blood sera was carried out twice, by ELISA using the test systems of Vector-Best Company, Novosibirsk. The first blood samples were carried out before vaccination, the second — 1 month after vaccination against COVID-19. The results were processed using STATISTICA 8.0. The vaccinated people were monitored for 6 months after vaccination. Levels of indices before vaccination: IL-1β (5.6 pg/ml (Q₂₅–Q₇₅ = 3.1–14.2); IL-4 (1.02 pg/ml (Q₂₅–Q₇₅ = 0.75–1.28); IL-6 (27.8 pg/ml (Q₂₅–Q₇₅ = 7.1–59.9); IL-8 (29.9 pg/ml (Q₂₅–Q₇₅ = 19.51–32.14); IL-10 (4.47 pg/ ml (Q₂₅–Q₇₅ = 1.84–14.75); IL-17 (7.33 pg/ml (Q₂₅–Q₇₅ = 6.82–8.58); IFNγ (0.7 pg/ml (Q₂₅–Q₇₅ = 0.4–0.9); TNFα (3.9 pg/ml (Q₂₅–Q₇₅ = 2.2–6.4). Levels of indices after vaccination: IL-1β (1.6 pg/ml (Q₂₅–Q₇₅ = 1.4- 2.2); IL-4 (0.84 pg/ml (Q₂₅–Q₇₅ = 0.59–1.12); IL-6 (1.2 pg/ml (Q₂₅–Q₇₅ = 0.6–1.7); IL-8 (10.1 pg/ml (Q₂₅–Q₇₅ = 3.8–28.9); IL-10 (5.84 pg/ml (Q₂₅–Q₇₅ = 1–9.99); IFNγ (0.6 pg /ml (Q₂₅–Q₇₅ = 0.3–0.8); TNFα (0.6 pg/ml (Q₂₅–Q₇₅ = 0.3–1.9). Both before and after vaccination against SARS-CoV-2, different distributions of cytokine levels were identified with a downward trend, but despite this, strong correlations were observed between many of them, which indicates an increase in the tension of the immune system in response to vaccination. When calculating the ratio of pro- and anti-inflammatory cytokines, its two-fold decrease was revealed, which reflects a decrease in the levels of pro-inflammatory cytokines after vaccination. The level of IgG antibodies to COVID-19 exceeded the protective level: more than 14 times in 98% of subjects. Further research into the impact of SARS-CoV-2 vaccination on innate immunity will allow us to reconsider the current vaccination strategy and determine the best approach to preventing COVID-19.

Russian Journal of Infection and Immunity. 2024;14(3):459-464
pages 459-464 views

The avidity of virus-specific antibodies obtained from in vitro stimulated memory b cells does not change one month after booster with Sputnik V or Comirnaty

Astakhova E.A.

Abstract

The protective properties of long-term immunological memory after vaccination against COVID-19 are characterized by the neutralizing activity of serum antibodies and antibodies secreted by memory B cells upon repeated encounter with the antigen. Somatic hypermutations occurring in the immunoglobulin genes of memory B cells are one of the mechanisms for increasing the affinity of antibodies. At the moment, the effect of booster vaccination against COVID-19 with vector vaccines, on the maturation of memory B cells remains poorly understood. The purpose of this work was to determine how COVID-19 booster affects the affinity of RBD-specific IgG antibodies secreted by memory B cells. B lymphocytes were isolated from peripheral mononuclear blood cells of volunteers who had been revaccinated against COVID-19 with Sputnik V or Comirnaty. B cells were stimulated in vitro with CD40L expressed on the surface of A549 feeder cells and IL-21. Supernatants were concentrated 8-fold using centrifugal concentrators. In the obtained supernatants from stimulated memory B cells, the level of IgG antibodies specific to wild-type RBD was determined by enzyme-linked immunosorbent assay (ELISA). To determine the avidity index, ELISA with 7M urea was provided. It was shown that despite a general increase in the amount of antigen-specific IgG antibodies obtained from stimulated memory B cells, there was no change in the avidity of these antibodies one month after booster in both groups of donors. The obtained results contribute to the understanding of the mechanisms of memory B cell maturation after booster vaccinations against COVID-19 and may be useful for deciding on the strategy of booster vaccination.

Russian Journal of Infection and Immunity. 2024;14(3):465-470
pages 465-470 views

Plasmablast response during acute SARS-CoV-2 infection

Byazrova M.G., Sukhova M.M., Mikhailov A.A., Romanova A.F., Yusubaliyeva G.M., Filatov A.V.

Abstract

Plasmablasts are a population of short-lived B cells that appear in the circulation shortly after vaccination and during acute infection. Plasmablasts are formed from resting B lymphocytes, from which they differ in their ability to secrete antibodies, making them similar to plasma cells. Plasmablasts are terminally differentiated cells that can form at various nodes and branches of the B cell response. The plasmablast response is an indicator of the success of vaccination and also helps in predicting antibody levels after recovery or vaccination. However, the definition and classification of plasmablasts faces great experimental and theoretical difficulties. The aim of the work was to determine the characteristics of the plasmablast response during acute SARS-CoV-2 infection. The study included patients (n = 28) with a severe form of COVID-19. Blood sampling was carried out once on the 10–18th day from the moment of hospitalization. B cells were isolated by immunomagnetic separation. Cells were phenotyped using flow cytometry. Secretion of IgM and IgG was determined by ELISpot method. B cell subsets were isolated using a cell sorter. Patients with COVID-19 had an approximately fourfold increase in total plasmablast levels compared to healthy donors. An even more pronounced excess over the negative control was observed for RBD-specific plasmablasts. In terms of their composition, plasmablasts were one third IgM⁺ cells. This distribution between B-cell BCR receptor isotypes was consistent with the primary nature of the immune response in COVID-19. Approximately a third of plasmablasts carried the CD138 antigen. CD138 marker is characteristic of the late stage of plasmablast maturation and is also found on plasma cells. The CD27+CD38⁺ population was divided according to the expression of the CD138 antigen. Using the ELISpot method, we have shown that a significant portion of circulating plasmablasts are antibody-secreting cells. Among circulating plasmablasts, both early and late plasmablasts can be distinguished, which are characterized by the absence of a surface BCR, but which carry the CD138 antigen. Determining how plasmablasts relate to other B cell populations is of paramount importance for the development of new treatments for COVID-19 and for the creation of promising vaccines against SARS-CoV-2 infection.

Russian Journal of Infection and Immunity. 2024;14(3):471-475
pages 471-475 views

Post-COVID-19 syndrome: a discussion of onset timing

Berdiugina O.V.

Abstract

Introduction. Post-COVID syndrome (alternatively: chronic COVID syndrome, post-acute sequelae of COVID-19, long-haul COVID, long COVID, PASC, CCS) is a state of permanent or permanent presence of symptoms of a pathological process after COVID-19. Currently, there is no consensus on the timing of the onset of post-COVID-19 syndrome. The purpose of this study was to analyze the appearance of some post-COVID symptoms 1, 2 and 3 months after infection with the SARS-CoV-2 virus. Materials and methods. The analysis of clinical and laboratory data of 59 medical workers who had a mild or moderate form of COVID-19 was carried out. Three groups were formed: with the assessment of post-COVID-19 changes 1 month after the onset of the disease; with the detection of changes after 2 months; and with the detection of dysfunctions after 3 months. Results and discussion. It was found that 57.7% of respondents complained of fatigue, weakness, sleep disorders in the first month of observation. After 2 months, the frequency of complaints decreased by 42.3%, and by 3 months it increased again by 15.6%. A month after COVID-19, several cases were recorded when employees were unable to perform any, even very light, work. However, by 3 months of follow-up, 96.2% of the surveyed declared full recovery of efficiency. The appearance of muscle, joint, and spinal pain was reported more often in the first month after COVID-19, then the number of complaints decreased by half to 23–25% of the total number of observations. The assessment of the severity of the infection among the respondents of the three groups did not reveal significant differences between the data in 1, 2 and 3 months after COVID-19. Conclusion. An analysis of some post-COVID symptoms showed that in mild and moderate COVID-19, manifestations are observed 1, 2 and 3 months after infection with the SARS-CoV-2 virus. Multidirectional change dynamics were revealed, more often accompanied by a decrease in the manifestation of post-COVID syndrome 2 months after coronavirus infection, which may create a false impression of an absence of signs of post-COVID syndrome during this period.

Russian Journal of Infection and Immunity. 2024;14(3):476-482
pages 476-482 views

Production of some cytokines as a reflection of various immunoregulatory mechanisms in post-covid myocarditis

Moskaletc O.V.

Abstract

Currently, the problem of persistent myocardial damage in patients who have had COVID-19 has become one of the most pressing in the practice of cardiologists. The main mechanisms of the pathogenesis of post-COVID myocarditis are associated with a violation of immunoregulation caused by long-term persistence of the virus in the heart muscle and the launch of autoimmune processes that can lead to myocardial remodeling, the formation of myocardiosclerosis and the development of heart failure or arrhythmia. The purpose of this study was to assess the dynamics of the production of certain cytokines (IFNg, IL-4, IL-17А), which may indirectly reflect the activation of various immune response pathways in patients with post-COVID myocarditis, depending on the duration of the disease and the degree of heart failure. The study included 32 patients with post-COVID myocarditis, 36 patients with myocardial cardiosclerosis, and 10 apparently healthy individuals. It was found that in all patients with post-COVID myocarditis, the content of IFNg, IL-4, IL-17А in the blood serum was higher than in patients with myocardial cardiosclerosis (p < 0.001; p < 0.05; p < 0.01, respectively) and conditionally healthy individuals (p < 0.001; p < 0.01; p < 0.001, respectively). Compared with the group of patients with no or moderate severity of symptoms of heart failure (functional class 0–II), those with more severe heart failure (functional class III) had a higher level of interferon gamma (p < 0.05). When comparing the results obtained with similar indicators in patients with myocardial cardiosclerosis who have the same degree of heart failure, no statistically significant differences were obtained. The maximum content of IFNg in post-COVID myocarditis was observed in the 2nd week of the disease (p < 0.001 compared with the control group); then its level gradually decreased and by the end of the 2nd month there were no longer any significant differences. The opposite trend was observed in relation to the content of IL-4 and IL-17А: in the first two weeks, no statistically significant differences were detected with the control group, but then their content increased quite quickly (p < 0.001 compared with the control group by the end of the first month of the disease) and continued to remain the same high until the end of the 2nd month. Thus, monitoring the content of IFNg, IL-4, IL-17А in blood serum can to some extent provide an idea of the sequence of development of the immune response in post-COVID myocarditis. An increase in IFNg levels in the early stages of the disease is probably associated with an increase in the manifestations of heart failure. Th17-mediated mechanisms may be involved in the process of myocardial remodeling resulting in myocardial cardiosclerosis.

Russian Journal of Infection and Immunity. 2024;14(3):483-487
pages 483-487 views

Variability of changes in proand antiinflammatory cytokines due to IFNα and IFNγ deficiency in patients with post-covid syndrome associated with activation of chronic herpes viral infections

Atazhakhova M.G., Chudilova G.A., Lomtatidze L.V., Poezzhaev E.A.

Abstract

Post-COVID syndrome (PCS) is characterized by long-term complications and conditions accompanied by neuroimmunoinflammation, and includes chronic fatigue syndrome (CFS) and cognitive disorders (CD), which are often associated with activation of chronic herpesvirus infections (HVI). Timely detection of symptoms and immunodiagnosis of PCS are a priority and are of undoubted interest. Objective: to clarify the levels of serum proand anti-inflammatory cytokines, alpha and gamma interferons in patients with post-COVID syndrome associated with confirmed activation of chronic herpesvirus infections. Patients (n = 60) aged from 18 to 65 years with complaints of manifestations of PCS associated with HVI were studied — the study group (SG). A survey was conducted using a modified scale-questionnaire to assess the severity of PCS symptoms in points from 0 to 4, real-time PCR of HVI (EBV, HSV1/2, VCH6, VCH8, CMV) in saliva and scrapings from the tonsils, determination of the level of IFNα and IFNγ, pro- (TNFα, IL-18, IL-1β, IL-6, IL-17A, IL-8) and anti-inflammatory (IL-4 and IL-10) cytokines in blood serum. Comparison group (CG) — 60 apparently healthy individuals. SG patients with mixed HVI with EBV dominance noted the most pronounced and persistent clinical manifestations of PCS, among which the leading place was occupied by longterm sensations of CFS and CD. A persistent multisystem inflammatory response was identified, confirmed by elevated levels of IL-6 and IL-17A, which caused severe PCS. In post-COVID period, hyperproduction of IL-1β was detected, which was accompanied by clinical manifestations of persistent neuroimmunoinflammation. At the same time, the identified deficiency of IFNα, IFNγ and dysregulatory disorders in the antiviral defense of the immune system in patients with PCS contributed to the activation of HVI. Data on the imbalance of proand anti-inflammatory cytokines in the SG were obtained, which confirms the presence of a persistent multisystem inflammatory reaction with dominance of persistent neuroimmunoinflammation, which causes severe PCS. An imbalance of the cytokine system with IFNα and IFNγ deficiency, associated with the activation of chronic HVI with EBV dominance in the post-COVID period, contributes to the development of neuroimmunoinflammation, which is accompanied by the leading clinical signs of PCS: CFS and CD.

Russian Journal of Infection and Immunity. 2024;14(3):488-494
pages 488-494 views

Broncho-obstructive syndrome and the enzymes of cellular energy metabolism after coronavirus infection

Kosyakova N.I., Akulenko M.V.

Abstract

Broncho-obstructive syndrome (BOS) after coronavirus infection is characterized by long-term, dry and painful cough which is hard for treatment, significantly reducing the quality of life of the patients. The goal of the study: to investigate the specific features of clinical manifestations of BOS diagnosed for the first time in patients belonging to different age groups in post-COVID-19 period and to estimate the degree of mitochondrial dysfunction by the imbalance of the enzymes of cellular energy metabolism. Materials and methods. 298 patients with BOS (age 18–78) were observed continuously for 2 years. Standard clinical, biochemical and functional examination was carried out, Saint George`s Respiratory Questionnaire (SGRQ) was used. Mitochondrial dysfunction was determined by the ratio of levels of two enzymes, lactate dehydrogenase (LDH) and succinate dehydrogenase (SDH), in peripheral blood lymphocytes. Statistical data processing was performed in STATISTICA 10.1 program package. Results. The duration and severity of BOS manifestations increased with age, they were the most prominent in the age group older than 60 y/o. Bronchial asthma was diagnosed for the first time in 85 patients, most of them belonging to the group 18–25 y/o. In all the patients with BOS, the SGRQ coeffitient was above 50, and comorbidity was established in 82.4% of the patients. The longest duration of BOS (49.4±3.5 days) was established in the group older than 60 y/o (n = 86). LDH/SDH ratio decreased from 6 to 4.8–5.2 a.u. in all the age groups. Such changes should be taken into account in the patients from young age groups. Conclusion. The revealed low values of LDH/SDH ratio have not been shown in the available literature earlier. These values demonstrate the development of secondary mitochondrial dysfunction in post-COVID-19 period in both younger and older age groups, particularly, in patients with more severe progression of BOS. Estimation of this parameter would allow to revealthe personified characteristics for each patients, which is important for quantifying the efficacy and duration of the required antioxidant therapy.

Russian Journal of Infection and Immunity. 2024;14(3):495-499
pages 495-499 views

Mice microglia cytokine profile changes under the influence of HSV-1

Bulgakova I.D., Zverev V.V., Kravtsova E.O., Usatova G.N., Shoichet D.A., Zadvornykh E.A., Shumkina A.A.

Abstract

Introduction. Today, prevalence of neurodegenerative diseases increases. In recent years, more studies have revealed a new knowledge about the role of microglia in the development of these diseases. Animal experiments showed that peripheral inflammation causes activation of microglia in brain. All this points to the essential role of the cells in the development of neurodegeneration. Under the influence of various factors, microglia can change the phenotype and participate in both repair and damage to brain cells. Chronic herpesvirus infection caused by HSV-1 is another known factor in the development of neurodegenerative pathology. However, the exact pathogenetic mechanisms are still unknown, nevertheless, studying the virus effect on microglia has great potential. The goal of our study in this connection was to assess the effect of HSV-1 on microglia polarization in mouse strain with normal susceptibility to this virus and in strain which is more resistant to the action of HSV-1. For this purpose, changes in the cytokine profile were detected. A comparison of interstrain differences in the expression of cytokine genes was also compared in control groups. Materials and methods. The study involved infecting C57BL/6 and BALB/c mice with herpes simplex virus type 1, an isolation of microglia was based on separation steps using a discontinuous gradient density, the cytokine profile was assessed by gene expression levels using a real-time reverse transcription PCR. To calculate the relative fold gene expression of samples the 2ΔΔCt method was used. Statistical significance was determined using the Mann–Whitney U-test. Results. There were found no interstrain differences in cytokine gene expression in control groups of different mouse strains. At the same time, gene expression differed in the experimental groups: in BALB/c mice, the expression of genes for both pro-inflammatory and anti-inflammatory cytokines increased; in C57BL/6 mice, a slight increase in the expression of IL-1β genes was observed. Conclusion. The data indicate the formation of different microglial phenotypes after HSV-1 infection in different mouse strains. Apparently, in BALB/c mice there is a switch from the pro-inflammatory M1 phenotype of microglia to the anti-inflammatory M2 phenotype, while in C57BL/6 mice the attenuation of the infectious process occurs through a return to the original M0 phenotype.

Russian Journal of Infection and Immunity. 2024;14(3):500-504
pages 500-504 views

Neutrophil extracellular traps as markers of infectious and aseptic inflammation

Kazimirskii A.N., Salmasi J.M., Poryadin G.V., Panina M.I., Kim A.E., Rogozhina L.S.

Abstract

One of the important problems of medicine is the search for new reliable markers of inflammation that would allow us to determine the type of inflammatory process. The aim of the study was to identify specific markers of infectious and aseptic inflammation based on the analysis of morphological variants of neutrophil extracellular traps (NETs). The study included 26 patients with various nosological forms of inflammation in the abdominal cavity (12 with acute appendicitis, 8 with acute cholecystitis, 6 with a diagnosis of pancreatitis/ pancreonecrosis) after surgery. The study also included 20 patients with post-COVID and a group of 10 volunteers no clinical manifestations of the disease, but at the same time had contacts with flu patients. Neutrophils were isolated using gradient centrifugation. Fluorescence microscopies with the dye SYBR Green (JSC “Evrogen”, Russia) were used for NET visualization and counting. NETs in the morphological form of neutrophils web structure were found in the blood of surgical patients with acute appendicitis who had a favorable course of the postoperative period. In a group of volunteers who were exposed to influenza but did not have symptoms of an infectious disease, we also found neutrophils web structure. In all patients with abdominal inflammation complicated by abdominal abscess, in addition to neutrophil web structure, abnormal forms of NETs were recorded, in particular, NETs in the form of single filaments. In the post-COVID patients an absolute absence of neutrophilis web structure was revealed. In all post-COVID patients, NETs are found only in the form of single filaments. The results of subsequent experiments showed that collagen peptides are inducers of the formation of NETs in the form of single filaments. The detection of neutrophils web structure is a sign of an infectious inflammatory process. NETs in the morphological form of single filaments are markers of aseptic inflammation, as well as a sign of endothelial damage.

Russian Journal of Infection and Immunity. 2024;14(3):505-510
pages 505-510 views

The influence of neutrophils and their exoproducts on biofilm biomass, bacterial viability and conjugative transfer into Escherichia Coli

Maslennikova I.L., Nekrasova I.V., Starčič E.M., Kuznetsova M.V.

Abstract

The purpose of this study was to investigate the effect of neutrophils and their antimicrobial factors, hydrogen peroxide and defensin α, on the biofilm biomass, the viability of bacteria in the biofilm and the efficiency of conjugative transfer of the pOX38:Cm plasmid from the E. coli N4i pOX38:Cm strain into different E. coli strains (commensal К12 TG1 and uropathogenic DL82, R32 and R45). The biofilm of the recipient E. coli TG1 with the donor E. coli N4i pOX38:Cm increased when 10⁵ cells/ml of neutrophils were added compared to the control, while the biofilm biomass of the uropathogenic E. coli recipient strains DL82/E. coli R45 with the donor E. coli N4i pOX38:Cm decreased when 10⁶/10⁴–10⁶ cells/ml of neutrophils were added, respectively. The survival of recipient E. coli TG1 cells and transconjugants in the biofilm was, compared to the control, higher when 10⁴, 10⁵, 10⁶ cells/ml of neutrophils were added. The addition of 0.1 mM H₂O₂ increased biofilm formation of E. coli DL82 and E. coli R45, and addition of 0.5 mM H₂O₂ reduced biofilm formation of E. coli DL82, while 0.5 mM or 2.5 mM reduced the E. coli R45 bacterial biofilm biomass in the conjugative mixture. The frequency of the pOX38:Cm conjugative transfer was lower in the presence of 2.5 mM H₂O₂ in the N4i pOX38:Cm × DL82 biofilm, and also in the presence of 0.5 and 2.5 mM H₂O₂ in the N4i pOX38:Cm × R45 biofilm, compared to the control. The frequency of pOX38:Cm conjugation from the donor E. coli N4i pOX38:Cm into E. coli DL82 decreased, when 5 or 25 ng/ml defensin α were added and the conjugation frequency in the mating mixture N4i pOX38:Cm×R45 decreased, when 5 ng/ml were added, while, when 25 ng/ml of defensin α were added it increased.

Russian Journal of Infection and Immunity. 2024;14(3):511-518
pages 511-518 views

Impact of Tritrichomonas spp. on the immune system of Muc2–/– mice after antibiotic therapy

Goncharova E.P., Bets V.D., Makusheva Y.S., Litvinova E.A.

Abstract

While pathogenic protists inhabiting the reproductive tract are well studied, the gastrointestinal (GI) tract contains a constitutive protist microbiota that is an integral part of the vertebrate microbiome. Currently, the effect of protozoan infections on the host immune system and their potential contribution to disruption of mucosal immune homeostasis are not well understood. Protists, along with bacteria and viruses, are permanent representatives of the human microbiota. The main attention of researchers is focused on studying their pathogenic role in gastrointestinal diseases. However, their role in symbiotic relationships with hosts is relatively little studied. It was previously shown that the closest human ortholog of mouse Trichomonas (Tritrichomonas spp.) is Trichomonas Dientamoeba fragilis, which can cause symptoms of inflammatory bowel disease. It is currently unclear whether Dientamoeba fragilis and other protist species such as Enteromonas spp., Entamoeba dispar are commensals, pathobionts, or pathogens of the human intestinal tract. Thus, information about the mutualistic relationships between protists, the gastrointestinal microbiota, and the immune system of mice can be used to understand host-protozoan relationships in humans. The data obtained allow us to evaluate the potential contribution of commensal protozoa in the formation of protective mechanisms of the mucous membrane of animals and humans. We have previously shown that antibiotic therapy leads to an increase in the number of Tritrichomonas spp. along with a reduction in bacteria in the gut of mice with a mutation in the Muc2 gene. A mutation in this gene leads to impaired formation of the intestinal mucosa in mice. Mice with a mutation in the Muc2 gene can be used as model to study human inflammatory bowel diseases (IBDs). In this work, we conducted a comparative study of the immunological status of Muc2–/– mice harboring Tritrichomonas spp. after antibiotic therapy for 2 weeks followed by gavage of Lactobacillus johnsonii into mice and mice without introduction of probiotic microorganisms (self-recovery). Analysis of the main populations of lymphocytes in the blood, spleen and lymph nodes showed that the introduction of Lactobacillus johnsonii after antibiotic therapy leads to a significant increase in the population of T-lymphocytes in the blood and spleen, and an increase in the number of helper T cells in the lymph nodes of Muc2–/– mice compared to mice without the addition of probiotic microorganisms.

Russian Journal of Infection and Immunity. 2024;14(3):519-524
pages 519-524 views

The course of tuberculosis infection in hyper-susceptible mice carrying the H2ᵛ haplotype

Baikuzina P.G., Gorbacheva D.V., Apt A.S., Korotetskaya M.V.

Abstract

Genetic regulation of the host susceptibility to Mycobacterium tuberculosis (Mtb) and severity of tuberculosis (TB) infection remain incompletely investigated. Identification of particular genes and involved in TB control and immune reactions regulated by these genes is essential for our understanding of pathogenesis of the disease, discovery of drug targets and rational vaccine development. We have shown that mice of the B10.SM (H2ᵛ) strain are extremely TB susceptible; meanwhile, the general genome structure of this mouse strain and the H2ᵛ haplotype itself are poorly characterized. We selected a pool of Mit genetic markers differentiating B10.SM mice from Chr. 17-congenic mice of the B10 strain by the PCR products motility in the electrophoresis setting. TB susceptibility of B10 mice is much lower than that of B10.SM. In the model of infection triggered by two different dosed of Mtb (100 and 600 CFU per mouse) administered via respiratory tract we demonstrated that B10.SM mice have significantly shorter survival time and significantly higher lung mycobacterial multiplication compared to B10 mice. We demonstrated (intracellular staining and ELISA) that IFNγ production in the lungs of infected mice of the two strains corresponds well to their disease phenotypes. Thus, more resistant B10 mice possess significantly more lung IFNγ-positive CD4⁺ T cells and a higher level of IFNγ secretion. We have established (B10х B10.SM) F1 hybrids and demonstrated that the post-infection phenotypes of survival time, lung mycobacterial multiplication and IFNγ production in these mice are intermediate compared to parental mice. Thus, we deal with the genetic trait with incomplete dominance expression. These data were confirmed in F2 hybrids by segregation genetic analysis. To characterize the phenotype of B10.SM mice in more detail, we vaccinated these mice with the BCG vaccine before TB challenge. Vaccination significantly prolonged survival time, diminished mycobacterial multiplication in the lungs and the degree of lung tissue pathology. Thus, a high level of susceptibility to primary infection did not interfere with BCG vaccination efficacy. We intend to continue genetic and immunologic analyses of TB-hyper-susceptible B10.SM mice. Experimental data regarding the cause of extreme disturbances in protection against infection are prerequisite for our better understanding causality of the wide spectrum of TB manifestations in human populations, as well as for rational search for novel vaccines and medications against TB infection.

Russian Journal of Infection and Immunity. 2024;14(3):525-531
pages 525-531 views

Overexpressing miR-222-3p in cultured Mycobacterium Tuberculosis-infected macrophages does not affect their bacteriostatic activity

Shepelkova G.S., Evstifeev V.V., Yeremeev V.V.

Abstract

Tuberculosis, a disease caused by the bacterium Mycobacterium tuberculosis, is a major public health concern. Innate and adaptive immunity provide robust defense against pathogens. However, M. tuberculosis, which co-evolved with humans, has acquired many mechanisms to evade the immune response and ensure its intracellular existence and long-term survival within the host. Moreover, emerging evidence suggests that this secretive bacterium can alter expression of regulatory noncoding RNAs (including microRNAs), leading to dysregulation of biological processes underlying tuberculosis pathogenesis. For example, miR-222-3p has been shown to regulate the functional reprogramming of macrophages and is involved in the regulation of host innate immunity. Previously, we demonstrated the important role of miR-222-3p as a biological marker of tuberculosis activity. To confirm their biological targets and understand their role in the pathogenesis of tuberculosis, many research groups are working to establish functional relationships between miRNA expression under different conditions and their actual biological action using molecular biology and bioinformatics methods. In the present study, we demonstrated the effect of miR-222-3p overexpression on several functions of human macrophages of monocytic origin activated with M. tuberculosis antigens in in vitro culture. Specifically, we found that miR-222-3p overexpression significantly decreased IL-6 and IFNγ expression and increased IL-1β and cxcl10 expression in cultures of uninfected macrophages. Infected macrophages overexpressing miR-222-3p were characterized by increased NF-κB and IL-6 expression, as were infected macrophages without transfection. Another important finding was that miR-222-3p overexpression caused a small but significant increase in reactive nitrogen species production by infected macrophages, but did not affect their bacteriostatic activity against M. tuberculosis. Elucidating the functions of different microRNAs in regulating different pathogenic pathways in TB may lead to discovering new therapeutic targets. The detailed study of microRNAs that regulate immune-associated pathways will be useful for the design of miRNA mimetic molecules, either as inhibitors or as activators. Immune effects induced by miRNA drugs are currently a major challenge for miRNA therapeutics.

Russian Journal of Infection and Immunity. 2024;14(3):532-538
pages 532-538 views

Longitudinal tracking of T-cell repertoire reveals long-lasting CD4⁺ yellow fever specific clone cluster

Salnikova M.A., Lebedev Y.B.

Abstract

Infection is inconceivable without T cells. T cells not only eliminate virus-infected cells and participate in the formation of immunological memory, but also indirectly modulate the humoral response through the selection and maintenance of specific B cells. The T-cell receptor (TCR) recognizes processed antigen presented on the surface of cells in the MHC of one of two classes. Thus, the formed TCR repertoire reflects the history of encountered antigens through the prism of the specific organism with a particular set of MHC. To investigate changes in the TCR repertoire in response to acute viral infection, we utilized a yellow fever vaccination model. The yellow fever vaccine has been a benchmark for both safety and efficacy for over half a century. The vaccine is based on a live attenuated virus, allowing the study of the immune response under conditions closely to the viral infection. The yellow fever-specific T-cell response to immunodominant peptides presented on HLA-A02 is well studied, but experiments with HLA-A02-negative donors are still lacking. The aim of this study was to examine the dynamics of changes in the T-cell repertoire structure that occur in response to yellow fever vaccination in a donor without the HLA-A02 allele. We found that the overall T-cell response dynamics were similar to that in HLA-A02-positive donors: vaccination led to rapid expansion of yellow fever-reactive clones by day 14. Despite the absence of a known immunodominant epitope for HLA I alleles in this donor, the immune response also shifted towards CD8⁺ T cells, with increasing of the CD8⁺ clones fraction by day 53. The amino acid sequences of CDR3 TCRb yellow fever specific clones formed a stable cluster by CD4⁺ T cells, further confirming the presence of novel immunogenic epitopes.

Russian Journal of Infection and Immunity. 2024;14(3):539-543
pages 539-543 views

State of the vaginal biocenosis depending on the species diversity of lactobacilli

Fedorova K.S., Abramovskikh K.A., Savochkina A.Y., Minasova A.A., Zotova M.A., Samatova A.I., Nokhrin D.Y., Nikushkina K.V.

Abstract

Bacterial vaginosis is one of the most common reproductive health problems in women. Lactobacillus spp. play a leading role in the vaginal biocenosis and provide local antimicrobial defense, but not all species are equally capable of protecting the vaginal ecosystem from pathogens. Diagnostic methods in practical healthcare do not allow identification of Lactobacillus spp. species, which limits the ability to comprehensively assess the status of the vaginal biocenosis. We conducted a study in which we compared microscopy data of the examined smear with the detection of Lactobacillus spp. and other microorganisms. The aim of the study was to evaluate the species composition of Lactobacillus spp. from the vagina depending on morphologic characteristics and composition of associated flora. The study included 64 conditionally healthy women of reproductive age from 18 to 35 years old. The study of species composition of the vaginal biocenosis and typing of lactobacilli was carried out by real-time PCR methods. The obtained results were processed using generally accepted methods of descriptive and ordinal statistics. During the study, it was found that the vaginal biocenosis was dominated by species of Lactobacillus spp. L. crispatus, L. vaginalis, L. iners and L. jensenii. L. johnsonii was rarely found, and L. acidophilus was not detected. Typing results showed that the vagina was more frequently colonized by more than one species of Lactobacillus spp. while a single species of Lactobacillus spp. was detected less frequently. A correlation was found between Lactobacillus spp. species and bacilli thickness. If thick bacilli are detected in gynecological smear microscopy, they belong to the species L. crispatus, which has high colonization resistance and is a factor in the stability of the vaginal biocenosis. If smear microscopy reveals thin bacilli, then these are species of L. iners and L. jensenii. These representatives of Lactobacillus spp. are not directly related to the dysbiotic state of the vagina, but may indicate the possible development of dysbiosis in the future.

Russian Journal of Infection and Immunity. 2024;14(3):544-550
pages 544-550 views

Preparation of monoclonal antibodies for detection of recombinant flagellin C from Pseudomonas Aeruginosa

Zherebtsov A.P., Yakovleva I.V., Gavrilova N.F., Mikhailova N.A.

Abstract

An important virulence factor in the pathogenesis of infections caused by Pseudomonas aeruginosa is flagellin: it serves as the main structural component of the bacterial flagellum and an acceptor for the TLR5 receptor of the innate immune system. Toll-like receptor 5 is able to bind bacterial flagellin and activate the anti-inflammatory transcription factor NF-kB through the adapter protein MyD88, which induces the production of anti-inflammatory cytokines. The inclusion of flagellin in recombinant proteins increased the ability to stimulate the production of anti-inflammatory cytokines and activate antigen-presenting cells. A number of experiments have shown that the use of flagellin as a molecular adjuvant in vaccines increases the expression of CD80, CD83, CD86 and MHC II molecules on the surface of dendritic cells, and also leads to an increase in the secretion of IFNγ and α-defensins by dendritic and NK cells; T cell proliferation and activation of antigen-specific cytotoxic T lymphocytes, as well as increased induction of antigen-specific IgG and IgA antibodies. Due to the natural and acquired resistance of P. aeruginosa to antibiotics, the available choice of antipseudomonas drugs is decreasing, and therefore the problem of developing effective therapeutic drugs to protect against this infection is of high medical and social importance. For this purpose, it seems promising to study the immunobiological properties of P. aeruginosa flagellin as a possible vaccine component. Based on this, in the Laboratory of Protective Antigens of the I. Mechnikov Research Institute of Vaccines and Sera, recombinant flagellin C (FliC) of P. aeruginosa was obtained, and its immunogenicity and protective properties were proven. However, the question of standardizing methods for screening and monitoring the resulting recombinant FliC protein remains open. To solve this issue, hybridomas producing monoclonal antibodies (mAb) of a given specificity were obtained, the basic immunochemical properties of mAbs were studied, and the possibility of using them as reagents in constructing a test system for identifying and standardizing the recombinant FliC protein upon its production was assessed. Purpose of the work: to obtain monoclonal antibodies to the recombinant flagellin C protein of P. aeruginosa; to study their basic immunochemical properties and to evaluate the possibility of using the recombinant FliC protein for screening and control.

Russian Journal of Infection and Immunity. 2024;14(3):551-556
pages 551-556 views

Humoral immune response to shiga toxin 2 (Stx2) in children with escherichiosis with hemolytic-uremic syndrome

Shkuratova M.A., Khlyntseva A.E., Kalmantaeva O.V., Kartsev N.N., Muzurov A.L., Firstova V.V.

Abstract

Shiga toxin-producing Escherichia coli (STEC) causes acute intestinal infections and also causes acute renal failure, especially in children. Shiga toxins (Stx) occupy a central place in the pathogenesis of hemolytic uremic syndrome (HUS) in Escherichiosis. The presented work analyzes the effectiveness of laboratory diagnostics of enterohemorrhagic escherichiosis in patients at the stage of manifestation of HUS and/or acute renal failure using microbiological, immunological research methods and PCR analysis. The study used clinical material from 30 patients in the pediatric intensive care unit of the St. Vladimir Children’s City Clinical Hospital in Moscow with symptoms of HUS aged from 8 months to 5 years. Blood sera from 20 healthy donors were used as control. As a result of PCR analysis, stx2 DNA was detected in 23.3% of cases. Bacteriological research made it possible to sow a pure culture of Escherichia coli O157:H7 in only 3.3% of cases. Since the development of HUS begins in patients with acute intestinal infection caused by Shiga toxin-producing microorganisms starting from the 5th day of the disease, when antibiotic therapy is already carried out, the bacteria can be completely destroyed, which makes it difficult to identify them by bacteriological methods, as well as to detect genes encoding Shiga toxin in PCR analysis. Typically, patients with HUS are admitted to the intensive care unit 5–7 days after the onset of the disease, when class G immunoglobulins specific to the pathogen are already beginning to circulate in the blood. In this regard, the use of immunological tests can be effective to confirm the diagnosis of STEC infection. In our studies, enzyme immunoassay allowed us to detect antibodies to Stx2A in 63.3% and to Stx2B in 43.3% of patients. Using immunoblotting, antibodies to Stx2A were detected in all sera obtained from patients and in 66.7% of cases to Stx2B. Immunoblot analysis was characterized by higher sensitivity for detecting antibodies to Stx2, however, due to the presence of an immunological layer among healthy people, it is preferable to use ELISA analysis. In healthy donors with antibodies to Stx2, the antibody titer was significantly lower than in patients. Laboratory confirmation of the diagnosis of STEC infection is difficult when conducting microbiological and molecular genetic studies, which is confirmed in this work. The effectiveness of laboratory diagnostics can be expanded by performing an ELISA aimed at detecting antibodies to Stx2A.

Russian Journal of Infection and Immunity. 2024;14(3):557-563
pages 557-563 views

The effect of the probiotic bacteria Akkermansia Muciniphila in intestinal homeostasis and dss-induced inflammation in mice

Sheynova A.D., Podosokorskaya O.A., Gubernatorova E.O., Gubernatorova E.O.

Abstract

Akkermansia muciniphila is a Gram-negative anaerobic bacterium, a component of the normal human intestinal microbiota. A decrease in the presence of this bacterium is associated with pathologies, including metabolic disorders, intestinal inflammation and colorectal cancer. A. muciniphila is a probiotic approved for patients with diabetes and obesity. In recent years, A. muciniphila was studied in the control of intestinal inflammation and colorectal cancer. The exact mechanisms of A. muciniphila action remain unclear, while the use of different administration protocols shows different effects in mouse models of colitis and colorectal cancer. We reported that A. muciniphila has distinct effects on intestinal mucin production depending on viable or pasteurized form of bacteria. Another factor affecting the outcome of the A. muciniphila administration is the number of bacteria. To address how the dose of bacteria may affect the severity of acute intestinal inflammation wild-type mice were subjected to daily oral injections with 10⁸ CFU or 109 CFU of viable A. muciniphila for two weeks; the control group was injected with PBS. After that, groups were subjected to the induction of acute colitis by adding 7% DSS to drinking water for five days. 8 days after the onset of colitis induction, a morphometric assessment of the colitis severity was performed. Mice given a high dose of A. muciniphila (109 CFU) were found to be protected from developing severe colitis. RT-PCR analysis of colon samples from mice receiving a high dose of bacteria showed an increase in the gene expression of antimicrobial peptides, IL-17A, IL-17F. Interestingly, the protective effect of A. muciniphila was observed only in a high dose group, but not in a low dose group. Our data suggest that A. muciniphila provides the protective effect in colitis and highlight the importance of selecting the dose of the bacterium for proper interpretation.

Russian Journal of Infection and Immunity. 2024;14(3):564-568
pages 564-568 views

Study of the adjuvant properties of beta-glucans from Saccharomyces Cerevisiae yeast

Volosnikova E.A., Shcherbakov D.N., Volkova N.V., Esina T.I., Zaikovskaya A.V., Shimina G.G., Danilenko E.D.

Abstract

To increase the effectiveness and immunogenicity of modern vaccines, especially subunit ones, it is required to use adjuvants. Polysaccharides, due to their safety and biocompatibility, are desirable candidates for the creation of vaccine adjuvants. The aim of our study was to develop a method for obtaining beta-Glucans from the yeast Saccharomyces cerevisiae cell wall, and evaluate their adjuvant properties. The high purity and non-toxicity of the resulting preparation was achieved by using enzyme complexes of cellulase and protease in combination with ultrasound (22 kHz) at the purification stage. The developed scheme allows for the yield of beta-Glucans up to 2 g from 100 g of the biomass of wet cells. The adjuvant properties of beta-Glucans were studied in 50 male BALB/c mice, weighing 16–18 g. Immunization was performed twice, with a 14-day interval, intramuscularly, 200 μl per animal. The recombinant receptor-binding domain (RBD) of the surface S protein of the SARS-CoV-2 virus (Wuhan-Hu-1 and B.1.617.2 (Delta)) was used as an antigen, at a dose of 50 μg per animal. A positive control group was administered with the antigen combined with aluminum hydroxide. As a negative control, mice injected with the saline solution were used. The titers of specific antibodies in the blood sera were determined by ELISA assays. RBD (Wuhan-Hu-1 and Delta), and S protein (Wuhan-Hu-1, Delta and Omicron) were used as antigens. The titers of virus-neutralizing antibodies were measured in neutralization tests using SARS-CoV-2 virus strains Wuhan-Hu-1, Delta (B.1.617.2) and Omicron (B.1.1.529). The results of the study have shown that beta-Glucans have the ability to enhance the production of specific and virus-neutralizing antibodies in mice immunized with RBD. The titers of specific and virus neutralizing antibodies are comparable to their levels in the group immunized with RBD and Al(OH)₃. It has been found in the experiments in white outbred ICR mice that the preparation belongs to practically non-toxic substances. Therefore, it can be concluded that the use of beta-Glucans could become a preferable alternative to the conventional adjuvants based on aluminum salts, being biocompatible, biodegradable and non-toxic substances of low labor-intensive production.

Russian Journal of Infection and Immunity. 2024;14(3):569-574
pages 569-574 views

PD-1 AND Tim-3 Expression on different subpopulations of monocytes in chronic often recurrent herpesvirus infection

Rashchupkin I.M., Meledina I.V., Kotova M.A., Zheltova O.I.

Abstract

More than half of the world’s population is infected with the herpes simplex virus. In most cases, infection is not accompanied by symptoms, but in some people the disease occurs as a chronic infection with frequent and severe relapses. One of the most likely reasons for this may be a dysregulation of the immune system. In recent years, the role of checkpoint molecules, in particular PD-1 and Tim-3, in the regulation of the immune response and the functions of immunocompetent cells has been actively studied. Activation of PD-1 and Tim-3 on T cells has previously been shown to suppress the immune response. PD-1 and Tim-3 are also expressed on other immune cells, in particular monocytes. However, the expression of these molecules on monocytes during chronic viral infections has not been previously studied. The study was aimed at assessing the level of PD-1 and Tim-3 expression on various populations of monocytes in patients with chronic often recurrent herpesvirus infection. Twenty-six patients were recruited into the study. All patients received antiviral and immunomodulatory therapy in the immunological department. The number of classical, intermediate, and non-classical monocytes and the expression of PD-1 and Tim-3 on monocytes, were assessed by flow cytometry before and after the therapy. Monocytes were isolated from peripheral blood, and subpopulations were divided according to the level of expression of CD14 and CD16. In patients with herpes, a reduced number of monocytes was observed in comparison with healthy donors. The relative number of PD-1-positive monocytes, the mean fluorescence intensity of PD-1 and Tim-3, and the number of double-positive cells were reduced in herpes patients in all three monocyte subpopulations examined. Three months after therapy, the response to the therapy was assessed; patients who did not have a single recurrence of herpes within 3 months were considered to respond. Responding patients had a lower initial content of double-positive cells among intermediate and non-classical monocytes. The decrease in the level of PD-1 and Tim-3 positive monocytes during herpesvirus infection revealed in the present study may indicate the involvement of monocytes deficient in the expression of checkpoint molecules in the pathogenesis of the disease.

Russian Journal of Infection and Immunity. 2024;14(3):575-580
pages 575-580 views

Long non-coding RNAs — regulators of rubella virus infection and antiviral response

Gulimov M.K., Kalyuzhnaya N.O., Ammour Y.I., Zverev V.V., Svitich O.A.

Abstract

Introduction. Rubella virus is an RNA-containing virus capable of infecting human cells and causing infectious disease. Infection of pregnant women with rubella virus can lead to abortion or congenital rubella syndrome (CRS), a set of long-term birth defects including incomplete fetal organ development and mental retardation. There is no specific treatment for rubella and CRS. The regulation of antiviral immune response and viral reproduction by long non-coding RNAs is currently under active investigation. In this study, we evaluated the changes in the expression profile of long non-coding RNAs in rubella virus-infected A549 epithelial by RNA sequencing. Materials and Methods. A549 cells were infected with a wild-type variant of laboratory strain C-77 of rubella virus with a multiplicity of infection of 1.0 infectious units per cell and incubated for 72 hours. Virus titres were determined by the CCID method in the sensitive RK-13 cell culture. 48 h after infection, the cell monolayer was lysed, RNA was isolated, and libraries were prepared for sequencing. Sequencing was performed on the NextSeq500 platform (Illumina, USA) in paired-end reading mode. Validation of the obtained RNA sequencing data was performed using quantitative real-time PCR. Results. Rubella virus replication affects the production of some long non-coding RNAs by altering their expression profile. Thus, upon infection of A549 epithelial cells with rubella virus, there was a significant increase in the expression of such long non-coding RNAs as GAS5, NEAT1, LUCAT1, MIR210HG, MEG3, EPB41L4A-AS1, ZFAS1, and SNHG 1, 7, 12, 29, 32. DANCR, IGFL2-AS1, IGFL2-AS1, MIR1915HG, and SNHG14 were most significantly decreased in expression. Gene ontology (GO)-analysis revealed that long non-coding RNAs are involved at different levels in the mechanisms of immune response, in particular, RNA processing and nucleic acid metabolism; therefore, up- and down-regulation of these molecules leads to modulation of human antiviral immune response in response to rubella virus infection. Conclusion. Thus, the regulation of long non-coding RNA production by rubella virus has been shown for the first time. Differentially expressed long non-coding RNAs can be used as prognostic and diagnostic biomarkers of viral diseases.

Russian Journal of Infection and Immunity. 2024;14(3):581-585
pages 581-585 views

Markers of CD4⁺ AND CD8⁺ T-cell exhaustion in hiv/hcv coinfected immunological non-responders to antiretroviral therapy

Saidakova E.V., Korolevskaya L.B., Vlasova V.V., Shmagel N.G., Shmagel K.V.

Abstract

Coinfection with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) is a risk factor for immunological non-response to antiretroviral therapy. In cases of immunological non-response, HIV viral load suppression occurs without an increase in CD4⁺ T-cell counts, heightening the risk of morbidity and mortality in infected individuals. T-cell exhaustion may hinder their regeneration in immunological non-responders. This study aimed to identify markers of CD4⁺ and CD8⁺ T-cell exhaustion in HIV/HCV coinfected immunological non-responders. The study examined three clinical groups: 1) HIV/HCV coinfected immunological non-responders (CD4⁺ T-cells < 350/µl blood; n = 9), 2) HIV/HCV coinfected individuals with a standard response to therapy (CD4⁺ T-cells > 500/µl blood; n = 9), and 3) relatively healthy volunteers without HIV and HCV infections (n = 9). Ex vivo, the number of CD4⁺ and CD8⁺ T-cells expressing the inhibitory receptor PD-1 was determined using multi-color flow cytometry. In the 7-day in vitro experiment, cell cultures were stimulated with phytohemagglutinin. The number of dying proliferated CD4⁺ and CD8⁺ T-cells (CFSElowZombieUV+) was determined using multi-color flow cytometry. The amount of interleukin-2 in the culture supernatants was measured using an enzyme-linked immunosorbent assay. It was found that in HIV/HCV coinfected immunological non-responders, there was a higher number of CD4⁺ and CD8⁺ T-cells expressing PD-1, a phenotypic marker of exhaustion, compared to the other two groups. Furthermore, the frequency of dying dividing T-cells was higher in immunological non-responders, with an increase in CD4⁺ T-cells but not CD8⁺ T-lymphocytes. Similarly, a decrease in interleukin-2 production was found in stimulated T-cells of HIV/HCV coinfected immunological non-responders in the CD4⁺ T-cell pool, but not in CD8⁺ T-lymphocytes. Thus, in HIV/HCV coinfected immunological non-responders, CD4⁺ T-cells appear exhausted both phenotypically and functionally. While CD8⁺ T-cells express inhibitory receptors, they do not show functional impairments. It appears that the specialized therapy for HIV/HCV coinfected immunological non-responders should aim to improve CD4⁺ T-cell function.

Russian Journal of Infection and Immunity. 2024;14(3):586-592
pages 586-592 views

Conserved linear B-cell peptides among the influenza A viral neuraminidases enhance the cross-protective potential of inactivated whole-virion influenza vaccine

Kotomina T.S., Sychev I.A., Rak A.Y., Wong P., Bazhina A.V., Isakova-Sivak I.N., Rudenko L.G.

Abstract

Introduction. Influenza is a disease caused by a widespread virus with pandemic potential. Frequently, individuals vaccinated against seasonal influenza virus are still susceptible to the disease, indicating the need to improve the immunogenic potential of existing vaccines. To assess the efficacy of influenza virus vaccines, immune response only to a single viral antigen — hemagglutinin molecule, is taken into consideration. However, according to preclinical and clinical studies, neuraminidase (NA) stimulates cross-protective immunity, which is effective against not only homologous but also drifted variants of influenza A virus. Materials and methods. In the present study, we investigated the ability of previously selected conserved linear B-cell NA epitopes (SGYSGK, SWPDGK, EECSCYPK, VELIRGRK) to enhance the immunogenicity of an inactivated whole-virion influenza vaccine based on the model strain PR8 (iPR8). BALB/c mice were injected with iPR8 in combination with one of the peptides intramuscularly three times at two-week intervals. Blood samples were collected 14 days after the last immunization, after which the mice were challenged with heterosubtypic influenza viruses H1N1pdm09 and H3N2. Results. All immunized mice showed induction of H1N1 (PR8)-specific IgG antibodies two weeks after the third immunization. The group of mice immunized with the iPR8 vaccine preparation in combination with VELIRGRK peptide showed the most pronounced induction of IgG antibodies to the H6N1 reassortant strain, the NA of which corresponds to the iPR8 virus, indicating the ability of the NA peptide to stimulate the production of NA-specific antibodies. However, the antibodies produced after immunization were not capable to inhibit the NA enzymatic activity. Despite this, mice immunized with iPR8 in combination with anti-NA peptides showed a higher survival rate after infection with heterologous virulent influenza viruses: A/California/07/09 (H1N1pdm09) and A/Philippines/2/82 (H3N2) compared to the PBS and iPR8 groups. Conclusion. Thus, the study demonstrated the immune-potentiating effect of individual peptides corresponding to conservative linear epitopes of the NA molecule in combination with a standard inactivated influenza vaccine, which made it possible to improve the protective effect of the vaccine against heterosubtypic influenza viruses.

Russian Journal of Infection and Immunity. 2024;14(3):593-600
pages 593-600 views

Comparative analysis of the conservation of nucleoprotein immunogenic T-cell epitopes of master donor viruses for live and inactivated influenza vaccines

Rak A.Y., Rudenkо L.G., Isakova-Sivak I.N.

Abstract

Antigen-specific T cells are an important part of antiviral responses, and modern influenza vaccines are designed to induce this mode of immunity. Live attenuated influenza vaccine (LAIV) is a potent inducer of T-cell immunity because of its ability to cause productive infection in the upper respiratory tract. Inactivated influenza vaccines (IIV) and novel vaccine candidates can also induce virus-specific T-cells when appropriate adjuvants are used. In this case, non-structural and intrinsic antigens of the master donor viruses, particularly nucleoprotein (NP), are the main targets for the development of T-cell immunity. The most commonly used donor strains for LAIVs and IIVs worldwide were derived from viruses isolated between 1933 and 1960. In this regard, the question of conservation of epitopes immunogenic for CD8⁺ T-lymphocytes (CTL-epitopes) in donor-derived NPs, i.e., the ability of cytotoxic T cells specific to the donor’s NP to recognize modern influenza A virus nucleoproteins, is relevant. The aim of the study was to evaluate the conservation of CTL-immunogenic NP epitopes of donors traditionally used to create LAIVs and IIVs. Materials and methods. Epitope NP analysis was performed for 1614 and 1767 strains of influenza A virus subtypes H1N1 and H3N2, respectively, which circulated in 2009–2023 (data from the NCBI Influenza Virus Database). Immune Epitope Database (IEDB, www.iedb.org), NetCTL’s built-in CTL-epitope prediction algorithm and NetChop proteolysis site predictor were used. CTL-epitopes were mapped to NPs of master donor viruses A/Leningrad/134/17/57 (H2N2), A/Ann Arbor/6/60 (H2N2), A/PR/8/34 (H1N1), and A/WSN/1933 (H1N1) using the CrustalO alignment algorithm in JalView 2.8.1 Software. The immunogenicity and conservation of selected epitopes were further evaluated using IEDB T-cell Immunogenicity Predictor and Epitope Conservancy Assay, respectively. Results. The majority of immunogenic CTL-epitopes of donor viruses proved to be non-conserved, i.e., not found in NPs of circulating influenza strains. Conversely, most CTL-immunogenic NP epitopes of modern viruses are absent in donor viruses and cannot be induced by vaccination with conventional vaccines. The data obtained indicate the need to actualize NP in vaccine composition by directed mutagenesis of the donor-derived NP gene or by introduction of the gene encoding NP of circulating influenza viruses into vaccine strains.

Russian Journal of Infection and Immunity. 2024;14(3):601-608
pages 601-608 views

The role of сhemokine CX3CL1/Fractalkine in chronic viral hepatitis B

Arsentieva N.A., Batsunov O.K., Liubimova N.E., Basina V.V., Esaulenko E.V., Totolian A.A.

Abstract

Hepatitis B is an infectious disease resulting from infection with the hepatitis B virus. Chronic hepatitis B (CHB) is characterized by prolonged inflammation in the liver, the development of fibrosis, liver cirrhosis and hepatocellular carcinoma. Factors of the immune system play a critical role in the pathogenesis of CHB. Thanks to chemokines, immune cells migrate to the site of inflammation to implement their effector functions. The CX3CL1/Fractalkine chemokine is the only member of the CX3C family of chemokines with unique structural and functional properties. Its receptor CX3CR1 is expressed mainly on the surface of cytotoxic effector lymphocytes such as NK cells, TNK and cytotoxic T lymphocytes. The purpose of our study was to analyze the content of CX3CL1/Fractalkine in the blood plasma of patients with CHB and the analysis of this chemokine with liver fibrosis. The concentration of CX3CL1/Fractalkine was determined in the blood plasma of patients with CHB using a multiplex assay based on xMAP technology. Blood plasma from patients with chronic viral hepatitis C (CHC) and autoimmune liver diseases (AILD) was used as a comparison group. The control group consisted of healthy individuals. For statistical analysis of data, nonparametric statistics methods were used: Kruskal–Wallis test, Spearman correlation coefficient ROC-analysis. It was shown a reduced level of CX3CL1/Fractalkine in patients with CHB compared with the control group (p = 0.0003) and with the comparison groups of CHC (p < 0.0001) and AILD (p = 0.0005). A reduced concentration of CX3CL1/Fractalkine was shown in the blood plasma of CHB patients with initial fibrosis (p = 0.0092) and severe fibrosis/cirrhosis (p = 0.0009), while in patients with severe fibrosis/cirrhosis, a significantly reduced level of this chemokine was established compared with the initial degree of liver fibrosis (p = 0.0081). Correlation analysis revealed a highly significant inverse relationship between the severity of liver fibrosis and the content of CX3CL1/Fractalkine in the blood plasma of patients with CHB (Spearman r = –0.33; p = 0.02). Thus, the chemokine CX3CL1/Fractalkine is included in the immunopathogenesis of CHB; its reduced content is characteristic only of CHB and does not change in other chronic liver diseases. It is involved in the processes of liver fibrosis during infection with the hepatitis B virus. The concentration of the chemokine CX3CL1/Fractalkine depends on the stage of liver fibrosis in CHB, and a decrease in the level of CX3CL1/Fractalkine in the blood plasma can serve as a negative factor in the development of CHB.

Russian Journal of Infection and Immunity. 2024;14(3):609-614
pages 609-614 views

Synthetic thymic hexapeptide in the correction of alterations of antibacterial immune defense and normalization of the profile of proinflammatory cytokines in immunocompromized Children with local unlimited acute peritonitis

Kovaleva S.V., Chapurina V.N., Lomtatidze L.V., Lyagusha D.E., Teterin Y.V., Barova N.K., Melkonyan K.I.

Abstract

The study of dysregulatory disorders of the immune system underlying the immunopathogenesis of severe purulent-inflammatory diseases (PIDs) is important for development of new therapeutic tactics of restoring antibacterial defense. Acute peritonitis (AP) is a severe PID of the abdominal cavity, the course of which are dependent on the treatment, cytokine balance and adequate functioning of the immunity. Objective: to evaluate the modulating effects on the immune system and the levels of proinflammatory cytokines of the synthetic thymic hexapeptide, active substance of Imunofan, included in the complex postoperative treatment (CPOT) of immunocompromised children with local AP. Clinical and immunological examination of 20 immunocompromised children aged 5–12 years with local AP was carried out before (study group 1, SG1) and after (study group 1a, SG1a) CPOT including synthetic thymic hexapeptide (Arginyl-alpha-AspartylLysyl-Valyl-Tyrosyl-Arginine, НР), alongside 20 conditionally healthy children (comparison group, SG). The content of T and B lymphocytes, natural killer cells (NK), levels of serum pro-inflammatory cytokines IL-1β, IL-6, TNFα, IL-8, IL-18, phagocytic and microbicidal activity of neutrophils (NG) were assessed. In SG1, before treatment, a decrease in the number of T lymphocytes, T helpers, CTL-lymphocytes, NK and an increase in the level of B lymphocytes was revealed. Defects in the effector functions of NG were determined: impaired bacterial antigen killing and decreased NADPH oxidase activity. It was established that in case of AP in immunocompromised children, the cytokine profile is characterized by overproduction of studied proinflammatory and neutrophil-associated cytokines. After complex treatment including immunomodulatory therapy, there was a restoration of the content of T lymphocytes, T helper cells, TCTL lymphocytes, an increase in the number of NK and decrease in the level of B lymphocytes. In addition, regression of the levels of inflammatory, including neutrophil-associated, cytokines and emergence of effector functions of NG due to restoration of NADPH oxidases activity, was noted. Thus, the restoration of immunological parameters in AP leads to earlier regression of the purulent-inflammatory process in the abdominal cavity and to the absence of postoperative complications. The clinical and immunological effects of the immunomodulatory therapy program with inclusion of the drug based on HP determines the feasibility of its use in the postoperative period in immunocompromised children with local AP.

Russian Journal of Infection and Immunity. 2024;14(3):615-622
pages 615-622 views

Personalized approach to immune system rehabilitation in patients with year-round allergic rhinitis suffering from recurrent ARVI and recurrent herpes virus infections

Khalturina E.O., Garskova N.V., Shemetova A.D.

Abstract

Introduction. The problem of treating patients with respiratory allergopathology associated with recurrent infectious diseases, such as rARVI, frequent exacerbations of rCHVI, is becoming urgent. The presence of persistent inflammation and co-infection significantly complicates the treatment of immunocompromised patients with year-round allergic rhinitis (YAR) and necessitates the development of personalized programs, with the inclusion of immunomodulatory agents for restoring disorders in the immune system (IS) and interferon system (IFN). Materials and methods. The study group (SG) included 65 patients of both sexes aged 23–60 years, suffering from YAR associated with rARVI and rCHVI. The comparison group (CG) consisted of 50 healthy individuals, comparable in sex and age. All patients underwent standard physical, immunological and allergological examinations, including the use of serological (ELISA, ImmunoCUP), molecular genetic (PCR-RV) methods, FC, etc. Voluntary informed consent was obtained from all patients. The StatPlus computer program was used for statistical analysis. Results and discussion. In patients with YAR associated with rARVI and rCHVI, two variants of disorders in IS have been established, which are defined as pathological immunophenotypes (PIF). The PIF1 is characterized by a deficiency in the induced production of IFNα, a decrease in CD3⁻CD16⁺CD56+ EKKs, and a decrease in neutrophil granulocytes (NG). In the PIF2, along with a shortage of IFNα production, a decrease in EKKs is observed in combination with a decrease in CTLs, as well as a decrease in NGs. The clinical criteria for immunocompromising in this cohort of patients were studied. The severity of YAR symptoms was assessed by VAS. In order to correct the identified disorders in the IS and IFN system, complex personified IFN- and immunotherapy programs have been developed for each PIF, including prolonged local and systemic therapy with rIFNα2b in combination with antioxidants, as well as GMDP for patients of SG1, and for patients of SG2 — GMDP and hexapeptide. The high immunological and clinical efficacy of IFN- and immunotherapy was shown, which was expressed in the tendency to restore existing disorders, as well as in achieving control over the symptoms of YAR, with the possibility of reducing the volume of basic antiallergic pharmacotherapy.

Russian Journal of Infection and Immunity. 2024;14(3):623-631
pages 623-631 views


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies