Comparative Evaluation of the Dynamics of Parameters of Cell-Mediated Immunity under the Influence of Different Therapies for Chronic Acquired Toxoplasmosis

The article presents a comparative evaluation of the dynamics of parameters of cell-mediated immunity in patients under the influence of different therapies for chronic acquired toxoplasmosis (CAT). Efficiency of complex treatment using antiprotozoal combined drug pyrimethamine + sulfadoxine has bee...

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Main Authors: O.V. Bobrova, Anuar al Hatib
Format: Article
Language:English
Published: Zaslavsky O.Yu. 2015-02-01
Series:Aktualʹnaâ Infektologiâ
Subjects:
Online Access:http://ai.zaslavsky.com.ua/article/view/78498
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author O.V. Bobrova
Anuar al Hatib
author_facet O.V. Bobrova
Anuar al Hatib
author_sort O.V. Bobrova
collection DOAJ
description The article presents a comparative evaluation of the dynamics of parameters of cell-mediated immunity in patients under the influence of different therapies for chronic acquired toxoplasmosis (CAT). Efficiency of complex treatment using antiprotozoal combined drug pyrimethamine + sulfadoxine has been studied in 1 and 5–6 months after starting treatment. After 1 month of initiation of treatment with pyrimethamine + sulfadoxine, a significant increase of CD4+ (p < 0.01), CD16+ (p < 0.05) and a decrease in the level of Toxoplasma-specific IgG antibodies (p < 0.05) were detected. After 6 months of initiation of treatment, we have revealed elevated levels of CD3+ (p < 0.05), CD4+ (p < 0.001), CD8+ (p < 0.001), CD16+ (p < 0.001), phagocytic index (p < 0.05), decreased level of circulating immune complexes (CIC) with 3.5% polyethylene glycol (PEG) (p < 0.01) and 7% PEG (p < 0.001), lymphocytotoxic autoantibodies (p < 0.01) and Toxoplasma-specific IgG antibodies (p < 0.001). These data may indicate a significant lag in homeostatic adjustment of the immune system under the influence of antiprotozoal therapy. When studying the effectiveness of combination therapy (pyrimethamine + sulfadoxine and specific immunoglobulin against T.gondii), among the immunological parameters after 1 month of starting treatment we have found a significant increase in content of CD16+ compared with baseline (p < 0.001), IgA (p < 0.001) and reduction in the level of Toxoplasma-specific IgG antibodies (p < 0.001). After 6 months of observation, we have detected an increase of CD3+ (p < 0.01), CD4+ (p < 0.001), CD8+ (p < 0.01) content in comparison with baseline, as well as lower levels of CIC with 3.5% PEG (p < 0.001) and 7% PEG (p < 0.05), lymphocytotoxic autoantibodies (p < 0.001), IgA (p < 0.05), IgM (p < 0.05), IgE (p < 0.01) and IgG antibodies to Toxoplasma (p < 0.001). Combination therapy for CAT in the acute stage of the disease has a significant impact on the normalization of all parts of immunological homeostasis. Such action was maximal in 6 months of starting treatment. When studying the effectiveness of the therapy with specific immunoglobulin against human T.gondii, when analyzing the dynamics of indicators of immunity in 1 month from the initiation of immunoglobulin therapy, we have revealed only a significant increase in CD8+ (p < 0.05) and a decrease in the ratio of CD4+/CD8+ (p < 0.05). After 6 months of starting treatment, we have established a significant increase of CD4+ (p < 0.001), CD8+ (p < 0.001), CD4+/CD8+ (p < 0.001), CD16+ (p < 0.05) levels, phagocytic index (p < 0.001) and a decrease of CIC content with 3.5% PEG (p < 0.05), lymphocytotoxic autoantibodies (p < 0.001), IgG to Toxoplasma (p < 0.001) and IgE (p < 0.05) in comparison with baseline. Comprehensive assessment of the dynamics of immunity parameters using average values of t-test, depending on the type of therapy, showed that after 1 month from the initiation of treatment only combination therapy revealed significant (t = 3.19; p < 0.01) changes in their normalization. Application of pyrimethamine + sulfadoxine monotherapy (t = 1.25; p > 0.05) and immunoglobulin therapy (t = 1.75; p > 0.05) caused only a trend toward normalization of parameters. After 6 months of starting treatment, a pronounced dynamics was observed in patients received combination therapy (t = 5.5; p < 0.001), average — at immunoglobulin therapy (t = 3.68; p < 0.01) and a small one — in the group of patients treated with pyrimethamine + sulfadoxine (t = 2.91; p < 0.01). Combination therapy had a highest immunological effect when treating patients in the acute stage of CAT. Treatment with T.gondii-specific immunoglobulin took an intermediate position, and therapy using pyrimethamine + sulfadoxine revealed the lowest efficiency.
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spelling doaj.art-640c2a75f9fc48d5b2b6640cbb54f5902022-12-21T19:23:42ZengZaslavsky O.Yu.Aktualʹnaâ Infektologiâ2312-413X2312-41482015-02-0131.06455210.22141/2312-413x.1.06.2015.7849878498Comparative Evaluation of the Dynamics of Parameters of Cell-Mediated Immunity under the Influence of Different Therapies for Chronic Acquired ToxoplasmosisO.V. Bobrova0Anuar al Hatib1Kharkiv Medical Academy of Postgraduate Education, KharkivKharkiv Medical Academy of Postgraduate Education, KharkivThe article presents a comparative evaluation of the dynamics of parameters of cell-mediated immunity in patients under the influence of different therapies for chronic acquired toxoplasmosis (CAT). Efficiency of complex treatment using antiprotozoal combined drug pyrimethamine + sulfadoxine has been studied in 1 and 5–6 months after starting treatment. After 1 month of initiation of treatment with pyrimethamine + sulfadoxine, a significant increase of CD4+ (p < 0.01), CD16+ (p < 0.05) and a decrease in the level of Toxoplasma-specific IgG antibodies (p < 0.05) were detected. After 6 months of initiation of treatment, we have revealed elevated levels of CD3+ (p < 0.05), CD4+ (p < 0.001), CD8+ (p < 0.001), CD16+ (p < 0.001), phagocytic index (p < 0.05), decreased level of circulating immune complexes (CIC) with 3.5% polyethylene glycol (PEG) (p < 0.01) and 7% PEG (p < 0.001), lymphocytotoxic autoantibodies (p < 0.01) and Toxoplasma-specific IgG antibodies (p < 0.001). These data may indicate a significant lag in homeostatic adjustment of the immune system under the influence of antiprotozoal therapy. When studying the effectiveness of combination therapy (pyrimethamine + sulfadoxine and specific immunoglobulin against T.gondii), among the immunological parameters after 1 month of starting treatment we have found a significant increase in content of CD16+ compared with baseline (p < 0.001), IgA (p < 0.001) and reduction in the level of Toxoplasma-specific IgG antibodies (p < 0.001). After 6 months of observation, we have detected an increase of CD3+ (p < 0.01), CD4+ (p < 0.001), CD8+ (p < 0.01) content in comparison with baseline, as well as lower levels of CIC with 3.5% PEG (p < 0.001) and 7% PEG (p < 0.05), lymphocytotoxic autoantibodies (p < 0.001), IgA (p < 0.05), IgM (p < 0.05), IgE (p < 0.01) and IgG antibodies to Toxoplasma (p < 0.001). Combination therapy for CAT in the acute stage of the disease has a significant impact on the normalization of all parts of immunological homeostasis. Such action was maximal in 6 months of starting treatment. When studying the effectiveness of the therapy with specific immunoglobulin against human T.gondii, when analyzing the dynamics of indicators of immunity in 1 month from the initiation of immunoglobulin therapy, we have revealed only a significant increase in CD8+ (p < 0.05) and a decrease in the ratio of CD4+/CD8+ (p < 0.05). After 6 months of starting treatment, we have established a significant increase of CD4+ (p < 0.001), CD8+ (p < 0.001), CD4+/CD8+ (p < 0.001), CD16+ (p < 0.05) levels, phagocytic index (p < 0.001) and a decrease of CIC content with 3.5% PEG (p < 0.05), lymphocytotoxic autoantibodies (p < 0.001), IgG to Toxoplasma (p < 0.001) and IgE (p < 0.05) in comparison with baseline. Comprehensive assessment of the dynamics of immunity parameters using average values of t-test, depending on the type of therapy, showed that after 1 month from the initiation of treatment only combination therapy revealed significant (t = 3.19; p < 0.01) changes in their normalization. Application of pyrimethamine + sulfadoxine monotherapy (t = 1.25; p > 0.05) and immunoglobulin therapy (t = 1.75; p > 0.05) caused only a trend toward normalization of parameters. After 6 months of starting treatment, a pronounced dynamics was observed in patients received combination therapy (t = 5.5; p < 0.001), average — at immunoglobulin therapy (t = 3.68; p < 0.01) and a small one — in the group of patients treated with pyrimethamine + sulfadoxine (t = 2.91; p < 0.01). Combination therapy had a highest immunological effect when treating patients in the acute stage of CAT. Treatment with T.gondii-specific immunoglobulin took an intermediate position, and therapy using pyrimethamine + sulfadoxine revealed the lowest efficiency.http://ai.zaslavsky.com.ua/article/view/78498patients with chronic acquired toxoplasmosisdiagnosistreatmentparameters of cell-mediated immunity
spellingShingle O.V. Bobrova
Anuar al Hatib
Comparative Evaluation of the Dynamics of Parameters of Cell-Mediated Immunity under the Influence of Different Therapies for Chronic Acquired Toxoplasmosis
Aktualʹnaâ Infektologiâ
patients with chronic acquired toxoplasmosis
diagnosis
treatment
parameters of cell-mediated immunity
title Comparative Evaluation of the Dynamics of Parameters of Cell-Mediated Immunity under the Influence of Different Therapies for Chronic Acquired Toxoplasmosis
title_full Comparative Evaluation of the Dynamics of Parameters of Cell-Mediated Immunity under the Influence of Different Therapies for Chronic Acquired Toxoplasmosis
title_fullStr Comparative Evaluation of the Dynamics of Parameters of Cell-Mediated Immunity under the Influence of Different Therapies for Chronic Acquired Toxoplasmosis
title_full_unstemmed Comparative Evaluation of the Dynamics of Parameters of Cell-Mediated Immunity under the Influence of Different Therapies for Chronic Acquired Toxoplasmosis
title_short Comparative Evaluation of the Dynamics of Parameters of Cell-Mediated Immunity under the Influence of Different Therapies for Chronic Acquired Toxoplasmosis
title_sort comparative evaluation of the dynamics of parameters of cell mediated immunity under the influence of different therapies for chronic acquired toxoplasmosis
topic patients with chronic acquired toxoplasmosis
diagnosis
treatment
parameters of cell-mediated immunity
url http://ai.zaslavsky.com.ua/article/view/78498
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AT anuaralhatib comparativeevaluationofthedynamicsofparametersofcellmediatedimmunityundertheinfluenceofdifferenttherapiesforchronicacquiredtoxoplasmosis