Immune-mediated mechanisms of the inflammatory response in women with combined infections of the lower genital tract
Aim: to increase the effectiveness of combination therapy and reduce frequency of recurrences of inflammatory diseases in the lower genital tract of combined etiology.Materials and Мethods. There was conducted a prospective, randomized, blind, comparative clinical study. 80 women with vaginal microb...
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| Format: | Article |
| Language: | Russian |
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IRBIS LLC
2021-07-01
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| Series: | Акушерство, гинекология и репродукция |
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| Online Access: | https://www.gynecology.su/jour/article/view/1005 |
| _version_ | 1797884067690053632 |
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| author | G. B. Dikke A. A. Sukhanov I. I. Kukarskaya V. V. Ostromenskii |
| author_facet | G. B. Dikke A. A. Sukhanov I. I. Kukarskaya V. V. Ostromenskii |
| author_sort | G. B. Dikke |
| collection | DOAJ |
| description | Aim: to increase the effectiveness of combination therapy and reduce frequency of recurrences of inflammatory diseases in the lower genital tract of combined etiology.Materials and Мethods. There was conducted a prospective, randomized, blind, comparative clinical study. 80 women with vaginal microbiota disorders were examined randomized into 2 groups: group I (n = 40) – antibiotic therapy was carried out in combination with the preparation Superlimph, group II (n = 40) – a standalone antibacterial therapy; group III consisted of 20 patients lacking gynecological diseases considered to provide with control laboratory parameters. Clinical and laboratory methods were used: microscopy of vaginal smears, detection of viruses and sexually transmitted infections, measurement of serum cytokine levels – interleukins (IL-1â, IL-2, IL-4, IL-6, IL-8, IL-10), tumor necrosis factor alpha, (TNF-á), interferon gamma (IFN-ã).Results. It was found that clinical recovery occurred in 90.0 and 70.0 % of patients in group I and group II (р = 0.02), respectively. Microbiological recovery was observed in 100.0 and 67.5 % of patients, respectively (р = 0.003). In group I, the isolation of herpes simplex virus type 2 was found in 80.0 and 45.2 % of patients before and after treatment (p < 0.001), respectively, whereas in group II – in 82.5 and 77.5 %, respectively (p = 0.58), between groups – p < 0.001. Before treatment the level of all cytokines, excepting IFN-ã, was higher than the reference values in both groups: in group I, their magnitude decreased after treatment (p < 0.001) and corresponded to the reference values; in group II no changes occurred. Three months after treatment, no relapses were observed in group I, whereas frequency of relapses in group II was 22.5 %, within 1 year – 0 and 35.1 %, respectively. Predictors of recurrent dysbiosis (IL-2, IL-6 and TNF-á in increased concentrations after a course of treatment) were identified.Conclusion. Treatment with a combined broad-spectrum antimicrobial drug along with topical immunomodulatory agent containing exogenous cytokines is an effective strategy for treating concomitant dysbiosis and preventing relapse. |
| first_indexed | 2024-04-10T04:01:43Z |
| format | Article |
| id | doaj.art-77f1bc2247704ee8a8d52f00ff0b92df |
| institution | Directory Open Access Journal |
| issn | 2313-7347 2500-3194 |
| language | Russian |
| last_indexed | 2024-04-10T04:01:43Z |
| publishDate | 2021-07-01 |
| publisher | IRBIS LLC |
| record_format | Article |
| series | Акушерство, гинекология и репродукция |
| spelling | doaj.art-77f1bc2247704ee8a8d52f00ff0b92df2023-03-13T07:09:51ZrusIRBIS LLCАкушерство, гинекология и репродукция2313-73472500-31942021-07-0115324525710.17749/2313-7347/ob.gyn.rep.2021.209650Immune-mediated mechanisms of the inflammatory response in women with combined infections of the lower genital tractG. B. Dikke0A. A. Sukhanov1I. I. Kukarskaya2V. V. Ostromenskii3Academy of Medical Education named after F. I. InozemtsevTyumen State Medical University, Health Ministry of Russian FederationTyumen State Medical University, Health Ministry of Russian Federation; Tyumen Region Perinatal CenterAcademy of Medical Education named after F. I. InozemtsevAim: to increase the effectiveness of combination therapy and reduce frequency of recurrences of inflammatory diseases in the lower genital tract of combined etiology.Materials and Мethods. There was conducted a prospective, randomized, blind, comparative clinical study. 80 women with vaginal microbiota disorders were examined randomized into 2 groups: group I (n = 40) – antibiotic therapy was carried out in combination with the preparation Superlimph, group II (n = 40) – a standalone antibacterial therapy; group III consisted of 20 patients lacking gynecological diseases considered to provide with control laboratory parameters. Clinical and laboratory methods were used: microscopy of vaginal smears, detection of viruses and sexually transmitted infections, measurement of serum cytokine levels – interleukins (IL-1â, IL-2, IL-4, IL-6, IL-8, IL-10), tumor necrosis factor alpha, (TNF-á), interferon gamma (IFN-ã).Results. It was found that clinical recovery occurred in 90.0 and 70.0 % of patients in group I and group II (р = 0.02), respectively. Microbiological recovery was observed in 100.0 and 67.5 % of patients, respectively (р = 0.003). In group I, the isolation of herpes simplex virus type 2 was found in 80.0 and 45.2 % of patients before and after treatment (p < 0.001), respectively, whereas in group II – in 82.5 and 77.5 %, respectively (p = 0.58), between groups – p < 0.001. Before treatment the level of all cytokines, excepting IFN-ã, was higher than the reference values in both groups: in group I, their magnitude decreased after treatment (p < 0.001) and corresponded to the reference values; in group II no changes occurred. Three months after treatment, no relapses were observed in group I, whereas frequency of relapses in group II was 22.5 %, within 1 year – 0 and 35.1 %, respectively. Predictors of recurrent dysbiosis (IL-2, IL-6 and TNF-á in increased concentrations after a course of treatment) were identified.Conclusion. Treatment with a combined broad-spectrum antimicrobial drug along with topical immunomodulatory agent containing exogenous cytokines is an effective strategy for treating concomitant dysbiosis and preventing relapse.https://www.gynecology.su/jour/article/view/1005vaginal microbiotadysbiosisimmunitycytokinessuperlymph |
| spellingShingle | G. B. Dikke A. A. Sukhanov I. I. Kukarskaya V. V. Ostromenskii Immune-mediated mechanisms of the inflammatory response in women with combined infections of the lower genital tract Акушерство, гинекология и репродукция vaginal microbiota dysbiosis immunity cytokines superlymph |
| title | Immune-mediated mechanisms of the inflammatory response in women with combined infections of the lower genital tract |
| title_full | Immune-mediated mechanisms of the inflammatory response in women with combined infections of the lower genital tract |
| title_fullStr | Immune-mediated mechanisms of the inflammatory response in women with combined infections of the lower genital tract |
| title_full_unstemmed | Immune-mediated mechanisms of the inflammatory response in women with combined infections of the lower genital tract |
| title_short | Immune-mediated mechanisms of the inflammatory response in women with combined infections of the lower genital tract |
| title_sort | immune mediated mechanisms of the inflammatory response in women with combined infections of the lower genital tract |
| topic | vaginal microbiota dysbiosis immunity cytokines superlymph |
| url | https://www.gynecology.su/jour/article/view/1005 |
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