Correction of mucosal immunity and antiviral therapy of frequently recurrent chronic tonsillitis/pharyngitis with local replication of herpes viruses

Abstract

Introduction. Insufficient effectiveness of traditional methods of treatment of chronic tonsillitis/pharyngitis (CT/CF), leads to the need for a deeper study of the ethio- and immuno-pathogenesis of these conditions and the search for new approaches to the treatment of such patients.

Aim - to study the features of mucosal immunity in patients with chronic often recurrent oropharyngeal inflammation in combination with local replication of herpes group viruses (Ep-stein-Barr virus, Human Herpes Virus 6, Cytomegalovirus) and to evaluate the clinical and laboratory effectiveness of combined therapy.

Material and methods. The study included 70 patients who received combination therapy. Before and after treatment, they conducted questionnaires, oropharyngeal culture for bacterial flora, quantitative determination of herpes virus DNA, and determination of the concentration of α-defensins (HNP1-3), catelicidin LL-37, lactoferrin, and sIgA in saliva.

Results. On the background of treatment was a reduction in the proportion of pathogenic microflora, the rate of detection and viral load herpes viruses, recovery factors, mucosal immunity in the oropharynx of patients of the study group, as well as decrease the frequency of relapses HT/HF in a year after treatment.

Conclusion. The clinical and laboratory effectiveness of combined therapy of frequently recurrent CT/CF has been proved.

Keywords:herpes viruses; mucosal immunity; antimicrobial peptides; valacyclovir; Imunofan® nasal spray

For citation: Shchubelko R.V, Zuykova I.N., Shulzhenko A.E. Correction of mucosal immunity and antiviral therapy of frequently recurrent chronic tonsillitis/pharyngitis with local replication of herpes viruses. Immunologiya. 2020; 41 (6): 540-8. DOI: https://doi.org/10.33029/0206-4952-2020-41-6-540-548 (in Russian)

Funding. As part of the thematic plan for the implementation of applied research and development in the field of healthcare, performed by the Federal state budgetary institution «SSC Institute of immunology» of the FMBA of Russia under the state task for 2016-2020. NN 388-00049-16, 388-03-108, 388-03-2018-179, 388-03-2019110, 388-02-2020-008.

Conflict of interests. The authors declare no conflict of interests.

References

1. Palchun V.T. Magomedov M.M., Kryukova A.I. Guide to focal infection in otorhinolaryngology. Moscow: GEOTAR-Media, 2015. 224 p. (in Russian)

2. Sagandykova N.S. Features of the microflora of the Palatine tonsils in chronic inflammation. Vestnik KazNMU. 2015; 2: 105-7. (in Russian)

3. Borisova O.Yu., Aleshkin V.A., Pimenova A.S. The microbial composition of the microflora of the oropharynx in patients with tonsillar pathology. Infekcija i immunitet. 2015; 5 (3): 225-32. (in Russian)

4. Aas J.A., Paster B.J., Stokes L.N. Defining the normal bacterial flora of the oral cavity. Journal of clinical microbiology. 2005; 43 (11): 5721–32. DOI: https://www.doi.org/10.1128/JCM.43.11.5721-5732.2005.

5. Berger C., Hug M., Gysin C., et al. Distribution patterns of β- and γ-herpesviruses within Waldeyer’s ring organs. Journal of Medical Virology. 2007; 79: 1147–52.

6. Assadian F., Sandström K., Bondeson K., et al. Distribution and molecular characterization of human adenovirus and Epstein-Barr virus infections in tonsillar lymphocytes isolated from patients diagnosed with tonsillar diseases. PLoS ONE. 2016; 11(5): 1-19. DOI: https://www.doi.org/10.1371/journal.pone.0154814.

7. Astrid A., Bosch T.M., Biesbroek G., et al. Viral and bacterial interactions in the upper respiratory tract. PLOS Pathogens. 2013; 9 (1): 1-12. DOI: https://www.doi.org/10.1371/journal.ppat.1003057.

8. Shchubelko R.V., Zuikova I.N., Shulzhenko A.E. Mucosal immunity of the upper respiratory tract. Immunologiya. 2018; 39 (1): 81–8. (in Russian)

9. Wu R.-Q., Zhang D.-F., Tu E., et al. The mucosal immune system in the oral cavity – an orchestra of T cell diversity. International Journal of Oral Science. 2014; 6: 125–32.

10. Brandtzaeg P. Secretory immunity with special reference to the oral cavity. Journal of Oral Microbiology. 2013; 5: 1-24. DOI:https://www.doi.org/10.3390/proteomes1030275.

11. Dale B.A., Fredericks L.P. Antimicrobial peptides in the oral environment: expression and function in health and disease. Current Issues in Molecular Biology. 2005; 7 (2): 119–33.

12. Davison G., Allgrove J., Gleeson M. Salivary antimicrobial peptides (LL-37 and alpha-defensins HNP1–3), antimicrobial and IgA responses to prolonged exercise. European Journal of Applied Physiology. 2009; 106: 277–84.

13. Fábián T.K., Tibor K.F., Hermann P., et al. Salivary defense proteins: their network and role in innate and acquired oral immunity. Review. International Journal of Molecular Sciences. 2012; 13: 4295-320.

14. Khurshid Z., Naseem M., Sheikh Z. Oral antimicrobial peptides: types and role in the oral cavity. Saudi Pharmaceutical Journal. 2016; 24: 515–24.

15. Immunotherapy in the practice of ENT doctors and therapists. Ed. Simbirtsev A.S., Lavrenova G.V., SPb.: Dialog, 2018. 456 p. (in Russian)

16. Karaulov A.V., Kalyuzhin O.V. Immunotherapy of infectious diseases: problems and prospects. Therapevticheskiy archive. 2013; 11: 100-8. (in Russian)

17. Immunotherapy. 2nd edition, revised and enlarged. Ed. Khaitov R.M., Ataullakhanov R.I., Shulzhenko A.E., Moscow: GEOTAR-Media, 2018. 768 p. (in Russian)

18. Mirzoeva E.Z. Method for selecting informative symptoms of chronic tonsillitis and chronic pharyngitis. Rossijskaja otorinolaringologija. 2015; 2 (75): 60-3. (in Russian)

19. Mirzoeva E.Z. Diagnostic significance of symptoms of chronic tonsillitis and chronic pharyngitis. Verhnevolzhskij medicinskij zhurnal. 2014; 12 (4): 32-6. (in Russian)

20. Shchubelko R.V., Zuikova I.N., Shulzhenko A.E. Human herpesvirus infections: clinical features and treatment options. Russian medical journal. 2018; 8 (1): 39–45.

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