[Pathogenetic approaches to the correction of vascular homeostasis in patients with COVID-19: A review].

The adverse outcomes in patients with COVID-19 in the initial phase of the disease are often due to the development of cytokine storm, endothelial dysfunction, shifts in the hemostasis system, microangiopathy, angiocentric inflammation, and pathological angiogenesis, which require targeted therapy. Unfortunately, to date, there is still no drug with proven high efficacy. This review is to analyse the literature data on the pathogenesis of vascular homeostasis lesions and possible ways to correct the existing shifts in patients with COVID-19. When the oxygen content in the tissue decreases, one of the most important mechanisms of adaptation is the activation of the succinate oxidase pathway, but under conditions of prolonged hypoxia and intoxication, the succinate reserve is rapidly depleted. That is why exogenous of succinic acid can enhance the adaptive capabilities of the organism and improve the prognosis in patients with COVID-19. Succinic acid preparations contribute to normalization of energy exchange and reduction of oxidative stress, especially in combination with inosine, nicotinamide and riboflavin and are widely used in clinical practice in various nosological forms. Taking into account the analysis of data on the mechanisms of clinical effects of succinate-containing preparations, this group of drugs can be considered as promising with regard to the correction of vascular disorders in COVID-19.

[Influence of therapy with interferon inducer on the parameters of quality of life in patients with pulmonary tuberculosis].

The evaluation of quality of life using a questionnaire--Version 2 of the "SF-36 Health Survey" was performed in 144 patients with widespread pulmonary tuberculosis. The low level of "quality of life" was revealed in patients with pulmonary tuberculosis in comparison with healthy persons. It is caused by limiting physical activity, reducing the psychological component due to low vitality and mental health. By the end of the second month of chemotherapy, the changes are saved (PE, RP) and even exacerbated (RE, MN) in patients with MDR MBT. Combined therapy with Cycloferon improves physical activity of patients without MDR MBT. In this case, the mental health of the patient is perceived positively due to increasing the emotional activity, more expressed in patients without MDR MBT and minimization emotional problems related to the disease in patients with MDR MBT.

[Antihypoxants in current clinical practice].

Hypoxia is a universal process accompanying and determining the development of various pathological conditions. In the most general form hypoxia can be defined as the incompatibility between energy requirements of the cell and energy production in the system of mitochondrial oxidative phosphorylation. The energetic status of the cell can be improved by such pharmacological products as antihypoxants of 5 groups: inhibitors of fatty acid oxidation, succinate-containing and succinate-producing agents, components of the natural respiratory chain, artificial redox-systems, and macroergic compounds. This paper is focused on the mechanisms of action of these products, their major effects, and results of clinical studies. Special emphasis is laid on succinate-containing products combining properties of a balanced polyionic solution and an antihypoxant (reamberin, cytoflavin, remaxol). They are known to be effective against various pathological conditions including ischemic stroke, toxic, hypoxic and dyscirculatory encephalopathies, infectious diseases, posthypoxic lesions in the central nervous system of newborns, various intoxications), etc.

[Dose-dependent interferon-induction activity and pharmacokinetics of cycloferon in healthy humans].

Dose-dependent interferonogenic activity and pharmacokinetics of cycloferon--a low-molecular inductor of interferon--have been studied in a group of 35 healthy volunteers. It is established that cycloferon induces the production of early alpha-IFN within 24 h from the moment of drug introduction. In a dose of 500 mg, the drug induces production of gamma-IFN by leukocytes in vitro within 24 h from the moment of introduction, with retention of the titer for 48 h. This proves the need for differentiated approach to a choice of the dose of cycloferon, depending on diseases in which complex treatment involving interferon inductors is required. After the introduction of cycloferon (500 mg) in healthy volunteers, the peak of drug concentration in the blood is observed in 40 min, with the subsequent considerable decrease within 2 h. Variation of the cycloferon concentration in the blood correlates with its content in urine, which is evidence for the drug elimination from organism through kidneys.

[Clinicoimmunological monitoring of therapy in patients with associated forms of yersiniosis].

Characteristics of the clinical process and immunological profile in children with yersiniosis as a monoinfection or in association with acute intenstinal infections and virus hepatitis A are presented. The efficacy of the immunotropic therapy with cycloferon, an interferon inductor, and recombinant interferon in the patients with the viral and bacterial association of the disease (yersiniosis + hepatitis A) and initial disbalance of the serum cytokines was estimated. Dependence of the interferon clinicolaboratory efficacy on the initial levels of serum y-interferon, IL2 and IIA, promoting shorter terms of hyperthermia, diarrhea syndrome and cytolysis syndrome was shown. It allowed to optimize the scheme of the pathogenetic therapy of Yersinia mixed infection.

[Modified therapy of herpetic infection].

The study demonstrates a higher pharmacotherapeutic and economic efficacy of an alternative treatment modality for genital herpes using cycloferon, an inducer of endogenous interferons, compared with acyclovir. Clinical remission due to suppression of virus replication occurred in 72.3 and 73.5% of the cases within 6 months after the treatment with cycloferon and cycloferon + acyclovir respectively. Acyclovir alone prevented reactivation of the disease only in 128% of the patients. The cost/effectiveness ratio in patients given combined therapy was 27.95 compared with 12.9 in case of monotherapy with acyclovir which suggests economic feasibility of the use of cycloferon as the drug of choice for the management of genital herpes. The efficacy of therapy was identical in patients with and without deletion of the GSTM1 gene encoding glutathione-S-transferase which suggests the possibility to effectively use cycloferon in genetically heterogeneous patients.

[Effect of immunomodulator cycloferon on quality of life and psychoemotional state of patients with chronic active brucellosis subjected to complex pharmacotherapy].

Indices of the quality of life and parameters of the psychofunctional status of patients with chronic active brucellosis are presented and the clinical efficiency of immunomodulator cycloferon in a complex therapy of this disease is estimated for a group of 40 patients. Cycloferon was administered to 20 patients, while the control group of 20 other patients received only a traditional therapy. It is established that the chronic active brucellosis is accompanied by a considerable decrease in parameters of the quality of life. The administration of cycloferon on the background of a base therapy leads to improvement of the quality of life and the parameters of the psychoemotional status in comparison to those achieved with the traditional methods of therapy.