[Efficacy and safety of bacterial lysate OM-85 in the treatment of uncomplicated acute respiratory infections: a double-blind, placebo-controlled, multicenter, randomized trial].

AIM: To evaluate the efficacy and safety of OM-85 in the treatment of uncomplicated acute respiratory infections (ARI) in adults. MATERIALS AND METHODS: A double-blind, placebo-controlled, multicenter, randomized trial included 556 patients (18-60 years old) with mild and moderate ARI and negative results of polymerase chain reaction analysis for SARS-CoV-2 RNA and rapid test for influenza A and B viruses. Patients were randomized into two groups: in the first group (n=278), patients received OM-85 (Broncho-munal®) one capsule 7 mg/day for 10 days, while the second group (n=278) was treated with placebo in the same regimen. The primary endpoint was the dynamics of the severity of symptoms over 3, 5, 7 and 10 days of treatment according to the 21-item Wisconsin Upper Respiratory Symptom Survey (WURSS-21), which was assessed by the area under the curve. Secondary efficacy criteria were the dynamics of the severity of symptoms according to the Common Cold Questionnaire (CCQ), the time to the resolution of symptoms according to WURSS-21 and CCQ, the proportion of patients with body temperature below 37°C on each day of treatment, frequency of the need for systemic antibacterial therapy. RESULTS: The superiority of OM-85 over placebo by primary endpoint was observed on the 5th, 7th and 10th days of treatment. OM-85 efficacy has also been proven by secondary criteria. OM-85 shortened the time until the symptoms of ARI resolved according to the WURSS-21 and CCQ, increased the proportion of patients with body temperature below 37°C by 2-9 days. The time needed to resolve the symptoms of disease in 20% of patients according to WURSS-21 was 7 and 9 days in patients taking OM-85 and placebo, respectively. Bacterial lysate increased the probability of complete disappearance of symptoms according to CCQ by 45.7% compared to placebo. The analysis of the frequency and severity of adverse events, laboratory tests, physical and instrumental examination results during treatment confirmed the good tolerability and safety of OM-85. CONCLUSION: The study confirmed the efficacy and safety of OM-85 in the complex treatment of ARI in adults.

[The prospects for the use of drugs based on the phenomenon of RNA interference against HIV infection].

The human immunodeficiency virus (HIV) is currently one of the most pressing global health problems. Since its discovery in 1978, HIV has claimed the lives of more than 35 million people, and the number of people infected today reaches 37 million. In the absence of highly active antiretroviral therapy (HAART), HIV infection is characterized by a steady decrease in the number of CD4+ T-lymphocytes, but its manifestations can affect the central nervous, cardiovascular, digestive, endocrine and genitourinary systems. At the same time, complications induced by representatives of pathogenic and opportunistic microflora, which can lead to the development of bacterial, fungal and viral concomitant infections, are of particular danger. It should be borne in mind that an important problem is the emergence of viruses resistant to standard therapy, as well as the toxicity of the drugs themselves for the body. In the context of this review, of particular interest is the assessment of the prospects for the creation and clinical use of drugs based on small interfering RNAs aimed at suppressing the reproduction of HIV, taking into account the experience of similar studies conducted earlier. RNA interference is a cascade of regulatory reactions in eukaryotic cells, which results in the degradation of foreign messenger RNA. The development of drugs based on the mechanism of RNA interference will overcome the problem of viral resistance. Along with this, this technology makes it possible to quickly respond to outbreaks of new viral diseases.

[Probiotics as stimulators of immune response against pathogens in the respiratory tract].

This review analyzes whether.it is expedient to use oral probiotics for the stimulation of immune response against pathogens in the respiratory tract. It considers a relationship between.mucosal microbial colonization in different biotopes of the body and mucosal.immunity in the respiratory tract. The principal and terminological controversial issues of colonic dysbiosis and the possibilities of using the medicines and products containing live commensals/symbionts to correct microbiota disturbances are examined. There are data on the degree of resistance and resilience of the colonic microbial community exposed to destabilizing factors, antibiotics in particular. The properties of probiotics that have been proven to enhance host response against pathogens and the phenomena that characterize these probiotics as immunomodifiers and distinguish them from other immunostimulating/immunomodulating agents are described. Criteria for choosing effective and safe oral probiotics to stimulate an immune response in the respiratory tract are formulated. Finally, we review the data on the clinical and immunomodulatory effects of dietary supplement containing a combination of three probiotic strains (Lactobacillus gasseri PA 16/8, Bifidobacterium bifidum MF 20/5 and Bifidobacterium longum SP 07/3) with vitamins and minerals as an agent to prevent and reduce the severity of acute and recurrent respiratory tract infections.

[A study of urease activity of mouth cavity microflora].

STUDY OBJECTIVE: Analysis of the prevalence of mouth cavity urealytic microflora and determination of the level of its enzymatic activity depending on concentration and amount of urea solution taken as a substrate. MATERIALS AND METHODS: 62 randomly chosen patients at the age of 5-64 took part in the study. Each of them rinsed the mouth with 50 ml of 1% urea solution. Before and after rinsing the concentration of ammonia in the mouth cavity air was measured. In patients with highest and lowest activity of mouth cavity urealytic microflora a series of tests was carried out including mouth rinsing with urea solution in various concentrations and amounts and measuring ammonia concentration before and after rinsing. Obtained results were analyzed using mathematical statistics methods. RESULTS: It was found that in 91% ± 1.8% of randomly chosen patients (p < 0.05) mouth cavity microflora showed apparent urease activity. The lowest concentration (0.0625% in 50 ml) and volume (0.5 ml of 1% solution) levels of urea solution were obtained that can exert negative influence on the results of helicobacteriosis diagnosis by means of mouth cavity air analysis. CONCLUSION: Urealytic microflora in the mouth cavity is very common and may constitute a factor that decreases the specificity of helicobacteriosis diagnosis by means of the methods based on detection of indicators of gas metabolites resulting from the enzymatic reaction in air samples taken from the mouth cavity after oral administration of urea.

[20-year experience with laserofluorescent diagnostics in clinical microbiology].

Results of rapid laser-assisted identification of microorganisms for diagnostics of microbial processes based on auto-fluorescence effect in bacteria-containing materials are summarized. It is proposed to use the auto-fluorescence technique for express diagnostics of pyoinflammatory diseases, evaluation of microflora conditions (eubiosis, dysbiosis) and sensitivity to antibiotics, monitoring and prognostication, assessment of the quality of antibiotic therapy. Priority in the development of this medical technology for laserofluorescent diagnostics and its practical application is protected by 15 patents.

[Immunobiological properties of bacteria].

Opsonins found on the surface of microbial cells in vivo and ex vivo are characterized. The possibility of their visualization by immune electron and fluorescent microscopy has been demonstrated. Opsonins are shown to play a role in immune-mediated adhesion of bacteria to phagocytes and erythrocytes and formation of virus-bacterium associations. Staphylococci, Streptococci, and Propionibacteria appear to actively adsorb blood proteins on their cell surface giving rise to well-apparent capsular structures tentatively called immunoglobulin coatings. Pathogen (microorganism)-associated molecular patterns of gram-positive and gram-negative bacteria show different degree of interaction with soluble proteins that in turn promote their adhesion to blood corpuscles. The role of erythrocytes in transportation and elimination of immune complexes bound to their membrane receptors is discussed.

[The role of regulatory cells CD4+CD25+ in the development of chronic infective diseases].

Regulatory T-cells CD4+CD25+Foxp3 (Treg) present a small subpopulation of CD4+ T lymphocytes, which develop in the thymus and are disseminated into peripheral lymphoid organs on the 3rd or the 4th day of the neonatal period. Treg play a decisive role in the pathogenesis of autoimmune diseases and the development of tolerance to transplantation antigens, regulate the immune response to allergens, and suppress antimicrobial immunity. Treg suppress proliferation as well as the cytotoxic effect and the secretion of Th1 and Th2 cytokines by effectory T lymphocytes, thus limiting the strength of the immune response of effectory T-cells, which makes them impossible to adequately control viral and bacterial infections. Recognition via antigen-presenting cells and the subsequent induction of the proliferation of antigen-reactive T and B lymphocytes, directed towards infectious agent elimination, is accompanied by the activation of regulatory T cells as well, which leads to immune response suppression; repeated microbial infections are not only able to strengthen T-cell immunity by generating memory T-cells, but can also strengthen the suppressive activity of endogenous T regulators CD4+CD25+. Moreover, T reg are capable of the direct recognition of a microbial product; these cells selectively express Toll-like receptors (TLR)-2, -4, -5, -7, and -8. Under normal conditions T reg are anergic, but are capable of direct proliferation in response to stimulation by TLR ligands, expressed on microbes and parasites. Treg removal enforces protective immune response to contagious microorganisms, including bacteria, viruses, and fungi, which leads to the elimination of pathogens from the host organism. The removal of Treg population will help to accomplish infectious pathogen elimination and diminish inflammation within a short period of time.

[Molecular genetic variety of rickettsiae].

In this review modern data on the study of the genome of the representatives of the family Rickettsiaceae and, as follows from the accumulated information, on changes in the nomination and hierarchical place of its pathogenic and avirulent representatives are presented.

[Taxonomy and classification of Rickettsiae]. / Taksonomiia i klassifikatsiia rikketsii.

During the recent 20 years the improvement of the methodological research basis including the molecular and genetic analysis of microorganisms parasites of eukaryotic cells, led to considerable changes in the taxonomy and classification of rickettsiae. This problem was not discussed in the Russian literature. At present the term "rickettsiae" conventionally embraces the group of microorganisms of the class Proteobacteria, nominated as species belonging to the genera Rickettsia, Orientia, Ehrlichia, Coxiella and Bartonella. An original scheme of the modern taxonomy of rickettsiae, pathogenic for man, is presented. The scheme is made with due regard to their phenotypic, clinico-epidemiological and genetic features.

[Human microecology studies at Department of Microbiology with Virology and Immunology, I.M. Sechenov Moscow Medical Academy]. / Issledovanie po mikroékologii cheloveka na kafedre mikrobiologii s virusologiei i immunologiei.

Studies of human microflora in health and disease and during exposure to professional and ecological factors is a traditional problem solved for many years by staff members of Department of Microbiology with Virology and Immunology, I. M. Setchenov Moscow Medical Academy. The purpose of research is to develop methods and means for diagnosis and prevention of human microbiocenosis disorders. Fundamental and applied research in cooperation with prophylactic and clinical institutions and departments yielded data contributing to solution of many pressing problems in prevention and diagnosis of infectious diseases.

[Skin microbiocenosis in patient with chronic dermatoses]. / Mikrotsenoz kozhi bol'nykh khronicheskimi dermatozami.

The skin microflora of patients with chronic dermatoses (atopic dermatitis and psoriasis) have been studied by the original "Bactotests" method. The data thus obtained indicate that the clinical picture of the disease is related to the severity of skin dysbacteriosis. The electron-microscopic study of 2 staphylococcal strains isolated from patients has revealed the presence of the immunoglobulin cover (capsule-like outer sheath consisting of immunoglobulins and other humoral protective factors) on the cell wall of these bacteria.

[Infections caused by non spore-forming anaerobic bacteria]. / Sostoianie problemy infektsii, vyzyvaemykh nesporoobrazuiushchimi anaérobnymi bakteriiami.

Pyo-inflammatory diseases continue to be one of the topical problems of modern medicine. Their etiological agents are opportunistic microorganisms among which non spore-forming anaerobes are prevalent in the normal microscopic flora. They cause a pathological process when the body's immunity is decreased. The authors consider the biological features of this group of bacteria, epidemiological and pathogenetic aspects, the problems of laboratory and clinical diagnosis of non clostridial anaerobic infection and outline immediate steps to be taken to solve the problems.

[Current status of laboratory diagnosis of infections caused by nonspore-forming anaerobes and ways of its improvement]. / Sovremennoe sostoianie laboratornoi diagnostiki infektsii, vyzyvaemykh nesporoobrazuiushchim anaerobami, i puti eë sovershenstvovaniia]

Nonspore-anaerobic bacteria are the most common pathogens of purulent opportunistic infection. However, this group of infections is not recorded in our country due to the lack of national culture media and special laboratory equipment for anaerobic bacteriology. The laboratory diagnosis of infections caused by nonspore-forming anaerobes are analyzed and urgent measures to solve this topical problem are defined.

[Morphologic characteristics of bacteria treated with human blood serum and immunoglobulin]. / Morfologicheskaia kharakteristika bakterii, obrabotannykh syvorokoi krovi i immunoglobulinom cheloveka.

The electron microscopic study of ultrathin sections of bacterial cells treated with blood serum has revealed the presence of the immunoglobulin cover located on the cell wall and consisting of blood serum components. Staphylococci (strain Smith), studied with the use of ruthenium red, have been found to possess the capsule and the immunoglobulin cover located at its base. The immunoglobulin cover has proved to be more pronounced in gram-positive bacterial (actinomycetes, peptococci, staphylococci) and faintly pronounced in gram-negative bacteria (Bacteroides, Proteus, Pseudomonas, Escherichia).

[Bacteriologic and gas chromatographic diagnosis of nonclostridial anaerobic infection in suppurative-inflammatory diseases of the maxillofacial area and of the ENT organs]. / Bakteriologicheskaia i gazokhromatograficheskaia diagnostika neklostridial'noi anaérobnoi infektsii pri gnoino-vospalitel'nykh zabolevaniiakh cheliustno-litsevoi oblasti i LOR-organov.

The etiological role of nonsporulating anaerobic microorganisms as the causative agents of inflammatory purulent processes in the E. N. T. and maxillofacial regions has been studied. The rapid diagnosis has been made by the method of gas and liquid chromatography (GC and LC), the results of chromatographic and bacteriological studies have been compared and the main causes of false results obtained in the GC/LC analysis have been considered. The information content of the GC/LC analysis has been shown to exceed that of the main clinico-laboratory results.

[Possible role of opsonins in adsorption and transport of biological membranes and viruses by Staphylococci]. / Vozmozhnaia rol' opsoninov v adsorbtsii i transportirovke stafilokokkami biologicheskikh membran i virusov.

Electron microscopy of ultrathin sections of Staphylococcus aureus cells, Wood-46 strain, opsonized by the blood serum has revealed deposition of blood serum components on the bacterial cell walls. The bacteria opsonized by the blood serum absorbed biological membranes and the influenza virus virions. Staphylococcus-opsonin-virus complexes were digested by polymorphonuclear leukocytes. In mixed infection models staphylococci and influenza virus virions were detected in different parts of the phagocyte cytoplasm.