[Role of a host in spontaneous recovery from viral hepatitis C: genetic predetermined factors].

The impact of both congenital and specific human immune responses on the invasion of viruses is determined by a broad spectrum of genetically determined parameters. The review attempts to characterize the influence of genetic determinants on the outcome of human hepatitis C viral (HCV) infection. The increased rate of convalescence is associated with female sex and white ethnicity. Hereditary immune disorders/deficiency lead to the reduced probability of spontaneous convalescence and the complicated course of a chronic stage of the disease. The carriage of some HLA haplotypes and gene alleles, which determine the development of an immune response following the Th1 or Th2 type, is essential in predicting both the outcome of acute HCV infection and the course of chronic hepatitis C. Specifically, the higher elaboration of IFN-gamma and IL-12 which specify a Th1 immune response facilitates the good outcome of HCV infection. At the same time, the increased generation of Th2-orienting IL-6 and IL-10 predisposes to the chronic course of the disease. In recent studies, the outcome of the infection is also associated with the polymorphism of genes, encoding for low-density lipoproteins and complement type 1 receptors, with other genes determining the development of a congenital immune response and a specific one. The understanding of genetic predisposition of the outcome of HCV infection and the possibility of its prediction may make a considerable contribution to the definition of treatment policy for viral hepatic C.

[Role of host in spontaneous recovery from viral hepatitis C: the body's condition at the moment of infection].

The condition of the host at the moment of infection is that its immune competence largely determines the efficiency, kinetics, and profile (Thl/Th2) of a further specific immunity response and, accordingly, the outcome of penetration of hepatitis C virus (HCV) into the body and subsequent acute infection (if it occurs). The parameters determining immune competence may include age, traumatizing exposures (operations, burns, wounds, and fractures), immunosuppressive therapy, stresses, con-infections, and alcohol use. The highest rates of spontaneous convalescence from HCV infection are observed in children and adolescents. Other human conditions are much shorter, transient; their impact is difficult to determine in the retrospective review and therefore it has not been adequately studied. Previous operations, posttransplantation immune suppression, immune modulation after blood transfusion, alcohol-induced immune imbalance, drug and narcotic intoxication are poor predictors. Immunosuppression and immune imbalance caused by viral and parasitic infections are observed among the host's temporary conditions affecting the outcome of HCV infection. The authors have analyzed the sequels of superinfections in patients with chronic hepatitis C, other hepatotropic viruses and the common liver fluke Schistosoma mansoni. The interesting therapeutic activities against HCV and parasitic infection (contamination with Echinococcus granulosus in particular), which are shown in the treatment of co-infection patients with alpha-interferon preparations that ensure normalization of immune deficiency caused by each of the infections and their increased combination. A deeper insight into the correlation between the condition of the host and its ability to eliminate the virus may be one more step on the road to the prevention of the infection and to the designing an effective vaccine against HCV.

[The organ pathology in the acute stage of tissue helminthiases: the role of eosinophilia of the blood and tissues, blood immunoglobulins E and G4 and immune response-inducing factors]. / Organnaia patologiia v ostroi stadii tkanevykh gel'mintozov: rol' éozinofilii krovi i tkanei, immunoglobulinemii E, G4 i faktorov, indutsiruiushchik immunnyi otvet.

The pathogenesis of organic lesions in the early phase of tissue-dwelling helminthic infections has been analyzed and discussed by taking into account the previous findings [8, 9, 12], the results of current clinical and immunological studies [10, 11, 60] in the light of a fundamental literature data review. The products secreted by invasive helminthic larvae and the substances expressed onto their cuticula tegument surface mimic nonspecific [34, 43] and specific [21, 28, 33, 42] modulators of host inflammatory processes or induce the latter directly [37, 30, 42, 70]. The development of severe visceral pathology at the very early stage of human toxocariasis [60] is associated with unbalanced overproduction of these modulators and directly acting substances by a zoonotic agent. Some of these substances provoke organic and systemic pathology in the nearest day-hours after massive human invasion with sylvatic Trichinella spiralis strains or with Paragonimus westermani ichunensis larvae with a fatal end in 2-2.5 weeks [8, 14]. Parasitic enzymes that mimic the host proteins [73, 42], perhaps recently revealed [30] parasitic myogenic proteins, human tissue epitopes normally unexpressed [71], i.e. autoantigens from the impaired tissues [16] have been regarded as the factors leading to immunopathological/autoimmunological processes [21, 73]. Experimental allergic myocarditis (EAM) with endo-, pericardial, and valvular damages was reproduced in the guinea pigs immunized with T. spiralis somatic antigen and myocardial tissue homogenate (without BCG) in lanoline and mineral oil [8]. The development of trichinellosis-induced EAM with its pathomorphological characteristics revealed the existence of a Th1-variant of myocarditis in trichinosis similar to that of myosin-induced myocarditis [69] and confirmed the unfavourable effect of Th1 population stimulated in tissue-dwelling helminthic infections [62, 66, 70]. Visceral pathology in 22 patients at the acute stage of trichinosis, Opisthorchis felineus infection and in the early phase of toxocariasis coincided with serum IgG4 hyperproduction, competitive with serum IgE production, or with hypereosinophilia in IL-4-independent allergic reaction [60]. The absence of visceral pathology in the examined patients with high blood eosinophilia and serum IgE content (without elevated IgG4 levels) confirmed the protective functions of these parameters of immune responses in helminthic infections. However, there were individual variations of responses in terms of these parameters: high levels of all 3 parameters in three patients and IL-4-independent allergic reaction in 4 patients, only 6 of them had no visceral pathology. These substantial individual variations of immune responses at the early stage of disease seem to reflect the susceptibility to infections [71].

[Organ pathology in chronic tissue-dwelling helminthic infections: role of blood and tissue eosinophilia, immunoglobulinemia E, G4, and immune response-inducing factors]. / Organnaia patologiia v khronicheskoi stadii tkanevykh gel'mintozov: rol' éozinofilii krovi i tkanei, immunoglobulinemii E, G4 i faktorov, indutsiruiushchikh immunnyi otvet.

The results of earlier clinical, pathomorphological, and immunological studies of organic visceral and tissue lesions in helminthic infections [2, 3, 8, 10, 11, 14, 46] and present clinical and immunological ones [4-6, 44, 45] were analyzed and discussed in the light of a fundamental literature data review. The chronic visceral pathology in tissue-dwelling helminthic infections is associated with super- and reinfections [1, 2, 16, 36], with an inadequate immune response of humans to the invasion of zoonotic agents [2, 6, 13, 20] and with an individual invalidity of an immune response to infections [1, 2, 6, 16, 54]. The persistent course of infections, especially zoonotic, leads to organic pathology, sometimes irreversible [2, 13, 15, 21, 34, 46] if an individual (population) does not respond by immunity or by acquired (inherited) tolerance of invasion [1, 2, 3, 11, 16, 20, 36]. Transplacental transfer of Opisthorchis felineus antigens in the hyperendemic foci of the infection does not prevent superinfections, but does prevent the acute phase of disease and significantly mitigates the organic lesions in the chronic phase in spite of a very high intensity of infection [7, 10, 11]. Paramyosines (Pmes), proteins expressed on the tegument of Schistosoma mansoni and S. japonicum, show their immunogenic effect [42]. Antibodies to PM of Lumbricoidea and to a cardiac muscle myosin peptide (alpha-mp), known to induce experimental allergic myosites [55], were revealed in the sera of 32 trichinellosis, toxocarosis, opisthorchiasis, and hydatid echinococcosis patients with organic visceral abnormalities. The levels of antibodies against alpha-mp correlated with the severity of pathology [44]. S. mansoni PM peptide smp97 is a homologue of alpha-mp [25]. This fact suggests that there is a relationship between the development of an immune response to Pmes immunological processes in helminthiases. The relationship between organic visceral pathology and a competitive with serum IgE serum IgG4 hyperproduction at the early [6] and late stages of the studied helminthic infections was revealed. One may resume that this balance of production of these isotypes is not beneficial for the development of disease as IgG4-antibody hyperproduction is not beneficial for reinfection resistance [26, 28, 54]. One of the mechanisms may be serum IgG4 blocking the antibody-dependent cytotoxic effect, as it was supposed for unspecific IgE hyperproduction [47]. The selected development of cardiomyopathy or obstructive fibrosis in the lung after trichinellosis [2, 6, 45], endomyocardiofibrosis in the foci of filariases [21, 31] suggests that their development like resistance or susceptibility to infections [54] should be programmed.

[The molecular bases of the pathogenesis of malaria and their potential uses in developing a combined therapy for the infection]. / Molekuliarnye osnovy patogeneza maliarii i vozmozhnosti ikh ispol'zovaniia v razrabotke kompleksnoi terapii infektsii.

Molecular mimicry of a host is essential malaria parasite invasion and spreading in a host and it makes self-advantage for the parasite affecting vital organs and systems of the latter. It is tempting to assume that monoclonal antibody (MA) blocking specific (such as IMAM-I or CD36) and some unspecific (such as C3b) receptors of the blood stages of P. falciparum may prevent the malignant course of the infection. In our experience pyrazolone derivative not only suppressed schizont P. vivax infection but parasitemia too. After ceasing the drug administration, fever and parasitemia reappeared. It is of interest to study whether MA to the parasite hsp75 kD are able to suppress blood schizogony in P. falciparum infection. The prevention with MA to IFN-u the development of experimental cerebral malaria has been reported. Principally new approach in advancing the therapy of malignant malaria might be inducing agents of TNF inhibitors production. The suppressing of the parasite activity by blocking its receptors in a host seems to be perspective in the therapy of malignant malaria.

[Blood eosinophilia and immunoglobulin E: the characteristics of their regulation in helminthiases and allergic diseases]. / Eozinofiliia krovi i immunoglobulinemiia E: osobennosti reguliatsii pri gel'mintozakh i allergicheskikh bolezniakh.

Patients with eosinophilia (due to helminthic infections in 44 patients, to allergic diseases in 32, and to unknown causes in 37) were studied and followed up at the in- and outpatient departments of the E. I. Martsinovskii Institute. Conventional laboratory studies and several parasitological, serological and image techniques were used in each case. During surveillance made during 1994 and 9 months of 1995, 11 patients (8 with toxocariasis) of the last group were replaced in the first one, 9 patients were found to have atopic diseases, and 3 patients were diagnosed as having lymphoma or blood diseases. Yet, the origin of eosinophilia remained unclear in 14 patients, 12 of whom were studied at the inpatient department of the E. I. Martsinovskii Institute. The regulatory features of immune responses were analyzed in helminthic and allergic diseases by reviewing vast recent experimental data. Conceivably, comparative estimation of serum IgE/IgG4 ratios in these two groups of patients may be helpful in limiting the field of search and the time of an examination/analysis.

[The biological aspects of the therapy of parasitic diseases]. / Biologicheskie aspekty terapii parazitarnykh boleznei.

Specific drugs, most of them heterocyclic compounds, are leading in the therapy of parasitic infections despite their relative toxicity and potent mutagenicity. In some parasitic diseases chemotherapy is of low efficacy (hydatid and multilocular echinococcosis, African trypanosomiasis) or practically absent (American trypanosomiasis) mostly due to suppression or distortion of an immune response. Methods of immunocorrection using recombinant cytokines (interleukins, interferons) or their inducers are to be borrowed from the practice of treatment of oncological, lymphoproliferative diseases and other immune deficiencies. For instance, alpha-interferon and gamma-interferon inducers should be used in echinococcosis, where, as our studies have shown, the production of these cytokines is markedly suppressed. The enforcement of chemotherapeutic effect by "parachemotherapy" (Sh. D. Moshkovskii, 1944), the effect of nonspecific pharmacological drugs upon the cells and tissues damaged by parasites (like Ca2+ transport blockers in drug-resistant falciparum malaria), should be used, for instance, recombinant gamma-interferon plus specific drugs in toxoplasmosis. Modern methods of immunotherapy based on the molecular mechanisms of a host-parasite relationship should be created, for instance, monoclonal antibodies to C3 receptors of membranes of cells invaded with Toxoplasma gondii. Immunotoxins such as monoclonal antibodies to myoblast receptors conjugated to 5-nitroimidazolyl-thiadiazole in Chagas' disease should be tested. The above mentioned biological approaches should increase the efficacy of chemotherapy in parasitic diseases with smaller amounts of specific drugs and less courses of treatment.

[The specific and biological action of chemical preparations and their combination with pathogenetic agents in trichinosis]. / Spetsificheskoe i biologicheskoe deistvie khimiopreparatov i ikh kombinatsii s patogeneticheskimi sredstvami pri trikhinelleze.

The hypersensitizing effect of benzimidazole carbamates (BC), the therapy for trichinellosis, especially in heavily infected patients, determines the necessity of simultaneous administration of glucocorticoids (GC) for the prevention of severe systemic and organ-specific complications. This combination delayed the convalescent period, in severe cases it provokes coagulopathic disorders, infrequently fatal haemorrhages. The combination of BC with nonsteroidal anti-inflammatory drugs (NSAIDs) significantly shortened the convalescent period in semisevere and moderate cases of the disease along with normalized PGF and PGE production. In experimental mice and guinea pigs, the inhibition of specific T-cell responses without inhibiting their response to FGA, and the high antibody mediated cytotoxic activity after BC and NSAID therapy were found. Thus, in severe cases of the disease GC should be applied very immediately, replaced later by NSAIDs. The possible role of the biological action of BC, as donors of imidazoles in the microenvironment of muscle larvae, favoured by the poor content of natural imidazoles is discussed.

[The mass treatment of opisthorchiasis with praziquantel from the viewpoints of the clinician and the epidemiologist]. / Massovoe lechenie opistorkhoza prazikvantelem s pozitsii klinitsista i épidemiologa.

About a 20-years period of chloxyl (hexaparaxylol) mass treatment of opisthorchiasis in hyper- and mesoendemic territories of Russia did not change the prevalence of the infection, reducing only by some degree its intensity. Morbidity and incapacity in treated patients and in cured ones paradoxically appeared to be higher than in untreated persons. High parasitocidal activity of praziquantel in trematode infections has tempted (20) to use the drug as a tool in improving the level of health of population of endemic areas. For areas with a moderate and with a high rates of the infection "radical" and "selective" treatment with praziquantel was proposed (6). The study of clinical and immunological parameters in aboriginal, settler and migrant population of hyperendemic area in the Ob-Irtysh basin--Khanty-Mansi Autonomous District revealed striking differences in the groups and their different responses to praziquantel treatment. The possibility of transplacental transmission of O. felineus antigens in aborigines and in a part of settlers leading to immunological tolerance was revealed. "Retreatment" with praziquantel can lead to the loss of the latter and can challenge higher morbidity in adults and unsafety of their progeny. Monitoring system, checking the results of "retreatment" with praziquantel is proposed.

[Antibody-dependent cell-mediated immune reactions in experimental trichinelliasis in mice]. / Antitelozavisimye kletochno-oposredovannye immunnye reaktsii pri éksperimental'nom trikhinelleze myshei.

The experiments on mice experimentally infected with Trichinella larvae have established that in mild infection adhesive and killer cell reactions developed on day 14, reached their maximum on days 21-30 and began to attenuate on day 45. The cells from animals with moderate infection showed a higher immune activity which remained unchanged till day 90 of infection. The cells from mice with severe infection showed inhibition of immune activity which was most marked on days 21 and 30 of the infection. Eosinophiles and neutrophils are characterized by IgE-dependent cell adherence and killing activity, the involvement of macrophages in the responses seems to be insignificant.

[The interferon status in helminthiases. 3. Opisthorchiasis]. / Interferonovyi status pri gel'mintozakh. 3. Opistorkhoz.

In 23 patients with Opisthorchis felineus infection, 4 in subacute and 19 in chronic stages of the disease (7 subclinical, 8 with cholepathy and 4 with gastroduodenitis) the blood levels of alpha-interferon (IF-alpha) and IF-gamma were measured using vesical stomatitis virus culture. In patients with subacute opisthorchiasis the blood contents of IF-alpha and IF-gamma were the same as in control-30 practically healthy people (640-1280, log2 9.73 +/- 0.19, and 128-256, log2 7.75 +/- 0.25 against 640-1280, log2 10.04 +/- 0.12 and 128-256, log2 7.47 +/- 0.13 respectively). In patients with chronic opisthorchiasis the levels of IF-alpha and IF-gamma were lower than in control (320-640, log2 8.68 +/- 0.28 and 32-128, log2 6.0 +/- 0.58, p less than 0.01 and p less than 0.01 respectively). Among the ones with the subclinical course of the infection the content of IF-alpha was lower than in control (320-1280, log2 9.31 +/- 0.27, p less than 0.05). Patients with cholepathy had lower levels of IF-alpha and IF-gamma than those with subclinical course of the infection (160-640, log2 8.55 +/- 0.24 and 16-64, log2 5.0 +/- 0.26, p less than 0.01, p less than 0.01 respectively). That seemed to be a sign of immunodepression in the chronic stage of the disease some way more prominent in cases with cholepathy. Immediately after praziquantel therapy interferon levels remained unchanged.

[Comparative characteristics of clinical and immunologic indicators of various groups of opisthorchiasis patients in a focus. Aboriginal population]. / Sravnitel'naia kharakteristika kliniko-immunologicheskikh pokazatelei raznykh kontingentov bol'nykh opistorkhozom v ochage. Korennoe naselenie.

Clinical and immunological observations of people belonging to two population groups--aborigens (khanty, mansi, komi) and 40 immigrants--were performed in opisthorchiasis foci of the Tyumen region. Rapid clinical reinvasion of unimmune immigrants (in a 3-4 year period) was established; the aborigens featured subclinical invasion pattern. T-system immunity in immigrants was suppressed, while in the aboriginal group insignificant reduction of the number of T-helpers and significant increase in the number of T-suppressors, lack of apparent mobilization of humoral immunity factors--reduction of the absolute B-lymphocytes number, normal A, G immunoglobulines and CIC levels-were observed. Such T--B immune systems' ratio may indicate immune tolerance of a suppressor type. The observed indicators of aborigens' tolerance to helminths' antigens point to the necessity of differentiated approach to chemotherapy prescription (especially of the repeated courses) in the endemic invasion foci.

[The effect of toluene and ammonia on the invasive process and immunological indices in experimental trichinelliasis in mice]. / Vliianie toluola i ammiaka na invazionnyi protsess i immunologicheskie pokazateli pri éksperimental'nom trikhinelleze u myshei.

Rap mice were exposed to toluene (T) inhalation for 10 days before invasion with 20 Trichinella spiralis larvae per g body weight (moderate infection). This resulted in diminished number of intestinal parasites in the presence of greater number of mast cells in the peritoneal exudate, higher IgE production, enhanced cell adhesion to trichinella larvae and of migration of splenic lymphocytes. Simultaneous inhalation of T and ammonia diminished the immune stimulating effect of the former. The number of intestinal trichinella was 1.5 times more but still twice less than in controls. Inhalation of T during the first 10 days of infection stimulated the immune response only in mice given 5 larvae per g. In those given 20 or 60 larvae per g, the immune response was suppressed and 40 and 100% of mice perished respectively. The exposure to T during 30-39 days of infection of mice given 35 larvae per g (the intensive infection) resulted in 50% death of the animals without significant changes in immune response. Simultaneous therapy with mebendazole (75 mg/kg) provided 100% survival in the presence of suppressed immune response. 100% of mice of the same group not exposed to T but treated with mebendazole died. The toxic and immunomodulating effects of T differ in intact and infected mice due to the dense, the stage of infection and to chemotherapy.

[Differences in the dynamics of the eosinophilia, blood immunoglobulin E and the level of circulating immune complexes in patients with chronic opisthorchiasis treated with different doses of praziquantel]. / Razlichiia v dinamike éozinofilii krovi, immunoglobulinemii E i soderzhaniia tsirkuliruiushchikh immunnykh kompleksov u bol'nykh khronicheskim opistorkhozom, lechennykh raznymi dozami prazikvantelia.

Sixty patients with a chronic Opisthorchis felineus infection were administered one-day therapy with praziquantel in doses 25, 40, or 60-75 mg/kg b. m. The former two doses of the drug did not much improve the levels of the examined immunologic parameters. In patients treated with the highest dose of praziquantel a significant decrease of the total and specific IgE and CIC levels, reaching that in the reference groups, was observed in 6-8 months after the treatment, this indicating a 92% efficacy of the drug in this group of patients.

[Comparative efficacy of tiniba and fasigyn in treating primary and persisting Giardia infections]. / Sravnitel'naia éffektivnost' tiniba i fasizhina pri lechenii bol'nykh s liamblioznoi infektsieì obychnogo i upornogo techeniia.

Efficacity of tiniba (tinidasole, Kadila, India) and of fasigyn (Polfa, Poland) dosed 300 mg daily for 7 days was 87.5 and 85.2% (P greater than 0.05) immediately after treatment and 45.5 and 50.0% (P greater than 0.05) 4-8 months later, respectively. The lack of parasitocidal effect was established in 4 out of 27 tiniba-treated patients and in 3 out of 24 fasigyn treated ones. Direct correlation between the efficacy of persisting giardia infection chemotherapy and the cAMP phosphodiesterase activity in blood lymphocytes was found previously. Authors established an indirect correlation between the former and hydrochloric acid secretion by the bowel.

[Interferon status and the HLA antigen system. 1. Unilocular echinococcosis]. / Interferonovyi status i antigeny sistemy HLA. 1. Odnokamernyi ékhinokokkoz.

In 26 patients with hydatid disease interferons (IFN) blood levels by titration method and HLA-antigens by lymphocyte cytotoxicity microtest were estimated. In total group B5 antigen frequency was significantly (p = 0.007 after Fischer) higher than in the control group of 155 practically healthy persons: 38.5% and 14.7% respectively. The determination of possible correlation between IFN-alpha and IFN-gamma production, HLA-antigens specificity and the localisation of Echinococcus granulosus cysts showed that in hydatid disease A2 and B5 antigens carriers are significantly stronger producers of the cytokines as compared with patients having A3 and B13 antigens. The highest titers of IFN-alpha was found in A2 antigen carriers with the liver cysts, the highest level of IFN-gamma had B5 antigen carriers with the lung damage. A3 and B13 antigens carriers had low IFN titers independently of the character of damaged organ. Relatively high IFN-gamma blood titers in B5 antigen carriers with the lung cysts, persons predisposed to hydatid disease, permit supposing the stimulation of the cytokine production by the parasite for cysts formation in the lungs.

[Changes in the invasive process and the immune response of the host during the mebendazole and voltaren treatment of experimental trichinelliasis in guinea pigs]. / Izmenenie invazionnogo protsessa i immunnogo otveta khoziaina pri lechenii mebendazolom i vol'tarenom éksperimental'nogo trikhinelleza morskikh svinok.

Guinea pigs infested with Trichinella (5-10 larvae per 1 g body weight) at the intestinal (at days 2-4 of infection), migration al (at days 6-11), and muscular (at days 22-27) stages of invasion, were given voltaren, 2.14 mg/kg daily, and mebendazole, 75 mg/kg daily. The amount of adult Trichinella in small intestine and larvae in the diaphragm, T- and B-lymphocyte count (T-REC and B-RFC), functional leukocyte activity in RTML for FGA and Trichinella larvae antigens, content of circulating immune complexes and complement were determined. Voltaren did not cause delay in adult Trichinella elimination from the intestine of experimental animals, it also did not increase invasion rate at the muscular stage. As compared to the control, T- and B-lymphocyte content and RTML for FGA remained unaltered. Experimental animals show elevated blood complement activity and RTML inhibition of trichinella antigens. The combination of mebendasole and voltaren did not reduce parasitogenic effect. Despite the terms of drug injection, T- and B-lymphocytes count and complement levels in blood were found to increase, as well as the RTML index on FGA and its inhibition of specific antigens as compared with the infected untreated animals.

[Interleukin-1 production in patients with unilocular echinococcosis]. / Produktsiia interleikina-1 u bol'nykh odnokamernym ékhinokokkozom.

The production of interleukin-1 (IL-1) by peripheral blood monocytes was estimated by the H. R. Recalde method (1984) in 45 patients with echinococcosis and 10 virtually healthy controls. In echinococcosis patients interleukin-1 turned to be significantly lower (p less than 0.05) than in the controls (Kact 1.2 +/- 0.1 and 2.2 +/- 0.1 respectively). In patients with a malignant course of the disease (mostly in those with disseminated lung damages) Kact of Il-1 was 0.93 +/- 0.1. In patients who underwent surgical interventions 1.5-6 years before Kact of Il-1 reached 1.43 +/- 0.1 but was still lower (p less than 0.05) than in the controls. The lowest production of IL-1 was identified in patients with lung disseminated lesions and bone damages (Kact 0.9 +/- 0.1 and 0.79 +/- 0.1, respectively).

[The interferon status in helminthiases. 2. Alveolar hydatid disease]. / Interferonovyi status pri gel'mintozakh. Soobshchenie 2. Mnogokamernyi ékhinokokkoz.

In 11 patients with Echinococcus multilocularis infection the blood levels of alpha-interferon (alpha-IF) and gamma-interferon (gamma-IF) were measured using vesical stomatitis virus culture. In patients with the disease the contents of alpha- and gamma-IF were significantly (p less than 0.01) lower than in healthy controls: 392 +/- 101.6 and 101.6 +/- 20.9 U/ml and 1024 +/- 83.2 and 187 +/- 16.9 U/ml, respectively. The lower levels of alpha- and gamma-IF were found in patients with multiorgan damages including the lungs, as compared with the liver and abdomen infestation: alpha-IF 160 +/- 56.6, gamma-IF 88 +/- 24.0 and 525.7 +/- 124.3 and 109 +/- 18.3 (p less than 0.01), respectively. The similar data have been found in patients with hydatid disease (S. N. Suntsov et al., 1990). After 5 to 6 courses of mebendazole therapy in a dose of 50 mg/kg body weight dai y for 30 days with 30-day intervals there was a tendency to a slight elevation of cytokines levels (S. N. Suntsov et al., 1990), as seen in hydatid disease. The estimation of IF levels in multilocular echinococcosis infection may be of prognostic value and perhaps for the evaluation of the efficacy of surgical and chemotherapeutic treatment.

[Clinico-immunologic indices of various patient contingents in a focus of chronic opisthorchiasis. 3. Dynamics of the indices following praziquantel treatment]. / Kliniko-immunologicheskie pokazateli u raznykh kontingentov bol'nykh khronicheskim opistorkhozom v ochage. Soobshchenie 3. Dinamika pokazatelei posle lecheniia prazikvantelem.

Studies of the time course of the immune status characteristics after praziquantel treatment and of the nature of its side-effects on various groups of opisthorchiasis patients in the focus established significant differences in their immune response to specific treatment. The lack of alterations in the T- and B-immunity systems in aboriginal population of the focus may suggest its tolerance to helminthic antigens. The trend towards cellular immunity stimulation and a significant increase in the levels of circulating immune complexes and specific antibodies in the serum were observed in aboriginal population of the focus. The comers showed significant initial alterations of the immunity status before treatment, pointing to their sensitization to parasitic antigens. Suppression of the infection normalizes several cellular and humoral immunity characteristics--the number of T-helpers, T-lymphocytes, B-lymphocytes, Th/Tc indices, T-lymphocyte functional activity, thus eliminating immune depression. The increased IgG, CIC and specific antibody levels significantly exceeding the normal level, occurrence or enhancement of allergic reactions point to the necessity of performing a desensitizing therapy and using effective cholagogic drugs in the multimodality treatment to rapidly eliminate the parasitic antigen.