Comparative Evaluation of the Dynamics of Parameters of Cell-Mediated Immunity under the Influence of Different Therapies for Chronic Acquired Toxoplasmosis
Journal Title: Актуальна інфектологія - Year 2015, Vol 1, Issue 6
Abstract
The article presents a comparative evaluation of the dynamics of parameters of cell-mediated immunity in patients under the influence of different therapies for chronic acquired toxoplasmosis (CAT). Efficiency of complex treatment using antiprotozoal combined drug pyrimethamine + sulfadoxine has been studied in 1 and 5–6 months after starting treatment. After 1 month of initiation of treatment with pyrimethamine + sulfadoxine, a significant increase of CD4+ (p < 0.01), CD16+ (p < 0.05) and a decrease in the level of Toxoplasma-specific IgG antibodies (p < 0.05) were detected. After 6 months of initiation of treatment, we have revealed elevated levels of CD3+ (p < 0.05), CD4+ (p < 0.001), CD8+ (p < 0.001), CD16+ (p < 0.001), phagocytic index (p < 0.05), decreased level of circulating immune complexes (CIC) with 3.5% polyethylene glycol (PEG) (p < 0.01) and 7% PEG (p < 0.001), lymphocytotoxic autoantibodies (p < 0.01) and Toxoplasma-specific IgG antibodies (p < 0.001). These data may indicate a significant lag in homeostatic adjustment of the immune system under the influence of antiprotozoal therapy. When studying the effectiveness of combination therapy (pyrimethamine + sulfadoxine and specific immunoglobulin against T.gondii), among the immunological parameters after 1 month of starting treatment we have found a significant increase in content of CD16+ compared with baseline (p < 0.001), IgA (p < 0.001) and reduction in the level of Toxoplasma-specific IgG antibodies (p < 0.001). After 6 months of observation, we have detected an increase of CD3+ (p < 0.01), CD4+ (p < 0.001), CD8+ (p < 0.01) content in comparison with baseline, as well as lower levels of CIC with 3.5% PEG (p < 0.001) and 7% PEG (p < 0.05), lymphocytotoxic autoantibodies (p < 0.001), IgA (p < 0.05), IgM (p < 0.05), IgE (p < 0.01) and IgG antibodies to Toxoplasma (p < 0.001). Combination therapy for CAT in the acute stage of the disease has a significant impact on the normalization of all parts of immunological homeostasis. Such action was maximal in 6 months of starting treatment. When studying the effectiveness of the therapy with specific immunoglobulin against human T.gondii, when analyzing the dynamics of indicators of immunity in 1 month from the initiation of immunoglobulin therapy, we have revealed only a significant increase in CD8+ (p < 0.05) and a decrease in the ratio of CD4+/CD8+ (p < 0.05). After 6 months of starting treatment, we have established a significant increase of CD4+ (p < 0.001), CD8+ (p < 0.001), CD4+/CD8+ (p < 0.001), CD16+ (p < 0.05) levels, phagocytic index (p < 0.001) and a decrease of CIC content with 3.5% PEG (p < 0.05), lymphocytotoxic autoantibodies (p < 0.001), IgG to Toxoplasma (p < 0.001) and IgE (p < 0.05) in comparison with baseline. Comprehensive assessment of the dynamics of immunity parameters using average values of t-test, depending on the type of therapy, showed that after 1 month from the initiation of treatment only combination therapy revealed significant (t = 3.19; p < 0.01) changes in their normalization. Application of pyrimethamine + sulfadoxine monotherapy (t = 1.25; p > 0.05) and immunoglobulin therapy (t = 1.75; p > 0.05) caused only a trend toward normalization of parameters. After 6 months of starting treatment, a pronounced dynamics was observed in patients received combination therapy (t = 5.5; p < 0.001), average — at immunoglobulin therapy (t = 3.68; p < 0.01) and a small one — in the group of patients treated with pyrimethamine + sulfadoxine (t = 2.91; p < 0.01). Combination therapy had a highest immunological effect when treating patients in the acute stage of CAT. Treatment with T.gondii-specific immunoglobulin took an intermediate position, and therapy using pyrimethamine + sulfadoxine revealed the lowest efficiency.
Authors and Affiliations
O. V. Bobrova, Anuar al Hatib
Keywords
Related Articles
- EP ID EP214765
- DOI -
- Views 77
- Downloads 0
Zika Virus Infection
Zika virus disease — an infectious disease caused by a virus of the same name from the Flaviviridae family. The main route of transmission of the virus is the infection through the blood during a bite by tropical mosqui...
Carbapenems in clinical practice
Increasing frequency of infections caused by multi-drug resistant organisms is currently observed in the adult and pediatric population. It is the clinician’s responsibility to use wide-spectrum antibiotics when appropri...
Clinical features of nervous system disorders in patients with EBV as monoinfection and in association with other herpes viruses in their reactivation and persistence
We have examined 48 patients with nervous system disorders caused by Epstein — Barr virus (EBV) as monoinfection or in association with other herpes viruses during their reactivation (n = 34) or persistence (n = 14). Wit...
Peculiarities of Protein Fractions Indices in Patients with Destructive Drug-Resistant Pulmonary Tuberculosis at the Beginning of Treatment
The objective was to study the peculiarities of protein fractions indices in patients with destructive drug-resistant pulmonary tuberculosis, depending on the clinical form and resistance profile of Mycobacterium tubercu...
Clinical case of tetanus in an injecting drug user
The article presents data on the incidence of tetanus in the Dnipropetrovsk region from 2014 to 2017. At the present time, taking into account the decrease of the immune layer of the population of our country, the clinic...