Bulletin of the Russian Military Medical AcademyBulletin of the Russian Military Medical AcademyВестник Российской военно-медицинской академии1682-73922687-1424Eco-Vector7130210.17816/brmma71302Clinical TrialsКлинические исследованияResearch ArticleDynamics of endogenous interferon-alpha and -gamma production under the influence of ingaron therapy in patients with chronic epstein – barr viral infection with chronic fatigue syndromeДинамика продукции эндогенного интерферон-альфа и -гамма под влиянием терапии ингароном у больных хронической эпштейна – барр вирусной инфекцией с синдромом хронической усталостиRakityanskayaIrina A.РакитянскаяИрина Aнисимовна
Russian Federation

doctor of medical sciences

доктор медицинских наук

tat-akyla@inbox.ruRyabovaTatyana S.РябоваТатьяна Сергеевна
Russian Federation

doctor of medical sciences, associate professor

доктор медицинских наук, доцент

tita74@mail.ruKalashnikovaAnastasia A.КалашниковаАнастасия Андреевна
Russian Federation

candidate of biological sciences

кандидат биологических наук

petkova_nas@mail.ruManuilovAndrey S.МануиловАндрей Сергеевич
Russian Federation

senior resident

старший ординатор

andre.manuilov@yandex.ruBel'skikhAndrey N.БельскихАндрей Николаевич
Russian Federation

doctor of medical sciences, professor

доктор медицинских наук, профессор

belsky@gmail.comApchelAndrey V.АпчелАндрей Васильевич
Russian Federation

doctor of medical sciences

доктор медицинских наук

andre.manuilov@yandex.ruCity Ambulant Department № 112Городская поликлиника № 112Military Medical Academy named after S.M. Kirov of the Ministry of Defense of the Russian FederationВоенно-медицинская академия имени С.М. Кирова МО РФAll-Russian Center for Emergency and Radiation Medicine named after A.M. NikiforovВсероссийский центр экстренной и радиационной медицины имени А.М. НикифороваMilitary Medical Academy named after S.M. Kirov of the Ministry of Defense of the Russian FederationВсероссийский центр экстренной и радиационной медицины имени А.М. НикифороваSevero-Western Medical Training Center for Postgraduate EducationСеверо-Западный медицинский учебный центр последипломного образования1506202123217280406202104062021Copyright ©; 2021, Rakityanskaya I.A., Ryabova T.S., Kalashnikova A.A., Manuilov A.S., Bel'skikh A.N., Apchel A.V.Copyright ©; 2021, Ракитянская И.A., Рябова Т.С., Калашникова А.А., Мануилов А.С., Бельских А.Н., Апчел А.В.2021Rakityanskaya I.A., Ryabova T.S., Kalashnikova A.A., Manuilov A.S., Bel'skikh A.N., Apchel A.V.Ракитянская И.A., Рябова Т.С., Калашникова А.А., Мануилов А.С., Бельских А.Н., Апчел А.В.http://creativecommons.org/licenses/by-nc-nd/4.0https://journals.eco-vector.com/1682-7392/article/view/71302

The influence of antiviral therapy with ingaron on the dynamics of production of interferons α and γ and clinical effects in patients with chronic viral Epstein – Barr infection was studied. The study involved 51 patients (33 women and 17 men aged 35,27 ± 1,28 years) suffering from chronic infection caused by the Epstein – Barr virus. The duration of the disease from the appearance of the first complaints to laboratory confirmation of the Epstein – Barr virus infection and diagnosis was 2,23 ± 0,21 years. Determined the serum, spontaneous and induced production of cytokines interferons α and γ in serum and in the culture of lymphocytes. Three months after the end of antiviral therapy, in patients with an initially low level of induced interferon-γ, the production of interferon-γ increased. The absence of an increase in the production of induced interferon-γ in patients one and three months after the end of therapy with ingaron indicates the absence of the effect of the drug on the level of endogenous interferon-γ. It has been established that the initially low level of induced interferon-γ can be a marker of the positive effect of the therapy with ingaron. Correlation analysis revealed the effect of baseline interferon-γ induced on the clinical picture of the disease. Thus, initially a high level of induced interferon-γ (2706 ± 1058.94 pg/ml) inversely affects the development of sweating in patients (r = –0.506, p = 0,023; τ = –0.419, р = 0.021), and initially low level of the induced IFN-γ (287.2 ± 64.65 pg/ml) — on development of weakness (r = –0.405, р = 0.045; τ = –0.419, р = 0.037). In general, ingarone can be used in the therapy of patients with chronic Epstein virus — Bar infection at a dose of 500,000 IU every other day, at least 10 injections.

Изучено влияние противовирусной терапии ингароном на динамику продукции интерферонов α и γ и клинические эффекты у больных хронической вируснойинфекцией Эпштейна – Барр. Обследован 51 пациент (33 женщины и 17 мужчин в возрасте 35,27 ± 1,28 лет), страдающих хронической инфекцией, вызванной вирусом Эпштейна – Барр. Длительность заболевания от появления первых жалоб до лабораторного подтверждения вирусной инфекцией Эпштейна – Барр и постановки диагноза составила 2,23 ± 0,21 года. Определяли сывороточную, спонтанную и индуцированную продукцию цитокинов интерферонов α и γ в сыворотке и в культуре лимфоцитов. Через три месяца после окончания противовирусной терапии у больных с исходно низким уровнем индуцированного интерферона-γ продукция интерферона-γ увеличилась. Отсутствие увеличения продукции индуцированного интерферона-γ у больных через один и три месяца после окончания терапии ингароном свидетельствует об отсутствии влияния препарата на уровень эндогенного интерферона-γ. Установлено, что исходно низкий уровень индуцированного интерферона-γ может быть маркером положительного эффекта проводимой терапии ингароном. Корреляционный анализ позволил выявить влияние исходного уровня индуцированного интерферона-γ на клиническую картину заболевания. Так, исходно высокий уровень индуцированного интерферона-γ (2706 ± 1058,94 пг/мл) обратно влияет на развитие у больных потливости (r = –0,506, р = 0,023; τ = –0,419, р = 0,021), а исходно низкий уровень индуцированного интерферона-γ (287,2 ± 64,65 пг/мл) — на развитие слабости (r = –0,405, р = 0,045; τ = –0,419, р = 0,037). В целом ингарон может быть использован в терапии больных хронической вирусной инфекцией Эпштейна – Барр в дозе 500 000 МЕ через день, не менее 10 инъекций.

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