Использование принципов персонализированной медицины сегодня является ключевой составляющей эффективного лечения любой патологии. Применение иммуномодулирующей терапии при острых респираторных инфекциях (ОРИ) с позиций прецизионной медицины позволяет сформировать эффективную лечебно-диагностическую траекторию для каждого конкретного пациента. Одной из наиболее часто используемых в комплексной терапии ОРИ групп иммуномодуляторов, имеющих самую высокую доказательную базу, являются бактериальные лизаты, которые имеют показания для использования и в остром периоде ОРИ, и в период выздоровления, и с целью профилактики повторных эпизодов. Особое место в практике клинициста занимает ОМ-85 (Бронхо-Мунал). Наличие многолетнего опыта использования, высокой доказательной базы, клинико-иммунологических показаний к его применению с позиций таргетного воздействия на поврежденные звенья иммунитета при ОРИ определяет высокую эффективность применения препарата. Ключевые слова: персонализированная иммунотерапия, острые респираторные инфекции, бактериальные лизаты, ОМ-85.
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Personalized medicine principles application is, nowadays, a key part of any pathology treatment. Immunomodulating therapy application in cases of acute respiratory infection (ARI) using personalized medicine allows us form an effective diagnostic and treatment tactic for each specific patient. One of the most frequently applied immunomodulator groups with high evidence base, used in complex ARI treatment, are bacterial lysates. Bacterial lysates can be applied both in acute and recovery period (also as a prevention measure). OM-85 (Broncho-Munal) is an important and a very specific tool of a clinician. Its’ high evidence base, many years of clinical application, clinic and immunologic indications from the point of view of it’s impact on violated immunity links in cases of ARI determines its high efficience. Key words: personalized immunotherapy, acute respiratory infection, bacterial lysates, OM-85.
Список литературы
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24. Schaad UB. OM-85 BV, an immunostimulant in pediatric recurrent respiratory tract infections: a systematic review. World J Pediatr 2010; 6: 5–12. DOI: 10.1007/s12519–010–0001x
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1.Pal'tsev M.A. Personifitsirovannaia meditsina. Nauka v Rossii. 2011; 1: 12–7 (in Russian).
2. Flores M, Glusman M et al. P4 medicine: how systems medicine will transform the healthcare sector and society. Future Medicine 2013; 10 (6): 565–76.
3. Jain KK. Personalized clinical laboratory diagnostics. Adv Clin Chem 2009; 47: 95–119.
4. Miroshnichenko I.I., Ptitsina S.N. Biomarkery v sovremennoi mediko-biologicheskoi praktike. Biomeditsinskaia khimiia. 2009; 55 (Vyp. 4): 425–40 (in Russian).
5. Sepiashvili R.I. Klassifikatsiia i osnovnye printsipy primeneniia immunomoduliruiushchikh preparatov v klinicheskoi praktike. Allergologiia i immunologiia. 2002; 3 (3): 325–31 (in Russian).
6. Khaitov R.M., Pinegin B.V. Sovremennye immunomoduliatory. Klassifikatsiia, mekhanizm deistviia. Ros. allergologich. zhurn. 2005; 4: 30–43 (in Russian).
7. Kaliuzhin O.V. Acute respiratory infections: current challenges, antiviral response, immunoprophylaxis and immunotherapy. Moscow, 2014; p. 140 (in Russian).
8. Tataurshchikova N.S. Effective use of immunotherapy for acute respiratory infections. Uchebnoe posobie. Moscow, 2018; p. 28 (in Russian).
9. Tataurshchikova N.S., Degtiareva E.A., Krasnov V.V., Romantsov M.G. Immunocompromised patient. Saint Petersburg, 2009 (in Russian).
10. Avondt KV et al. Bacterial Immune Evasion through Manipulation of Host Inhibitory Immune Signaling. PLoS Pathog 2015; 11 (3).
11. Tactics and treatment of acute respiratory viral infection in children. Metodicheskie rekomendatsii. Pod red. B.M.Blokhina. M., 2014 (in Russian).
12. Baranov A.A., Lobzin Iu.V. Federal'nye klinicheskie rekomendatsii po okazaniiu meditsinskoi pomoshchi detiam s ostroi respiratornoi virusnoi infektsiei (ostryi nazofaringit). 2015 (in Russian).
13. Tataurshchikova N.S. Personalized immunotherapy: immunocompromised child in focus. Pediatrics (Suppl. Consilium Medicum). 2018; 3: 50–4. DOI: 10.26442/2413-8460_2018.3.50-54 (in Russian).
14. Cazzola ML, Anapurapu S, Page CP. Polyvalent mechanical bacterial lysate for the prevention of reccurent respiratory infections; a meta-analysis. Pulm Pharmacol Ther 2012; 25 (1): 62–8.
15. De Benedetto F, Sevieri G. Prevention of respiratory tract infections with bacterial lisate OM-85 bronchomunal in children and adults a state of the art. Multidisp Respir Med 2013; 8 (1): 33.
16. Navarro S, Cossalter G, Chiavaroli CM et al. The oral administration of bacterial extracts prevent asthma via the recruitment of regulatory T-cells to the airways. Mucosal Immunol 2011; 4 (1): 53–5.
17. Yin J, Xu B, Zeng X, Shen K. Broncho-Vaxom in pediatric recurrent respiratory tract infections: A systematic review and meta-analysis. Int Immunopharmacol 2018; 54: 198–209. DOI: 10.1016/j.intimp.2017.10.032
18. Parola C, Salogni L, Vaira X et al. Selective Activation of Human Dendritic Cells by OM-85 through a NF-kB and MAPK Dependent Pathway. PLoS 2011; 1: 12–7.
[Pal'tsev M.A. Personifitsirovannaia meditsina. Nauka v Rossii. 2011; 1: 12–7 (in Russian).]
19. Huber M, Mossmann H, Bessler W. G.Th-1orientated immunological properties of the bacterial extract OM-85 BV. Eur JMed Res 2005; 10 (5): 209–17.
20. Pasquali C, Salami O, Taneja M et al. Enhanced Mucosal Antibody Production and Protection against Respiratory Infections Following an Orally Administered Bacterial Extract. Front Med 2014; 1: 41. DOI:10.3389/fmed.2014.00041
21. Roth M, Pasquali C, Stolz D, Tamm M. Broncho Vaxom (OM-85) modulates rhinovirus docking proteins on human airway epithelialcells via Erk1/2 mitogen activated protein kinase and cAMP. PLoS ONE 2017; 12 (11): e0188010. DOI: 10.1371/journal.pone.0188010
22. Kaliuzhin O.V. OM-85 v profilaktike/lechenii respiratornykh infektsii i obostrenii khronicheskikh zabolevanii legkikh: kriterii vybora, mekhanizmy i dokazatel'stva. Lechashchii vrach. 2018; 3 (in Russian).
23. De Benedetto F, Sevieri G. Prevention of respiratory tract infections with bacterial lysate OM-85 bronchomunal in children and adults: a state of the art. Multidisciplin Respir Med 2013; 8 (1). Art. 33. DOI: 10.1186/2049–6958–8-33
24. Schaad UB. OM-85 BV, an immunostimulant in pediatric recurrent respiratory tract infections: a systematic review. World J Pediatr 2010; 6: 5–12. DOI: 10.1007/s12519–010–0001x
25. Del-Rio-Navarro BE, Espinosa-Rosales FJ, Flenady V, Sienra-Mongen JJL. Immunostimulants for preventing respiratory tract infection in children. Evid Based Child Health 2012; 7: 629–717. DOI: 10.1002/ebch.1833.31
26. Gutiérrez-Tarango MD et al. Safety and efficacy of two courses of OM-85 in the prevention of respiratory tract infections in children during 12 months. Chest 2001; 119 (1): 742–8.
27. Luss L.V. Vtorichnaia immunnaia nedostatochnost' i immunokomprometirovannyi patsient. V chem problemy? Allergologiia i immunologiia v pediatrii. 2007; 2 (11): 6–11 (in Russian).