Бактериальные лизаты как иммуностимуляторы при респираторной инфекции у детей: механизм действия, эффективность и безопасность
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Shevyakov M.A. Bacterial lysates as immunostimulants for respiratory infection in children: mechanism of action, efficacy and safety. Pediatrics. Consilium Medicum. 2020; 3: 52–58. DOI: 10.26442/26586630.2020.3.200356
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Ключевые слова: иммуностимулятор, иммунитет, бактериальный лизат, инфекция респираторного тракта, эффективность, безопасность.
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The relevance of the use of immunostimulants in the complex treatment of acute and recurrent respiratory infections is beyond doubt. At the same time, a number of factors: unexplored mechanism of action, lack of evidence of efficacy, unexplored safety - inhibit the widespread use of many immunostimulants. In contrast to bacterial lysates, in particular the drug OM-85 (Broncho-Munal®), on the contrary, there are reliable data on good efficacy against both acute and recurrent respiratory infections, evidence of safety and scientific information on the mechanism of action.
Key words: immunostimulant, immunity, bacterial lysate, respiratory tract infection, efficacy, safety.
[Ursova N.I. Intestinal dysbacteriosis in childhood: innovations in the diagnosis, correction and prevention. A guide for doctors. Moscow, 2013 (in Russian).]
2. Косенко И.М. Иммуномодулирующая терапия заболеваний ротоглотки у детей. Детские инфекции. 2010; 9 (1): 56–61.
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3. Согласованное мнение экспертов IX Образовательного международного консенсуса по респираторной медицине в педиатрии по вопросам применения бактериальных лизатов в педиатрической практике. Под ред. Н.А. Геппе, А.Б. Малахова. Доктор.РУ. Педиатрия. 2020; 19 (3): 61–3.
[Soglasovannoe mnenie ekspertov IX Obrazovatel'nogo mezhdunarodnogo konsensusa po respiratornoi meditsine v pediatrii po voprosam primeneniia bakterial'nykh lizatov v pediatricheskoi praktike. Pod red. N.A. Geppe, A.B. Malakhova. Doktor.RU. Pediatriia. 2020; 19 (3): 61–3 (in Russian).]
4. Kearney SC et al. Immunoregulatory and immunostimulatory responses of bacterial lysates in respiratory infections and asthma. Ann Allergy Asthma Immunol 2015; 114 (5): 364–9.
5. Zagar S, Lofler-Badzek D. Broncho-Vaxom in children with rhinosinusitis: a double-blind clinical trial. J Otorhinolaryngol Relat Spec 1988; 50 (6): 397–404.
6. Dang AT et al. OM-85 is an immunomodulator of interferon-b production and inflammasome activity. Sci Rep 2017; 7 (43844).
7. Liu YW, Dong SH, Zhan GY et al. Analysis of the effect of bacterial lysate and the immunologic mechanism in treating infant bronchiolitis. Eur Rev Med Pharmacol Sci 2017; 21 (14): 3332–6.
8. Rossi GA et al. Evidence that a primary anti-viral stimulation of the immune response by OM-85 reduces susceptibility to a secondary respiratory bacterial infection in mice. Italian J Pediatrics 2018; 44 (1): 112.
9. Del-Rio-Navarro BE, Espinosa-Rosales FJ, Flenady V, Sienra-Monge JJL. Immunostimulants for preventing respiratory tract infection in children (Review). A reprint of a Cochrane review, prepared and maintained by The Cochrane Collaboration and published in The Cochrane Library. 2011; 6. http://www.thecochranelibrary.com
10. Esposito S et al. Impact of OM-85 Given during Two Consecutive Years to Children with a History of Recurrent Respiratory Tract Infections: A Retrospective Study. Int J Environmental Res Public Health 2019; 16 (6): 1065.
11. Esposito S et al. A randomized placebo-controlled double-blinded, single-centre, phase IV trial to assess the efficacy and safety of OM-85 in children suffering from recurrent respiratory tract infections. J Trans Med 2019; 17 (1): 284.
12. Yin J et al. Broncho-Vaxom in pediatric recurrent respiratory tract infections: A systematic review and meta-analysis. Int Immunopharmacol 2018; 54: 198–209.
13. Bitar MA, Saade R. The role of OM-85 BV (Broncho-Vaxom) in preventing recurrent acute tonsillitis in children. Int J Pediatr Otorhinolaryngol 2013; 77 (5): 670–3.
14. Sorokman TV, Moldovan PM, Popeliuk NO et al. Clinical and Immunological Efficacy of OM-85 Bacterial Lysate In Children With Respiratory Tract Infection. Actual Infectology 2020; 8: 18–24. DOI: 10.22141/2312-413x.8.2.2020.199731
15. Berber A, Del-Rio-Navarro BE. Cost-effectiveness analysis of OM-85 vs placebo in the prevention of acute respiratory tract infections in children that attend day-care centers. Health Econ Rev 2019; 9 (1): 12.
16. Bodemer C et al. Adjuvant treatment with the bacterial lysate (OM-85) improves management of atopic dermatitis: A randomized study. PloS One 2017; 12 (3): e0161555.
17. Triantafillou V et al. Broncho‐VaxomR (OM‐85 BV) soluble components stimulate sinonasal innate immunity. Int Forum Allergy Rhinol 2019.
18. Геппе Н.А. и др. Острые инфекции дыхательных путей у детей. Диагностика, лечение и профилактика: клиническое руководство. М.: МЕдКом-Про, 2018.
[Geppe N.A. et al. Acute respiratory tract infections in children. Diagnosis, Treatment and Prevention: A Clinical Guide. Moscow: MEDKom-Pro, 2018 (in Russian).]
19. Fokkens WJ et al. Executive summary of EPOS 2020 including integrated care pathways. Rhinology 2020.
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1. Ursova N.I. Intestinal dysbacteriosis in childhood: innovations in the diagnosis, correction and prevention. A guide for doctors. Moscow, 2013 (in Russian).
2. Kosenko I.M. Immunomoduliruiushchaia terapiia zabolevanii rotoglotki u detei. Detskie infektsii. 2010; 9 (1): 56–61 (in Russian).
3. Soglasovannoe mnenie ekspertov IX Obrazovatel'nogo mezhdunarodnogo konsensusa po respiratornoi meditsine v pediatrii po voprosam primeneniia bakterial'nykh lizatov v pediatricheskoi praktike. Pod red. N.A. Geppe, A.B. Malakhova. Doktor.RU. Pediatriia. 2020; 19 (3): 61–3 (in Russian).
4. Kearney SC et al. Immunoregulatory and immunostimulatory responses of bacterial lysates in respiratory infections and asthma. Ann Allergy Asthma Immunol 2015; 114 (5): 364–9.
5. Zagar S, Lofler-Badzek D. Broncho-Vaxom in children with rhinosinusitis: a double-blind clinical trial. J Otorhinolaryngol Relat Spec 1988; 50 (6): 397–404.
6. Dang AT et al. OM-85 is an immunomodulator of interferon-b production and inflammasome activity. Sci Rep 2017; 7 (43844).
7. Liu YW, Dong SH, Zhan GY et al. Analysis of the effect of bacterial lysate and the immunologic mechanism in treating infant bronchiolitis. Eur Rev Med Pharmacol Sci 2017; 21 (14): 3332–6.
8. Rossi GA et al. Evidence that a primary anti-viral stimulation of the immune response by OM-85 reduces susceptibility to a secondary respiratory bacterial infection in mice. Italian J Pediatrics 2018; 44 (1): 112.
9. Del-Rio-Navarro BE, Espinosa-Rosales FJ, Flenady V, Sienra-Monge JJL. Immunostimulants for preventing respiratory tract infection in children (Review). A reprint of a Cochrane review, prepared and maintained by The Cochrane Collaboration and published in The Cochrane Library. 2011; 6. http://www.thecochranelibrary.com
10. Esposito S et al. Impact of OM-85 Given during Two Consecutive Years to Children with a History of Recurrent Respiratory Tract Infections: A Retrospective Study. Int J Environmental Res Public Health 2019; 16 (6): 1065.
11. Esposito S et al. A randomized placebo-controlled double-blinded, single-centre, phase IV trial to assess the efficacy and safety of OM-85 in children suffering from recurrent respiratory tract infections. J Trans Med 2019; 17 (1): 284.
12. Yin J et al. Broncho-Vaxom in pediatric recurrent respiratory tract infections: A systematic review and meta-analysis. Int Immunopharmacol 2018; 54: 198–209.
13. Bitar MA, Saade R. The role of OM-85 BV (Broncho-Vaxom) in preventing recurrent acute tonsillitis in children. Int J Pediatr Otorhinolaryngol 2013; 77 (5): 670–3.
14. Sorokman TV, Moldovan PM, Popeliuk NO et al. Clinical and Immunological Efficacy of OM-85 Bacterial Lysate In Children With Respiratory Tract Infection. Actual Infectology 2020; 8: 18–24. DOI: 10.22141/2312-413x.8.2.2020.199731
15. Berber A, Del-Rio-Navarro BE. Cost-effectiveness analysis of OM-85 vs placebo in the prevention of acute respiratory tract infections in children that attend day-care centers. Health Econ Rev 2019; 9 (1): 12.
16. Bodemer C et al. Adjuvant treatment with the bacterial lysate (OM-85) improves management of atopic dermatitis: A randomized study. PloS One 2017; 12 (3): e0161555.
17. Triantafillou V et al. Broncho‐VaxomR (OM‐85 BV) soluble components stimulate sinonasal innate immunity. Int Forum Allergy Rhinol 2019.
18. Geppe N.A. et al. Acute respiratory tract infections in children. Diagnosis, Treatment and Prevention: A Clinical Guide. Moscow: MEDKom-Pro, 2018 (in Russian).
19. Fokkens WJ et al. Executive summary of EPOS 2020 including integrated care pathways. Rhinology 2020.
ФГБОУ ВО «Северо-Западный государственный медицинский университет им. И.И. Мечникова» Минздрава России, Санкт-Петербург, Россия
*shevyakov@inbox.ru
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Mikhail A. Shevyakov*
Mechnikov North-Western State Medical University, Saint Petersburg, Russia
*shevyakov@inbox.ru