Профилактика и лечение сезонных обострений инфекционного генеза у пациентов с хроническими заболеваниями респираторного тракта

Лазарева Н.Б. Профилактика и лечение сезонных обострений инфекционного генеза у пациентов с хроническими заболеваниями респираторного тракта. Справочник поликлинического врача. 2017; 5: 47–51.

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Lazareva N.B. Prevention and treatment of seasonal exacerbations of infectious origin in patients with chronic diseases of the respiratory tract. Handbook for Practitioners Doctors. 2017; 5: 47–51.

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Аннотация

Фармакотерапия при бактериальных инфекциях дыхательных путей (ИДП) – это прежде всего антибактериальные препараты, а при вирусных инфекциях, в большинстве случаев, – симптоматическая терапия. Совершенно очевидно, что спектр возбудителей инфекционных заболеваний дыхательных путей намного разнообразнее имеющихся на сегодня возможностей для специфической иммунопрофилактики, в связи с чем проблема иммунокоррекции, направленной на повышение резистентности организма к широкому спектру инфекционных агентов, представляется, несомненно, актуальной. Среди достаточно обширного списка препаратов, воздействующих на иммунную систему, особое место занимают иммуномодуляторы бактериального происхождения – бактериальные лизаты. Препараты данного класса могут быть рекомендованы как для профилактики рецидивирующей ИДП, обострений хронического бронхита, так и для лечения острых ИДП в составе комплексной терапии.

Ключевые слова: хроническая обструктивная болезнь легких, обострения, иммуномодуляторы, ОМ-85.

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Pharmacotherapy in bacterial infections of the respiratory tract (RTI) is primarily antibacterial agents and in viral infections, in most cases, a symptomatic therapy. Obviously, the spectrum of causative agents of infectious diseases of the respiratory tract is much more diverse available opportunities for specific immunoprevention, in connection with the problem of immunocorrection aimed at increasing resistance of the organism to a wide range of infectious agents, seems clearly relevant. Among the rather extensive list of drugs that affect the immune system, a special place is occupied immunomodulators of bacterial origin and bacterial lysates. These drugs can be recommended for the prevention of recurrent RTI, acute exacerbations of chronic bronchitis and for the treatment of acute RTI in the complex therapy.

Key words: chronic obstructive pulmonary disease, exacerbation, immunomodulators, OM-85.

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Список литературы

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19. Solèr M, Mütterlein R, Cozma G; Swiss-German OM-85 Study Group. Double-blind study of OM-85 in patients with chronic bronchitis or mild chronic obstructive pulmonary disease. Respiration 2007; 74 (1): 26–32.
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1. Wilson R. Bacteria, antibiotics and COPD. Eur Respir J 2001; 17: 995–1007.
2. Prescott E, Lange P, Vestbo J. Chronic mucus hypersecretion in COPD and death from pulmonary infection. Eur Respir J 1995; 8: 1333–8.
3. Anthonison NR. The British hypothesis revisited. Eur Respir J 2004; 23: 657–8.
4. Sethi S, Evans N, Grant B, Murphy TF. New strains of bacteria and exacerbations of chronic obstructive pulmonary disease. N Engl J Med 2002; 347: 465–71.
5. Stockley RA, O’Brien C, Pye A et al. Relationship of sputum colour to nature and outpatient management of acute exacerbations of COPD. Chest 2001; 117: 1638–45.
6. Bandi V, Jakubowycz M, Kinyon C et al. Infectious exacerbations of chronic obstructive pulmonary disease associated with respiratory viruses and non-typeable Haemophilus influenzae. FEMS Immunol Med Microbiol 2003; 37: 69–75.
7. Karaulov A.V. OM-85: novye molekuliarno-kletochnye mekhanizmy protivovirusnogo, antibakterial'nogo i protivovospalitel'nogo deistviia immunomoduliatora. Respiratory Organs Diseases (Suppl. Consilium Medicum). 2016.
8. Feleszko W, Ruszczynski M, Zalewski BM. Non-specific immune stimulation in respiratory tract infections. Separating the wheat from the chaff. Pediatr Res Rev 2014; 15: 200–6.
9. Schaad UB, Mutterlein R, Goffin H. Immunostimulation with OM-85 in children with recurrent infections of the upper respiratory tract. Chest 2002; 122: 2042–9.
10. Bessler WG, Huber M, Baier W. Bacterial cell wall components as immunomodulators II. The bacterial cell wall extract OM-85-BV as unspecific activator, immunogen and adjuvant in mice. Int J Immunopharmac 1997; 19: 551–8.
11. Karaulov A.V., Klimov E.V. Klinicheskaia effektivnost' bakterial'nykh immunomoduliatorov i ikh vliianie na gumoral'nye i sekretornye faktory chasto boleiushchikh detei. Pediatriia. 2001; 4: 86–90.
12. Evans SE, Scott BL, Clement CG et al. Stimulated innate resistance of lung epithelium protects mice broadly against bacteria and fungi. Am J Respir Cell Mol Biol 2010; 42 (1): 40–50.
13. Pasquali C, Salami O, Taneja M et al. Enhanced Mucosal Antibody Production and Protection against Respiratory Infections Following an Orally Administered Bacterial. Front Med 2014; 1: 41. DOI: 10.3389/fmed.2014.00041
14. Caramori G, Casolari P, Adcock I. Role of transcription factors in the pathogenesis of asthma and COPD. Cell Commun Adhes 2013; 20: 21–40.
15. Mauel J. Stimulation of immunoprotective mechanisms by OM-85 BV. A review of results from in vivo and in vitro studies. Respiration 1994; 61 (Suppl. 1): 8–15.
16. Collet JP, Shapiro P, Ernst P et al. Effects of an immunostimulating agent on acute exacerbations and hospitalizations in patients with chronic obstructive pulmonary disease. The PARI-IS Study Steering Committee and Research Group. Prevention of Acute Respiratory Infection by an Immunostimulant. Am J Respir Crit Care Med 1997; 156: 1719–24.
17. Van den Bergh MR et al. Associations between pathogens in the upper respiratory tract of young children: interplay between viruses and bacteria. PLoS One 2012; 7 (10): e47711.
18. Pan L, Jiang XG, Guo Jet al. Effects of OM-85 BV in patients with chronic obstructive pulmonary disease: A systematic review and meta-analysis. J Clin Pharmacol 2015; 55 (10): 1086–92.
19. Solèr M, Mütterlein R, Cozma G; Swiss-German OM-85 Study Group. Double-blind study of OM-85 in patients with chronic bronchitis or mild chronic obstructive pulmonary disease. Respiration 2007; 74 (1): 26–32.
20. Collet JP, Shapiro P, Ernst P et al. Effects of an immunostimulating agent on acute exacerbations and hospitalizations in patients with chronic obstructive pulmonary disease. The PARI-IS Study Steering Committee and Research Group. Prevention of Acute Respiratory Infection by an Immunostimulant. Am J Respir Crit Care Med 1997; 156 (6): 1719–24.
21. Tang H, Fang Z, Saborío GP et al. Efficacy and Safety of OM-85 in Patients with Chronic Bronchitis and/or Chronic Obstructive Pulmonary Disease. Lung 2015; 193 (4): 513–9.
22. Schaad UB. OM-85 BV, an immunostimulant in pediatric recurrent respiratory tract infections: a systematic review. World J Pediatr 2010; 6 (1): 5–12.

Авторы

Н.Б.Лазарева

ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М.Сеченова» Минздрава России. 119991, Россия, Москва, ул. Трубецкая, д. 8, стр. 2
natalia.lazareva@gmail.com

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N.B.Lazareva

I.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation. 119991, Russian Federation, Moscow, ul. Trubetskaia, d. 8, str. 2
natalia.lazareva@gmail.com

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