RESUMEN
The review article provides information about the features of the Varicella-zoster virus (VZV), about the clinical manifestations of CNS damage in acute and chronic VZV infection in children and adults, about the mechanisms of interaction of the pathogen with the immune system during the development of the disease. The question of whether to consider neurological disorders in VZV infection as a complication or manifestation of the disease caused by a defective virus or the presence of subclinical immunodeficiency is discussed, which is confirmed by modern scientific studies. The critical mechanisms of immune defense against VZV, which are the main reason for the penetration of the virus into the CNS and the development of neurological disorders, as well as the relationship between VZV genotypes, the presence of mutations in the gE gene and the nature of the course, the identification of rare variants of the POLR3A, POLR3C, POLR3E and POLR3F genes associated with violation of IFNs induction, and the development of severe VZV infection, in which vasculopathy also occurs, which is the basis for the use of vascular drugs of complex action, such as Cytoflavin, the effectiveness of which has been proven by the authors. A special place is given to the analysis of intrathecal immunopathogenesis, which is likely to be associated with the presence and severity of neurological manifestations, their relapses. The issue of the causes of the development of a severe course of the disease in patients vaccinated against chickenpox, as well as the issue of resistance to specific antiviral drugs, probably associated with the presence of mutations responsible for the resistance of the virus to therapy, is discussed.
Asunto(s)
Varicela , Herpes Zóster , Enfermedades del Sistema Nervioso , Adulto , Niño , Humanos , Herpesvirus Humano 3/genética , Varicela/tratamiento farmacológico , Varicela/prevención & control , Antivirales/uso terapéutico , Mutación , Enfermedades del Sistema Nervioso/tratamiento farmacológico , ARN Polimerasa III/genéticaRESUMEN
The morbidity structure was analyzed in children vaccinated against epidemic parotitis in 1993-2002. Eight children (4 with serous meningitis and 4 with lesions of the salivary glands) underwent virologic and immunologic examinations. The molecular typing of the SH-gene fragment of the parotitis virus showed the process in 7 cases to be provoked by the vaccination strain. Presumedly, progressing vaccine-associated meningitis inhibits antibody formation. The total incidence of vaccine-associated meningitis was shown, according to Saint Petersburg data, to be not high, which testifies to a low reactogenicity of the Russian vaccine strain.
Asunto(s)
Meningitis/etiología , Vacuna contra la Parotiditis/efectos adversos , Paperas/etiología , Paperas/prevención & control , Rubulavirus , Vacunación/efectos adversos , Adolescente , Anticuerpos Antivirales/sangre , Antígenos Virales/análisis , Niño , Preescolar , Humanos , Incidencia , Lactante , Meningitis/sangre , Paperas/epidemiología , Filogenia , Estudios Retrospectivos , Rubulavirus/genética , Rubulavirus/inmunología , Rubulavirus/aislamiento & purificación , Federación de Rusia/epidemiología , Glándulas Salivales/patología , Glándulas Salivales/virología , Población Urbana , Proteínas Virales/genéticaRESUMEN
Four levels (types) of immune response, differing by expression of cytokines (TNF-alpha, IL-1 beta, IL-4, and gamma-IFN) and immunoglobulins IgG2, IgG3, IgG4, and IgE) and by expression and time course of specific cell-mediated and humoral immune response, were detected in children with different clinical forms of mumps. Types 1 and 3 immune response are predominantly cell-mediated, while types 2 and 4 predominantly humoral during the acute phase of the disease. The cytokine and antigen-specific profiles of each type of immune response correlate with the severity of clinical course of mumps.
Asunto(s)
Anticuerpos Antivirales/biosíntesis , Inmunidad Celular , Paperas/inmunología , Niño , Citocinas/biosíntesis , Humanos , Inmunoglobulinas/biosíntesis , Inmunoglobulinas/clasificación , Paperas/patología , Virus de la Parotiditis/inmunologíaRESUMEN
The immunological study of children with infectious parotitis (IP) without complications and with such complications as pancreatitis, meningitis or orchitis in the glandular form was carried out. In accordance with the previously proposed principle, 4 types of immune response (IR) were established on the basis of differences in initial resistance and the IR profile: cell-mediated immunity (types I and III) and humoral immunity (types II and IV). The patients included nonvaccinated children, as well as children vaccinated on epidemic indications, 3-6, 7-9, 10 and more years before infection. The comparative analysis of the number of IP cases with and without complications in the groups of children, divided according to their immunization history and the type of IR, revealed that postvaccinal immunity in children vaccinated on epidemic indications (less than a month ago) or 3-6 years before infection had protective potential, sufficient for the prevention of complicated forms of IP. Immunity obtained 7-9 years ago was effective for the protection from IP complications only in cell-mediated, but not humoral IR. Postvaccinal immunity obtained more than 10 years ago did not ensure the decrease in the occurrence of complicated forms of IP (in comparison with that in nonvaccinated patients) in children with any type of IR.