Four molecules of active ingredient per million tablets. In what cases is it better not to take preventative medications? Is Anaferon an antibiotic?

Registration number: P N000372/01-061009

Dosage form: lozenges

Compound

Active components: antibodies to human interferon gamma, affinity purified – 0.003 g*

Excipients: lactose, microcrystalline cellulose, magnesium stearate.

* administered in the form of a water-alcohol mixture of the active form of the active substance ⃰⃰ ⃰

** The active form of the active substance is the active form containing no more than 10-16 ng/g of the active substance.
Description

Tablets are flat-cylindrical, scored and chamfered, from white to almost white. On the flat side with a notch there is the inscription MATERIA MEDICA, on the other flat side there is the inscription ANAFERON KID.

Pharmacotherapeutic group

Immunomodulators. Antiviral agents.

ATX codes: L03, J05AX

pharmachologic effect

When used prophylactically and therapeutically, the drug has an immunomodulatory and antiviral effect. Experimental and clinical efficacy has been established against influenza viruses (including avian influenza), parainfluenza, herpes simplex viruses types 1 and 2 (labial herpes, genital herpes), other herpes viruses (varicella, infectious mononucleosis), enteroviruses, tick-borne virus encephalitis, rotavirus, coronavirus, calicivirus, adenovirus, respiratory syncytial virus (RS virus). The drug reduces the concentration of the virus in the affected tissues, affects the system of endogenous interferons and associated cytokines, induces the formation of endogenous “early” interferons (IFN α/β) and interferon gamma (IFNγ). Stimulates the humoral and cellular immune response. Increases the production of antibodies (including secretory IgA), activates the functions of T-effectors, T-helpers (Tx), normalizes their ratio. Increases the functional reserve of Tx and other cells involved in the immune response. It is an inducer of a mixed Txl and Th2 type of immune response: it increases the production of Txl (IFNγ, IL-2) and Th2 (IL-4, 10) cytokines, normalizes (modulates) the balance of Th1/Th2 activities. Increases the functional activity of phagocytes and natural killer cells (EK cells). Has antimutagenic properties.

Indications for use

Prevention and treatment of acute respiratory viral infections (including influenza). Complex therapy of infections caused by herpes viruses (infectious mononucleosis, chicken pox, labial herpes, genital herpes). Complex therapy and prevention of relapses of chronic herpesvirus infection, including labial and genital herpes. Complex therapy and prevention of other acute and chronic viral infections caused by tick-borne encephalitis virus, enterovirus, rotavirus, coronavirus, calicivirus. Use as part of complex therapy of bacterial infections. Complex therapy of secondary immunodeficiency states of various etiologies, including prevention and treatment of complications of viral and bacterial infections.

Contraindications

Increased individual sensitivity to the components of the drug, children under 1 month of age.

Pregnancy and lactation

The safety of using Anaferon for children in pregnant women and during lactation has not been studied. If it is necessary to take the drug, the risk/benefit ratio should be taken into account.

Directions for use and doses

Inside. For one dose – 1 tablet (keep in mouth until completely dissolved - not during meals).

Children from 1 month. When prescribing the drug to young children (from 1 month to 3 years), it is recommended to dissolve the tablet in a small amount (1 tablespoon) of boiled water at room temperature. ARVI, influenza, intestinal infections, herpesvirus infections, neuroinfections.

Treatment should begin as early as possible - when the first signs of an acute viral infection appear according to the following scheme: in the first 2 hours the drug is taken every 30 minutes, then during the first 24 hours three more doses are taken at equal intervals.

If there is no improvement, on the third day of treatment with the drug for acute respiratory viral infections and influenza, you should consult a doctor.

During the epidemic season, for prophylactic purposes, the drug is taken daily once a day for 1-3 months.

Genital herpes. For acute manifestations of genital herpes, the drug is taken at regular intervals according to the following scheme: days 1-3 – 1 tablet 8 times a day, then 1 tablet 4 times a day for at least 3 weeks. To prevent relapses of chronic herpesvirus infection - 1 tablet per day. The recommended duration of the preventive course is determined individually and can reach 6 months.

When using the drug for the treatment and prevention of immunodeficiency conditions, in complex therapy of bacterial infections, take 1 tablet per day. If necessary, the drug can be combined with other antiviral and symptomatic agents.

The instructions do not contain a scheme for using the drug as a prophylaxis for tick-borne encephalitis. The following is information from open sources:
. The study used the following prophylaxis regimen: for those under 12 years of age, 1 tablet 3 times a day, for those over 12 years of age, 2 tablets 3 times a day for 21 days.

Side effect

When using the drug for the indicated indications and in the indicated dosages, no side effects were identified. Manifestations of increased individual sensitivity to the components of the drug are possible.

Overdose

No cases of overdose have been reported to date. In case of accidental overdose, dyspepsia may occur due to the excipients included in the drug.

Interaction with other drugs

No cases of incompatibility with other drugs have been identified to date. If necessary, the drug can be combined with other antiviral, antibacterial and symptomatic agents.

special instructions

The drug contains lactose, and therefore it is not recommended for use in patients with congenital galactosemia, glucose malabsorption syndrome, or congenital lactase deficiency.

Release form

Lozenges. 20, 50 tablets in polymer jars with a screw neck and a screw-on lid for vitamins and medicines or polymer jars with a shock absorber and a pull-on lid with first opening control for vitamins and medicines. 20 tablets in a blister pack made of polyvinyl chloride film and aluminum foil. 1 or 2 blister packs (20 tablets each) or each jar along with instructions for use are placed in a cardboard pack.

Storage conditions

In a dry place, protected from light, at a temperature not exceeding 25°C. Keep out of the reach of children.

Best before date

Do not use after the expiration date.

Conditions for dispensing from pharmacies

Copy, print and hang in the kitchen. Before purchasing a new medicine at the pharmacy, check its availability in the proposed list. So.

1) Medicines with unproven effects (fuflomycins)
from the book by A.L. Myasnikov "About the most important things with Dr. Myasnikov"

There is also information about Anaferon there.

Medicines with unproven effects (fuflomycins)

from the book by A.L. Myasnikov "About the most important things with Dr. Myasnikov"

2) 48 pairs of drugs with identical composition, but very different prices
http://chipstone.livejournal.com/1239598.html

The list is many years old, the prices are outdated, but the essence is not outdated.

1. Nurofen (120 rubles) = Ibuprofen (10 rubles)

2. Mezim (300 rubles) = Pancreatin (30 rubles)

3. No-spa (150 rubles) = Drotaverine hydrochloride (30 rubles)

4. Panadol (50 rubles) = Paracetamol (5 rubles)

5. Belosalik (380 rubles) = Akriderm SK (40 rubles)

6. Bepanthen (250 rubles) = Dexpanthenol (100 rubles)

7. Betaserc (600 rubles) = Betahistine (250 rubles)

8. Bystrumgel (180 rubles) = Ketoprofen (60 rubles)

9. Voltaren (300 rubles) = Diclofenac (40 rubles)

10. Gastrozole (120 rubles) = Omeprazole (50 rubles)

11. Detralex (580 rubles) = Venarus (300 rubles)

12. Diflucan (400 rubles) = Fluconazole (30 rubles)

13. For nose (100 rubles) = Rhinostop (30 rubles)

14. Zantac (280 rubles) = Ranitidine (30 rubles)

15. Zyrtec (220 rubles) = Cetirinax (80 rubles)

16. Zovirax (240 rubles) = Acyclovir (40 rubles)

17. Immunal (200 rubles) = Echinacea extract (50 rubles)

18. Imodium (300 rubles) = Loperamide (20 rubles)

19. Iodomarin (220 rubles) = Potassium iodide (100 rubles)

20. Cavinton (580 rubles) = Vinpocetine (200 rubles)

21. Claritin (180 rubles) = Loragexal (60 rubles)

22. Klacid (600 rubles) = Clarithromycin (180 rubles)

23. Lazolvan (320 rubles) = Ambroxol (20 rubles)

24. Lamisil (400 rubles) = Terbinafine (100 rubles)

25. Lyoton-1000 (350 rubles) = Heparin-acrigel 1000 (120 rubles)

26. Lomilan (150 rubles) = Loragexal (50 rubles)

27. Maxidex (120 rubles) = Dexamethasone (40 rubles)

28. Midriacil (360 rubles) = Tropicamide (120 rubles)

29. Miramistin (200 rubles) = Chlorhexidine (10 rubles)

30. Movalis (410 rubles) = Meloxicam (80 rubles)

31. Neuromultivit (250 rubles) = Pentovit (50 rubles)

32. Normodipine (620 rubles) = Amlodipine (40 rubles)

33. Omez (180 rubles) = Omeprazole (50 rubles)

34. Panangin (140 rubles) = Asparkam (10 rubles)

35. Pantogam (350 rubles) = Pantocalcin (230 rubles)

36. Rhinonorm (50 rubles) = Rhinostop (20 rubles)

37. Sumamed (450 rubles) = Azithromycin (90 rubles)

38. Trental (200 rubles) = Pentoxifylline (50 rubles)

39. Trichopolum (90 rubles) = Metronidazole (10 rubles)

40. Troxevasin (220 rubles) = Troxerutin (110 rubles)

41. Ultop (270 rubles) = Omeprazole (50 rubles)

42. Fastum-gel (250 rubles) = Ketoprofen (70 rubles)

43. Finlepsin (280 rubles) = Carbamazepine (50 rubles)

44. Flucostat (200 rubles) = Fluconazole (20 rubles)

45. Furamag (380 rubles) = Furagin (40 rubles)

46. ​​Chemomycin (300 rubles) = Azithromycin (100 rubles)

47. Enap (150 rubles) = Enalapril (70 rubles)

48. Ersefuril (400 rubles) = Furazolidone (40 rubles)

Those who have more complete and recent lists of fuflomycins, please post them here.

Antibodies to interferons, it seems, should attach to them in order to mark them as “enemy particles” (we examined the mechanism and logic of this ensemble in the article about). The idea of ​​injecting patients with antibodies (immunoglobulins) against an infectious agent - for example, doctors are trying to help those sick with tick-borne encephalitis - is generally not without logic, but when antibodies are aimed at their means of communication, then these are some kind of incorrect antibodies, which are much more reminiscent of the principle of “like cures like.”

If you look at the footnote, then 0.003 grams of the active substance, which are indicated on the package, are dissolved in “an active form containing no more than 10-16 ng/g.” One nanogram is equal to a gram times ten to the minus ninth power. Accordingly, 10 nanograms is 10 -8 grams. It’s not much, but it fits into the tablet (for simplicity, we’ll assume that it weighs one gram).

However, in the scanned copies of the instructions stored in the state registry of the Ministry of Health, you can see numbers showing that there was a small typo on the site: it turns out that with the wave of the cursor, 16 from the power of ten crawled down, and instead of “10 -16” we got the whole “10-16” ng/y. The spread is a quadrillion times.

As we already calculated in the previous article, without dilution, 0.006 grams will contain an honest 2.4x10 15 antibody molecules. Then in 0.003 grams there are 1.2x10 15 pieces left. And how many such molecules will there be in 10 -16 ng per gram of medicine, that is, in one tablet? The result is 4x10 -6. This means that there are only four molecules in a million tablets. But this does not bother manufacturers, who named in the patent the principle of potentiation by “activation” of antibodies, after which they, in their opinion, begin to act.

The most interesting thing is that to carry out such calculations you do not need to run a supercomputer the size of a three-story house. Any ninth grader with a calculator, whose memory of chemistry lessons is not covered with the dust of centuries, can easily repeat them for other drugs if there are doubts about the concentration of the active substance. Armed with the Internet, even an adult can do them.

In the situation with Anaferon, we found that, as in the case of Ergoferon, these antibodies can only harm your wallet. With one exception: if you try to use them as a substitute for real, effective methods, without precautions where your belief in placebos does not have a strong impact on your health, it can be harmful and even dangerous. For example, with tick-borne encephalitis.

Encephalitis: softening of the brain, literally and figuratively

“The child was bitten by a tick, which turned out to be encephalitic. Can Anaferon be used for treatment? - There are many such questions with variations in the age of children and details of how the bite occurred on the drug’s website. In her answer, a certain Anna steadily recommends the use of Anaferon both as a prophylaxis and in case of infection. Given the severity of the disease, this advice leaves medical professionals angry and horrified.

Encephalitis is an inflammation that affects the gray matter of the brain, mainly the bodies of neurons and their processes, which are not covered with “insulation” - the myelin sheath. This inflammation can be caused by various viral, bacterial and other infections, as well as secondary complications from influenza and other diseases. Tick-borne encephalitis is caused by a virus of the genus Flavivirus. Its closest relatives are the yellow fever virus, Zika fever and West Nile fever, and a little further away are the culprits of many other dangerous diseases, such as the hepatitis C virus.

The tick-borne encephalitis virus stores its hereditary information in the form of RNA. Viruses are similar to astronauts who set off to colonize new planets: outside the cell they hide in a special “space suit”, a capsid, and generally do not show signs of a living organism during “interstellar flights”, like heroes of science fiction works who are in suspended animation. The only difference is that their “planets” are alive, but may cease to be so due to settlement (another interesting plot for science fiction writers, showing how much inspiration can be drawn from biology).

When a person is infected, immune cells rush to the rescue. Among them are macrophages - the body's guardians, discovered by Mechnikov, who seek to eat any enemy and intruder. The insidious encephalitis virus needs only this: it frees itself from its capsid shell, releases RNA into free floating and multiplies inside macrophages, turning them into a springboard for further conquests inside the body, in order to finally reach the neurons of the cervical spine and soft tissues of the brain. First, the patient develops a high temperature, has a fever and nausea, and muscles ache; then consciousness, sensitivity, and motor activity are impaired (even to the point of paralysis). For European encephalitis, the mortality rate is 1-2%, for the more violent Far Eastern subtype - 20-25%, but even surviving patients can receive a bunch of severe complications from the nervous system for the rest of their lives.

The main tick-borne encephalitis viruses in Russia are ixodid ticks Ixodes ricinus And Ixodes persulcatus. The first settled throughout the European part of Russia, the second chose Siberia and the Far East. Ticks bite ungulates and other wild mammals or birds, transmitting the disease to humans.

Tick ​​Ixodes Ricinus

Wikimedia Commons

According to Doctor of Biological Sciences Nina Tikunova from the Institute of Chemical Biology and Fundamental Medicine of the Siberian Branch of the Russian Academy of Sciences, on average, only 6% of ticks are infected with encephalitis, and only 2-6% of people bitten by them get sick, and some even manage to acquire resistance, something like natural immunity. Moreover, in some regions, ticks infected with encephalitis are almost never found, while in others they are very numerous. But do not forget that in addition to the encephalitis virus, these arthropods can carry dozens of other bacteria and viruses that are dangerous to health, which cause, for example, borelliosis (Lyme disease). Even if these diseases are not fatal, they can lead to lifelong disability, especially when the disease is not treated promptly. For some of them there is still no medicine that is 100% effective.

Lies, damned lies or statistics?

In the Pubmed database of medical scientific publications, you can find 23 scientific articles on the effectiveness of Anaferon, as well as dozens of dissertations defended on its research.

Of these 23 articles (of which, by the way, there is not a single one about encephalitis), nine were written in co-authorship with the head of the company Oleg Epstein - one can immediately suspect a conflict of interest, so the accuracy of the experiments must be assessed with great care. Several articles are written only in Russian. This, of course, does not refute everything that they contain, but it does cast doubt: it’s strange if you don’t want to show the results to your foreign colleagues. And again doubts.

By the way, Oleg Epshtein himself was promoted to corresponding member of the Russian Academy of Sciences and even became one of them. Alexander Panchin notes that the number of his scientific publications suddenly jumped from 1 to 50 in 2003 due to articles in the journal Bulletin of Experimental Biology and Medicine, published in a special issue edited by Epstein himself.

Doctors around the world have long come up with criteria, compliance with which will make a clinical trial more honest and transparent, reducing the influence of the subjective factor. For this, the study needs to be randomized, double-blind, placebo-controlled, and the sample must be large enough, not tens or even hundreds of people.

A double-blind, randomized, placebo-controlled method is a method of clinical drug research in which the subjects are not privy to important details of the study. “Double blind” means that neither the subjects nor the experimenters know who is being treated with what, “randomized” means that the assignment to groups is random, and placebo is used to show that the effect of the drug is not based on self-hypnosis and that This medicine helps better than a tablet without active ingredients. This method prevents subjective distortion of the results. Sometimes the control group is given another drug with proven effectiveness, rather than a placebo, to show that the drug not only treats better than nothing, but is superior to its analogues.

However, out of 23 articles, most of which are devoted to influenza, acute respiratory viral infections and other viral diseases, the double-blind, placebo-controlled study is a study of Anaferon’s activity against ... schizophrenia. It showed on a “large” group of 40 people that the effect of the drug was comparable to the effect of placebo.

Another study, this time not on people, but only on a flat surface with holes - a tablet, where some “release-active” forms of antibodies with interferons, or “regular” forms, were mixed, was published in a decent scientific journal PLOS ONE. It was supposed to prove the effectiveness of “relatively low concentrations” of their substance. The co-author of the article, by the way, was again Oleg Epstein.

But somehow miraculously this technique works. At least that's what those who tested it think. Russian scientists (Alexander Panchin and his colleagues) sent a letter to the journal indicating a factor that could greatly distort the measurement results: it turns out that the device in which the reaction took place heats up unevenly, and the scientific community has been distributing different substances among the wells in the tablet for decades in a random order so as not to get false results, indicating that on one side the reaction was faster. The magazine promised to look into this problem, but stopped responding, and instead of a separate article, the criticism was published as a commentary on this work. However, one of the editors of PLOS ONE admitted the errors of the publication, about which he wrote an article on his blog.

Most of the remaining articles were published in the already mentioned Bulletin, whose impact factor has been hovering around 0.5 for many years, or even much lower.

Of course, the impact factor is not the only and strictly objective indicator of quality, and it can only play the role of a “primary sieve”, but looking into these articles we again see the risk of bias, non-double-blind studies and other shortcomings.

Sugar against ticks

Is it advisable to entrust the treatment of encephalitis to a drug (even if recommended by the Ministry of Health), in which whole mountains of tablets do not contain a single molecule of the active substance? Draw your own conclusion. But let's think about whether, in this case, at least the fillers, of which there are much more in the tablet, will help us.

The gene that makes people able (or not able) to deal with this carbohydrate is called MCM6. Some of its mutations once allowed most Caucasians to digest lactose in adulthood, while others interfere with some in childhood. It contains two sections that regulate the operation of the gene, where the sequence of lactase, the enzyme for breaking down lactose, is written.

Quaternary structure of the lactase enzyme

Wikimedia Commons

Scientists have predicted that ticks, at least blacklegged ones ( Ixodes scapularis), common in North America, there is such a gene. They were helped by the fact that the sequence they found was similar to a homologous (related by origin) gene in fruit flies, humans, fish and other animals.

But it is not as simple as it seems, and its main role is to help in DNA doubling (replication), when the two chains of this molecule unwind, forming a replication “fork.” Each chain is eventually completed to form a whole molecule. So this gene may well not be in charge of any breakdown of lactose, but only be involved in doubling DNA during cell division.

This means that even if you start using Anaferon topically in the hope of lactose intolerance in some ticks, the success of this undertaking is questionable. Moreover, ticks feed on blood, in which lactose will already be broken down anyway. So the topic is open for research. Perhaps, to establish this, you will have to feed a large number of ticks with Anaferon personally. In the correct dosage (half a tablet per piece should be enough for the eyes), the ill-fated arthropod can be killed with lactose. With well-conducted experiments and interesting, “public” results, such research can even earn an Ig Nobel Prize. The main thing is not to become infected with anything from these mites in the process, so that the prize does not have to be awarded posthumously (the committee does this very rarely, you can end up with nothing).

How to protect yourself from tick-borne encephalitis

There are no well-constructed studies that have clearly and without any complaints proven the effectiveness of Anaferon even against influenza and ARVI. As for emergency prevention and especially treatment of tick-borne encephalitis, rely on the power of homeopathy, albeit hidden (but not for those who dare to look into the original patent Oleg Epstein on the “method of treating viral diseases”), this is not only stupid, but also life-threatening. So let's stop giving some biologists a reason to sneer at “natural selection is on, keep drinking sugar balls,” put aside the jokes, statistical tricks and thought experiments and talk about the protection measures that work.

If you are going to a region in the spring or summer where tick-borne encephalitis is common, worry about your safety in advance. The best protection against viral encephalitis (by the way, even the Anaferon website does not deny this, although in a separate tab, and not answering patients on forums) is not an attack, but vaccination. But this process is not quick: in order to meet the summer fully armed, vaccinations must begin in the fall. However, despite the inconvenience, high cost and side effects (which, however, are not dangerous to life and health in general), vaccines do protect against tick-borne encephalitis.

Choose clothing that ticks cannot penetrate. The virus hides in a capsid spacesuit from the cruel outside world, and you hide from the virus. Although a full astronaut suit is unlikely to be available to you (and wearing it in the forest is not very convenient), you can equip yourself with long pants tucked into shoes and a jacket or sweater with long sleeves, put on a hat, leaving no gaps where dangerous things can get through. arachnid. Treat your clothes with repellent, and after your walk, ask to be carefully examined for a parked viral starship with eight legs. You should also not drink raw milk from animals that may have been bitten by infected ticks. But when boiled, the virus dies in two to three minutes (although it is not at all afraid of the cold).

If you do become infected with tick-borne encephalitis, modern medicine can offer supporting vitamins, painkillers and symptomatic treatment. In Russia, immunoglobulins are also used, but this method also does not provide a significant effect: the immune system, like any complex system, is much easier to harm than to help. Due to the lack of indisputable evidence of benefit and even hints of some harm of this technique for tick-borne encephalitis in Western Europe, it was completely stopped being used.

It has not been confirmed that anti-epilepsy drugs can help in the treatment of viral tick-borne encephalitis. So don't be fooled. Not just Anaferon, but no medicine in general will cure you of encephalitis quickly and completely. But observation by a doctor and symptomatic treatment may reduce the risk of complications, save your life, or help you not remain disabled. Agree, this is a lot.

The relevance of studying the prevention and treatment of tick-borne encephalitis is caused, first of all, by its almost universal distribution, as well as by an annual increase of an average of 5% in the number of registered cases of disease (1).

Tick-borne encephalitis (TBE) is characterized by a strict spring-summer seasonality of the onset of the disease, associated with the seasonal activity of ticks. In the habitat of ticks of the species I. persulcatus, the disease occurs in spring and the first half of summer, May-June, when the biological activity of this species of ticks is highest. For ticks of the species I. ricinus, there is an increase in biological activity twice per season, and in the area of ​​this tick there are 2 peaks of seasonal incidence of tick-borne encephalitis: in spring (May-June) and at the end of summer (August-September).

A very alarming feature of the incidence of tick-borne encephalitis in recent years is the predominance of sick city residents. Among the patients, up to 75% are city residents who became infected in suburban forests, gardens and vegetable plots.

The polymorphism of clinical manifestations, the development of a chronic progressive course in every fifth patient, and the possibility of deaths (1.4-9%) determine the advisability of further search for new methods of prevention and treatment (1-3).

Currently, the most effective way to protect against TBE is vaccination. Unfortunately, low public awareness of the need for vaccination does not contribute to the coverage of preventive vaccinations. Another method of preventing TBE is the administration of anti-tick immunoglobulin (IG). However, the effectiveness of immunoglobulin is observed only with its early administration (72-96 hours after the bite); unfortunately, later administration of IG does not have a proven preventive effect. It is known that when a tick bites, it secretes special substances that cause anesthesia of the tissues in the area of ​​the bite, which causes late detection of the attached insect and, consequently, a late request by the patient for specialized medical care.

All of the above problems dictate the need to develop new approaches to emergency prevention and treatment of TBE.

It has been proven that the diversity of clinical forms of TBE is due not only to the circulation of different serotypes of the virus, but also to the nature of the body’s immune response, which depends on the functioning of the interferon system, and especially on the production of IFN-gamma (2, 3). Therefore, IFN inducers are currently widely used for the prevention and treatment of EC.

Some of the drugs used for this purpose are “Anaferon” (registration certificate number 003362/01) and “Anaferon for children” (registration certificate number 000372/01), developed by scientists of the research and production company “Materia Medica” together with employees of the Research Institute of Pharmacology of the Siberian Branch RAMS. These drugs are interferon inducers and have a wide spectrum of antiviral activity (4, 5, 6).

The active ingredients of the drugs are ultra-low doses of antibodies to human interferon gamma (IFN-γ). Anaferon is produced using technology that allows the active substance to be used in ultra-low doses, while maintaining the high pharmacological activity of the drug. According to medical instructions and data from numerous studies, Anaferon has an immunomodulatory and antiviral effect. Stimulates the humoral and cellular immune response. Increases the production of antibodies (including secretory IgA, activates the functions of T-effectors and T-helpers (Th). Increases the functional reserve of T-helpers and other cells involved in the immune response. Induces the formation of endogenous “early” interferons (α/ß) and gamma - interferons (IFN-γ). It is an inducer of a mixed Th 1 and Th 2 type of immune response: increases the production of Th 1 (IFN-γ, IL-2) and Th 2 (IL-4, 10) cytokines, normalizes (modulates) balance of Th 1/Th 2 activities. Increases the functional activity of phagocytes and NK cells. Reduces the concentration of the virus in affected tissues. Has antimutagenic properties (4-6).

Experience with the use of Anaferon and Anaferon for children was obtained in a number of studies conducted in St. Petersburg and the Urals.

Thus, employees of the Ural State Medical Academy conducted a comparative randomized clinical and laboratory study of the therapeutic effectiveness of Anaferon against the background of a single injection of highly titrated domestic immunoglobulin (IG) in 68 patients with different forms of TE aged from 25 to 65 years with a diagnosis confirmed by enzyme immunoassay ( 8).

According to the data obtained, in patients (n=33), who received, in addition to high-titer specific immunoglobulin and symptomatic therapy, Anaferon 1 tablet 3 times a day for 14 days, the duration of the febrile period and meningeal symptoms was reduced. More pronounced positive dynamics in patients with focal forms of EC who received Anaferon were also noted when analyzing the results of a serological examination. Thus, in the second week of the disease, log 2 IgM titer in this group was higher than in the comparison group: 4.7 ± 0.5 and 2.9 ± 0.1 (p<0,05). Кроме того, под влиянием Анаферона в группе больных лихорадочной и менингеальной формами КЭ на 1 месяц быстрее чем в группе сравнения купировались вегетативная патология (гипер-вентиляционный синдром, синдром вегетативной дисфункции) и нарушение ночного сна. Полученные результаты позволили авторам сделать вывод об эффективности двухнедельного курса терапии Анафероном на фоне раннего введения высокотитражного противоклещевого иммуноглобулина у больных с разными формами КЭ и целесообразности применения Анаферона в комплексной терапии больных КЭ в остром периоде. (8)

Work to study the effectiveness of Anaferon for children as a means of emergency prevention of TBE in children was carried out at the Research Institute of Childhood Infections (7). The study included 403 children aged 2 to 17 years who had been bitten by ticks. The main group consisted of 82 children who did not receive IG for one reason or another. Patients in this group received Anaferon for children orally, regardless of food intake, according to the following regimen: 1 table. 3 times a day 3 times a day for 21 days (incubation period of FE). The comparison group consisted of 321 children who, for prophylactic purposes, were administered intramuscularly with domestic anti-mite immunoglobulin in standard doses.

Laboratory diagnosis of children bitten by infected ticks was based on blood testing using ELISA methods for specific immunoglobulins M and G class and virus antigen using PCR, as well as a modified complement fixation reaction. The study was carried out at the first visit, and then 1, 3, 6 months and 1 year after the tick bite. The level of systemic interferons was determined at initial treatment and after 1 month. Clinical and laboratory follow-up observation of children was carried out for 3 years on the basis of the outpatient department of the Research Institute of Children's Infections of Roszdrav.

According to the study, no cases of TE were observed in children taking Anaferon for Children, whereas in the group receiving traditional prophylaxis with anti-tick immunoglobulin, 6 children became ill. At the same time, only one patient from the main group had an antigen of the TBE virus detected by PCR, and in the control group the antigen was detected in 44% of patients, and in some children the antigen was detected for 6 months.

In children who received anti-tick immunoglobulin for prophylactic purposes, the tick-borne encephalitis virus antigen was detected in 44% of children when examined a month later, in 10.1% - after 2 months, in 5.1% - after 6 months. Moreover, 6 children fell ill with tick-borne encephalitis. 3 were diagnosed with a febrile form of the disease, 2 - meningeal, 1 - focal. In all cases, a severe course of the disease was observed.

When studying interferonogenesis in children of the main group, a significant increase in the level of IFN-γ was found to 30.6±0.12 IU/ml compared to the initial values ​​(1.6±0.05 IU/ml). In the comparison group, no significant dynamics of interferonogenesis were observed. Researchers noted that the use of Anaferon for children as a means of emergency prevention is a promising direction for inclusion in algorithms for the prevention of TBE.

Thus, the use of Anaferon and Anaferon for children for the prevention and treatment of tick-borne encephalitis is a promising area and needs to be more widely introduced into medical practice.

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