Modern immunomodulators. Pharmacological group - Immunomodulators. Reviews of the use of Amiksin tablets

Immunomodulators are drugs that help the body fight bacteria and viruses by strengthening the body's defenses. Adults and children are allowed to take such medications only as prescribed by a doctor. Immunotherapy drugs have a lot of adverse reactions if the dosage is not observed and the drug is selected incorrectly.

In order not to harm the body, you need to choose immunomodulators wisely.

Description and classification of immunomodulators

What immunomodulatory drugs are in general terms is clear, now it’s worth understanding what they are. Immunomodulatory agents have certain properties that affect human immunity.

The following types are distinguished:

1. Immunostimulants These are unique immunoboosting drugs that help the body develop or strengthen existing immunity to a particular infection.
2. Immunosuppressants– suppress the activity of the immune system if the body begins to fight against itself.

All immunomodulators perform different functions to some extent (sometimes even several), so they also distinguish:

• immunostrengthening agents;
• immunosuppressants;
• antiviral immunostimulating drugs;
• antitumor immunostimulating agents.

It makes no sense to choose which drug is the best of all groups, since they are on the same level and help with various pathologies. They are incomparable.

Their action in the human body will be aimed at immunity, but what they will do depends entirely on the class of the drug chosen, and the difference in choice is very large.

An immunomodulator may be by nature:

• natural (homeopathic medicines);
• synthetic.

Also, an immunomodulatory drug can be different in the type of synthesis of substances:

• endogenous – substances are synthesized already in the human body;
• exogenous - substances enter the body from the outside, but have natural sources of plant origin (herbs and other plants);
• synthetic - all substances are grown artificially.

The effect of taking a drug from any group is quite strong, so it is also worth mentioning why these drugs are dangerous. If immunomodulators are used uncontrolled for a long time, then when they are canceled, the person’s real immunity will be zero and there will be no way to fight infections without these drugs.

If medications are prescribed for children, but the dosage is not correct for some reason, this may contribute to the fact that the growing child’s body will not be able to independently strengthen its defenses and subsequently the baby will often get sick (you need to choose special children’s medications). In adults, such a reaction can also be noted due to the initial weakness of the immune system.

Video: advice from Dr. Komarovsky

What is it prescribed for?

Immune drugs are prescribed to those people whose immune status is significantly lower than normal, and therefore their body is unable to fight various infections. The prescription of immunomodulators is appropriate when the disease is so severe that even a healthy person with good immunity cannot overcome it. Most of these drugs have an antiviral effect, and therefore are prescribed in combination with other drugs to treat many diseases.

Modern immunomodulators are used in the following cases:

• for allergies to restore the body's strength;
• for herpes of any type to eliminate the virus and restore immunity;
• for influenza and ARVI to eliminate the symptoms of the disease, get rid of the causative agent of the disease and maintain the body during the rehabilitation period, so that other infections do not have time to develop in the body;
• for a cold for a speedy recovery, so as not to use antibiotics, but to help the body recover on its own;
• in gynecology, an immunostimulating drug is used to treat some viral diseases to help the body cope with it;
• HIV is also treated with immunomodulators of various groups in combination with other drugs (various stimulants, drugs with antiviral effects and many others).

For a certain disease, even several types of immunomodulators can be used, but all of them must be prescribed by a doctor, since self-prescription of such strong drugs can only worsen a person’s health condition.

Features in purpose

Immunomodulators should be prescribed by a doctor so that he can select an individual dosage of the drug according to the patient’s age and illness. These medications come in different forms of release, and the patient may be prescribed one of the most convenient forms for administration:

• pills;
• capsules;
• injections;
• candles;
• injections in ampoules.

Which is better for the patient to choose, but after coordinating his decision with the doctor. Another plus is that inexpensive but effective immunomodulators are sold, and therefore the price problem will not arise in the way of eliminating the disease.

Many immunomodulators have natural herbal components in their composition, others, on the contrary, contain only synthetic components, and therefore it will not be difficult to choose a group of drugs that is better suited in a particular case.

It should be borne in mind that such medications should be prescribed with caution to people from certain groups, namely:

• for those who are preparing for pregnancy;
• for pregnant and breastfeeding women;
• It is better not to prescribe such drugs to children under one year of age unless absolutely necessary;
• children from 2 years of age are prescribed strictly under the supervision of a doctor;
• To old people;
• people with endocrine diseases;
• for severe chronic diseases.

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The most common immunomodulators

There are many effective immunomodulators sold in pharmacies. They will differ in their quality and price, but with proper selection of the drug they will greatly help the human body in the fight against viruses and infections. Let's consider the most common list of drugs in this group, the list of which is indicated in the table.

Photos of drugs:

Interferon

Lycopid

Dekaris

Kagocel

Arbidol

Viferon

Amiksin

Immunostimulants It is customary to call those substances that stimulate the body’s nonspecific resistance and person. Very often the terms " immunostimulant " And " immunomodulator " are used as synonyms. However, there is still a certain difference between such drugs.

Types of drugs that affect the immune system

All drugs that in one way or another affect the immune system are usually divided into four types: immunocorrectors , immunomodulators , immunostimulants , immunosuppressants . Application immunomodulators It is advisable in the case of treatment of malfunctions in the immune system, as well as to restore the functions of this system. Such drugs are used for treatment only after prescription by a specialist.

Preparations- immunocorrectors act only on some parts of the immune system, but not on its work as a whole. Facilities- immunosuppressants , on the contrary, do not stimulate, but suppress its work if its functioning is too active and harms the human body.

Preparations- immunostimulants are not intended for therapy: they only strengthen the human immune system. Under the influence of these drugs, the immune system functions more efficiently.

Immunomodulators have different origins and affect the human immune system depending on its initial state. Experts classify such drugs according to their origin, as well as guided by the mechanism of their action. If we consider the origin of immunomodulators, they are divided into endogenous , exogenous And chemically clean drugs. The mechanism of action of such drugs is based on the effect on T- , B-system immunity , and phagocytosis .

How do immunomodulators and immunostimulants work?

The human immune system is a unique body system that can neutralize foreign substances entering the body. antigens . Immunity prevents the harmful effects of pathogens of infectious diseases. Immunomodulators are capable of influencing changes in human immunity.

Immunostimulants act specifically on the functioning of a specific part of the immune system, activating it. And immunomodulators are prescribed in order to balance all components of the immune system, while the activity of some increases and the activity of others decreases.

However, taking these drugs must be strictly dosed, since if the treatment is too long, the body’s own immunity may be less active. If immunostimulants are used for too long without proper supervision by the attending physician, such drugs can negatively affect the immunity of both the child and the adult patient.

Indications for the use of immunomodulators

The main indicator that is taken into account when prescribing immunomodulators is the presence of signs of immune deficiency. This condition is characterized by a very frequent manifestation viral , bacterial , fungal infections that are not affected by traditional methods of therapy.

Before starting treatment, the doctor must determine what kind of immune disorders a person has, as well as how severe these disorders are. If a healthy person is diagnosed with a decrease in a certain immunity parameter, then taking such drugs is not always advisable. In this case, it is important that the patient is examined and consulted by a specialist immunologist.

Often, in parallel with immunomodulators, patients are prescribed vitamin-containing drugs, as well as And microelements . In most cases, sorption therapy is prescribed as an additional method in order to reduce the level of endogenous intoxication.

Immunostimulants and immunomodulators of plant origin

In addition to artificially synthesized drugs, immunomodulators and immunostimulants of plant origin are also actively used. Such drugs naturally and gradually restore the body, without changing the hormonal balance. These preparations are created on the basis of medicinal plants: nettle, chicory, lungwort, yarrow, clover, etc. In addition to medicinal plants, some food plants also have immunostimulating properties

Has very powerful immunostimulant properties echinacea . This is a herbaceous perennial plant, the extract of which is very often used today both in cosmetics and in the manufacture of medicines. Echinacea promotes the formation of red blood cells, it enriches the body selenium , calcium , silicon , vitamins A , WITH , E and other elements no less important for life and strengthening the immune system. In addition, preparations based on Echinacea have antiallergic , diuretic , anti-inflammatory , antibacterial , antivirus influence. Basically, a ten percent alcohol tincture of Echinacea is used, as well as herbal preparations that include this plant. Quite popular preparations are also made based on echinacea. , Immunorm . These remedies have a gentle and beneficial effect on the human immune system. They are prescribed even to children who are already one year old. For preventive purposes, these drugs are recommended to be taken three times
per year, one month at a time, which helps strengthen the resistance of the human body as a whole.

Preparations based on echinacea are used as immunostimulants for children. However, it is very important to take into account that immunostimulants of plant origin cannot be used uncontrolled, since there are certain contraindications that need to be known before use.

In addition to echinacea, a popular natural immunostimulant is the extract Eleutherococcus roots . Adults take 30-40 drops of this plant infusion, and children should count one drop of infusion for one year of life. Today, Eleutherococcus extract is very often used as a remedy that prevents infection. And cold during the epidemic. Quite often in such cases they also use ginger . Immunomodulators for children are often used in kindergartens, and are also recommended for use at home during epidemics.

Use of immunostimulants for children

It is very important that immunostimulants and immunomodulators for children are used especially carefully. After all, a number of such drugs have clear contraindications, information about which is indicated in the instructions for these drugs. Treatment with such means should not be given to children whose relatives have been diagnosed with , since their exposure can provoke the development of such diseases in a child. Among the diseases that are indicated as contraindications, it should be noted insulin type , , multiple sclerosis , scleroderma , as well as other autoimmune diseases. Most of these diseases are incurable.

But there are also direct indications for the use of such drugs to treat children. Thus, immunostimulants for children are prescribed for some serious illnesses. This flu with complications , severe coldA . Immunomodulators are also used to treat pregnant women with colds, since such drugs have relatively few contraindications.

A very useful and practically harmless immunostimulant that is perfect for children is honey. It contains a very large number of useful essential vitamins And microelements Moreover, children consume such a tasty medicinal product with pleasure. Even small children who have not yet turned one year old can be treated with honey. The only contraindication in this case is allergic reactions for honey

In order for a child’s immune system to function at full strength, it is necessary to regularly replenish the supply of certain microelements. It is very important to constantly consume foods containing zinc: peas, carrots, oats, red bell peppers, buckwheat. Garlic is a very strong immunostimulant. However, it is important to note that children under three years of age can only be given boiled garlic.

But still, immunostimulant drugs, as well as drugs of this type that are of plant origin, are not ordinary vitamins. Therefore, if it is necessary to use this type of drug to strengthen the immunity of children, you should still consult with specialists.

Immunomodulators for the treatment of herpes

is a disease in the treatment of which some immunomodulators are also actively used. Drugs belonging to the interferon group and used for the treatment of herpes are, . The drug amixin has a pronounced effect on viruses and stimulates the body's production of interferons.

Recurrent herpes infections are often treated with medications Viferon , Gyaferon , leukinferon , which contain recombined human interferons. These immunostimulants for herpes effectively support the body's antiviral resistance.

In addition, other drugs of this type are used for herpes. An immunomodulator drug stimulates the formation in the body and activates its antioxidant system.

For young children with herpetic immunodeficiencies, treatment with the drug Lykopid is indicated. The doctor prescribes a treatment regimen for this drug on an individual basis.

In addition, for herpes in children and adults, drugs are used as immunostimulants, Tamerite , epithelamin , and a number of other effective drugs.

The problem of immunotherapy is of interest to doctors of almost all specialties due to the steady growth of infectious and inflammatory diseases prone to chronic and relapsing course against the background of low effectiveness of basic therapy, malignant neoplasms, autoimmune and allergic diseases, systemic diseases, viral infections causing a high level of morbidity, mortality and disability. In addition to somatic and infectious diseases, which are widespread among people, the human body is affected by social (inadequate and irrational nutrition, living conditions, occupational hazards), environmental factors, and medical measures (surgical interventions, stress, etc.) that are unfavorable to health. First of all, the immune system suffers, and secondary immunodeficiencies occur. Despite the constant improvement of methods and tactics of basic disease therapy and the use of deep reserve drugs using non-drug methods of influence, the effectiveness of treatment remains at a fairly low level. Often the reason for these features in the development, course and outcome of diseases is the presence of certain disorders of the immune system in patients. Research conducted in recent years in many countries around the world has made it possible to develop and introduce into widespread clinical practice new integrated approaches to the treatment and prevention of various nosological forms of diseases using immunotropic drugs of targeted action, taking into account the level and degree of disorders in the immune system. An important aspect in preventing relapses and treating diseases, as well as in preventing immunodeficiencies, is the combination of basic therapy with rational immunocorrection. Currently, one of the urgent tasks of immunopharmacology is the development of new drugs that combine such important characteristics as effectiveness and safety of use.

Immunity and immune system. Immunity- protection of the body from genetically foreign agents of exogenous and endogenous origin, aimed at preserving and maintaining the genetic homeostasis of the body, its structural, functional, biochemical integrity and antigenic individuality. Immunity is one of the most important characteristics for all living organisms created in the process of evolution. The principle of operation of defense mechanisms is to recognize, process and eliminate foreign structures.

Protection is carried out using two systems - nonspecific (innate, natural) and specific (acquired) immunity. These two systems represent two stages of a single process of protecting the body. Nonspecific immunity acts as the first line of defense and as its final stage, and the acquired immunity system performs intermediate functions of specific recognition and memory of a foreign agent and the activation of powerful innate immunity at the final stage of the process. The innate immune system operates on the basis of inflammation and phagocytosis, as well as protective proteins (complement, interferons, fibronectin, etc.). This system reacts only to corpuscular agents (microorganisms, foreign cells, etc.) and toxic substances that destroy cells and tissues, or rather , on the corpuscular products of this destruction. The second and most complex system - acquired immunity - is based on the specific functions of lymphocytes, blood cells that recognize foreign macromolecules and respond to them either directly or by producing protective protein molecules (antibodies).

Immunomodulators - these are medications that, when used in therapeutic doses, restore the functions of the immune system (effective immune defense).

Immunomodulators (immunocorrectors) - a group of drugs of biological (preparations from animal organs, plant materials), microbiological and synthetic origin, which have the ability to normalize immune reactions.

Currently, there are 6 main groups of immunomodulators based on their origin:

Immunomodulators of microbial origin can be divided into three generations. The first drug approved for medical use as an immunostimulant was the BCG vaccine, which has a pronounced ability to enhance factors of both innate and acquired immunity.

First-generation microbial preparations also include drugs such as pyrogenal and prodigiosan, which are polysaccharides of bacterial origin. Currently, due to pyrogenicity and other side effects, they are rarely used.

Second-generation microbial preparations include lysates (Bronchomunal, IPC-19, Imudon, the Swiss-made drug Broncho-Vaxom, which recently appeared on the Russian pharmaceutical market) and ribosomes (Ribomunil) of bacteria, which are mainly pathogens of respiratory infections Klebsiella pneumoniae, Streptococcus pneumoniae, Streptococcus pyogenes, Haemophilus influezae etc. These drugs have a dual purpose: specific (vaccinating) and non-specific (immunostimulating).

Likopid, which can be classified as a third generation microbial preparation, consists of a natural disaccharide - glucosaminylmuramyl and a synthetic dipeptide - L-alanyl-D-isoglutamine attached to it.

The ancestor of the first generation thymic drugs in Russia was Taktivin, which is a complex of peptides extracted from the thymus gland of cattle. Preparations containing a complex of thymic peptides also include Timalin, Timoptin, etc., and those containing thymus extracts include Timostimulin and Vilosen.

The clinical effectiveness of first-generation thymic drugs is beyond doubt, but they have one drawback - they are an unseparated mixture of biologically active peptides that are quite difficult to standardize.

Progress in the field of drugs of thymic origin proceeded through the creation of drugs of the second and third generations - synthetic analogues of natural thymic hormones or fragments of these hormones with biological activity. The last direction turned out to be the most productive. Based on one of the fragments, including amino acid residues of the active center of thymopoietin, the synthetic hexapeptide Immunofan was created.

The ancestor of drugs of bone marrow origin is Myelopid, which includes a complex of bioregulatory peptide mediators - myelopeptides (MP). It was found that various MPs affect different parts of the immune system: some increase the functional activity of T-helper cells; others suppress the proliferation of malignant cells and significantly reduce the ability of tumor cells to produce toxic substances; still others stimulate the phagocytic activity of leukocytes.

The regulation of the developed immune response is carried out by cytokines - a complex complex of endogenous immunoregulatory molecules, which continue to be the basis for the creation of a large group of both natural and recombinant immunomodulatory drugs. The first group includes Leukinferon and Superlymph, the second group includes Beta-leukin, Roncoleukin and Leukomax (molgramostim).

The group of chemically pure immunomodulators can be divided into two subgroups: low molecular weight and high molecular weight. The first includes a number of well-known drugs that additionally have immunotropic activity.

Their ancestor was levamisole (Dekaris) - phenylimidothiazole, a well-known anthelmintic agent, which was subsequently found to have pronounced immunostimulating properties. Another promising drug from the subgroup of low-molecular immunomodulators is Galavit, a phthalhydrazide derivative. The peculiarity of this drug is the presence of not only immunomodulatory, but also pronounced anti-inflammatory properties. The subgroup of low-molecular immunomodulators also includes three synthetic oligopeptides: Gepon, Glutoxim and Alloferon.

High-molecular, chemically pure immunomodulators obtained using directed chemical synthesis include the drug Polyoxidonium. It is an N-oxidized polyegilene piperazine derivative with a molecular weight of about 100 kD. The drug has a wide range of pharmacological effects on the body: immunomodulatory, detoxifying, antioxidant and membrane protective.

Medicines characterized by pronounced immunomodulatory properties include interferons and interferon inducers. Interferons, as a component of the body's general cytokine network, are immunoregulatory molecules that affect all cells of the immune system.???

Pharmacological action of immunomodulators.

Immunomodulators of microbial origin .

In the body, the main target for immunomodulators of microbial origin are phagocytic cells. Under the influence of these drugs, the functional properties of phagocytes are enhanced (phagocytosis and intracellular killing of absorbed bacteria are increased), and the production of proinflammatory cytokines necessary for the initiation of humoral and cellular immunity increases. As a result, antibody production may increase and the formation of antigen-specific T-helper and T-killer cells may be activated.

Immunomodulators of thymic origin.

Naturally, in accordance with the name, the main target for immunomodulators of thymic origin are T-lymphocytes. With initially low levels, drugs of this series increase the number of T cells and their functional activity. The pharmacological effect of the synthetic thymic dipeptide Thymogen is to increase the level of cyclic nucleotides, similar to the effect of the thymic hormone thymopoietin, which leads to stimulation of differentiation and proliferation of T-cell precursors into mature lymphocytes.

Immunomodulators of bone marrow origin.

Immunomodulators obtained from the bone marrow of mammals (pigs or calves) include Myelopid. Myelopid contains six bone marrow-specific immune response mediators called myelopeptides (MPs). These substances have the ability to stimulate various parts of the immune response, especially humoral immunity. Each myelopeptide has a specific biological effect, the combination of which determines its clinical effect. MP-1 restores the normal balance of activity of T-helpers and T-suppressors. MP-2 suppresses the proliferation of malignant cells and significantly reduces the ability of tumor cells to produce toxic substances that suppress the functional activity of T-lymphocytes. MP-3 stimulates the activity of the phagocytic component of immunity and, therefore, increases anti-infective immunity. MP-4 affects the differentiation of hematopoietic cells, promoting their faster maturation, i.e., it has a leukopoietic effect. . In immunodeficiency states, the drug restores the indicators of the B- and T-immune systems, stimulates the production of antibodies and the functional activity of immunocompetent cells, and helps restore a number of other indicators of the humoral immunity.

Cytokines.

Cytokines are low molecular weight hormone-like biomolecules produced by activated immunocompetent cells and are regulators of intercellular interactions. There are several groups of them - interleukins, growth factors (epidermal, nerve growth factor), colony-stimulating factors, chemotactic factors, tumor necrosis factor. Interleukins are the main participants in the development of the immune response to the introduction of microorganisms, the formation of an inflammatory reaction, the implementation of antitumor immunity, etc.

Chemically pure immunomodulators

The mechanisms of action of these drugs are best considered using Polyoxidonium as an example. This high-molecular immunomodulator is characterized by a wide range of pharmacological effects on the body, including immunomodulatory, antioxidant, detoxifying and membrane protective effects.

Interferons and interferon inducers.

Interferons are protective substances of a protein nature that are produced by cells in response to the penetration of viruses, as well as to the influence of a number of other natural or synthetic compounds (interferon inducers).

Interferons are factors of nonspecific protection of the body from viruses, bacteria, chlamydia, pathogenic fungi, tumor cells, but at the same time they can also act as regulators of intercellular interactions in the immune system. From this position, they belong to immunomodulators of endogenous origin.

Three types of human interferons have been identified: a-interferon (leukocyte), b-interferon (fibroblastic) and g-interferon (immune). g-Interferon has less antiviral activity, but plays a more important immunoregulatory role. Schematically, the mechanism of action of interferon can be represented as follows: interferons bind to a specific receptor in the cell, which leads to the cell’s synthesis of about thirty proteins, which provide the above-mentioned effects of interferon. In particular, regulatory peptides are synthesized that prevent the virus from entering the cell, the synthesis of new viruses in the cell, and stimulate the activity of cytotoxic T-lymphocytes and macrophages.

In Russia, the history of the creation of interferon drugs begins in 1967, the year human leukocyte interferon was first created and introduced into clinical practice for the prevention and treatment of influenza and ARVI. Currently, several modern alpha-interferon preparations are produced in Russia, which, based on production technology, are divided into natural and recombinant.

Interferon inducers are synthetic immunomodulators. Interferon inducers are a heterogeneous family of high- and low-molecular synthetic and natural compounds, united by the ability to induce the formation of the body’s own (endogenous) interferon. Interferon inducers have antiviral, immunomodulatory and other effects characteristic of interferon.

Poludan (a complex of polyadenylic and polyuridic acids) is one of the very first interferon inducers, used since the 70s. Its interferon-inducing activity is low. Poludan is used in the form of eye drops and injections under the conjunctiva for herpetic keratitis and keratoconjunctivitis, as well as in the form of applications for herpetic vulvovaginitis and colpitis.

Amiksin is a low-molecular interferon inducer belonging to the class of fluoreons. Amiksin stimulates the formation of all types of interferons in the body: a, b and g. The maximum level of interferon in the blood is reached approximately 24 hours after taking Amiksin, increasing tens of times compared to its initial values.

An important feature of Amiksin is the long-term circulation (up to 8 weeks) of therapeutic concentrations of interferon after a course of taking the drug. Significant and prolonged stimulation by Amiksin of the production of endogenous interferon ensures its universally wide range of antiviral activity. Amiksin also stimulates the humoral immune response, increasing the production of IgM and IgG, and restores the T-helper/T-suppressor ratio. Amiksin is used for the prevention of influenza and other acute respiratory viral infections, the treatment of severe forms of influenza, acute and chronic hepatitis B and C, recurrent genital herpes, cytomegalovirus infection, chlamydia, and multiple sclerosis.

Neovir is a low-molecular-weight interferon inducer (carboxymethylacridone derivative). Neovir induces high titers of endogenous interferons in the body, especially early interferon alpha. The drug has immunomodulatory, antiviral and antitumor activity. Neovir is used for viral hepatitis B and C, as well as for urethritis, cervicitis, salpingitis of chlamydial etiology, and viral encephalitis.

Clinical use of immunomodulators.

The most justified use of immunomodulators seems to be in cases of immunodeficiency, manifested by an increased infectious morbidity. The main target of immunomodulatory drugs remains secondary immunodeficiencies, which are manifested by frequent recurrent, difficult-to-treat infectious and inflammatory diseases of all locations and any etiology. Each chronic infectious-inflammatory process is based on changes in the immune system, which are one of the reasons for the persistence of this process. Studying the parameters of the immune system may not always reveal these changes. Therefore, in the presence of a chronic infectious-inflammatory process, immunomodulatory drugs can be prescribed even if an immunodiagnostic study does not reveal significant deviations in the immune status.

As a rule, in such processes, depending on the type of pathogen, the doctor prescribes antibiotics, antifungals, antivirals or other chemotherapeutic drugs. According to experts, in all cases when antimicrobial agents are used for phenomena of secondary immunological deficiency, it is advisable to prescribe immunomodulatory drugs.

Basic requirements requirements for immunotropic drugs are:

immunomodulatory properties; high efficiency; natural origin; safety, harmlessness; no contraindications; lack of addiction; no side effects; no carcinogenic effects; lack of induction of immunopathological reactions; do not cause excessive sensitization and do not potentiate it in other medications; easily metabolized and excreted from the body; do not interact with other drugs and have high compatibility with them; non-parenteral routes of administration.

Currently, the main principles of immunotherapy:

1. Mandatory determination of immune status before starting immunotherapy;

2. Determination of the level and extent of damage to the immune system;

3. Monitoring the dynamics of immune status during immunotherapy;

4. Use of immunomodulators only in the presence of characteristic clinical signs and changes in immune status indicators

5. Prescription of immunomodulators for preventive purposes to maintain immune status (oncology, surgical interventions, stress, environmental, occupational and other influences).

Determining the level and extent of damage to the immune system is one of the most important stages in selecting a drug for immunomodulatory therapy. The point of application of the drug's action must correspond to the level of disruption of the activity of a certain part of the immune system in order to ensure maximum effectiveness of the therapy.

Let us dwell on the consideration of individual immunomodulators.

Methylphenylthiomethyl-Dimethylaminomethyl-Hydroxybromoindole Carboxylic acid ethyl ester.

Chemical name.

6-Bromo-5-hydroxy-1-methyl-4-dimethylaminomethyl-2-phenylthiomethylindole-3-carboxylic acid ethyl ester hydrochloride

Gross formula - C 22 H 25 BrlN 2 O 3 S.HCl

Characteristic.

Crystalline powder from white with a greenish tint to light yellow with a greenish tint. Practically insoluble in water.

Pharmacology.

Pharmacological action - antiviral, immunostimulating. Specifically inhibits influenza A and B viruses. The antiviral effect is due to the suppression of the fusion of the lipid membrane of the virus with cell membranes when the virus comes into contact with the cell. It exhibits interferon-inducing and immunomodulatory activity, stimulates humoral and cellular immune responses, the phagocytic function of macrophages, and increases the body's resistance to viral infections.

Therapeutic effectiveness for influenza is expressed in a reduction in symptoms of intoxication, the severity of catarrhal symptoms, a shortening of the period of fever and the overall duration of the disease. Prevents the development of post-influenza complications, reduces the frequency of exacerbations of chronic diseases, and normalizes immunological parameters.

When taken orally, it is quickly absorbed from the gastrointestinal tract and distributed to organs and tissues. C max in the blood at a dose of 50 mg is achieved after 1.2 hours, at a dose of 100 mg - after 1.5 hours. T 1/2 ?— approximately 17?h. The largest amount of the drug is found in the liver. It is excreted mainly in feces.

Application.

Treatment and prevention of influenza and other acute respiratory viral infections (including those complicated by bronchitis and pneumonia); chronic bronchitis, pneumonia, recurrent herpetic infection (in complex treatment); for the prevention of infectious complications and normalization of immune status in the postoperative period.

Echinacea.

Latin name -Echinacea.

Characteristic.

Echinacea ( Echinacea Moench)?—a perennial herbaceous plant from the Asteraceae (Asteraceae) family?— Asteraceae (Compositae).

Echinacea purpurea ( Echinacea purpurea(L.) Moench.) and Echinacea pallidum ( Echinacea pallida Nutt.)?—herbaceous plants with a height of 50-100 and 60-90 cm, respectively. Echinacea angustifolia ( Echinacea angustifolia DC) has a lower stem, up to 60 cm high.

Herbs, rhizomes and roots of Echinacea in fresh or dried form are used as medicinal raw materials.

Echinacea purpurea herb contains polysaccharides (heteroxylans, arabinoramnogalactans), essential oils (0.15-0.50%), flavonoids, hydroxycinnamic (chicoric, ferulic, coumaric, caffeic) acids, tannins, saponins, polyamines, echinacin (polyunsaturated acid amide ), echinolone (unsaturated keto alcohol), echinacoside (glycoside containing caffeic acid and pyrocatechol), organic acids, resins, phytosterols; rhizomes and roots?—inulin (up to 6%), glucose (7%), essential and fatty oils, phenol carbonic acids, betaine, resins. All parts of the plant contain enzymes, macro- (potassium, calcium) and microelements (selenium, cobalt, silver, molybdenum, zinc, manganese, etc.).

In medical practice, tinctures, decoctions and extracts of Echinacea are used. On an industrial scale, mainly medicinal preparations are produced based on the juice or extract of the Echinacea purpurea herb.

Pharmacology.

Pharmacological action - immunostimulating, anti-inflammatory. Promotes the activation of nonspecific body defense factors and cellular immunity, improves metabolic processes. Stimulates bone marrow hematopoiesis, increases the number of leukocytes and cells of the reticuloendothelial system of the spleen.

Increases the phagocytic activity of macrophages and chemotaxis of granulocytes, promotes the release of cytokines, increases the production of interleukin-1 by macrophages, accelerates the transformation of B-lymphocytes into plasma cells, enhances antibody formation and T-helper activity.

Application.

Immunodeficiencies caused by acute infectious diseases (prevention and treatment): colds, flu, infectious and inflammatory diseases of the nasopharynx and oral cavity. Recurrent infections of the respiratory and urinary tract (as part of complex therapy); as an auxiliary drug for long-term treatment with antibiotics: chronic infectious and inflammatory diseases (polyarthritis, prostatitis, gynecological diseases).

Local treatment: long-term non-healing wounds.

Interferon alpha.

Latin name - Interferon alpha*

Pharmacology.

Pharmacological action - antiviral, immunomodulatory, antitumor, antiproliferative. Prevents viral infection of cells, changes the properties of the cell membrane, prevents adhesion and penetration of the virus into the cell. Initiates the synthesis of a number of specific enzymes, disrupts the synthesis of viral RNA and viral proteins in the cell. Changes the cytoskeleton of the cell membrane, metabolism, preventing the proliferation of tumor (especially) cells. It has a modulating effect on the synthesis of some oncogenes, leading to normalization of neoplastic cell transformation and inhibition of tumor growth. Stimulates the process of antigen presentation to immunocompetent cells, modulates the activity of killer cells involved in antiviral immunity. With intramuscular administration, the rate of absorption from the injection site is uneven. Time to reach C max in plasma is 4-8 hours. 70% of the administered dose is distributed in the systemic circulation. T 1/2 ?— 4-12? h (depending on the variability of absorption). It is excreted mainly by the kidneys by glomerular filtration.

Application.

Hairy cell leukemia, chronic myeloid leukemia, viral hepatitis B, active viral hepatitis C, primary (essential) and secondary thrombocytosis, transitional form of chronic granulocytic leukemia and myelofibrosis, multiple myeloma, kidney cancer; AIDS-related Kaposi's sarcoma, mycosis fungoides, reticulosarcoma, multiple sclerosis, prevention and treatment of influenza and acute respiratory viral infection.

Interferon alpha-2a + Benzocaine* + Taurine*.

Latin name -Interferon alfa-2a + Benzocaine* + Taurine*

Characteristic. Combined drug.

Pharmacology.

Pharmacological action - antimicrobial, immunomodulatory, regenerating, local anesthetic. Interferon alpha-2 has antiviral, antimicrobial and immunomodulatory effects; enhances the activity of natural killer cells, T-helpers, phagocytes, as well as the intensity of differentiation of B-lymphocytes. Activation of leukocytes contained in the mucous membrane ensures their active participation in the elimination of primary pathological foci and ensures the restoration of secretory IgA production. Interferon alpha-2 also directly inhibits the replication and transcription of viruses and chlamydia.

Taurine has regenerating, reparative, membrane and hepatoprotective, antioxidant and anti-inflammatory effects.

Benzocaine?—local anesthetic; reduces the permeability of the cell membrane to Na + . Prevents the occurrence of pain impulses at the endings of sensory nerves and their conduction along nerve fibers.

When administered intravaginally and rectally, interferon alfa-2 is absorbed through the mucous membrane and enters the surrounding tissues and the lymphatic system, providing a systemic effect. Due to partial fixation on the cells of the mucous membrane, it has a local effect. A decrease in the serum concentration of interferon alpha-2 is observed 12 hours after administration.

Application.

Infectious and inflammatory diseases of the urogenital tract (as part of complex therapy): genital herpes, chlamydia, ureaplasmosis, mycoplasmosis, recurrent vaginal candidiasis, gardnerellosis, trichomoniasis, papillomavirus infections, bacterial vaginosis, cervical erosion, cervicitis, vulvovaginitis, bartholinitis, adnexitis, it, urethritis, balanitis, balanoposthitis.

Interferon beta-1a.

Latin name - Interferon beta-1a

Characteristic.

Recombinant human interferon beta-1a produced by mammalian cells (Chinese hamster ovary cell culture). Specific antiviral activity? - more than 200 million IU/mg (1 ml of solution contains 30 μg of interferon beta-1a, which has 6 million IU antiviral activity). It exists in glycosylated form, contains 166 amino acid residues and a complex carbohydrate fragment linked to a nitrogen atom. The amino acid sequence is identical to natural (natural) human interferon beta.

Pharmacology.

Pharmacological action - antiviral, immunomodulatory, antiproliferative. It binds to specific receptors on the surface of cells in the human body and triggers a complex cascade of intercellular interactions, leading to interferon-mediated expression of numerous gene products and markers, incl. histocompatibility complex class I, protein M X, 2",5"-oligoadenylate synthetase, beta 2 - microglobulin and neopterin.

Markers of biological activity (neopterin, beta 2 -microglobulin, etc.) are determined in healthy donors and patients after parenteral administration of doses of 15-75µg. The concentration of these markers increases within 12 hours after administration and remains elevated for 4-7 days. The peak of biological activity in typical cases is observed 48 hours after administration. The exact relationship between plasma levels of interferon beta-1a and the concentration of marker proteins whose synthesis it induces is still unknown.

Stimulates the activity of suppressor cells, enhances the production of interleukin-10 and transforming growth factor beta, which have anti-inflammatory and immunosuppressive effects in multiple sclerosis. Interferon beta-1a significantly reduces the frequency of exacerbations and the rate of progression of irreversible neurological disorders in the relapsing-remitting type of multiple sclerosis (the increase in the number and area of ​​focal brain lesions according to MRI data slows down). Treatment may be accompanied by the appearance of antibodies to interferon beta-1a. They reduce its activity in vitro(neutralizing antibodies) and biological effects (clinical efficacy) in vivo. With a treatment duration of 2 years, antibodies are detected in 8% of patients. According to other data, after 12 months of treatment, antibodies appear in the serum of 15% of patients.

No mutagenic effect was detected. There are no data on carcinogenicity studies in animals and humans. In a study of reproductive function in rhesus monkeys receiving interferon beta-1a at doses 100 times the MRDC, some animals experienced cessation of ovulation and a decrease in serum progesterone levels (the effects were reversible). In monkeys receiving doses twice as high as the weekly recommended dose, these changes were not detected.

Administration of doses 100 times higher than the MRDC to pregnant monkeys was not accompanied by manifestations of teratogenic effects or negative effects on fetal development. However, doses 3-5 times higher than the weekly recommended dose caused miscarriage (there was no miscarriage at 2 times the weekly recommended dose).

There is no information on the effect on reproductive function in humans.

Pharmacokinetic studies of interferon beta-1a in patients with multiple sclerosis have not been conducted.

In healthy volunteers, pharmacokinetic parameters depended on the route of administration: with intramuscular administration at a dose of 60µg C max was 45?IU/ml and was achieved after 3-15?hours, T 1/2 ?— 10 hours; with subcutaneous administration of C max?— 30?IU/ml, time to reach it?—3-18?h, T 1/2 ?— 8.6?h. Bioavailability with IM administration was 40%, with SC administration it was 3 times lower. There are no data indicating possible penetration into breast milk.

Application.

Relapsing multiple sclerosis (with at least 2 relapses of neurological dysfunction within 3 years and no signs of continuous progression of the disease between relapses).

Sodium oxodihydroacridinyl acetate.

Latin name - Cridanimod*

Chemical name - Sodium 10-methylenecarboxylate-9-acridone

Pharmacology.

Pharmacological action - immunomodulatory, antiviral. The immunostimulating effect is due to the induction of interferon synthesis. Increases the ability of interferon-producing cells to produce interferon when induced by a pathological agent (the property persists for a long time after discontinuation of the drug) and creates high titers of endogenous interferons in the body, identified as early alpha and beta interferons. Activates bone marrow stem cells, eliminates imbalance in subpopulations of T-lymphocytes with activation of effector units of T-cell immunity and macrophages. Against the background of tumor diseases, it enhances the activity of natural killer cells (due to the production of interleukin-2) and normalizes the synthesis of tumor necrosis factor. Stimulates the activity of polymorphonuclear leukocytes (migration, cytotoxicity, phagocytosis). It has antiviral (against RNA and DNA genomic viruses) and antichlamydial effects.

After intramuscular injection, bioavailability exceeds 90%. WITH max in plasma (in the dose range of 100-500 mg) is registered after 30 minutes and is accompanied by an increase in the concentration of serum interferon (reaches 80-100? IU/ml plasma at a dose of 250 mg). Easily passes through histohematic barriers. Excreted by the kidneys, more than 98% unchanged, T 1/2 ?— 60 min. The activity of induced interferons, after reaching a maximum, gradually decreases and reaches initial values ​​after 46-48 hours.

When parenterally administered to animals of various types of doses, 40-50 times higher than the recommended therapeutic doses for humans, no fatalities were detected. A study of chronic toxicity indicates the absence of a negative effect on the functions of the cardiovascular, nervous, digestive, respiratory, excretory, hematopoietic and other body systems. No mutagenic activity was detected in tests on animals, human cell cultures and bacteria. Does not have a damaging effect on human germ cells. No embryotoxic or teratogenic effects were detected.

Application.

Prevention and treatment of infectious and inflammatory diseases, correction of immunodeficiency states and immunostimulating therapy: ARVI, incl. influenza (severe forms); herpetic infection (Herpes simplex, Varicella zoster) different localization (severe primary and recurrent forms); viral encephalitis and encephalomyelitis; hepatitis (A, B, C, acute and chronic form, including during the period of convalescence); CMV infection against the background of immunodeficiency; chlamydial, ureaplasma, mycoplasma infection (urethritis, epididymitis, prostatitis, cervicitis, salpingitis, chlamydial lymphogranuloma); candidiasis and bacterial candidiasis infections (skin, mucous membranes, internal organs); multiple sclerosis; oncological diseases; immunodeficiency (radiation-induced, acquired and congenital with inhibition of interferon synthesis).

Meglumine acridone acetate.

Latin name - Meglumine acridonacetate.

Characteristic.

Low molecular weight interferon inducer.

Pharmacology.

Pharmacological action - antiviral, immunostimulating, anti-inflammatory. Stimulates the production of alpha, beta and gamma interferons (up to 60-80?U/ml and higher) by leukocytes, macrophages, T- and B-lymphocytes, epithelial cells, as well as tissues of the spleen, liver, lungs, and brain. Penetrates the cytoplasm and nuclear structures, induces the synthesis of “early” interferons. Activates T-lymphocytes and natural killer cells, normalizes the balance between subpopulations of T-helpers and T-suppressors. Helps correct the immune status in immunodeficiency states of various origins, incl.

HIV-related.

Active against tick-borne encephalitis viruses, influenza, hepatitis, herpes, CMV, HIV, various enteroviruses, and chlamydia.

It is highly effective in treating rheumatic and other systemic connective tissue diseases, suppressing autoimmune reactions and providing anti-inflammatory and analgesic effects.

It is characterized by low toxicity and the absence of mutagenic, teratogenic, embryotoxic and carcinogenic effects.

When taken orally, the maximum permissible dose is C max in the blood is reached after 1-2 hours, the concentration gradually decreases after 7 hours, after 24 hours it is found in trace quantities. Passes through the BBB. T 1/2 is 4-5 hours. Does not accumulate with prolonged use.

Application

Solution for injection, tablets:

infections: HIV-related, cytomegalovirus, herpetic; urogenital, incl. chlamydia, neuroinfections (serous meningitis, tick-borne borreliosis, multiple sclerosis, arachnoiditis, etc.), acute and chronic viral hepatitis (A, B, C, D);

immunodeficiency states of various etiologies (postoperative period, burns, chronic bacterial and fungal infections, including bronchitis, pneumonia); peptic ulcer of the stomach and duodenum; oncological diseases; rheumatoid arthritis; degenerative-dystrophic diseases of the joints (deforming osteoarthritis, etc.); skin diseases (neurodermatitis, eczema, dermatosis).

Pills: influenza and ARVI.

Liniment: genital herpes, urethritis and balanoposthitis (nonspecific, candidal, gonorrheal, chlamydial and trichomonas etiology), vaginitis (bacterial, candidal).

Sodium deoxyribonucleate.

Latin name - Sodium deoxyribonucleate

Characteristic.

Transparent colorless liquid (extract from sturgeon milk).

Pharmacology.

Pharmacological action - immunomodulatory, anti-inflammatory, reparative, regenerative. Activates antiviral, antifungal and antimicrobial immunity at the cellular and humoral levels. Regulates hematopoiesis, normalizing the number of leukocytes, granulocytes, phagocytes, lymphocytes and platelets. Corrects the condition of tissues and organs in dystrophies of vascular origin, exhibits weak anticoagulation properties.

In patients with chronic ischemic disease of the lower extremities (including those associated with diabetes mellitus), it increases tolerance to stress when walking, reduces pain in the calf muscles, and prevents the development of a feeling of coldness and chilliness of the feet. Improves blood circulation in the lower extremities, promotes the healing of gangrenous trophic ulcers, and the appearance of a pulse in the peripheral arteries. Accelerates the rejection of necrotic masses (for example, on the phalanges of the fingers), which sometimes avoids surgical intervention. In patients with coronary artery disease, it improves myocardial contractility, improves microcirculation in the heart muscle, increases exercise tolerance and shortens recovery time. Stimulates reparative processes in gastric and duodenal ulcers, restores the structure of the mucous membrane, inhibits the growth of Helicobacter pylori. Facilitates the engraftment of autografts during skin and eardrum transplantation.

Application.

Solutions for external use and for injection: ARVI, trophic ulcers, burns, frostbite, long-term non-healing wounds, incl. for diabetes mellitus, purulent-septic processes, treatment of the graft surface before and after transplantation. Solution for external use: obliterating diseases of the lower extremities, defects of the mucous membrane of the mouth, nose, vagina. Injection solution: myelosuppression and resistance to cytostatics in cancer patients, acute pharyngeal syndrome, gastric and duodenal ulcers, gastroduodenitis, coronary artery disease, cardiovascular failure, chronic ischemic disease of the lower extremities stage II and III, prostatitis, vaginitis, endometritis, infertility and impotence caused by chronic infections, chronic obstructive bronchitis.

Polyoxidonium (Azoximer).

Latin name -Polyoxidonium

Chemical name - Copolymer of N-hydroxy-1,4-ethylenepiperazine and (N-carboxy)-1,4-ethylenepiperazinium bromide.

Characteristic.

Lyophilized porous mass with a yellowish tint. Soluble in water, isotonic sodium chloride solution, procaine solution. Hygroscopic. Molecular weight?—60000-100000.

Pharmacology.

Pharmacological action - immunomodulatory, detoxifying. Increases the body's resistance to infections (local, generalized). Immunomodulation is due to a direct effect on phagocytic cells and natural killer cells, stimulation of antibody formation.

Restores immune responses in severe forms of immunodeficiency, incl. for secondary immunodeficiency conditions caused by infections (tuberculosis, etc.), malignant neoplasms, therapy with steroid hormones or cytostatics, complications of surgical operations, injuries and burns.

When administered sublingually, polyoxidonium activates lymphoid cells located in the bronchi, nasal cavity, and Eustachian tubes, thereby increasing the resistance of these organs to infectious agents.

When administered orally, polyoxidonium activates lymphoid cells located in the intestine, namely B cells that produce secretory IgA.

The consequence of this is an increase in the resistance of the gastrointestinal tract and respiratory tract to infectious agents. In addition, when administered orally, polyoxidonium activates tissue macrophages, which facilitates faster elimination of the pathogen from the body in the presence of a focus of infection.

As part of complex therapy, it increases the effectiveness of antibacterial and antiviral agents, bronchodilators and glucocorticoids. Allows you to reduce the dose of these drugs and shorten the treatment time. Increases the resistance of cell membranes to cytotoxic effects, reduces the toxicity of drugs. It has pronounced detoxifying activity (due to the polymeric nature of the drug). It does not have mitogenic polyclonal activity, antigenic or allergenic properties.

Has high bioavailability (89%) with intramuscular administration, C max observed 1 hour after rectal and 40 minutes after intramuscular administration. T 1/2 ?—30 and 25 minutes for rectal and intramuscular administration? (fast phase), 36.2 hours with rectal and intramuscular administration and 25.4 hours with intravenous administration (slow phase). Metabolized in the body and excreted primarily by the kidneys.

Tiloron.

Latin name - Tilorone*

Chemical name - 2,7-Bis--9H-fluoren-9-one (and as dihydrochloride)

Gross formula - C 25 H 34 N 2 O 3

Pharmacology.

Pharmacological action - antiviral, immunomodulatory. Induces the formation of interferons (alpha, beta, gamma) by intestinal epithelial cells, hepatocytes, T-lymphocytes and granulocytes. After oral administration, the maximum production of interferon is determined in the sequence intestine? - liver? - blood after 4-24 hours.

Activates bone marrow stem cells, stimulates humoral immunity, increases the production of IgM, IgA, IgG, affects antibody formation, reduces the degree of immunosuppression, restores the T-helper/T-suppressor ratio.

The mechanism of antiviral action is associated with inhibition of the translation of virus-specific proteins in infected cells, as a result of which viral replication is suppressed. Effective against influenza viruses and viruses that cause ARVI, hepato- and herpesviruses, incl. CMV, etc.

After oral administration, it is quickly absorbed from the gastrointestinal tract. Bioavailability is 60%. Plasma protein binding: about 80%. Does not undergo biotransformation. T 1/2 ?— 48?h. It is excreted unchanged in feces (70%) and urine (9%). Does not accumulate.

Application.

In adults: viral hepatitis A, B, C; herpetic and cytomegalovirus infection; as part of complex therapy of infectious-allergic and viral encephalomyelitis (multiple sclerosis, leukoencephalitis, uveoencephalitis, etc.), urogenital and respiratory chlamydia; treatment and prevention of influenza and ARVI.

In children over 7 years of age: treatment and prevention of influenza and ARVI.

Preparations of complex composition.

Wobenzym.

Pharmacological action - immunomodulatory, anti-inflammatory, decongestant, fibrinolytic, antiplatelet.

Pharmacodynamics.

Wobenzym is a combination of natural enzymes of plant and animal origin. Entering the body, enzymes are absorbed in the small intestine by resorption of intact molecules and, by binding to transport proteins in the blood, enter the bloodstream. Subsequently, enzymes, migrating along the vascular bed and accumulating in the area of ​​the pathological process, have an immunomodulatory, anti-inflammatory, fibrinolytic, decongestant, antiplatelet and secondary analgesic effect.

Wobenzym has a positive effect on the course of the inflammatory process, limits the pathological manifestations of autoimmune and immunocomplex processes, and has a positive effect on the body’s immunological reactivity. Stimulates and regulates the level of functional activity of monocytes-macrophages, natural killer cells, stimulates antitumor immunity, cytotoxic T-lymphocytes, and phagocytic activity of cells.

Under the influence of Wobenzym, the number of circulating immune complexes decreases and membrane deposits of immune complexes are removed from tissues.

Wobenzym reduces the infiltration of the interstitium by plasma cells. Increases the elimination of protein debris and fibrin deposits in the area of ​​inflammation, accelerates the lysis of toxic metabolic products and necrotic tissue. Improves the resorption of hematomas and edema, normalizes the permeability of vascular walls.
Wobenzym reduces the concentration of thromboxane and platelet aggregation. Regulates the adhesion of blood cells, increases the ability of red blood cells to change their shape, regulating their plasticity, normalizes the number of normal discocytes and reduces the total number of activated forms of platelets, normalizes blood viscosity, reduces the total number of microaggregates, thus improving microcirculation and rheological properties of blood, as well as blood supply tissues with oxygen and nutrients.

Wobenzym reduces the severity of side effects associated with taking hormonal drugs (hypercoagulation, etc.).
Wobenzym normalizes lipid metabolism, reduces the synthesis of endogenous cholesterol, increases HDL content, reduces the level of atherogenic lipids, and improves the absorption of polyunsaturated fatty acids.

Wobenzym increases the concentration of antibiotics in the blood plasma and the site of inflammation, thus increasing the effectiveness of their use. At the same time, enzymes reduce the unwanted side effects of antibiotic therapy (immune suppression, allergic manifestations, dysbacteriosis).

Wobenzym regulates nonspecific defense mechanisms (phagocytosis, production of interferons, etc.), thereby exhibiting antiviral and antimicrobial effects.

Lycopid.

Pharmachologic effect - immunomodulatory.

Pharmacokinetics.

The bioavailability of the drug when taken orally is 7-13%. The degree of binding to blood albumin is weak. Does not form active metabolites. T max?— 1.5 h, T 1/2 ?—4.29 hours. Excreted from the body unchanged, mainly through the kidneys.

Pharmacodynamics.

The biological activity of the drug is due to the presence of specific receptors (NOD-2) for glucosaminylmuramyl dipeptide (GMDP), localized in the endoplasm of phagocytes and T-lymphocytes. The drug stimulates the functional (bactericidal, cytotoxic) activity of phagocytes (neutrophils, macrophages), enhances the proliferation of T- and B-lymphocytes, and increases the synthesis of specific antibodies.

The pharmacological action is carried out by enhancing the production of interleukins (IL-1, IL-6, IL-12), tumor necrosis factor-alpha, interferon gamma, and colony-stimulating factors. The drug increases the activity of natural killer cells.

The current situation and forecast for the development of the Russian market of immunomodulators can be found in the report of the Academy of Industrial Market Studies “Market of immunomodulators in Russia”.

Academy of Industrial Market Conditions

In the second half of the twentieth century, a fashion for “” appeared, which has not gone away to this day. Pharmacies offer us a huge selection of medications and dietary supplements, the purpose of which is... But in what cases are immunomodulators actually necessary, and when can they cause harm?

Still not fully studied. The immune system is made up of many different types of cells in a complex interdependence. Attempts to influence the immune system unless absolutely necessary can lead to unpredictable consequences in the future.

Immunomodulators are drugs that affect the immune system and change its functioning.

Immunomodulators can be divided into two groups:

Immunostimulants– stimulate immune reactions, increase immunity.

Immunosuppressants– lower immunity.

Use of immunomodulators

Immunomodulators are mainly used to increase the body's defenses in various diseases:

• chronic, indolent infections;
• allergic diseases;
• tumors;
• immunodeficiency states.

But in some cases (with autoimmune diseases, when the immune system begins to work not against “external enemies”, but against one’s own body), immunomodulators are used to reduce immunity.

The use of immunomodulators is based on the following principles:

• as part of complex treatment, in parallel with the prescription of antibiotics, antiviral, antifungal and other agents;
• appointment from the first day of treatment;
• under the control of immunological blood tests;
• Separately, without other drugs, immunomodulators are used at the stage of rehabilitation (recovery from illness).

Treatment with immunomodulators is not quite the correct term. These drugs do not cure the disease - they only help the body overcome it. The effect of the immunomodulator on the human body is not limited to the period of illness, it continues for a long time, even for years.

Classification of immunomodulators

Endogenous (synthesized in the body itself)

A representative of this group is interferon.

Exogenous (enter the body from the environment)

These include bacterial(such as Bronchomunal, IRS-19, Ribomunal, Imudon) and vegetable(for example, Immunal, Echinacea liquidum, Echinacea compositum, Echinacea VILAR, etc.) and synthetic(Levamisole, Polyoxidonium, Glutoxim, Galavit, Poludan, etc.).

Immunomodulators of plant origin

Plant immunomodulators have been used in folk medicine since ancient times - these are many of the medicinal herbs included in ancient recipes. It is these natural immunomodulators that have the most harmonious effect on our body. They are divided into 2 groups. The first group includes: licorice, white mistletoe, milky white iris, yellow egg capsule. These plants have a complex composition that can not only stimulate, but also suppress the immune system. Therefore, treatment with them is possible only with careful selection of the dose, with immunological blood tests and under the supervision of a doctor.

Second group plant immunomodulators is very extensive. These include:

• echinacea
• ginseng
• lemongrass
• Eleutherococcus
• Aralia
• lure
• radiola pink
• Walnut
• pine nut
• elecampane
• nettle
• cranberry
• rose hip
• thyme
• St. John's wort
• Melissa
• birch
• seaweed
• figs and many other plants.

They have a mild, slow, stimulating effect on the immune system without causing any side effects. Immunomodulators of this group can be recommended for self-medication. Official medicine also uses many of these plants to create immunomodulatory drugs (Echinacea: Immunal, Immunorm).

Antiviral immunomodulators

Many modern immunomodulators also have an antiviral effect. Such drugs include:

• Anaferon (lozenges)
• Ergoferon (tablets)
• Gendchron (rectal suppositories)
• Arbidol (tablets)
• Neovir (solution for injection)
• Altevir (solution for injection)
• Grippferon (nasal drops)
• Viferon (rectal suppositories)
• Epigen Intim (spray)
• Infagel (ointment)
• Isoprinosine (tablets)
• Amiksin (tablets)
• Reaferon EC (powder for solution, administered intravenously)
• Ridostin (solution for injection)
• Ingaron (solution for injection)
• Lavomax (tablets).

The main disadvantage of these drugs is the presence of side effects. Therefore, they are used only as prescribed by an immunologist. Many researchers have recently questioned the effectiveness of these drugs. For example, Arbidol, the most popular product in recent years, has no evidence base. An interesting fact is that in Europe and the USA these drugs do not exist at all and are not prescribed.

Immunomodulators: pros and cons

The benefits of immunomodulators are, of course, undeniable. Treatment of many diseases without the use of these drugs becomes significantly less effective. Strengthening the body's defenses is also necessary during the period of recovery from serious illnesses, after injuries and operations. However, the beneficial properties of immunomodulators are fully manifested only when all the individual characteristics of the body are taken into account and the dosage is carefully selected. But uncontrolled, and even long-term use of immunomodulators can cause severe harm to the body - depletion of the immune system, decreased immunity.

In addition, there are contraindications to the use of immunomodulators - the presence of autoimmune diseases. These diseases include:

• diabetes
• rheumatoid arthritis
• primary glomerulonephritis
• systemic lupus erythematosus
• diffuse toxic goiter
• multiple sclerosis
• autoimmune hepatitis
• primary biliary cirrhosis
• Hashimoto's thyroiditis
• bronchial asthma (some forms)
• Addison's disease and some other rare diseases.

If a person suffering from one of these diseases begins to independently use immunomodulators, an exacerbation of the disease will occur with unpredictable consequences.

Probiotics also belong to immunomodulators. Probiotic microorganisms (bifidobacteria, lactobacilli and others) have immunomodulatory activity, which, when introduced into food products, help restore and maintain the balance of the normal microflora of the body.

Conclusion

The use of immunomodulatory drugs under the supervision of a physician, taking into account all indications and contraindications, is certainly beneficial for the body of a sick person. Independent and uncontrolled use of these drugs is harmful, as it threatens to disrupt the immune system.

These drugs interact with cells of the immune system. According to their influence, they are conventionally divided into two groups: those that stimulate the immune system and those that reduce it. Depending on the goal to be achieved, one or another type of these drugs is used. To stimulate natural immunity in case of chronic infections, allergic diseases, and immunodeficiency states, immunostimulants are used. Immunomodulators are prescribed as part of complex therapy in parallel with taking antibiotics, antifungal, and antiviral drugs. When using them, it is necessary to monitor the dynamics of the disease and conduct immunological blood tests. These drugs are also prescribed during the recovery period after illness.

If the immune system malfunctions and it begins to work against the body's cells, it is necessary to reduce the activity of immune cells. This condition occurs in psoriasis and other autoimmune diseases. In these cases, you need to take medications that can limit the activity of the immune system.

Classification of immunomodulator drugs

All immunomodulators are divided into the following groups:

Endogenous, i.e. produced in the body. This group includes Interferon, which helps the body with colds and acute respiratory viral infections;

Exogenous - they enter the body from the external environment and contain elements that are not present in the body. Among the drugs in this group there are bacterial, herbal and synthetic drugs.

Immunomodulators of plant origin

These include medicinal herbs that are used in folk medicine. This type of immunomodulators is the most preferable because they act gently on the body without causing any harsh side effects. They are also divided into two groups. The first includes herbs that have the ability not only to stimulate, but also to suppress the immune system. These include licorice, iris (irris), yellow egg capsule, and white mistletoe. When treating with these drugs, you need to carefully select the dose and conduct immunological blood tests.

The second group stimulates the immune system. It includes echinacea, ginseng, aralia, lemongrass, Rhodiola rosea, elecampane and many other herbs rich in vitamins and nutrients. To achieve an effect, immunomodulatory drugs are prescribed for a long period, since their effect increases gradually, and taking immunomodulators helps the body cope with the state of chronic immunodeficiency, avoiding complications of chronic diseases.

Opinions for and against immunomodulators

Scientists still have a consensus regarding immunomodulatory drugs. Some doctors consider it inappropriate to frequently and unreasonably prescribe these drugs, since in case of overdose, even the safest drugs can have the opposite effect and cause the development of autoimmune diseases: diabetes mellitus, rheumatoid arthritis, toxic goiter, multiple sclerosis and other incompletely studied diseases. They are caused by improper functioning of the immune system, so in these diseases, taking immunomodulators can lead to unpredictable consequences. In any case, treatment with immunomodulators should be prescribed by a doctor; he is obliged to monitor the dynamics of the disease.

The best natural immunomodulators are natural products: honey, rose hips, onions, garlic, vegetables, fruits.