9 immunity and its types. Anti-infectious and non-infectious immunity. To perform the agglutination reaction, complement

The body's main defense is immunity. There are several types of immunity depending on the classification sign.

Concept

Immunity is the body's response to the action of foreign bodies - antigens. The body considers as antigens any substances or microorganisms (viruses, bacteria) that come from the external environment and do not participate in metabolic processes. Allergy, elevated temperature, painful signs may be an immune response.

The immune system consists of specific organs (spleen, red bone marrow, thymus) responsible for the production and learning immune cells, as well as natural barriers - mucous membranes, skin.

Rice. 1. Immune organs.

How does it work

The mechanism of action of immunity is always the same. In human blood there are special immune cells - leukocytes, which, depending on the type, can act differently. Throughout life, leukocytes learn to recognize and destroy antigens. Vaccination helps them with this.

Rice. 2. Different types of leukocytes.

The vaccine contains dead or inactive microorganisms. This is enough to provoke the actions of leukocytes, but not cause disease. A person remains immune to pathogens, because When meeting familiar microorganisms, leukocytes know what to do and what substances to release.

The main weapon of leukocytes is antibodies or immunoglobulins. They are isolated special groups leukocytes - B-lymphocytes. These are receptor proteins that, by binding to an antigen, trigger an immune response in the body.

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Rice. 3. Antibodies.

Most often, killer lymphocytes (killer T-cells) provoke the self-destruction of foreign cells - apoptosis. This self-destruction program is built into any cell. The broken cell into fragments is absorbed and digested by phagocytes - one of the types of leukocytes.

Kinds

The classification is presented in the table of types of immunity.

What have we learned?

Immunity is necessary for a person as a response to the effects of pathogenic and foreign particles. Immunity can be congenital or acquired. Depending on the antigen, certain leukocytes are activated, which secrete specific antibodies. Leukocyte training occurs in the thymus. The higher the immunity, the more active and successful the immune cells react.

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CHAPTER 12 FEATURES OF IMMUNITY IN VARIOUS LOCATIONS AND CONDITIONS

12.1. Features of local immunity

Local immunity is formed within the skin and mucous membranes that are in direct contact with the environment and the most likely entry point for exogenous antigens, and protects them. Factors of local immunity can act extracorporeally - go beyond the macroorganism to the surface of the skin and be secreted or migrate into the secretion of the mucous membranes. The concept of local immunity was first expressed by A.M. Bezredka (1919).

The local immune system functions quite separately and has a number of features. There is a close relationship between general and local immunity. Firstly, the general immune system is a reserve source of protective factors. Secondly, with the development of the infectious process, the transition of local immune reactivity to general one is clearly visible. Thirdly, between these two systems there is a constant exchange of immune factors (antibodies, clones of antigen-reactive lymphocytes, etc.), which is important for the spread of immunological memory throughout the body (see section 11.5).

12.1.1. Skin immunity

The skin performs the function of mechanical protection - it protects the macroorganism from external influences and, in case of damage, is able to independently restore its integrity. It is also a factor of physical and chemical protection - products of the sweat and sebaceous glands are bactericidal. In addition, the local immune system operates effectively in the skin.

Outer layer of skin epidermis, is being formed epithelial cells- keratinocytes. In its thickness there are two types of dendritic cells: Langerhans cells And Greenstein. Lymphocytes are localized in the dermis and epidermis and mast cells. The lymphoid population is represented mainly by T2 helper cells and T killer cells. In the dermis and epidermis, differentiation of immature T lymphocytes into mature cells occurs.

Keratinocytes- non-migrating epithelial cells that perform barrier and immunoregulatory functions in the skin. They express MHC class II, co-stimulatory molecules CD40, 80, 86 and Fas-ligand. Cells synthesize a wide range of cytokines: IL-1, 6, 7, 8, TNF, β-TGF, GM-CSF, α,β-IFN, etc.

Non-activated keratinocytes provide only a barrier function. Damaging influences (trauma, burn, inflammation, etc.) or immunocytokine stimulation activate keratinocytes, and they become capable of presenting antigen to T-helper cells, triggering an antibody immune response and suppressing local cellular proliferation of immune lymphocytes.

Langerhans cells, or white process epidermocytes - migrating dendritic cells of myeloid nature. Originate from bone marrow cells or circulating monocytes. Life expectancy is about 20 days, sensitive to UV radiation. They express MHC class II, CD4, 40 on the cell membrane, synthesize IL-1, 12, α,β-IFN, GM-CSF, chemokines.

In the dermis, Langerhans cells are capable of capturing and processing antigen, but cannot perform the functions of APCs, since they do not express co-stimulating factors - molecules CD80, 86. After activation by inflammatory products or cytokines, the Langerhans cell that has captured the antigen migrates with the lymph flow to regional lymph nodes. There it differentiates into a mature dendritic cell - the interdigital cell of the lymph nodes and expresses the missing molecules CD80, 86, and also begins to synthesize cytokines. The interdigital cell loses the ability to capture and process antigen, but at the same time turns into an effective APC. It activates T-helper cells and triggers a specific antibody immune response and the formation of immunological memory.

The separation in space and time of the induction of a specific immune response in the skin couples the system of local and general

immunity, ensures the generalization of the protective response and the formation of immunological memory. In the case of inactivation of Langerhans cells (for example, by UV irradiation), the functions of APCs in the skin begin to be performed by keratinocytes and Greenstein cells, but they potentiate immunosuppression - inhibition of skin immunoreactivity.

There are no antibodies in the skin of great importance, a predominantly cellular immune response develops. The intensity of local immunity in the skin, as well as the integral state of the cellular immunity as a whole, is characterized by skin allergy tests.

12.1.2. Mucosal immunity

Epithelial cells themselves provide a good mechanical barrier that prevents pathogen invasion. The secretion of the mucous membranes also functions as a physicochemical barrier (see section 9.2.1.1), and the normal microflora inhabiting the mucous membranes functions as a biological barrier, since they provide colonization resistance (see section 9.2.1.2). The local immune system of the mucous membranes is characterized by developed lymphoid tissue and a high saturation of immunocompetent cells.

The lymphoid composition of the mucous membranes has characteristic features due to its formation. A distinction is made between early (relict) and late (modern) components. Early component is represented by γδT and B1 lymphocytes, which are early resettled into peripheral lymphoid formations directly from the bone marrow and subsequently develop autonomously from the central organs of the immune system. The antigenic receptors of these cells have a relatively low affinity, but have a fairly wide spectrum of sensitivity. This allows them to provide the first line of defense against microbial aggression and the necessary delay for the activation of the late component.

Cells late component develop under the control of the central organs of the immune system. These include traditional αβT and CD5 B lymphocytes, which have high specificity and affinity of the receptor apparatus. These cells provide a highly effective specific immune response and form the second line of immune defense in the mucous membranes.

The most striking example of the organization of immune defense of the mucous membranes is the highly developed lymphoid system of the gastrointestinal tract. intestinal tract, in which two functional zones are distinguished - inductive and effector. The inductive zone is formed by lymphoid follicles (including the appendix, Peyer's patches), consisting of equal numbers of T- and B-lymphocytes. In the inductive zone, areas of preferential settlement of T- and B-lymphocytes are identified. In the B region there is a germinal (germinal) center, where B lymphocytes, mainly IgA producers, multiply and mature. The T-population is 2/3 represented by T-killers and 1/3 by T-helpers. Macrophages and dendritic cells are also found. In this zone, the presentation and recognition of antigen, the induction of an immune response, the formation of clones of antigen-specific T and B lymphocytes, and the differentiation of B lymphocytes into IgA producers are carried out.

Epithelial M cells assist in antigen presentation. They capture antigen molecules in the lumen of the organ and transfer it to the APC by transcytosis.

Efferent zone covers the periepithelial region and lamina propria. In the periepithelial region there is a population of intraepithelial lymphocytes, which consists of 3/4 killer T cells, as well as γδT lymphocyte I. They provide the function of immunological surveillance of rapidly multiplying epithelium. The antigen can be presented by enterocytes, which, in an activated state, express MHC class II and synthesize cytokines and chemokines (IL-8). However, enterocytes are non-classical APCs.

IN lamina propria many T- and B-lymphocytes, macrophages and natural killer cells are found. T lymphocytes account for up to 60% of the entire lymphoid population. 2/3 are T-helper cells, the remaining cells are T-killer cells, including γδT lymphocytes. The proportion of B lymphocytes is 40%, half of them are B1 cells. The vast majority of antibody producers (80%) synthesize polymeric IgA molecules. An antibody response develops in this area. There is an intensive biosynthesis of immunoglobulins, mainly class A, which act both within the tissues themselves and as part of the secretion of the mucous membranes, where they arrive as a result of directed transport (sIg) or diffusion.

Phagocytic cells contained in the lamina propria are capable of pendulum-like movements. Attracted by chemoattractants, they can exit through the epithelium into the lumen of a hollow organ (intestine, bronchus, oral cavity, etc.) and return back.

Many mast cells and eosinophils are found within the mucous membranes. By synthesizing vasoactive amines (mast cells), toxins (eosinophils), enzymes, immunocytokines, lipid mediators and other biologically active substances, they participate in the regulation of immune and inflammatory reactions within the tissue. In the case of overproduction of IgE and a special genetic predisposition, mast cells potentiate the development of a type I allergic reaction (anaphylaxis).

12.1.2.1. Features of oral immunity

The immune defense system of the oral cavity successfully combines a variety of nonspecific and specific factors that provide effective protection against cariogenic and other pathogenic microbes.

The cells of the mucous membrane act as a mechanical barrier. The antimicrobial activity of saliva is of particular importance. During the day, the body of an adult produces up to 2 liters of saliva - a secretion with pronounced enzymatic activity. This is not only a powerful physico-chemical, but also a biological barrier. Saliva contains a wide range of substances with pronounced bactericidal properties: lysozyme, lactoferrin, lactoperoxidase, individual components of complement, etc. Up to 200,000 phagocytic cells are also constantly present in saliva. Cellular elements of nonspecific resistance are also found in the connective tissue stroma of the oral cavity: actively migrating tissue macrophages, fibroblasts, granulocytes and mast cells.

The system of specific immune defense of the oral cavity is represented by powerful tonsils of the pharyngeal ring, a well-developed system of lymphoid drainage in the submandibular, sublingual, parotid and cervical lymph nodes. Lymphoid accumulations are found in tissues, and lymphocytes and a wide range of immunoglobulins are found in saliva. IgA dominates quantitatively. Here it is contained noticeably more than in blood serum. The secretory form bears the greatest functional load

IgA (sIgA). The content of IgM, G and E in saliva is slightly lower than in blood serum. A decrease in the content of immunoglobulins, especially IgA, in saliva is fraught with purulent-inflammatory or allergic diseases of the oral mucosa.

12.2. Features of immunity in various conditions

The macroorganism has a wide range of means of protecting its integrity and maintaining homeostasis. However, to minimize energy and plastic costs, the macroorganism uses only the most effective mechanisms and protective factors to eliminate a specific antigen. Therefore, when exposed to antigens of different nature and properties, the immune response of the macroorganism has its own characteristics.

12.2.1. Features of immunity in bacterial infections

The immune response of a macroorganism in response to a bacterial infection is largely determined by the pathogenicity factors of the microbe and, first of all, its ability to produce toxins. Differentiate between immunity antibacterial- against the structural components of the bacterial cell and antitoxic- against protein toxins.

The main factors of antibacterial protection are antibodies and phagocytes. Antibodies effectively inactivate biologically active molecules of the bacterial cell (toxins, aggression enzymes, etc.), mark them, trigger antibody-dependent bacteriolysis and immune phagocytosis. Phagocytes directly carry out phagocytosis, including immune, antibody-dependent bacteriolysis and extracellular killing of the pathogen using radical ions and enzymes. An important role in the fight against gram-positive microbes belongs to lysozyme, and in the fight against gram-negative microbes - complement (an alternative activation pathway), in addition, acute phase proteins (C-reactive and mannose-binding protein) are essential.

cytosis). These include mycobacteria, yersinia, brucella, salmonella and some others. In such a situation, the macroorganism is forced to switch the load to the cellular component of immunity, which leads to allergization of the body through the HRT mechanism. Of particular importance are activated macrophages and natural killer cells that carry out ADCT, as well as γδT lymphocytes.

The intensity of specific antibacterial immunity is assessed in serological tests by the titer or dynamics of the titer of specific antibodies, as well as by the state of cellular immunoreactivity (for example, according to the results of a skin allergy test).

12.2.2. Features of antiviral immunity

The peculiarities of the immune defense of the macroorganism during viral infections are determined by two forms of existence of the virus: extracellular and intracellular. The main factors providing antiviral immunity are specific antibodies, T-killers, natural killer cells, interferon and serum inhibitors of viral particles.

Specific antiviral antibodies can only interact with extracellular viruses, since they do not have access inside a living cell. Antibodies neutralize viral adhesins and neuraminidases, preventing the adsorption of viruses on target cells and their infection. They also bind viral proteins and nucleic acids formed after the destruction of virus-infected cells. Formed immune complexes are eliminated by immune phagocytosis. Specific binding of antibodies to viral proteins expressed on the cytoplasmic membrane of infected cells induces natural killer cells to ADCT (see section 11.3.1).

Cells infected with a virus and begun to replicate express viral proteins on the cytoplasmic membrane as part of histocompatibility antigen molecules - MHC class I (see section 10.1.4.2). The altered MHC class I structure of these histocompatibility antigens is a marker for killer T cells that recognize virus-infected cells and destroy them (see section 11.3.2).

Interferon has powerful antiviral properties (see section 9.2.3.4). It does not act directly on the intracellular virus, but binds to a receptor on the cell membrane and suppresses all biosynthetic processes in it.

Serum inhibitors nonspecifically bind to the viral particle and neutralize it, thereby preventing the adsorption of the virus on target cells.

The intensity of antiviral immunity is assessed mainly in serological tests by increasing the titer of specific antibodies in paired sera during the course of the disease. The concentration of interferon in the blood serum is also determined.

12.2.3. Features of antifungal immunity

Fungal antigens have relatively low immunogenicity: they practically do not induce antibody formation (titers of specific antibodies remain low), but stimulate the cellular component of immunity. The main active factors of antifungal immunity are activated macrophages, which carry out ADCT of fungi.

With mycoses, allergization of the macroorganism is observed. Skin and deep mycoses are usually accompanied by HRT. Fungal infections mucous membranes of the respiratory and genitourinary tracts cause allergization via the HNT mechanism (type I reaction). The intensity of antifungal immunity is assessed based on the results of skin allergy tests with fungal allergens.

12.2.6. Transplant immunity

The macroorganism forms an immune reaction directed against the foreign tissue (graft) transplanted into it. This is the main problem preventing successful organ and tissue transplantation. The immune reaction to foreign cells and tissues is due to the fact that they contain antigens that are genetically foreign to the body. These antigens are called transplantation or histocompatibility antigens (see section 10.1.4.2). They are most fully represented on the cytoplasmic membrane of cells.

The rejection reaction does not occur if the donor and recipient are fully compatible with histocompatibility antigens - this is only possible for identical twins. Expressiveness

Rejection reactions largely depend on the degree of foreignness, the volume of transplanted material and the state of immunoreactivity of the recipient.

The body reacts to foreign transplantation antigens with cellular and humoral immunity. The main ones are T-killers and specific antibodies. Killer T cells carry out ANCCT of transplant tissues (recipient-versus-graft reaction) or recipient (graft-versus-recipient reaction). Specific antibodies that are formed to graft antigens trigger complement or cell-mediated cytolysis of the graft.

Adoptive transfer of transplantation immunity is possible using activated lymphocytes or with specific antiserum from a sensitized individual to an intact macroorganism.

The mechanism of immune rejection of transplanted cells and tissues has two phases. In the first phase, an accumulation is observed around the graft and vessels. immunocompetent cells(lymphoid infiltration), including T-killers. In the second phase, destruction of the transplant cells by T-killers occurs, the macrophage link, natural killer cells, and specific antibody genesis are activated. Then immune inflammation, thrombosis of blood vessels occurs, the nutrition of the graft is disrupted and its death occurs. Destroyed tissues are utilized by phagocytes. The graft tissue reacts to the recipient tissue in a similar way. However, the graft's immune response is weaker, as it is limited by its resources.

During the rejection reaction, a clone of immunological memory cells is formed. A repeated attempt to transplant the same organs and tissues causes a secondary immune response, which is very violent and quickly ends in transplant rejection.

12.2.7. Immunity against neoplasms

Antitumor immunity has its own characteristics associated with the low immunogenicity of cancer cells. These cells practically do not differ from normal, intact morphological elements of their own body. The specific antigenic repertoire of tumor cells is also poor. In number

Tumor-associated antigens (see section 10.1.4.3) include a group of carcinoembryonic antigens, oncogene products, some viral antigens and overexpressed normal proteins. Weak immunological recognition of tumor cells is facilitated by the absence of an inflammatory reaction at the site of oncogenesis, their immunosuppressive activity - the biosynthesis of a number of negative cytokines (β-TGF, etc.), as well as the shielding of cancer cells by antitumor antibodies.

The mechanism of antitumor immunity is still poorly understood. It is believed that activated macrophages play a major role in it; natural killer cells also play a certain role. The protective function of humoral immunity is largely controversial - specific antibodies can shield tumor cell antigens without causing their cytolysis.

Recently, cancer immunodiagnosis has become widespread, which is based on the determination of cancer-embryonic and tumor-associated antigens in blood serum. Thus, it is currently possible to diagnose some forms of cancer of the liver, stomach, intestines, prostate, etc.

There is a close connection between the state of immune defense and the development of tumors. Malignant neoplasms are observed more often in individuals with immunodeficiencies and the elderly (due to decreased activity of the immune system). Immunosuppressive chemotherapy is also often accompanied by proliferative processes. Therefore, immunomodulators (interleukins, interferons), as well as adjuvants (muramyl dipeptides, BCG vaccine, etc.) have been used in the treatment of tumors.

12.2.8. Immunology of pregnancy

Pregnancy is directly associated with the phenomenon of immunological tolerance. A whole complex of factors is formed in the pregnant woman’s body that ensures the mother’s immune system is unresponsive to fetal heteroantigens. Firstly, the syncytiotrophoblast of the placenta is “invisible” to the receptors of immunocompetent cells. It does not express classical histocompatibility molecules, but only non-polymorphic ones that are difficult to recognize. Secondly, the syncytiotrophoblast synthesizes immunosuppressive cytokines (IL-4, 10, β-TGF). Thirdly, CD16 -

CD56 are many natural killer cells (see section 11.3.2), which eliminate lymphocytes activated by fetal alloantigens by inducing apoptosis in them.

12.3. Immune status and its assessment

Immune status is the totality of all parameters of the immune system, with the help of which the recognition and elimination of foreign substances of an antigenic nature are carried out from the body. The study of immune status is an important part of clinical immunology. The objectives of clinical immunology are the diagnosis, treatment and prevention of diseases of the immune system. Assessment of immune status is carried out for the purpose of immunodiagnosis, i.e. identification of the disturbed part of the immune system, on which the development of the disease depends. There are 4 groups of immune system diseases: immunodeficiencies, autoimmune, allergic and lymphoproliferative diseases. First of all, immunodiagnosis, like any laboratory diagnostics, aimed at confirming the clinical diagnosis. Immunodiagnosis is of greatest importance for immunodeficiencies, which are divided into primary and secondary. Primary immunodeficiencies are a consequence of the presence of a genetic defect in the body. Based on the clinical picture, it can be assumed which part of the immune system is affected: phagocytosis, humoral or cellular immunity. But an accurate establishment of a clinical diagnosis for primary immunodeficiencies is only possible through immunodiagnostics, including immunogenetic testing. Thus, a diagnosis of chronic granulomatous disease can be made only by studying the ability of blood leukocytes to form reactive oxygen species, and X-linked agammaglobulinemia - only by determining the level of immunoglobulins in the patient’s blood. In primary immunodeficiencies, immunodiagnosis is crucial in establishing a clinical diagnosis.

For the first time, the methodology for immunodiagnosis of diseases of the immune system was developed by R.V. Petrov et al., who published methodological recommendations “Assessment of a person’s immune status” in 1984. In accordance with these methodological recommendations, all immunodiagnostic methods are divided into

levels I and II (Table 12.1). Level I tests are aimed at identifying severe damage to the immune system, i.e. primary immunodeficiencies. Level II tests are aimed at an in-depth study of the functional state of the immune system. For example, determining the functional state of T and B cells using the blast transformation reaction with mitogens and specific antigens; determining their ability to synthesize various cytokines, etc. In other words, level II tests include any methods and approaches aimed at revealing the mechanisms of breakdowns in the immune system that lead to the development of the disease.

Table 12.1. Tests to assess immune status

Currently, the following minimum set of tests is recommended to assess immune status (Khaitov R.M. and

al., 2009):

phagocytosis: determination of absorption and bactericidal (intracellular death of absorbed microbes) activity of leukocytes peripheral blood person; identification of the formation of reactive oxygen species by leukocytes;

complement: determination of hemolytic activity of blood serum (plasma);

immunoglobulins: determination of the level of IgG, IgA, IgM and IgE in serum (plasma);

Subpopulations lymphocytes: quantitative and percentage content in the peripheral blood of CD3 +, CD4 +, CD8 +, CD19 + (or CD20 +) lymphocytes, as well as, if indicated, CD16 + - and HLA-DR + - lymphocytes.

All laboratories and clinical immunology centers that are part of the immunological service system of the Russian Federation, as well as clinical immunology groups at clinical diagnostic laboratories of republican, regional and regional clinical hospitals should be equipped with a minimum set of tests. Using a minimal set of tests, it is possible to carry out immunodiagnosis of the main primary human immunodeficiencies. Although the latter are relatively rare (1:100,000-150,000), in most cases they are quite severe and require immediate treatment. As a rule, the minimum set of tests is insufficient to identify the causes of secondary immune deficiency. In this case, it is necessary to use a more complex set of Level II tests, which must be strictly individual for each specific case.

12.4. Pathology of the immune system

Immune system disorders are of two types: immune deficiency or immunodeficiencies, where there is a defect, i.e. abnormalities in one or more immune response mechanisms; excessive activation of immune mechanisms, leading to the development of allergic or autoimmune diseases. Immunoproliferative diseases stand apart.

12.4.1. Immunodeficiencies

Immunodeficiencies are disorders of the immune status caused by a defect in one or more mechanisms of the immune response.

There are primary (congenital) and secondary (acquired) immunodeficiencies.

The clinical picture of various immunodeficiencies is similar. Immunodeficiencies do not have characteristic clinical symptoms and are accompanied by infectious complications; hematological disorders; gastrointestinal disorders; autoimmune processes; tumors; allergic reactions; birth defects development.

Diagnosis of immunodeficiencies is carried out on the basis of anamnesis (frequent infectious diseases, tumors, autoimmune processes, allergies, etc.), clinical symptoms (opportunistic infection, allergies, tumors, condition of lymph nodes, malformations, etc.), as well as test results in vitro And in vivo, morphological studies (histological studies of central and peripheral organs of the immune system).

12.4.1.1. Primary congenital immunodeficiencies

Congenital immunodeficiency syndromes and diseases are quite rare. The causes of congenital immunodeficiencies can be chromosome duplication, point mutations, defects in nucleic acid metabolism enzymes, genetically determined membrane disorders, genome damage in the embryonic period, etc. Primary immunodeficiencies appear in the early stages of the postnatal period and are inherited in an autosomal recessive manner. Primary immunodeficiencies can manifest as insufficiency of phagocytosis, complement system, humoral and cellular immunity, and combined immune deficiency.

Insufficiency of phagocytosis caused by a decrease in the number of phagocytes or their functional inferiority. Periodic neutropenia underlies cyclic disorders of hematopoiesis. This process manifests itself in a decrease in the number of granulocytes and a change in the number of monocytes. Despite the fact that neutropenia is not accompanied by a deficiency of humoral or cellular immunity, it does cause an increased risk of

the risk of infectious diseases, especially those caused by highly virulent bacteria. Functional defects in phagocytosis can be caused by disturbances at any stage of the phagocytosis process.

Complement deficiency is rare. More often, a defect in the synthesis of complement components is observed, caused by hereditary deficiency of the C1 esterase inhibitor, which is clinically manifested by angioedema. A low concentration of C1 esterase inhibitor allows for continuous partial activation of C1 followed by consumption of C4 and C2. In a number of diseases, especially those that occur with the formation of immune complexes, activation of complement leads to its excess consumption. In this case, the number of C1, C4, C2 and C3 decreases most significantly.

Insufficiency of humoral immunity manifested by dysgammaglobulinemia and agammaglobulinemia. Agammaglobulinemia is caused by a violation of the synthesis of immunoglobulins or their accelerated decay. With it, there are no immunoglobulins in the patients’ blood and antitoxic and antibacterial immunity is impaired, i.e. those types of immunity where the leading role belongs to antibodies. Dysgammaglobulinemia is caused by a selective deficiency of one class or subclass of immunoglobulins or their combined deficiency, while the total level of serum immunoglobulins may remain within normal limits or even increase due to a compensatory increase in the synthesis of immunoglobulins of other classes. The most common are selective IgG deficiency at the same time high level IgM, deficiency of IgG and IgA with high levels of IgM, selective deficiency of IgA. There is a deficiency of certain subclasses of immunoglobulins and a defect in the light chains of immunoglobulins.

Insufficiency of cellular immunity caused by a violation of the functional activity of T cells. Since T lymphocytes are involved in the manifestation of the functional activity of B cells, it is more common combined immunodeficiency(damage to the T- and B-cell link) than selective T-cell immunodeficiency. Isolated T-cell immunodeficiencies have also been described, such as alymphocytosis (Nozelof syndrome), DiGeorge syndrome (congenital aplasia of the thymus and parathyroid glands), immunodeficiency in Down syndrome, imm.

munodeficiency with dwarf stature. In persons with such T-cell immunodeficiency, antiviral, antifungal, antitumor, and transplant immunity are impaired, i.e. those types of immunity where the main role belongs to the reactions of the T-cell component of the immune system. The first signs of cellular immunodeficiency are mycosis, recurrent viral infections, complications after vaccination with live vaccines (poliomyelitis, BCG, etc.). Persons with insufficient cellular immunity die in childhood, less often in adolescence from severe recurrent opportunistic infection or malignant tumors.

Combined immunodeficiencies develop with a combination of disorders of the T- and B-links of the immune system. These are the most severe immunodeficiencies. Combined forms are more common than selective forms; as a rule, they are associated with a violation of the central organs of the immune system. Depending on the severity of the defect, susceptibility to infectious diseases is expressed to varying degrees. With significant immune disorders, frequent bacterial and viral infections and mycotic lesions are observed, which leads to death at an early age. An immune defect at the stem cell level is caused by a number of disorders: a stem cell defect, a block of T- and B-cell differentiation, primary T-cell immunodeficiency, in which a decrease in immunoregulatory function leads to the development of B-cell immunodeficiency. The defect can be caused by endogenous and exogenous factors. Functional disorders can manifest themselves even if morphologically the cells of patients do not differ from normal ones. In combined immunodeficiencies, the leading role belongs to the T-cell defect.

12.4.1.2. Secondary immunodeficiencies

Secondary immunodeficiencies, unlike primary ones, develop in individuals with a normally functioning immune system from birth. They are formed under the influence environment at the phenotypic level and are caused by dysfunction of the immune system as a result of various diseases or adverse effects on the body. In secondary immunodeficiencies, the T- and B-immune systems and nonspecific resistance factors may be affected, and their combinations are possible.

nia. Secondary immunodeficiencies are much more common than primary ones. Secondary immunodeficiencies are transient and amenable to immunocorrection, i.e. restoration of normal activity of the immune system.

Secondary immunodeficiencies develop after infections (especially viral) and invasions (protozoal and helminthiasis); for burn disease, uremia, tumors, metabolic disorders and exhaustion, dysbiosis, severe injuries and extensive surgical operations, especially under general anesthesia, radiation, exposure chemical substances; aging, taking certain medications.

Immunodeficiencies, both primary and especially secondary, are widespread among people. They are the cause of many diseases and pathological conditions. Therefore, they require prevention and treatment with immunotropic drugs.

12.4.2. Autoimmune diseases

Autoimmune diseases are diseases in which autosensitization plays a leading role in the pathogenesis.

There are autoimmune reactions and autoimmune diseases, which are based on the interaction of components of the immune system with their own healthy cells and tissues. Autoimmune diseases are sometimes classified as immune complex diseases.

Autoimmune reactions are observed normally in healthy individuals, as well as in pathology. In the first case, they occur continuously and their effect is reduced to the removal of dying, aging, diseased cells, modified by any influences. They are the initial component of the immune response to various antigens. These reactions are beneficial to the body and do not develop into disease.

Autoimmune diseases are less common. These pathological conditions are based on autoimmune reactions with barrier cross-reacting antigens, the formation of “forbidden” clones of immunocompetent cells that react with their own normal tissues, genetically programmed weakness of the immune response to a specific antigen, insufficiency

suppression, blockade of lymphocyte receptors and other reasons. They may be a consequence of taking medications.

There are organ-specific, non-organ-specific and mixed autoimmune diseases. In organ-specific diseases, autoantibodies are specific for antigens of cells and tissues of one organ. Usually these are barrier antigens, to which there is no innate tolerance. In organ-nonspecific diseases, autoantibodies react with a structural element of the cells and tissues of a given or even another organism that has cross-antigenic structures. Mixed diseases involve both mechanisms.

Normal autoantibodies can often be detected and do not cause visible symptoms of the disease. They occur in completely healthy people, for example, rheumatoid, antinuclear factors. It can be difficult to prove that the clinical picture of the disease is a consequence of an autoimmune process. The detection of antibodies to autoantigens does not yet allow us to draw a conclusion about the cause-and-effect relationship of the disease with autoimmune reactions. To confirm this, it is necessary to identify an immune response to an autoantigen related to the disease, identify it, passively transfer the disease and provoke the disease with the corresponding antigen in an animal experiment. Human autoimmune diseases are presented in table. 12.2.

Table 12.2. Autoimmune diseases

End of table. 12.2

There are many known diseases whose pathogenesis involves autoimmune processes due to a number of reasons, including the aggressiveness of the immune system, aimed at the formation of autoantibodies to the antigens of one’s own cells and tissues. These diseases are difficult to treat. An important place among therapeutic agents is occupied by immunotropic drugs aimed at reducing the aggressiveness of the immune system.

12.4.3. Allergic diseases

The body responds to initial contact with the antigen by producing antibodies and sensitized lymphocytes. Upon secondary contact, the antigen reacts with antibodies and sensitized lymphocytes. These reactions are aimed at eliminating the antigen, but under certain conditions can lead to pathological consequences. The disease occurs only when immunoreactivity deviates significantly from the norm. With an increased level of individual reactivity to these antigens, an allergy develops.

From a clinical point of view, it is important to divide allergic reactions into 4 types. Various types of allergic reactions rarely occur in their pure form; as a rule, they transform into one another or are combined during the course of the disease.

12.4.3.1. Type I reactions (anaphylactic)

Anaphylaxis is an immune reaction that requires specific cytophilic antibodies and target cells. It manifests itself in the form of local (on the skin and mucous membranes)

membranes) or systemic (anaphylactic shock) reaction. Local anaphylactic reactions, depending on the location, are manifested by a rash, vasomotor runny nose, bronchial asthma, and intestinal disorders. An anaphylactic reaction can occur in any organ, since mast cells and basophils are found everywhere in the body, therefore, each type of animal is characterized by certain organs that are affected more often than others (shock organs). In humans, arterioles and bronchi are most often affected. Anaphylactic reactions in humans that are caused by IgE include seizures bronchial asthma, hay fever, urticaria, reactions to wasp and bee stings. Substances that cause anaphylaxis

Xenogeneic serums:

Antilymphocyte serum;

Antitetanus serum;

Antidiphtheria serum;

Other protein preparations.

Plant Pollen:

Ambrosia.

Natural poisons:

Bee venom;

Snake poison.

Medications:

Antibiotics (penicillin);

Salicylates;

Protein hormones;

Vaccines (measles, influenza, etc.).

12.4.3.2. Type II reactions (cytotoxic)

Type II allergic reactions are mediated by antibodies to cell surface antigens or to secondary antigens associated with the cell surface. The leading role belongs to antibodies that can activate the complement system (IgM, IgG1-3). In addition to complement-dependent cytotoxicity, this may also include antibody-dependent cell-mediated cytotoxicity that does not require complement.

Antibodies involved in cytotoxic reactions are specific for surface antigens of the cell membrane or secondary antigens associated with it. This is observed in some forms

a drug allergy, when drug molecules are adsorbed on the surface of blood cells. The consequence of this may be hemolytic anemia, leukocytopenia, thrombocytopenia, agranulocytosis. Greatest value for clinical picture have those humoral cytotoxic reactions that affect red blood cells. A reaction directed against the red blood cells of another individual is called isoimmune, and a reaction against one’s own red blood cells is called autoimmune. Every person has a high titer of antibodies in their serum to those antigens of the AB0 system that are absent on their own red blood cells. When incompatible blood is transfused, these isohemagglutinins cause a cytotoxic immune reaction, which is accompanied by hemolysis of the blood. During repeated pregnancies with a Rh-positive fetus in Rh-negative women, anti-Rhesus IgG is formed in the blood, which can pass through the placenta and, having a cytotoxic effect on the red blood cells of the fetus, destroy them. This leads to development hemolytic disease newborns. In autoimmune hemolytic anemia, autoantibodies are formed to the antigens of one's own red blood cells, which destroy them with the participation of complement. Some low molecular weight substances, for example certain drugs, having an affinity for the erythrocyte membrane, can become immunogenic and cause the formation of antibodies with the development of hemolytic anemia. This is how quinine, phenacetin, salicylates, streptomycin, penicillin, cephalosporins, sulfonamides, etc. act. Other blood cells (agranulocytosis, thrombocytopenia) can also become the object of cytotoxic action.

12.4.3.3. Type III reactions (immune complex)

Type III allergic reactions are mediated by immune complexes that form when a small excess of antigen precipitates. Depending on the amount and immunogenicity of the antigen, deposition of the resulting immune complexes in tissues sometimes occurs. The biological properties of such complexes are determined by the ratio of antigen and antibodies. Immune aggregates formed with a significant excess of antigen are small and medium in size and may have toxic properties. IgM, IgG1-3, which fix complement, participate in the formation of toxic immune complexes. Thanks to ac-

Activation of complement in places where immune complexes are deposited causes the release of biologically active mediators-anaphylotoxins (C3a, C3b, C5a), which, by increasing vascular permeability and attracting polymorphonuclear leukocytes, contribute to the development of inflammation. Phagocytosed toxic immune complexes damage and destroy granulocytes, from which proteolytic enzymes are released that destroy body tissue. Symptoms caused by toxic immune complexes are caused by the damaging effects of toxic factors of an endogenous nature, released during inflammation as a result of complement activation and the breakdown of neutrophils.

Immune complexes are formed in the bloodstream when antigen and antibodies are simultaneously in the blood plasma or in tissues, when the antigen is introduced into the tissue and the antibodies are in the blood and their mutual diffusion occurs. In the first case, vasculitis due to immune complexes develops, in the second - the Arthus phenomenon. In allergic vasculitis, the formation of immune complexes occurs with a slight excess of antigen directly in the lumen of the vessel. Their location can be any blood vessel, and then, as a result of complement activation and leukotaxis, tissue damage and even vessel desolation occur. The vessels of the lower extremities and capillaries are most often affected renal glomeruli. Typical example allergic vasculitis- glomerulonephritis. The very fact of antigen persistence and its concentration are of decisive importance in this type of pathology. Some microbes (group A streptococci) and their breakdown products contribute to the development of chronic glomerulonephritis. A special case vasculitis caused by immune complexes is a serum sickness that develops 8-10 days after a single injection of heterologous serum and is accompanied by an increase in temperature, an enlargement of the spleen and lymph nodes, leukocytosis and a decrease in complement activity. Symptoms of serum sickness occur with the appearance of antibodies in the bloodstream and persist as long as free antigen is in the bloodstream. Symptoms disappear after immune elimination of the antigen. With the Arthus phenomenon, the immune reaction is primarily directed only at the foreign antigen, but the release of lysosomal

enzymes in places where immune complexes are deposited leads to secondary tissue damage. The classic Arthus reaction in humans occurs with exposure to certain inhalant allergens, especially with regular, repeated exposure. Similar diseases include allergic alveolitis, in which precipitating antibodies to industrial allergens (“farmer’s lung”, “poultry farmer’s lung”) are often found in the serum of patients.

12.4.3.4. Type IV reactions (T-lymphocyte mediated)

The morphological picture during HRT is inflammatory in nature, caused by the reaction of lymphocytes and macrophages to the resulting antigen complex with sensitized lymphocytes and manifests itself after 24-48 hours. Its typical example is the tuberculin reaction. Intradermal administration of tuberculin to a sensitized individual causes redness and swelling at the injection site, reaching a maximum 24-48 hours after the introduction of the allergen. A dense hyperemic papule with necrosis in the center is formed. Necrotic tissue is sometimes sloughed off, leaving behind an ulceration that slowly

is healing. Histologically, an accumulation of macrophages and lymphocytes is detected.

HRT may involve the administration of drugs or exposure to certain low molecular weight substances. Low molecular weight compounds are haptens; when they attach to carriers, which are the body’s own proteins, they induce the development of HRT. A typical example of cell-mediated skin hypersensitivity is contact eczema. When a sensitized individual encounters a hapten, local activation of T-lymphocytes and macrophages occurs. The lymphokines released during this process trigger a pathological process that is clinically manifested by eczema. The most common causes of contact allergies are synthetic detergents, compounds of chromium, nickel, mercury, paraphenylenediamine, DNCB, many preservatives and medications.

12.5. Immunocorrection

Immunocorrection is a branch of clinical immunology that studies methods and techniques for the prevention and treatment of diseases or conditions (immunodeficiencies) associated with dysfunction of the immune system.

Drugs that affect the immune status and are used for immunocorrection are called immunomodulators. To date, hundreds of immunomodulators used in medicine are known (for more details, see Chapter 14).

The goal of optimal immunocorrection is a targeted effect on the body’s ability to respond to the immune system, i.e. to activate or suppress the activity of the immune system, depending on the indications. For example, to create immunity to pathogens of infectious diseases, the immune system is activated using vaccines, and passive immunity is created by introducing serums or immunoglobulins. In allergic conditions and some immunopathological processes, it is necessary to suppress the immune system, therefore immunosuppressants are used. They are also used in organ and tissue transplantation. Antigen-specific stimulation or suppression is of particular importance. Since there are certain

restrictions on clinical use, the main approach to treatment remains nonspecific correction.

The general principle of immunocorrection is to carry it out against the background of good nutrition, taking vitamins, micro- and macroelements. Principles of immunocorrection:

Immunotherapy should be used only after determining the state of the immune system, i.e. immune status and identification of insufficient functioning of the immune system;

Immunotherapy must be prescribed for disorders of the immune status accompanied by clinical symptoms;

During the process of immunotherapy, it is necessary to monitor the immune status over time;

Use immunomodulators to prevent those influences that can cause immunodeficiencies (environmental, social and other factors).

Tasks for self-preparation (self-control)

A. Indicate the forms of immunity in which the company takes part:

1. Immunity of mucous membranes.

2. Antitoxic.

3. Antibacterial humoral.

4. Humoral antiviral.

B. Indicate the forms of immunity in which T-killers take part:

1. Transplantation.

2. Antitumor.

3. Antiviral.

4. Antibacterial.

B. Specify the forms of infections accompanied by the development of HRT:

1. Helminthic infestation.

2. Fungal.

3. Viral.

5. Bacterial.

G. Note the components of antihelminthic immunity:

2. T-killer.

3. Complement.

4. Eosinophils.

D. The patient suffers from recurrent viral infections and mycosis that is not curable. The doctor suggested that he had an immunodeficiency. Name the affected part of the immune response.

For quotation: Shcheplyagina L.A., Kruglova I.V. Age characteristics immunity in children // Breast cancer. 2009. No. 23. S. 1564

Mechanisms of immune defense

Immunity is a way of protecting the body from living bodies and substances (antigens - Ags) that carry signs of foreign information [R.V. Petrov et al., 1981; R.M. Khaitov et al., 1988; W. Bodman, 1997].

Exogenous antigens most often include microorganisms (bacteria, fungi, protozoa, viruses); endogenous antigens include human cells modified by viruses, xenobiotics, aging, pathological proliferation, etc.

Human protection from foreign agents is ensured by the immune system, which consists of central and peripheral organs. The former include the bone marrow and thymus gland, the latter – the spleen, lymph nodes, and lymphoid tissue associated with the mucous membranes and skin (Fig. 1).

The main cell of the immune system is the lymphocyte. In addition, tissue macrophages, neutrophils, and natural killer (NK) cells are also involved in providing the immune response.

There are innate and acquired immunity. Innate immunity is provided by natural resistance factors. Some infection-fighting mechanisms are innate, that is, they are present in the body before encountering any infectious agent and their activity does not depend on a previous encounter with microorganisms.

The main external protective barrier that prevents the penetration of microorganisms into the human body is the skin and mucous membranes. The protective properties of the skin are, first of all, its impermeability (physical barrier) and the presence of microorganism inhibitors on the surface (lactic acid and fatty acids in sweat and sebaceous gland secretions, low pH on the surface).

The mucous membrane has a multicomponent defense mechanism. The mucus secreted by its cells prevents microorganisms from attaching to it; the movement of the cilia promotes the “sweeping out” of foreign substances from the respiratory tract. Tears, saliva and urine actively wash away foreign substances from the mucous membranes. Many fluids secreted by the body have specific bactericidal properties. For example, gastric hydrochloric acid, spermine and zinc in sperm, lactoperoxidase in breast milk and lysozyme in many external secretions (nasal, tears, bile, duodenal contents, breast milk, etc.) have powerful bactericidal properties. Some enzymes also have a bactericidal effect, for example, hyaluronidase, α1-antitrypsin, lipoproteinase.

A special defense mechanism is provided by microbial antagonism, when the body's normal intestinal microflora suppresses the growth of many potentially pathogenic bacteria and fungi. Antagonism is based on competition for the nutrient medium or the production of agents with bactericidal properties. For example, the invasion of microbes into the vagina is prevented by lactic acid, formed by commensal microbes during the breakdown of glycogen secreted by vaginal epithelial cells.

Phagocytosis is the most important mechanism of nonspecific defense. Monocytes, tissue macrophages, and polymorphonuclear neutrophils are involved in a process that facilitates the processing of antigen and its subsequent presentation to lymphocytes for the development of the immune response itself.

The complement system significantly increases the efficiency of phagocytosis and helps destroy many bacteria. There are many known complement components, they are designated by the symbol “C”. The body contains the largest amount of the C3 component of complement. The complement system is involved in the development of an acute inflammatory reaction in response to the introduction of an infectious agent. There is evidence that the C3 component of complement (C3b) plays a role in antibody formation.

Nonspecific protective factors also include proteins of the acute phase of inflammation. They are able to initiate reactions of precipitation, agglutination, phagocytosis, complement fixation (features similar to immunoglobulins), increase the mobility of leukocytes, and can bind to T lymphocytes.

Interferon is also included in the list of nonspecific protection factors, although it occupies a special place among them. It is produced by many cells and appears several hours after the cell is infected with the virus. The impact of a “current infection” is accompanied by the formation of an inactivated virus in the cell, which stimulates interferon formation.

The human body has a huge range of specific immune defenses. Its implementation requires the participation of very subtle mechanisms.

Humoral immunity. A specific immune response is provided by antibodies, which, as a result of binding to a microbe, activate complement along the classical pathway. A specific immune response is carried out by lymphocytes (B and T). The precursor of all immunocompetent cells is a pluripotent stem cell of bone marrow origin. B lymphocytes are programmed to produce antibodies (AT) of one specificity. These antibodies are present on its surface as receptors for binding antigens. One lymphocyte has up to 105 identical AT molecules on its surface. AG interacts only with those AT receptors for which it has affinity. As a result of the binding of AG to AT, a signal is generated that stimulates an increase in cell size, its reproduction and differentiation into plasma cells that produce AT. A significant amount of AT for detection in serum is most often formed within a few days.

All antibodies are represented by the main classes of immunoglobulins - IgG, IgA, IgM, IgE, IgD - which in biological fluids reflect the state of humoral immunity. Classes of immunoglobulins differ in the antigenic characteristics of their heavy chain constant domains (Fc fragment). Antibodies to living and non-living Ags are part of the existing classes of immunoglobulins. The quantitative ratio of immunoglobulins is presented as follows: IgG – γ (Fc γ) – 75% (12 mg/ml); IgA – α(Fc α) – 15–20% (3.5 mg/ml); IgM – μ(Fc μ) – 7% (1.5 mg/ml); IgD – δ(Fc δ) – 0.03 mg/ml; IgE – ε(Fc ε) – 0.00005 mg/ml.

Since an increase in the amount of antibodies occurs as a result of interaction with antigen, the reaction based on this is called the “acquired immune response.” Primary contact with hypertension leaves an imprint in the form of some information - immunological memory, thanks to which the body gains the ability to effectively resist re-infection with the same pathogen, i.e. acquires a state of immunity. Acquired immunity is characterized by antigen specificity, that is, immunity to one microbe does not provide protection from another infectious agent.

Ontogenesis of local immunity. Local immunity is provided by the lymphoid apparatus of the subepithelial spaces and epithelial cells covering the mucous membranes of organs communicating with the external environment. The main immunoglobulin is sIgA. The child is born without sIgA. The secretory component IgA – (SC) is also absent in a newborn baby. Its trace amounts appear by the 5th–7th day of life. Sometimes, instead of sIgA, a child is found to have sIgM, which to a certain extent takes on the function of sIgA, which reflects the evolutionary features of the development of the immune response. This fact is important to consider when assessing secretory immunity in infants and preschool children. The age-related dynamics of secretory immunoglobulin A coincides with the dynamics of serum IgA. Secretory immunoglobulin reaches its maximum concentration in secretions by the age of 10–11 years.

To understand the functional capabilities of the immune system of a growing organism, it is important to know the physiology of its formation, which is characterized by the presence of five critical periods of development.

The first critical period occurs before the age of 28 days of life, the second – up to 4–6 months, the third – up to 2 years, the fourth – up to 4–6 years, the fifth – up to 12–15 years.

The first critical period is characterized by the fact that the child's immune system is suppressed. Immunity is passive in nature and is provided by maternal antibodies. At the same time, your own immune system is in a state of suppression. The phagocytosis system is not developed. The newborn exhibits weak resistance to opportunistic, pyogenic, gram-negative flora. There is a tendency to generalize microbial-inflammatory processes and to septic conditions. The child is very sensitive to viral infections, against which he is not protected by maternal antibodies. Approximately on the 5th day of life, the first crossover occurs in the white blood formula and the absolute and relative predominance of lymphocytes is established.

The second critical period is due to the destruction of maternal antibodies. The primary immune response to infection develops through the synthesis of class M immunoglobulins and does not leave immunological memory. This type of immune response also occurs during vaccination against infectious diseases, and only revaccination forms a secondary immune response with the production of IgG antibodies. The insufficiency of the local immune system is manifested by repeated acute respiratory viral infections, intestinal infections and dysbacteriosis, and skin diseases. Children have a very high sensitivity to respiratory syncytial virus, rotavirus, parainfluenza viruses, adenoviruses (high susceptibility to inflammatory processes of the respiratory system, intestinal infections). Whooping cough and measles occur atypically, leaving no immunity. Many hereditary diseases appear, including primary immunodeficiencies. The frequency of food allergies is sharply increasing, masking atopic manifestations in children.

Third critical period. The child’s contacts with the outside world (freedom of movement, socialization) expand significantly. The primary immune response (IgM synthesis) to many antigens is preserved. At the same time, a switch of immune reactions to the formation of IgG class antibodies begins. The local immune system remains immature. Therefore, children remain susceptible to viral and microbial infections. During this period, many primary immunodeficiencies, autoimmune and immune complex diseases (glomerulonephritis, vasculitis, etc.) first appear. Children are prone to repeated viral and microbial inflammatory diseases of the respiratory and ENT organs. The signs of immunodiathesis (atopic, lymphatic, autoallergic) become clearer. Manifestations of food allergies gradually weaken. According to immunobiological characteristics, a significant part of children in the second year of life are not ready for the conditions of being in a children's group.

The fifth critical period occurs against the background of rapid hormonal changes (accounts for 12–13 years in girls and 14–15 years in boys). Against the background of increased secretion of sex steroids, the volume of lymphoid organs decreases. The secretion of sex hormones leads to the suppression of cellular immunity. The level of IgE in the blood decreases. Strong and weak types of immune response are finally formed. The impact of exogenous factors (smoking, xenobiotics, etc.) on the immune system is increasing. Increased sensitivity to mycobacteria. After some decline, there is an increase in the frequency of chronic inflammatory, as well as autoimmune and lymphoproliferative diseases. The severity of atopic diseases (bronchial asthma, etc.) in many children is temporarily weakened, but they can recur at a young age.

Can a child's immunity decrease?

There are many reasons and risk factors for decreased immunity. A transient decrease in immunity is caused by insufficient protein and energy nutrition, a deficiency in the consumption of micronutrients, especially vitamins A, C, E, D, β-carotene, essential microelements (zinc, iron, selenium, iodine), polyunsaturated fatty acids, and the presence of chronic diseases of the digestive system. , a history of infectious diseases, taking antibiotics, exposure to ecopathological factors, disturbances in the composition of the intestinal microflora.

Insufficient protein and energy intake is known to reduce antibody synthesis. A deficiency in the diet of polyunsaturated fatty acids, vitamins A, C, β-carotene, and zinc is accompanied by disturbances in all parts of the immune response. Lack of iodine reduces the activity of the phagocytic link, components of antioxidant protection (vitamins A, E, zinc, selenium, etc.), and adversely affects the functional activity and vital activity of immunocompetent cells.

IN modern conditions Children are exposed to the above risk factors for immune system disorders. In real conditions, these factors adversely affect the immunity of the population of all age groups.

Considering the above, it is obvious that immunorehabilitation measures deserve special attention and should become components of programs for maintaining and restoring health. In pediatric practice, immunomodulatory agents are widely used. However, it is not entirely clear what medications the pediatrician should use and how they should be selected.

What is known about drugs that can change the functioning of the immune system?

Among immunotropic drugs, there are three main groups:

Immunostimulants;

Inducers of immunological tolerance;

Immunosuppressants (Fig. 2).

A pediatrician can only prescribe drugs that can have a “mild” modulating effect on the immune system.

Among drugs aimed at increasing immunity, in our opinion, it is advisable to distinguish three groups of drugs. Group 1 – drugs that promote the processes of age-related maturation of the immune system; Group 2 – drugs aimed at increasing the functional activity of the immune system; Group 3 – drugs related to “emergency” support of the immune system (Fig. 3).

Group 1 drugs (promote the maturation of immunocompetent cells and the functioning of the immune system) include immunonutrients (essential microelements (ME), vitamins, polyunsaturated fatty acids (PUFAs), etc.) and probiotics. Group 2 includes the largest number of immunotropic drugs. Among the drugs in this group, immunotropic drugs of different nature are distinguished: endogenous origin and their synthetic analogues; exogenous substances and their synthetic analogues, synthetic substances that can influence various parts of the immune system, including interferon preparations. Group 3 includes immunoglobulin preparations for intravenous and/or intramuscular administration (they are used for emergency assistance to the immune system).

When choosing immunotropic drugs, it is important to keep in mind that the natural activation of the immune system is ensured by normal intestinal microflora.

As you know, a child’s immune system is formed in utero. The baby is born with sterile intestines. In this case, the differentiation of T-helpers is focused on the predominant formation of T-helpers of the second type (Th2), which promote the formation of IgE, which increases the risk of developing atopic diseases. The main condition for the further maturation and functioning of the child’s immune system is the provision of adequate nutrition (vitamins and essential microelements, polyunsaturated fatty acids) and the colonization of open loci with normal microflora. The intestinal microflora is of greatest importance. Normal microflora in healthy newborn interrupts the prenatal differentiation of T-helpers predominantly into type 2 helpers and ensures a normal ratio of Th1 and Th2 (1:2). Normalizing the ratio of these cells, on the one hand, helps to increase food tolerance, and on the other, reduces the risk of developing immune-based inflammatory diseases.

The intestinal microflora in the postneonatal period largely determines the quality of the immune response and the functioning of local and systemic immunity.

What immunotropic drugs are popular among doctors?

The most widely used drugs in medical practice are those of natural origin, that is, those that correspond in composition to natural resistance factors. Among them, interferon occupies a special place.

Interferons (IFNs) are a group of genetically determined, biologically active proteins synthesized by nucleated cells in the process of a protective reaction to the influence of agents that carry signs of genetically foreign information. These proteins are capable of nonspecifically suppressing intracellular stages of reproduction wide range microorganisms (viruses, bacteria, protozoa, chlamydia, rickettsia, etc.). Interferons form a protective barrier against viruses much earlier than specific protective reactions of the immune system, stimulating cellular resistance, making cells unsuitable for the reproduction of viruses.

There are interferons of the first (IFN-I) and second type (IFN-II). Type 1 interferon includes IFN-α (alpha), IFN-β (beta), IFN-δ (delta), IFN-ω (omega), IFN-τ (tau), type 2 – IFN-γ (gamma), IFN-λ (lamda). They have a number of common biological properties, but differ in molecular structure. The most studied are IFN-α, IFN-β and IFN-γ. In humans, there is one subtype of interferon β and γ and at least 14 types of interferon α. The most significant are interferons of the α2 class, which are produced in the body most.

Numerous studies have established that interferons have antiviral, antibacterial, antiproliferative and immunomodulatory effects. Of great interest is the antibacterial effect of interferons discovered in recent years against gram-positive and gram-negative microorganisms. In addition to their direct effect on viruses and other microorganisms, interferons are important modulators of immunity, which allows them to be classified as a family of regulatory cytokines.

Of particular interest to doctors is the modulating effect of IFN on the immune system (activation of the immune system, including interferon production if they are reduced and a decrease in their activity if they are increased). Against the background of IFN, there are no changes in the immune system if deviations from the norm are not registered before the start of treatment). An important advantage of interferon drugs is their ability to have a positive effect on the immune system when using low therapeutic doses of the drug. In addition, interferon drugs combine well with other drugs, including antibiotics and chemotherapy, and have minimal risk unwanted effects(for example, flu-like effect) when administered rectally and can be prescribed to children of any age.

The introduction of exogenous interferon allows for the elimination of the infectious agent long before one’s own cells begin to synthesize endogenous interferon in sufficient quantities. In addition, the introduction of interferon allows you to relieve the affected cells and compensate for their inability to produce their own interferon in the required quantities. Finally, accelerated elimination of the infectious agent with the introduction of exogenous interferon makes it possible to shorten the duration of the infectious process, which prevents the achievement of a critical concentration pro-inflammatory cytokines. It has been established that under the influence of interferon in the body, the activity of natural killer cells, cytotoxic T-lymphocytes, T-helpers, phagocytic activity, and the expression of HLA system antigens 1 and 2 are enhanced.

In healthcare practice, interferon preparations of two generations are used. 1st generation drugs of natural origin, obtained from donor blood, and developed using genetic engineering - recombinant forms of interferon.

Interferon preparations are used primarily for viral infections, among which the most studied are acute and chronic viral hepatitis, herpetic lesions, influenza, ARVI and others. The effectiveness of interferons in the treatment of cytomegalovirus infection, various bacterial diseases (purulent-septic infection in newborns and surgical patients, chlamydia, etc.). Interferons are also used in many cancer diseases. Currently, methodological documents and standards for prescribing interferon for the treatment of various diseases have been developed.

Russia was not the first country to develop technology for obtaining and began clinical application recombinant interferon drugs. However, the creation of rectal and vaginal suppositories based on recombinant interferon is a unique domestic development.

Currently, doctors are increasingly using the drug Kipferon® suppositories for vaginal or rectal administration. This is a combination drug consisting of recombinant interferon-a 2b (500,000 IU) and a complex immunoglobulin preparation (CIP) in the amount of 60 mg. The CIP contains a set of highly specific antibodies consisting of immunoglobulins G, A, M to those common and circulating in Russia and the CIS countries pathogenic microorganisms: herpes viruses, cytomegaloviruses, rotaviruses, chlamydia, ureaplasma, staphylococci, streptococci, enterobacteria (shigella, salmonella, ischerichia), fungi, etc. A wide range of antibodies in the composition of immunoglobulins KIP allows the drug to actively act on various associations of microorganisms. On the other hand, interferon has an antiviral, antibacterial, antiprotozoal, anti-inflammatory effect and also activates the function of immunocompetent cells and stimulates the synthesis of γ-interferon, the most important factor in anti-infective defense. Interferon α2b effectively participates in the processes of pathogen elimination, provides prevention of complications of the infectious process, activates the immune system and increases the body's immunological reactivity. Available clinical researches This combination drug of immune-oriented action also indicates that due to the activation of the synthesis of g-interferon, the patient’s sIgA level increases and the state of local immunity as a whole improves.

If we summarize the effects of Kipferon®, we can assume that its use guarantees double protection against infection, since it is aimed at destroying pathogens due to the antibodies present in the KIP composition, and at the same time at speedy recovery due to stimulation of cellular immunity, active production of γ-interferon and increasing the level of local immunity.

The fact that Kipferon® belongs to the suppository form of medicines deserves an independent positive assessment. The advantages of the suppository form of the drug include the following properties: the ability for long-term active circulation of substances in the bloodstream, the convenience of administering large doses of interferon, and the elimination of “flu-like syndrome.” Interferon administered through the rectum as part of Kipferon® reaches its maximum concentration in the blood after 1 hour and remains at a therapeutic level for 12 hours. From the third day of treatment, the basic level of interferon increases every day.

The safety and effectiveness of the drug has been proven in neonatology, obstetrics and gynecology, infectious disease practice, and pediatric gastroenterology. During the drug's presence on the pharmaceutical market and its use in practical work doctors of different specialties did not register a single undesirable effect.

Conclusion

The human immune system begins its formation before the birth of a child. Its place and extent of influence on health are genetically programmed. From birth to the end of puberty, step by step, the structure and functions of the immune system are formed. The development of the immune system goes through a number of critical stages that must be taken into account when assessing health status, developing preventive programs and prescribing treatment for diseases. To maintain age-related maturation of the immune system and its full functioning in subsequent years, it is necessary to receive immunonutrients (microelements and vitamins) daily from food and take measures to preserve and restore normal intestinal microflora.

Many are sharp and chronic diseases negatively affect the immune system, which significantly reduces the child’s resistance to infection and other damaging factors. Therefore, in some cases, in order to increase the effectiveness of treatment, prevent severe complications and reduce the risk of an unfavorable outcome of the disease, drugs are prescribed that increase the functional activity of organs and tissues of the immune system (immunotropic drugs). Priority among them should be given to medicines endogenous origin, with maximum immunomodulatory activity and safety. First of all, these are interferon drugs.

In emergency situations that threaten life or epidemiological safety, to influence the immune system, preference is given to immunoglobulin preparations for intravenous or intramuscular administration.

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Active (post-vaccination) immunity is created by introducing into the human body vaccines containing weakened or killed pathogens. It is produced approximately two weeks after vaccination and persists long time.

3. Immunity after illness

A - Acquired natural passive

B- Acquired natural active

B - Acquired artificial passive

G - Acquired artificial active

Active form acquired in natural conditions life is post-infectious immunity that occurs in a person as a result of contracting a disease. This type of immunity is carried out by antibodies produced by B lymphocytes. It persists for many years, and often throughout life.

4. Immunity after administration of serums

A - Acquired natural passive

B - Acquired natural active

B - Acquired artificial passive

G - Acquired artificial active

Passive artificial immunity is created several hours after the administration of serum containing antibodies against the causative agent of any disease (for example, anti-tetanus serum, against snake venom, etc.). This form of immunity lasts no more than a month. It is used mainly for medicinal purposes.

5. Immunity of newborns

A - Acquired natural passive

B - Acquired natural active

B - Acquired artificial passive

G - Acquired artificial active

Only IgG is able to penetrate the placenta, which ensures the formation of passive immunity in the fetus. Therefore, a child is born with only passive natural immunity. The passive form of natural acquired immunity is placental and maternal. It is provided by passively transferred antibodies from the mother to the fetus through the placenta or to the infant through breastfeeding. After birth and cessation of breastfeeding breast milk this form of immunity fades away after 1-1.5 months.

A - Bacterial lysate

B - Bacterial toxins

B - Suspension of whole bacterial cells

Agglutination is the process of microparticles such as red blood cells or suspended bacteria sticking together under the action of serum antibodies called agglutinins to form visible aggregates.

7. Chemical nature of full antigens

A - Lipids

B - Polysaccharides

Human erythrocytes contain agglutinable protein factors - agglutinogens (antigens) A and B. In the erythrocytes of different people they can be present separately, together, or absent.

8. To perform the agglutination reaction, complement

A - Necessary

B - Not used

9. Antigen for passive (indirect) hemagglutination reaction

A - Suspension of whole bacterial cells

B - Bacterial toxins

B - Erythrocyte diagnosticum

D - Suspension of red blood cells

Passive indirect hemagglutination is a reaction used to diagnose viral infections, agglutination of erythrocytes pre-coated with virus-specific antibodies by the virus.

10. When assessing RSC in the test tube, complete hemolysis is observed

A - The reaction is positive

B - Negative reaction

When complete hemolysis is observed, free complement interacts with the components of the hemolytic system, in this case a negative reaction is observed.

11. To set up the bacteriolysis reaction, complement

A - Necessary

B - Not used

Reactions involving complement are based on the activation of complement as a result of its attachment to antibodies complexed with the antigen (complement fixation reactions, radial hemolysis, etc.).

12. Anatoxin is prepared from

A - Exotoxin

B - Endotoxin

B - Antitoxin

Anatoxins are prepared from exotoxins of the corresponding pathogens by treating them with 0.3-0.4% formaldehyde and keeping them at a temperature of 38-400C for 3-4 weeks.

13. Non-specific protective factors do not include

A-antibodies

B - lysozyme

B - phagocytosis

G - complement system

Lysozyme belongs to the first line of defense, the complement system belongs to the second line of nonspecific mechanisms, phagocytosis is the process of absorption and digestion of microorganisms by phagocytes. And antibodies belong to inducible protective factors, that is, to specific reactions of the immune system induced by the penetration of an infectious or any other agent that has signs of foreignness.

14. The central organs of the immune system include

A - Thymus, bone marrow

B - Spleen, thymus, bone marrow

B - Spleen, thymus

D - Circulating immunocompetent cells

The central organs of the immune system are the bone marrow and thymus. In them, from hematopoietic stem cells, lymphocytes differentiate into mature non-immune lymphocytes, the so-called naive lymphocytes (from the English naive), or virgin (from the English virgine).

A - Activation of phagocytosis by antibodies and complement

B - Activation of complement via the alternative pathway

B - Interaction of the pathogen with immunocompetent cells

Opsonization is the process of interaction of opsonins with bacteria, during which the latter become more susceptible to the action of phagocytes. Opsonins attach to the outer walls of bacteria, changing their physical and chemical structure.

16. O-antigen

A - Flagellate

B - Somatic

B - Capsule

17. Anatoxin is

A - Serum preparation

B - Diagnosticum

B - Vaccine

Toxoids are molecular vaccines that are used for active immunoprophylaxis of toxinemic infections.

18. The specificity of antibodies is determined by

A - Determinant groups

B - Active centers

B - Heavy chains

G - Light chains

D - Fc fragment

The Fc fragment determines various effector functions of antibodies that are not related to their specificity, binding of complement components, interaction with the Fc receptor of macrophages, etc. The specificity of the antibody is determined by the chemical structure and spatial pattern of antideterminants. It is associated with the primary structure (alternation of amino acids) of the antibody protein molecule. The heavy and light chains of immunoglobulins determine the specificity of the active site.

19. The peripheral organs of the immune system include

A - thymus, bone marrow

B - spleen, thymus, bone marrow

B - spleen, lymph nodes, lymphoid tissue associated with skin and mucous membranes

G - circulating immunocompetent cells

Peripheral lymphoid organs and tissues (lymph nodes, lymphoid structures of the pharyngeal ring, lymphatic ducts and spleen) - the territory of interaction of mature non-immune lymphocytes with antigen-presenting cells (APC) and subsequent antigen-dependent differentiation (immunogenesis) of lymphocytes. This group includes: skin-associated lymphoid tissue (Scin-Assoelated Lymphoid Tissue SALT); lymphoid tissue associated with mucus membranes (Mucosus-Associated Lymphoid Tissue - MALT), gastrointestinal, respiratory and genitourinary tracts (solitary follicles, tonsils, Peyer's patches, etc.).

20. Local immunity is due to

lg G is the main class of AT (up to 75% of all lg), protecting the body from bacteria, viruses and toxins.

21. H-antigen

A - Flagellate

B - Somatic

B - Capsule

Antigens are distinguished according to their location in the bacterial cell: capsular (K-antigen, in capsule-forming species), somatic (O-antigen) and flagellar (H-antigen)

22. α - interferon is produced

A - Leukocytes

B - Stimulated lymphocytes

B - Fibroblasts

Currently known different types interferon. The main ones are a-interferon (with varieties a 1 and a 2), b-interferon, g-interferon. a-Interferon is a protein, and b- and g-interferons are lycoproteins. a-Interferon is produced mainly by peripheral blood b-lymphocytes and lymphoblastoma lines, b-interferon by ibroblasts, and g-interferon by peripheral blood T-lymphocytes.

23. The specificity of antigens is determined

A - Determinant groups

B - Active centers

B - Macromolecularity

G - Colloidal state

An antigen contains several different or repeated epitopes. Epitope (antigenic determinant) is a distinctive part of the antigen molecule that determines the specificity of antibodies and effector T lymphocytes in the immune response. The epitope is complementary to the active site of the antibody or T-cell receptor.

24. γ-interferon is produced

A - Leukocytes

B - Stimulated lymphocytes

We often hear that a person’s health largely depends on his immunity. What is immunity? What is its significance? Let's try to understand these questions that are unclear to many.

Immunity is the body’s resistance, its ability to resist pathogenic pathogens, toxins, as well as the effects of foreign substances with antigenic properties. Immunity ensures homeostasis - constancy internal environment organism at the cellular and molecular level.
Immunity happens:

- congenital (hereditary);

- acquired.

Examples of absolute immunity. A person is absolutely not sick with bird plague or plague cattle. Animals are absolutely free from typhoid fever, measles, scarlet fever and other human diseases.

An example of relative immunity. Pigeons usually don't get sick anthrax, but they can be infected with it if you first give the pigeons alcohol.

A person acquires acquired immunity throughout life. This immunity is not inherited. It is divided into artificial and natural. And they, in turn, can be active and passive.

Artificial acquired immunity created by medical intervention.

Active artificial immunity occurs during vaccinations with vaccines and toxoids.

Passive artificial immunity occurs when serums and gamma globulins are introduced into the body, which contain antibodies in finished form.

Natural acquired immunity created without medical intervention.

Active natural immunity occurs after an illness or latent infection.

Passive natural immunity is created when antibodies are transferred from the mother’s body to the child during its intrauterine development.

Immunity is one of the most important characteristics of humans and all living organisms. The principle of immune defense is to recognize, process and remove foreign structures from the body.

Intact skin, mucous membranes of the eyes, respiratory tract with cilia of the ciliated epithelium, gastrointestinal tract, genitals are impermeable to most microorganisms.

Peeling of the skin is an important mechanism for its self-cleansing.

Saliva contains lysozyme, which has an antimicrobial effect.

The mucous membranes of the stomach and intestines produce enzymes that can destroy pathogens that enter there.

On mucous membranes there is natural microflora, capable of preventing pathogens from attaching to these membranes, and thus protecting the body.

The acidic environment of the stomach and the acidic reaction of the skin are biochemical factors of nonspecific protection.

Slime too nonspecific factor protection. It covers the cell membranes on the mucous membranes, binds pathogens that enter the mucous membrane and kills them. The composition of mucus is lethal to many microorganisms.

Blood cells that are nonspecific protection factors: neutrophils, eosinophils, basophilic leukocytes, mast cells, macrophages, platelets.

The skin and mucous membranes are the first barrier to pathogens. This defense is quite effective, but there are microorganisms that can overcome it. For example, Mycobacterium tuberculosis, salmonella, listeria, some coccal forms of bacteria. Certain forms of bacteria are not destroyed by natural defenses, for example, capsular forms of pneumococcus.

Specific mechanisms of immune defense is the second component of the immune system. They are triggered when a foreign microorganism (pathogen) penetrates through the body’s natural nonspecific defenses. Appears inflammatory reaction at the site of pathogen introduction.

Inflammation localizes the infection and the death of invading microbes, viruses or other particles occurs. The main role in this process belongs to phagocytosis.

Phagocytosis– absorption and enzymatic digestion cells phagocytes of microbes or other particles. At the same time, the body is freed from harmful foreign substances. In the fight against infection, all the body's defenses are mobilized.

From the 7th – 8th day of illness, specific immune mechanisms are activated. This the formation of antibodies in the lymph nodes, liver, spleen, bone marrow. Specific antibodies are formed in response to the artificial introduction of antigens during vaccinations or as a result of a natural encounter with infection.

Antibodies- proteins that bind to antigens and neutralize them. They act only against those microbes or toxins in response to the introduction of which they are produced. Human blood contains proteins albumin and globulins. All antibodies belong to globulins: 80 - 90% of antibodies are gamma globulins; 10 – 20% - beta globulins.

Antigens– foreign proteins, bacteria, viruses, cellular elements, toxins. Antigens cause the formation of antibodies in the body and interact with them. This reaction is strictly specific.

A large number of vaccines and serums have been created to prevent human infectious diseases.

Vaccines– these are preparations from microbial cells or their toxins, the use of which is called immunization. 1–2 weeks after the vaccine is administered, protective antibodies appear in the human body. The main purpose of vaccines is prevention.

Modern vaccine preparations are divided into 5 groups.

1.Vaccines from live attenuated pathogens.

2.Vaccines made from killed microbes.

3. Chemical vaccines.

4.Anatoxins.

5.Associated or combined vaccines.

For long-term infectious diseases, such as furunculosis, brucellosis, chronic dysentery and others, vaccines can be used for treatment.

Serums- prepared from the blood of those who have been ill infectious disease people or artificially infected animals. Unlike vaccines, Serums are more often used to treat infectious patients and less often for prophylaxis. Serums are antimicrobial and antitoxic. Serums purified from ballast substances are called gamma globulins. They are prepared from human and animal blood.

Serums and gamma globulins contain ready-made antibodies, therefore, in infectious foci, persons who have been in contact with an infectious patient are administered serum or gamma globulin, and not a vaccine, for prophylactic purposes.

Interferon– an immunity factor, a protein produced by the cells of the human body that has a protective effect. It occupies an intermediate position between general and specific mechanisms of immunity.

Organs of the immune system (IOS):

- primary (central);

- secondary (peripheral).

Primary OIS.

B. Red bone marrow– the central organ of hematopoiesis and immunogenesis, contains stem cells, is located in the cells of the spongy substance flat bones and in the epiphyses of tubular bones. It differentiates B lymphocytes from their predecessors, and also contains T lymphocytes.

Secondary IP.

A. Spleen – parenchymal organ immune system, also performs a depository function in relation to blood. The spleen can contract because it has smooth muscle fibers. It contains white and red pulp.

White pulp makes up 20%. It contains lymphoid tissue, which contains B - lymphocytes, T - lymphocytes and macrophages.

Red pulp is 80%. It performs the following functions:

Deposition of mature blood cells;

Monitoring the condition and destruction of old and damaged red blood cells and platelets;

Phagocytosis of foreign particles;

Ensuring the maturation of lymphoid cells and the transformation of monocytes into macrophages.

B. Lymph nodes.

B. Tonsils.

G. Lymphoid tissue, associated with the bronchi, intestines, and skin.

By the time of birth, secondary AIS are not formed, since they do not come into contact with antigens. Lymphopoiesis (formation of lymphocytes) occurs if there is antigenic stimulation. Secondary OIS are populated by B - and T - lymphocytes from primary OIS. After contact with the antigen, lymphocytes start working. No antigen goes unnoticed by lymphocytes.

Immunocompetent cells – macrophages and lymphocytes. They jointly participate in protective immune processes and provide an immune response.

Cells involved in the immune response, T – lymphocytes.

T - helpers (T - helpers). The main goal of the immune response is to neutralize the extracellular virus and destroy the infected cells that produce the virus.

Cytotoxic T-lymphocytes- recognize virus-infected cells and destroy them using secreted cytotoxins. Activation of cytotoxic T-lymphocytes occurs with the participation of T-helpers.

T – helpers – regulators and administrators of the immune response.

T - cytotoxic lymphocytes - killers.

B – lymphocytes– synthesize antibodies and are responsible for the humoral immune response, which consists of activating B lymphocytes and their differentiation into plasma cells that produce antibodies. Antibodies to viruses are produced after the interaction of B lymphocytes with T helper cells. T-helpers promote the proliferation of B-lymphocytes and their differentiation. Antibodies do not penetrate the cell and neutralize only the extracellular virus.

Neutrophils- These are non-dividing and short-lived cells, contain a large amount of antibiotic proteins, which are contained in various granules. These proteins include lysozyme, lipoperoxidase and others. Neutrophils independently move to the location of the antigen, “stick” to the vascular endothelium, migrate through the wall to the location of the antigen and ingest it (phagocytic cycle). Then they die and turn into pus cells.

Eosinophils– are able to phagocytose microbes and destroy them. Their main task is the destruction of helminths. Eosinophils recognize helminths, contact them and release substances – perforins – into the contact zone. These are proteins that are integrated into helminth cells. Pores form in the cells through which water rushes into the cell and the helminth dies from osmotic shock.

Basophils. There are 2 forms of basophils:

Actually basophils circulating in the blood;

Mast cells are basophils found in tissues.

Mast cells are found in various tissues: in the lungs, in the mucous membranes and along the blood vessels. They are capable of producing substances that stimulate anaphylaxis (vasodilation, contraction of smooth muscles, constriction of the bronchi). Thus they are involved in allergic reactions.

Monocytes – turn into macrophages when moving from circulatory system in fabric. There are several types of macrophages:

1. Some antigen-presenting cells that absorb microbes and “present” them to T lymphocytes.

2. Kupffer cells – liver macrophages.

3. Alveolar macrophages – macrophages of the lungs.

4. Osteoclasts are bone macrophages, giant multinucleated cells that remove bone tissue by dissolving the mineral component and destroying collagen.

5. Microglia are phagocytes of the central nervous system that destroy infectious agents and destroy nerve cells.

6. Intestinal macrophages, etc.

Their functions are varied:

Phagocytosis;

Interacting with the immune system and maintaining the immune response;

Maintaining and regulating inflammation;

Interaction with neutrophils and their attraction to the site of inflammation;

Release of cytokines;

Regulation of reparation (recovery) processes;

Regulation of blood clotting processes and capillary permeability at the site of inflammation;

Synthesis of components of the complement system.

Natural killer cells (NK cells) - lymphocytes with cytotoxic activity. They are able to contact target cells, secrete proteins that are toxic to them, kill them, or send them into apoptosis (the process of programmed cell death). Natural killer cells recognize cells affected by viruses and tumor cells.

Macrophages, neutrophils, eosinophils, basophils and natural killer cells mediate the innate immune response. In the development of diseases - pathology, a nonspecific response to damage is called inflammation. Inflammation is a nonspecific phase of subsequent specific immune reactions.

Nonspecific immune response– the first phase of the fight against infection, starts immediately after the microbe enters the body. The nonspecific immune response is almost the same for all types of microbes and consists of the primary destruction of the microbe (antigen) and the formation of a focus of inflammation. Inflammation is a universal protective process aimed at preventing the spread of a microbe. High nonspecific immunity creates high resistance of the body to various diseases.

In some organs in humans and mammals, the appearance of foreign antigens does not cause an immune response. These are the following organs: brain and spinal cord, eyes, testes, embryo, placenta.

If immunological stability is impaired, tissue barriers are damaged and immune reactions to the body’s own tissues and cells may develop. For example, the production of antibodies to thyroid tissue causes the development of autoimmune thyroiditis.

Specific immune response- This is the second phase of the body’s defense reaction. In this case, the microbe is recognized and protective factors are developed specifically against it. The specific immune response is cellular and humoral.

Cellular immune response consists in the formation of cytotoxic lymphocytes capable of destroying cells whose membranes contain foreign proteins, for example, viral proteins. Cellular immunity eliminates viral infections, as well as bacterial infections such as tuberculosis, leprosy, and rhinoscleroma. Activated lymphocytes also destroy cancer cells.

Humoral immune response is created by B - lymphocytes, which recognize the microbe (antigen) and produce antibodies according to the principle of a specific antigen - a specific antibody. Antibodies (immunoglobulins, Ig) are protein molecules that combine with a microbe and cause its death and removal from the body.

There are several types of immunoglobulins, each of which performs a specific function.

Immunoglobulins type A (IgA) are produced by cells of the immune system and are released to the surface of the skin and mucous membranes. They are found in all physiological fluids - saliva, breast milk, urine, tears, gastric and intestinal secretions, bile, in the vagina, lungs, bronchi, genitourinary tract and prevent the penetration of microbes through the skin and mucous membranes.

Immunoglobulins type M (IgM) are the first to be synthesized in the body of newborns and are released during the first time after contact with infection. These are large complexes that can bind several microbes at the same time, promote the rapid removal of antigens from circulation, and prevent the attachment of antigens to cells. They are a sign of the development of an acute infectious process.

Immunoglobulins type G (IgG) appear after Ig M and protect the body from various microbes for a long time. They are the main factor of humoral immunity.

Immunoglobulins type D (IgD) function as membrane receptors for binding to microbes (antigens).

Antibodies are produced during all infectious diseases. The development of the humoral immune response takes approximately 2 weeks. During this time, enough antibodies are produced to fight the infection.

Cytotoxic T - lymphocytes and B - lymphocytes remain in the body for a long time and, when new contact with a microorganism occurs, they create a powerful immune response.

Sometimes the cells of our own body become foreign, their DNA is damaged and they have lost their normal function. The immune system continually monitors these cells for potential cancer development and destroys them. First, lymphocytes surround the foreign cell. Then they attach to its surface and extend a special process towards the target cell. When the process touches the surface of the target cell, the cell dies due to the injection of antibodies and special destructive enzymes by the lymphocyte. But the attacking lymphocyte also dies. Macrophages also capture foreign microorganisms and digest them.

The strength of the immune response depends on the reactivity of the body, that is, on its ability to respond to the introduction of infection and poisons. There are normergic, hyperergic and hypoergic responses.

Normoergic response leads to the elimination of infection in the body and recovery. Tissue damage during the inflammatory reaction does not cause serious consequences for the body. The immune system functions normally.

Hyperergic response develops against the background of sensitization to the antigen. The strength of the immune response greatly exceeds the strength of microbial aggression. The inflammatory response is very strong and leads to damage to healthy tissue. Hyperergic immune reactions underlie the formation of allergies.

Hypoergic response weaker than aggression from microbes. The infection is not completely eliminated, the disease becomes chronic. A hypoergic immune response is typical for children, the elderly, and people with immunodeficiencies. Their immune system is weakened.

Increasing immunity is the most important task of every person. So, if a person suffers from acute respiratory viral infections (ARVI) more than 5 times a year, then he should think about strengthening the body’s immune functions.

Factors that weaken the body's immune functions:

Surgical interventions and anesthesia;

Overwork;

Chronic stress;

Taking any hormonal medications;

Treatment with antibiotics;

Atmospheric pollution;

Unfavorable radiation conditions;

Injuries, burns, hypothermia, blood loss;

Frequent colds;

Infectious diseases and intoxications;

Chronic diseases, including diabetes;
- bad habits(smoking, frequent use of alcohol, drugs and spice);

Sedentary lifestyle;
- poor nutrition-eating foods that reduce immunity -smoked meats, fatty meats, sausages, sausages, canned food, semi-finished meat products;
- insufficient water consumption (less than 2 liters per day).

The task of every person is strengthening your immunity, usually nonspecific immunity.

To strengthen your immune system you should:

Observe the work and rest schedule;

Eat well; food should contain sufficient amounts of vitamins, minerals, amino acids; necessary in sufficient quantities to strengthen the immune system the following vitamins and microelements: A, E, C, B2, B6, B12, pantothenic acid, folic acid, zinc, selenium, iron;

Engage in hardening and physical training;
- take antioxidants and other drugs to strengthen the immune system;

Avoid self-administration of antibiotics and hormones, unless prescribed by a doctor;

Avoid frequent consumption of foods that reduce immunity;
- drink at least 2 liters of water per day.

Creating specific immunity against a certain disease is possible only through the introduction of a vaccine. Vaccination – reliable way protect against a specific disease. In this case, active immunity is carried out due to the introduction of a weakened or killed virus, which does not cause the disease, but activates the functioning of the immune system.

Vaccinations weaken general immunity, for the sake of increasing the specific. As a result, side effects may occur, for example, the appearance of mild “flu-like” symptoms: malaise, headache, slightly elevated temperature. Existing chronic diseases may worsen.

The child's immunity is in the hands of the mother. If a mother feeds her child with breast milk for up to a year, then the child grows healthy, strong and develops well.

A good immune system is a prerequisite for a long and healthy life. Our body constantly fights germs, viruses, and foreign bacteria that can cause fatal harm to our body and dramatically reduce our life expectancy.

Immune system dysfunction may be considered a cause of aging. This is the self-destruction of the body due to disturbances in the immune system.

Even in youth, in the absence of any diseases and leading a healthy lifestyle, toxic substances continuously appear in the body that can destroy the body’s cells and damage their DNA. Most of the toxic substances are formed in the intestines. Food is never 100% digested. Undigested food proteins undergo the process of rotting, and carbohydrates undergo fermentation. Toxic substances formed during these processes enter the blood and have a negative effect on all cells of the body.

From the perspective of Eastern medicine, a disorder of immunity is a violation of harmonization (balance) in the body’s energy system. Energy entering the body from the external environment through energy centers- chakras and those formed during the breakdown of food during the digestion process, through the channels of the body - meridians, enter organs, tissues, parts of the body, and into every cell of the body.

When immunity is impaired and diseases develop, an energy imbalance occurs. In certain meridians, organs, tissues, parts of the body, energy becomes more, it is in abundance. In other meridians, organs, tissues, parts of the body it becomes less, it is in short supply. This is the basis for the development of various diseases, including infectious diseases and immune disorders.

Reflexotherapists redistribute energies in the body using various reflexotherapeutic methods. Insufficient energies strengthen, energies that are in excess weaken, and this makes it possible to eliminate various diseases and improve immunity. The self-healing mechanism in the body is activated.

The degree of immune activity is closely related to the level of interaction of its components.

Variants of pathology of the immune system.

A. Immunodeficiency – congenital or acquired absence or weakening of one of the links of the immune system. If the immune system is insufficient, even harmless bacteria that have lived in our body for decades can cause serious illness. Immunodeficiencies make the body defenseless against germs and viruses. In these cases, antibiotics and antiviral drugs are not effective. They help the body slightly, but do not cure it. With prolonged stress and disruption of regulation, the immune system loses its protective significance and develops immunodeficiency - lack of immunity.

Immunodeficiency can be cellular and humoral. Severe combined immunodeficiencies lead to severe cellular disorders in which T - lymphocytes and B - lymphocytes are absent. This happens when hereditary diseases. In such patients, tonsils are often not detected, lymph nodes are very small or absent. They have a paroxysmal cough, congestion chest when breathing, wheezing, tense atrophic abdomen, aphthous stomatitis, chronic pneumonia, candidiasis of the pharynx, esophagus and skin, diarrhea, exhaustion, growth retardation. Such progressive symptoms lead to death within 1 to 2 years.

Immunological deficiency of primary origin is the genetic inability of the body to reproduce one or another part of the immune response.

Primary congenital immunodeficiencies. They appear soon after birth and are hereditary. For example, hemophilia, dwarfism, some types of deafness. A child born with a congenital defect of the immune system is no different from a healthy newborn as long as antibodies received from the mother through the placenta, as well as with mother’s milk, circulate in his blood. But the hidden trouble soon reveals itself. Repeated infections begin - pneumonia, purulent skin lesions, etc., the child lags behind in development, he is weakened.

Secondary acquired immunodeficiencies. They arise after some kind of primary exposure, for example, after exposure to ionizing radiation. This destroys lymphatic tissue, the main organ of immunity, and weakens the immune system. The immune system is damaged by various pathological processes, malnutrition, and hypovitaminosis.

Most diseases are accompanied by immunological deficiency to one degree or another, and this may cause the continuation and worsening of the disease.

Immunological deficiency occurs after:

Viral infections, influenza, measles, hepatitis;

Taking corticosteroids, cytostatics, antibiotics;

X-ray, radioactive exposure.

Acquired immunodeficiency syndrome may be independent disease caused by damage to immune system cells by the virus.

B. Autoimmune conditions– with them, immunity is directed against the body’s own organs and tissues, and the body’s own tissues are damaged. Antigens in this case can be foreign or own tissues. Foreign antigens can cause allergic diseases.

B. Allergy. The antigen in this case becomes an allergen, and antibodies are produced against it. Immunity in these cases does not act as a protective reaction, but as the development of increased sensitivity to antigens.

D. Diseases of the immune system. These are infectious diseases of the immune system organs themselves: AIDS, infectious mononucleosis and others.

D. Malignant tumors of the immune system– thymus gland, lymph nodes and others.

To normalize immunity, immunomodulatory drugs are used that affect the function of the immune system.

There are three main groups of immunomodulatory drugs.

1. Immunosuppressants- inhibit the body's immune defense.

2. Immunostimulants– stimulate the immune defense function and increase the body's resistance.

3. Immunomodulators– drugs whose action depends on the functional state of the immune system. These drugs inhibit the activity of the immune system if it is excessively increased, and increase it if it is decreased. These drugs are used in complex treatment in parallel with the prescription of antibiotics, antiviral, antifungal and other agents under the control of immunological blood tests. They can be used at the stage of rehabilitation and recovery.

Immunosuppressants are used for various autoimmune diseases, viral diseases that cause autoimmune conditions, and for organ transplantation. Immunosuppressants inhibit cell division and reduce the activity of recovery processes.

There are several groups of immunosuppressants.

Antibiotics- waste products of various microorganisms, they block the reproduction of other microorganisms and are used to treat various infectious diseases. A group of antibiotics that block the synthesis of nucleic acids (DNA and RNA), are used as immunosuppressants, inhibit the proliferation of bacteria and inhibit the proliferation of cells of the immune system. This group includes Actinomycin and Colchicine.

Cytostatics– drugs that have an inhibitory effect on the reproduction and growth of body cells. Red bone marrow cells, immune system cells, hair follicles, skin and intestinal epithelium are especially sensitive to these drugs. Under the influence of cytostatics, the cellular and humoral components of immunity are weakened, the production of biologically active substances by cells of the immune system is reduced, causing inflammation. This group includes Azathioprine, Cyclophosphamide. Cytostatics are used in the treatment of psoriasis, Crohn's disease, rheumatoid arthritis, as well as in organ and tissue transplantation.

Alkylating agents enter into chemical reaction with most of the body’s active substances, disrupting their activity, thereby slowing down the body’s metabolism as a whole. Previously, alkylating substances were used as combat poisons in military practice. These include Cyclophosphamide, Chlorbutin.

Antimetabolites– drugs that slow down the body’s metabolism due to competition with biologically active substances. The most famous metabolite is Mercaptopurine, which blocks the synthesis of nucleic acids and cell division; it is used in oncological practice - it slows down the division of cancer cells.

Glucocorticoid hormones the most common immunosuppressants. These include Prednisolone, Dexamethasone. These drugs are used to suppress allergic reactions, to treat autoimmune diseases, and in transplantology. They block the synthesis of some biologically active substances that are involved in cell division and reproduction. Long-term use of glucocorticoids can lead to the development of Itsenko-Cushing syndrome, which includes weight gain, hirsutism (excessive body hair growth), gynecomastia (enlargement of the mammary glands in men), development of stomach ulcers, arterial hypertension. Children may experience growth retardation and a decrease in the body's regenerative ability.

Taking immunosuppressants can lead to adverse reactions: the addition of infections, hair loss, the development of ulcers on the mucous membranes of the gastrointestinal tract, the development of cancer, accelerated growth of cancer tumors, impaired fetal development in pregnant women. Treatment with immunosuppressants is carried out under the supervision of specialist doctors.

Immunostimulants- used to stimulate the body's immune system. These include various groups pharmacological drugs.

Immunostimulants, made from microorganisms(Pyrogenal, Ribomunil, Biostim, Bronchovaxom) contain antigens of various microbes and their inactive toxins. When introduced into the body, these drugs cause an immune response and the formation of immunity against the introduced microbial antigens. These drugs activate the cellular and humoral immunity, increasing the overall resistance of the body and the speed of response to a potential infection. They are used in the treatment of chronic infections, the body's resistance to infection is broken, and germs of infection are eliminated.

Biologically active extracts of animal thymus stimulate the cellular component of immunity. Lymphocytes mature in the thymus. Peptide extracts of the thymus (Timalin, Taktivin, Timomodulin) are used for congenital deficiency T - lymphocytes, secondary immunodeficiencies, cancer, poisoning with immunosuppressants.

Bone marrow stimulants(Myelopid) is made from animal bone marrow cells. They increase bone marrow activity, and the process of hematopoiesis accelerates, immunity increases due to an increase in the number of immune cells. They are used in the treatment of osteomyelitis and chronic bacterial diseases. immunodeficiencies.

Cytokines and their derivatives belong to biologically active substances that activate molecular processes of immunity. Natural cytokines are produced by cells of the body's immune system and are information intermediaries and growth stimulators. They have pronounced antiviral, antifungal, antibacterial and antitumor effects.

Preparations Leukiferon, Likomax, different kinds Interferons are used in the treatment of chronic, including viral, infections, in complex therapy of associated infections (simultaneous infection with fungal, viral, bacterial infections), in the treatment of immunodeficiencies of various etiologies, in the rehabilitation of patients, after treatment with antidepressants. Interferon containing the drug Pegasys is used in the treatment of chronic viral hepatitis B and C.

Stimulators of nucleic acid synthesis(Sodium Nucleinate, Poludan) have an immunostimulating and pronounced anabolic effect. They stimulate the formation of nucleic acids, which accelerates cell division, regeneration of body tissues, increases protein synthesis, and increases the body's resistance to various infections.

Levamisole (Decaris) A well-known anthelmintic agent, it also has an immunostimulating effect. It has a beneficial effect on the cellular component of immunity: T - and B - lymphocytes.

3rd generation drugs created in the 90s of the 20th century, the most modern immunomodulators: Kagocel, Polyoxidonium, Gepon, Myfortic, Immunomax, Cellcept, Sandimmune, Transfer Factor. The listed drugs, except for Transfer Factor, have a narrowly targeted use; they can only be used as prescribed by a doctor.

Immunomodulators of plant origin have a harmonious effect on our body and are divided into 2 groups.

The first group includes licorice, white mistletoe, milky white iris, and yellow egg capsule. They can not only stimulate, but also suppress the immune system. Treatment with them should be carried out with immunological studies and under the supervision of a physician.

The second group of immunomodulators of plant origin is very extensive. These include: echinacea, ginseng, lemongrass, Aralia Manchurian, Rhodiola rosea, Walnut, pine nut, elecampane, nettle, cranberry, rose hips, thyme, St. John's wort, lemon balm, birch, seaweed, figs, king cordyceps and other plants. They have a mild, slow, stimulating effect on the immune system, causing almost no side effects. They can be used for self-medication. Immunomodulatory drugs are made from these plants and are sold in pharmacies. For example, Immunal, Immunorm are made from echinacea.

Many modern immunomodulators also have an antiviral effect. These include: Anaferon (lozenges), Genferon (rectal suppositories), Arbidol (tablets), Neovir (injection solution), Altevir (injection solution), 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) .

All of the above drugs should be used only as prescribed by a doctor, as they have side effects. An exception is Transfer Factor, which is approved for use in adults and children. It has no side effects.

Most plant immunomodulators have antiviral properties. The benefits of immunomodulators are undeniable. Treatment of many diseases without the use of these drugs becomes less effective. But you should take into account the individual characteristics of the human body and carefully select the dosage.

Uncontrolled and long-term use of immunomodulators can cause harm to the body: depletion of the immune system, decreased immunity.

Contraindications to taking immunomodulators are the presence of autoimmune diseases.

These diseases include: systemic lupus erythematosus, rheumatoid arthritis, diabetes mellitus, diffuse toxic goiter, multiple sclerosis, primary biliary cirrhosis liver, autoimmune hepatitis, autoimmune thyroiditis, some forms of bronchial asthma, Addison's disease, myasthenia gravis and some others rare forms diseases. If a person suffering from one of these diseases starts taking immunomodulators on his own, the disease will worsen with unpredictable consequences. Immunomodulators should be taken in consultation with a doctor and under the supervision of a doctor.

Immunomodulators for children should be given with caution, no more than 2 times a year, if the child is often sick, and under the supervision of a pediatrician.

For children, there are 2 groups of immunomodulators: natural and artificial.

Natural– these are natural products: honey, propolis, rose hips, aloe, eucalyptus, ginseng, onions, garlic, cabbage, beets, radishes and others. Of this entire group, honey is the most suitable, healthy and pleasant to the taste. But you should remember the possible allergic reaction child for bee products. Raw onions and garlic are not prescribed to children under 3 years of age.

Among natural immunomodulators, children can be prescribed Transfer Factor, produced from bovine colostrum, and Derinat, produced from fish milk.

Artificial immunomodulators for children are synthetic analogues of human proteins - the interferon group. Only a doctor can prescribe them.

Immunomodulators during pregnancy. The immunity of pregnant women should be increased, if possible, without the help of immunomodulators, through proper nutrition, special physical exercise, hardening, organizing a rational daily routine. During pregnancy, immunomodulators Derinat and Transfer Factor are allowed in consultation with an obstetrician-gynecologist.

Immunomodulators for various diseases.

Flu. For influenza, the use of herbal immunomodulators is effective - rose hips, echinacea, lemongrass, lemon balm, aloe, honey, propolis, cranberry and others. The drugs Immunal, Grippferon, Arbidol, Transfer Factor are used. The same drugs can be used to prevent influenza during its epidemic. But you should also remember about contraindications when prescribing immunomodulators. Thus, the natural immunomodulator rosehip is contraindicated for people suffering from thrombophlebitis and gastritis.

Acute respiratory viral infections (ARVI) (colds) - are treated with antiviral immunomodulators prescribed by a doctor and natural immunomodulators. For an uncomplicated cold, you do not need to take any medications. It is recommended to drink plenty of fluids (tea, mineral water, warm milk with soda and honey), rinse the nose with a solution baking soda during the day (dissolve 2 teaspoons of soda in a glass of warm - hot water to rinse the nose), at a temperature - bed rest. If the elevated temperature persists for more than 3 days, and the symptoms of the disease increase, you need to begin more intensive treatment in consultation with your doctor.

Herpes- viral disease. Almost every person has the herpes virus in an inactive form. When immunity decreases, the virus is activated. In the treatment of herpes, immunomodulators are often and reasonably used. Are used:

1. Group of interferons (Viferon, Leukinferon, Giaferon, Amiksin, Poludan, Ridostin and others).

2. Nonspecific immunomodulators (Transfer Factor, Cordyceps, Echinacea preparations).

3. Also the following drugs(Polyoxidonium, Galavit, Lykopid, Tamerit and others).

The most pronounced therapeutic effect of immunomodulators for herpes is when they are used in conjunction with multivitamins.

HIV infection. Immunomodulators are not able to overcome the human immunodeficiency virus, but they significantly improve the patient’s condition by activating his immune system. Immunomodulators are used in the complex treatment of HIV infection with antiretroviral drugs. In this case, interferons, interleukins are prescribed: Thymogen, Thymopoietin, Ferrovir, Ampligen, Taktivin, Transfer Factor, as well as herbal immunomodulators: ginseng, echinacea, aloe, lemongrass, and others.

Human papillomavirus (HPV). The main treatment is removal of papillomas. Immunomodulators, in the form of creams and ointments, are used as aids that activate the human immune system. For HPV, all interferon drugs are used, as well as Imiquimod, Indinol, Isoprinosine, Derinat, Allizarin, Lykopid, Wobenzym. The selection of medications is carried out only by a doctor; self-medication is unacceptable.

Selected immunomodulatory drugs.

Derinat– an immunomodulator obtained from fish milt. Activates all parts of the immune system. Has anti-inflammatory and wound-healing effects. Approved for use by adults and children. Prescribed for ARVI, stomatitis, conjunctivitis, sinusitis, chronic inflammation of the genitals, gangrene, poorly healing wounds, burns, frostbite, hemorrhoids. Available in the form of a solution for injection and a solution for external use.

Polyoxidonium– an immunomodulator that normalizes the immune status: if immunity is reduced, then polyoxidonium activates the immune system; in case of excessively increased immunity, the drug helps to reduce it. Polyoxidonium can be prescribed without preliminary immunological tests. Modern, powerful, safe immunomodulator. Removes toxins from the human body. Prescribed for adults and children for any acute and chronic infectious diseases. Available in tablets, suppositories, and powder for preparing a solution.

Interferon– immunomodulator of protein nature, produced in human body. Has antiviral and antitumor properties. It is used more often for the prevention of influenza and acute respiratory viral infections during periods of epidemics, as well as to restore immunity during recovery from serious illnesses. The earlier preventive treatment with interferon is started, the higher its effectiveness. Available in ampoules in powder form - leukocyte interferon, diluted with water and dropped into the nose and eyes. A solution for intramuscular administration is also produced - Reaferon and rectal suppositories - Genferon. Prescribed for adults and children. Contraindicated if you are allergic to the drug itself or if you have any allergic diseases.

Dibazol– an old-generation immunomodulatory drug that promotes the production of interferon in the body and lowers blood pressure. Most often prescribed to hypertensive patients. Available in tablets and ampoules for injection.

Dekaris (Levamisole)– immunomodulator, has antihelminthic effect. Can be prescribed to adults and children in the complex treatment of herpes, ARVI, warts. Available in tablets.

Transfer Factor- The most powerful modern immunomodulator. Made from cow colostrum. It has no contraindications or side effects. Safe for use at any age. Appointed:

For immunodeficiency conditions of various origins;

For endocrine and allergic diseases;

Can be used to prevent infectious diseases. Available in gelatin capsules for oral administration.

Cordyceps– immunomodulator of plant origin. Made from the cordyceps mushroom, which grows in the mountains of China. It is an immunomodulator that can increase decreased immunity and reduce excessively increased immunity. Eliminates even genetic immunity disorders.

In addition to the immunomodulatory effect, it regulates the functioning of organs and systems of the body, and prevents aging of the body. This is a drug fast acting. Its action begins already in the oral cavity. The maximum effect appears a few hours after ingestion.

Contraindications to taking cordyceps: epilepsy, breastfeeding child. Prescribed with caution to pregnant women and children under five years of age. In Russia and the CIS countries, cordyceps is used in the form of a dietary supplement (BAA), produced by the Chinese corporation Tianshi. Available in gelatin capsules.

Many people prefer to take vitamins to boost their immunity. And of course, vitamins - antioxidants C, A, E. First of all, vitamin C. A person must receive it daily from the outside. However, if you take vitamins thoughtlessly, they can cause harm (for example, an excess of vitamins A, D and a number of others is quite dangerous).

Ways to strengthen the immune system.

From natural remedies You can use medicinal herbs to boost immunity. Echinacea, ginseng, garlic, licorice, St. John's wort, red clover, celandine and yarrow - these and hundreds of other medicinal plants were given to us by nature. However, we must remember that long-term uncontrolled use of many herbs can cause depletion of the body due to the intensive consumption of enzymes. In addition, they, like some medications, are addictive.

The best way to increase immunity is hardening and physical activity. Take a contrast shower, douse yourself with cold water, go to the pool, visit the bathhouse. You can start hardening at any age. Moreover, it should be systematic, gradual, taking into account the individual characteristics of the body and the climate of the region in which you live. Jogging in the morning, aerobics, fitness, yoga are indispensable for improving immunity.

Hardening procedures cannot be carried out after sleepless night, significant physical and emotional stress, immediately after eating and when you are sick. It is important that the ones you choose therapeutic measures were carried out regularly, with a gradual increase in load.

There is also a special diet to boost immunity. It involves excluding from the diet: smoked meats, fatty meats, sausages, sausages, canned food, and semi-finished meat products. It is necessary to reduce the consumption of canned, spicy foods, spices. There should be dried apricots, figs, dates, and bananas on the table every day. You can snack on them throughout the day.

A prerequisite for the formation of strong immunity is intestinal health, since most of the cells of the immune system are located in its lymphoid apparatus. Many medications, poor-quality drinking water, diseases, old age, sudden changes in diet or climate can cause intestinal dysbiosis. It is impossible to achieve good immunity with a diseased intestine. Products rich in lacto- and bifidobacteria (kefir, yogurt), as well as the pharmaceutical drug Linux, can help here.

2. An effective remedy for boosting immunity is a drink made from pine needles. To prepare it, you need to rinse 2 tablespoons of raw materials in boiling water, then pour a glass of boiling water and cook for 20 minutes. Let it brew for half an hour and strain. It is recommended to drink a glass of the decoction daily. You can add a little honey or sugar to it. You can not drink at once, dividing the entire volume into several parts.

3. Chop 250 g of onion as finely as possible and mix with 200 g of sugar, pour in 500 ml of water and cook over low heat for 1.5 hours. After cooling, add 2 tablespoons of honey to the solution, strain and place in a glass container. Drink one tablespoon 3-5 times a day.

4. Herbal mixture to improve immunity, consisting of mint, fireweed, chestnut flowers and lemon balm. Take 5 tablespoons of each herb, pour one liter of boiling water and let it brew for two hours. The resulting infusion must be mixed with a decoction made from cranberries and cherries (cherries can be replaced with strawberries or viburnum), and drink 500 ml daily.

5. Excellent tea for boosting immunity can be made from lemon balm, dried herb, valerian root, oregano herb, linden color, hop cones, coriander seeds and motherwort. All ingredients must be mixed in equal proportions. Then pour 1 tablespoon of the mixture into a thermos, pour 500 ml of boiling water and leave overnight. The resulting tea should be drunk during the day in 2-3 approaches. With the help of this infusion, you can not only strengthen your immune system, but also improve the functioning of your cardiovascular system.

6. A combination of lemongrass, licorice, Echinacea purpurea and ginseng will help improve immunity against herpes.

7. A vitamin decoction of apples has a good general strengthening effect. To do this, cut one apple into slices and boil in a glass of water in a water bath for 10 minutes. After this, add honey, an infusion of lemon and orange peels and a little brewed tea.

8. The beneficial effects of a mixture of dried apricots, raisins, honey, walnuts, taken 200 g each, and the juice of one lemon are known. All ingredients must be twisted in a meat grinder and mixed thoroughly. This product should be stored in a glass container, preferably in the refrigerator. Eat a tablespoon of the product daily. This must be done in the morning on an empty stomach.

9. With the onset of cold weather, ordinary honey can be an excellent way to boost immunity. It is recommended to take it with green tea. To do this, you need to brew tea, add the juice of half a lemon, ½ cup mineral water and a tablespoon of honey. You should drink the resulting healing solution twice a day, half a glass, for three weeks.

10. There is a gift from nature - mumiyo. It has a powerful tonic, antitoxic and anti-inflammatory effect. With its help, you can speed up the processes of renewal and restoration of all tissues of the body, soften the effects of radiation, increase efficiency, and enhance potency. To increase immunity, mumiyo should be taken as follows: dissolve 5–7 g until mushy in a few drops of water, then add 500 g of honey and mix everything thoroughly. Take a tablespoon three times a day before meals. The mixture should be stored in the refrigerator.

11. Among the recipes for increasing immunity there is this one. Mix 5 g mummy, 100 g aloe and juice of three lemons. Place the mixture in a cool place for a day. Take a tablespoon three times a day.

12. An excellent tool To improve immunity, which can relieve body aches and headaches, is a vitamin bath. To prepare it, you can use the fruits or leaves of currants, lingonberries, sea buckthorn, rowan or rose hips. There is no need to apply everything at once. Take equal parts of what you have on hand and pour boiling water over the mixture for 15 minutes. Pour the resulting infusion into the bath, add a few drops of cedar or eucalyptus oil. It is necessary to stay in such healing water for no longer than 20 minutes.

13. Ginger is another immunity-boosting herb. You need to finely chop 200 g of peeled ginger, add chopped pieces of half a lemon and 300 g of frozen (fresh) berries. Let the mixture brew for two days. Use the juice released to boost immunity by adding it to tea or diluting it with water.

Reflexology is effective for strengthening the immune system. It can be used at home. Harmonization of the body’s energy system using reflexology techniques can significantly improve well-being, relieve symptoms of weakness, fatigue, drowsiness or insomnia, normalize the psycho-emotional state, and prevent the development of exacerbations chronic diseases, strengthen the immune system.

If there are no wormwood sticks, you can use a well-dried high-grade cigarette. There is no need to smoke, as it is harmful. Impact on the basic points replenishes the energy supply in the body.

The points corresponding to the thyroid gland should also be warmed up, thymus gland, adrenal glands, pituitary gland and definitely the navel. The navel is a zone of accumulation and circulation of strong vital energy.

After warming up, place hot pepper seeds on these points and secure them with a band-aid. You can also use seeds:rose hips, beans, radishes, millet, buckwheat.

Useful for raising overall toneis a finger massage with an elastic massage ring. You can massage each finger and toe by rolling the ring over it several times until the finger feels warm. See pictures.

Dear blog visitors, you have read my article about immunity, I look forward to your feedback in the comments.

http: //valeologija.ru/ Article: The concept of immunity and its types.

http: //bessmertie.ru/ Articles: How to increase immunity.; Immunity and rejuvenation of the body.

http: //spbgspk.ru/ Article: What is immunity.

http: //health.wild-mistress.ru Article: increasing immunity with folk remedies.

Park Jae Woo Himself Su Jok Doctor M. 2007

Materials from Wikipedia.