What about immunomodulators? Domestic immunomodulators of the latest generation. Immunomodulators for various diseases

In order to prevent various diseases, strengthen the immune system, as well as complex treatment of many ailments, modern medicine uses special drugs, which have a common name - immunomodulators. The classification of immunomodulators is quite extensive, so it is difficult to describe their action “in a nutshell”. In general, it is generally accepted that immunomodulators are drugs that have the inherent ability to restore the functions of the immune system.

This class of drugs is indicated for use in children, since their immune system is still weak; elderly people, because the vital forces of the body are depleted; people with a busy lifestyle who have to study or work a lot. Constant stress, an unfavorable environmental situation, harmful and often even dangerous foods, bad habits - there are many factors that undermine our health and destroy our immune system, so immunomodulators will not hurt even healthy and active people. In addition, this class of drugs is indispensable in the complex treatment of chronic diseases in the acute stage, frequent relapses, as well as for supporting the body during the recovery period after surgical interventions. In modern medical practice, there are many cases in which immunomodulators are prescribed, the list of which is very large. In general, we can say that even now immunological studies are not absolutely accurate, therefore, in the vast majority of cases, immunomodulators are automatically prescribed along with antibiotics, antiviral or antifungal drugs.

The list of modern immunomodulators includes about 400 drugs with different mechanisms of action. As mentioned, the classification representing immunomodulators is quite broad, so let’s look at it in more detail.

Characteristics of immunomodulators

Modern immunomodulators are usually divided into three main groups depending on their origin: endogenous, exogenous and synthetic.

The first group - endogenous immunomodulators - are considered the safest and most acceptable for the human body, since they are obtained by isolating special substances from the central organs of the immune system. This group, in turn, is divided into 4 categories of immunomodulators:

1) Thymic preparations, created on the basis of thymus peptides (one of the central organs of the immune system, generating cells that protect our body from harmful elements), are mostly produced from the thymus gland of cattle. This includes drugs such as Timalin, Timogen, Imunofan and many others. Also included in this category are immunomodulator drugs obtained from mammalian bone marrow. An example is the drug Myelopid.

This category of immunomodulators is prescribed for exacerbations of chronic respiratory and allergic diseases, for bacterial infections, as well as for recovery after surgery.

2) The second category includes cytokines. This is a special category of molecules that carries information about the functioning of the immune system and is capable of influencing the processes of intercellular interaction. There are more than a dozen types of cytokines, but the most active of them are interleukins. This is a type of molecule that is synthesized by leukocytes - the main cells of the immune system. They are the first to be responsible for the invasion of pathogenic microorganisms. Preparations based on interleukins are prescribed for various sepsis, for the speedy healing of wounds (including purulent ones) and burns. In this category, the most common natural immunomodulators are Betaleukin and Roncoleukin.

3) The next category is interferons. Their action is similar to the action of interleukins, however, interferons are protein in nature and are produced by the body as a protective reaction to the invasion of the virus. Thanks to interferons, the virus cannot affect the body's cells. These natural immunomodulators are successfully prescribed in the complex treatment of ARVI, hepatitis, measles, chickenpox and many other diseases. Examples of interferon drugs are Kipferon, Viferon, Lokferon.

4) The fourth category of endogenous immunomodulators are immunoglobulins. These are protein molecules that act as homing weapons against viruses. Immunoglobulins in modern medicine are represented by therapeutic serums administered intravenously or intramuscularly. An example of a drug in this category is a complex immunoglobulin drug, or CIP for short.

The second group of exogenous immunomodulators is characterized by fungal or molecular origin. This includes the well-known BCG vaccine, as well as the drugs ribomunil, pyrogenal, bronchomunal and many others.

The third and final group of drugs under consideration are called synthetic immunomodulators. They are the product of scientific research and chemical synthesis.
Earlier developments include the drugs diucifon and levamisole. Modern synthetic immunomodulator drugs are widely known - these are amiksin, neovir, galavit, polyoxidonium, etc.

Modern immunomodulators

The list of modern drugs related to immunomodulators is very extensive. Many of them are subject to serious requirements for safety and effectiveness, non-addictiveness, interaction with other drugs and many other criteria. We can say with confidence that not all modern immunomodulators are able to strengthen the immune system without harming other organs and systems. You need to be especially careful when taking synthetic immunomodulators, because, unlike endogenous ones, they do not stimulate the immune system, but take over its functions. As a result, the immune system “relaxes”, and after discontinuation of the drug, the body becomes even more susceptible to the action of pathogens. As a result, a person walks in a vicious circle, unable to recover from a series of ailments. In this sense, it is considered more appropriate to take endogenous immunomodulators, since it is this group that is able to gently correct the functioning of the immune system.

Recently, modern immunomodulators have been replenished with a fundamentally new, revolutionary drug - Transfer Factor. It received its name due to a unique molecule containing information about immune memory. This molecule is capable of restoring damaged areas in the structure of the DNA chain, which are responsible for immunity, for the body’s ability to resist diseases and self-heal. To work correctly and effectively, the immune system must know HOW it does it. Transfer factors carry all the necessary information about this to the main organs of the immune system. As a result, there is an effective adjustment of the immune system and adjustment of its functions. It is this fact that makes this drug unique and one of a kind, since it does not act as a temporary substitute for the immune system, but as its teacher and mentor.

The best immunomodulator - Transfer factor

Transfer Factor is the best immunomodulator today, since it has no analogues in terms of effectiveness and mechanism of action on the immune system. This drug is completely safe and can be taken by adults, children and the elderly. It does not have a harmful effect on any organs or systems, does not cause addiction or unwanted reactions.

The drug received such amazing characteristics due to its origin. In the course of many years of research, it was found that the highest concentrations of transfer factors are contained in colostrum. Everyone knows that the mother's first colostrum is a cocktail of a huge amount of antibodies, so the baby's first breastfeeding is incredibly beneficial for
formation of his immunity. And since the principle of operation of transfer factors is the same in almost all vertebrates, this makes it possible to obtain a concentrate of molecules from a product of animal origin - bovine colostrum. This fact indicates the 100% naturalness and safety of the drug, which is “extracted” from cow colostrum. The effectiveness of this immunomodulator is also due to the fact that the size of its molecule is incredibly small. This allows transfer factors to be freely absorbed into the walls of the intestinal mucosa, and from there enter the blood. That is, every molecule of colostrum concentrate goes to its intended purpose.

Transfer factor is the best immunomodulator of natural origin, which can be used for the prevention and complex treatment of a wide range of diseases without harm to the body.

Introduction.

The emergence of new physical (radiation), chemical (hormones, antibiotics, pesticides, dioxins) and biological (HIV infection, prions) factors, including anthropogenic ones, influencing both the pathogenicity of microorganisms (stimulating or weakening it) and resistance in humans and animals (stimulating or weakening natural resistance and specific immunity) often leads to modifications of the immune system, causing immunodeficiency, autoimmune and allergic reactions.

From an immunobiological point of view, the state of animals in modern conditions is characterized by a decrease in the immunological reactivity of the body. According to some data, more than 80% of animals have various abnormalities in the functioning of the immune system, which increases the risk of acute diseases caused by opportunistic microorganisms.

The development of immunodeficiency states and other disorders of the immune system is facilitated by keeping a large number of animals in limited areas, untimely organization and implementation of veterinary-sanitary, preventive and anti-epizootic measures, lack or absence of insolation, active exercise, and adequate nutrition. Also, in the process of prevention and treatment of various animal diseases, low effectiveness of chemotherapy drugs and other traditional methods is often observed, which is most often associated with the low immunological reactivity of the body.

In this regard, the interest of doctors in immunotherapy and immunoprophylaxis is increasing.

To increase the resistance of animals, genetic (species, breed and individual genotype-dependent manifestations of natural resistance, dependence on the genotype of an intense immune response to various antigens) and phenotypic (modifying changes in immune reactivity under the influence of environmental factors) factors are used. However, the use of only these factors does not always provide full protection of animals from the effects of physical, chemical and biological factors on their immune system, which makes it necessary to continuously search for new ways to effectively protect against real infectious diseases, including through effects on the immune system.

Immunomodulators.

Immunomodulators are drugs of animal, microbial, yeast and synthetic origin that affect the immune system.

Some immunomodulators affect the immune system in the direction of strengthening it (immunostimulants), others – in the direction of weakening it (immunosuppressors); the former are used in the treatment of immunodeficiency conditions, the latter - in autoimmune pathology and allogeneic tissue transplantation. The effect of immunomodulators depends on the dose, as well as on the initial state of the immune system.

A type of immunomodulation is immunocorrection - bringing the initially altered activity of the immune system or its components to normal.

Classification of immunomodulators.

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

microbial immunomodulators;

thymic immunomodulators;

bone marrow immunomodulators;

cytokines;

nucleic acids;

chemically pure.

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

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

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

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

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

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

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

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

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

The group of chemically pure immunomodulators can be divided into two subgroups: low molecular weight and high molecular weight. The first includes a number of well-known drugs that additionally have immunotropic activity. Their ancestor was levamisole (Dekaris), a phenylimidothiazole, a well-known anthelmintic agent, which was subsequently found to have pronounced immunostimulating properties. Another promising drug from the subgroup of low-molecular immunomodulators is Galavit, a phthalhydrazide derivative. The peculiarity of this drug is the presence of not only immunomodulatory, but also pronounced anti-inflammatory properties. The subgroup of low-molecular immunomodulators also includes three synthetic oligopeptides: Gepon, Glutoxim and Alloferon.

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

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

Pharmacological action of immunomodulators.

Immunomodulators of microbial origin.

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

Immunomodulators of thymic origin.

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

Immunomodulators of bone marrow origin.

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

Cytokines.

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

Chemically pure immunomodulators

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

Interferons and interferon inducers.

Interferons are protective substances of a protein nature that are produced by cells in response to the penetration of viruses, as well as to the influence of a number of other natural or synthetic compounds (interferon inducers). Interferons are factors of nonspecific protection of the body from viruses, bacteria, chlamydia, pathogenic fungi, tumor cells, but at the same time they can also act as regulators of intercellular interactions in the immune system. From this position, they belong to immunomodulators of endogenous origin.

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

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

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

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

Amiksin is a low-molecular interferon inducer belonging to the class of fluoreons. Amiksin stimulates the formation of all types of interferons in the body: a, b and g. The maximum level of interferon in the blood is reached approximately 24 hours after taking Amiksin, increasing tens of times compared to its initial values. An important feature of Amiksin is the long-term circulation (up to 8 weeks) of therapeutic concentrations of interferon after a course of taking the drug. Significant and prolonged stimulation by Amiksin of the production of endogenous interferon ensures its universally wide range of antiviral activity. Amiksin also stimulates the humoral immune response, increasing the production of IgM and IgG, and restores the T-helper/T-suppressor ratio. Amiksin is used for the prevention of influenza and other acute respiratory viral infections, the treatment of severe forms of influenza, acute and chronic hepatitis B and C, recurrent genital herpes, cytomegalovirus infection, chlamydia, and multiple sclerosis.

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

Clinical use of immunomodulators.

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

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

The main requirements for immunotropic drugs are:

immunomodulatory properties;

high efficiency;

natural origin;

safety, harmlessness;

no contraindications;

lack of addiction;

no side effects;

absence of carcinogenic effects;

lack of induction of immunopathological reactions;

do not cause excessive sensitization or potentiate it

for other medications;

easily metabolized and excreted from the body;

do not interact with other drugs and

have high compatibility with them;

non-parenteral routes of administration.

Currently, the basic principles of immunotherapy have been developed and approved:

1. Mandatory determination of immune status before starting immunotherapy;

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

3. Monitoring the dynamics of immune status during immunotherapy;

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

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

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

Characteristics of some immunomodulators

As mentioned above, IMDs are classified depending on their composition, origin (for example, exogenous and endogenous, natural, synthetic, complex, etc.), targets of application and mechanism of action. The table provides information on the composition and biological activity of the IMDs most widely used in veterinary practice. These are drugs of natural origin - gamaprene (moraprenyl phosphate), Dostim, sodium nucleinate (usually in the composition of Gamavit), ribotan, salmosan and fosprenyl; synthetic - anandin, galavet, glycopin, immunofan, comedon, maxidin and roncoleukin; complex - gamavit, mastim-OL and kinonron.

Use of IMD for viral infections

Since viral infections are almost always accompanied by immunosuppression, it is important to search for and use those IMDs that can not only increase the body’s natural resistance (by stimulating phagocytosis and antibody production, enhancing the cytotoxic activity of lymphocytes, inducing the synthesis of IF and other cytokines), but also have a direct antiviral effect . Fosprenil and gamaprene satisfy these requirements to the greatest extent. Such drugs, combining the properties of IMD and an antiviral agent, can be recommended for the treatment and prevention of viral infections accompanied by an immunodeficiency state.

A favorable outcome in almost any viral infection directly depends on the early stimulation of the synthesis of cytokines, which ensure the formation of both cellular and humoral immune responses (5). Thus, during the first two days of a clinically pronounced disease, the use of IMDs is indicated, stimulating the production of interferon (IFN), and also capable of restoring early cytokine reactions suppressed by viruses. On the contrary, in the later stages of a viral disease, excessive stimulation of cytokines can lead to the development of a number of immunopathological reactions and significantly worsen the body's condition and even cause shock and death. In such cases, the most effective is the use of drugs that directly affect the reproduction of viruses in target cells (for example, fosprenil and gamapren), or have a systemic effect (fosprenil).

Thus, during the incubation period and in the first 1-2 days of the clinical stage of a viral disease, it is advisable to prescribe IMDs that stimulate the production of IFN, as well as other factors of the body’s natural resistance (for example, IL-12, TNF, IL-1). An objective criterion for the effectiveness of these IMDs can be the restoration of the production of early cytokines, the synthesis of which is suppressed by viruses (6). Thus, fosprenil, after administration into the body during a viral infection, stimulates the early production of IF-γ, TNFα and IL-6 and IL-12 in serum (12, 13), which, apparently, is one of the key mechanisms of the antiviral activity of the drug during its used as a prophylactic or in the earliest stages of the infectious process. Viruses have the ability to disrupt the balanced development of the Th1/Th 2 immune response necessary for the formation of effective antiviral immunity, and fosprenil appears to be able to restore this necessary balance, in particular by stimulating the production of key cytokines that ensure the balanced formation of Th1 (IL-12 , IF-?,) and Th2 (IL-4, IL-5, IL-6) immune response during a viral infectious process (13,15). This property of fosprenil, combined with a direct antiviral effect, apparently provides protection to animals from viral infection.

When treating severe infections, preference should be given to IMDs of natural origin (from the thymus, yeast, bacterial cells, plants), which, as a rule, do not have side effects. Currently, it is more often recommended to use IFN inducers - interferonogens, rather than IFN drugs themselves, including recombinant ones (currently, the only drugs based on IFN in the treatment of viral infections are Kinorone, which is more effective in the early stages of the disease). This is due, in particular, to the fact that, firstly, exogenous IFN, after being introduced into the body, is able to suppress the synthesis of endogenous IFN according to the principle of a feedback mechanism and cause an imbalance in the IFN system. Secondly, recombinant IFNs are antigenic and quickly inactivated. On the contrary, IFN inducers (maxidin, fosprenil, dostim, ribotan, comedon, salmosan, etc.) stimulate the synthesis of endogenous IFN (which is physiological, and the activity of endogenous IFN lasts longer), and also, in most cases, trigger the synthesis and production of other cytokines , first of all, it is the Th1 series. In addition, nonspecific natural killer cells (NKCs) are actively involved in the early antiviral process. These cells, after activation and proliferation, synthesize and secrete pro-inflammatory cytokines, which trigger a cascade of signals that help interrupt the viral reproduction cycle in the infected cell. In view of this, in the treatment of viral infections, it is advisable to use IMDs that stimulate NK - fosprenil, maxidin, roncoleukin (its activity naturally increases in combination with fosprenil). Unfortunately, a very effective IMD, cycloferon, which is capable of inducing the secretion of IFN of all types, has been removed from veterinary practice. On the contrary, it is welcome that veterinarians have largely stopped using levamisole (Decaris) as an IMD, which is not only quite toxic but also (when used in low doses) selectively stimulates suppressor (regulatory) T cells (4).

IMDs based on cytokines (including recombinant ones), when introduced into the body, can compensate for the deficiency of soluble immunoregulatory factors, which is especially important in cases of severe damage to the immune system, when its compensatory capabilities are impaired. On the other hand, unjustified prescription of such drugs (in the absence of serious indications) can lead to an imbalance in the immune system by blocking the synthesis of homologous endogenous molecules based on a feedback mechanism. The combination of IMD based on recombinant cytokines with other drugs is of great importance. It is obvious, for example, that the effectiveness of roncoleukin (recombinant IL-2) increases if, before its introduction into the body, the expression level of the corresponding receptors is increased using drugs that enhance the secretion of IL-1. This has been confirmed in practice in experiments on the complex use of roncoleukin with fosprenil or with gamavit (the latter contains sodium nucleinate, an effective inducer of IL-1 and IFN) - these IMDs significantly increase the activity of roncoleukin.

It is worth considering the possibility of combined use of IMDs that differ in the spectrum of their effects on target lymphoid cells. In particular, the combination of dostim or salmosan (more active on B cells than on T cells) with antiviral IMDs (for example, fosprenyl or gamaprene) may, if treated promptly, prevent the development of secondary infections and therefore reduce the need for in antibiotic therapy. In a series of experimental studies on a model of acute clinical infection caused by tick-borne encephalitis virus (TBEV) in mice, the effect of mutual enhancement of the activity of FP and maxidin was revealed (12). As a result of simultaneous joint administration of these two IMDs to mice, the protective effect increased by 2-2.5 times, compared with the effect of administration of any one drug. These data formed the basis for clinical trials in the treatment of dogs diagnosed with canine distemper and cats diagnosed with panleukopenia. As a result, it turned out that in severe cases of canine distemper, as well as in viral infections of cats, the combined use of FP and Maxidin gives a positive effect: both drugs, having different mechanisms of antiviral action, complement each other; their combined use speeds up treatment time and prevents relapses of the disease, and also allows one to significantly (more than halve) reduce single doses of drugs, thereby reducing the cost of treating animals (21).

However, there are many situations in which IMDs are contraindicated. In particular, the administration of lycopid (glycopin) to mice leads to the activation of the infectious process caused by the Langat virus. This effect appears to be related to IMD-induced expansion of the target macrophage cell population in which the virus replicates (2). In case of a severe viral infection, for example, canine distemper, against the background of already developed immunodeficiency, a veterinarian who achieves a delicate balance between immunostimulation and immunosuppression when selecting therapeutic agents has to literally walk on the edge of a knife. That is why, in the case of canine plague, IMDs that can directly affect the pathogen are first recommended. In the acute nervous form of plague, when the virus, multiplying in neurons and glial cells, causes demyelination, many veterinarians prescribe glucocorticoid hormones, since the use of immunostimulants (T-activin, etc.) at this stage of the disease can kill the dog in 1-2 days, and Before death, the clinical condition of animals sharply deteriorates (1). For example, IFN? promotes damage to nerve cells by activating cytotoxic T lymphocytes. Therefore, other IMDs that increase the synthesis of IFN? are contraindicated in the nervous form of canine distemper; as a result of their use, the development of the disease may accelerate and its course may worsen. Contraindicated in the nervous stage of canine distemper and mastim (according to the instructions). In contrast, Mastim-OL, which predominantly acts on B cells, is effective against the nervous form of distemper in dogs. At this stage, IMDs that have a strong systemic effect can also be used. In particular, fosprenil gives a good therapeutic effect when administered into the cerebrospinal fluid of dogs suffering from the nervous form of plague.

The experimental data obtained scientifically justify the use of IMD at various stages of the infectious viral process. It has been shown that fosprenil, a complex-action IMD, can be used not only in the early but also in later clinically pronounced stages of a viral infection, since it has a direct antiviral effect and the ability to disrupt the life cycle of virions in cells. Moreover, unlike most other antiviral drugs that disrupt certain stages of viral replication (and, therefore, have a limited range of applications), the mechanism of action of fosprenil is more diverse and includes both a direct effect on viruses, for example, inhibition of the synthesis of key proteins, leading to a change in structure virion, and disruption of viral replication indirectly, through changes in the metabolism of the infected cell, and, finally, a systemic effect.

Use of IMD for bacterial infections

The literature has long established the opinion that infectious diseases are monoetiological diseases. At one time, such ideas undoubtedly had a positive impact and contributed to the study of the problems of pathogenesis, immunity, diagnosis, prevention and etiotropic treatment of viral or bacterial infections. However, in practice, viral diseases in small domestic animals rarely occur as a monoinfection. As a rule, against the background of an existing immunodeficiency that accompanies a viral infection, secondary (secondary) infections develop, which are also often polyetiological. In addition to the state of the host’s immune system, great importance in the development of secondary infections is given to the biological properties and activity of pathogens, as well as external stress factors. Thus, respiratory viruses increase the susceptibility of the mucous membranes of the respiratory tract to staphylococci, streptococci and other microorganisms; enteroviruses have a similar effect on the sensitivity of the intestinal tract to salmonella and shigella. However, purely bacterial infections also occur in small domestic animals.

With the latter, the connection to a complex treatment regimen with salmosan - IMD of bacterial origin - has proven itself well. Salmosan, obtained and comprehensively studied at the Gamaleya Research Institute of Experimental Medicine, Russian Academy of Medical Sciences, is a purified polysaccharide from the O-antigen of typhoid bacteria. The drug increases the formation of antibodies, the phagocytic activity of leukocytes and macrophages, the titer of lysozyme in the blood, and stimulates nonspecific resistance to infections caused by Salmonella, Listeria, Klebsiella, Escherichia, Staphylococcus, Brucella, Rickettsia, pathogens of tularemia and some other diseases (23). According to clinical trials conducted by specialists from 10 different clinics in the Russian Federation, for bacterial infections (salmonellosis, colibacillosis and staphylococcosis, confirmed by laboratory diagnostics), respiratory diseases (bronchitis, pneumonia), enteritis of various etiologies and enterocolitis of dogs and cats, the use of salmosan has significantly reduced treatment time and increase the effectiveness of therapy. A conclusion was made about the advisability of using salmozan as a first-choice drug that stimulates immunity and nonspecific resistance. In the treatment of purulent and lacerated wounds, the use of salmosan made it possible to significantly shorten the treatment period; a decrease in swelling and purulent exudate was noted in the first 2-3 days; recovery occurred one and a half times faster.

The ability of salmosan to activate macrophages and stimulate the production of specific antibodies by B-lymphocytes determines that the combination of salmosan with IMDs that have antiviral activity can, with timely treatment, prevent the development of secondary infections. It has been shown that the use of salmosan in combination with such IMDs as fosprenil, maxidin, gamapren, gamavit, immunofan, kinoron, etc. not only significantly increases the effectiveness of the treatment of panleukopenia, herpesvirus infections and calicivirosis of cats, canine distemper and parvovirus enteritis of dogs, as well as skin , respiratory, purulent and some other diseases, but also allows you to reduce doses of antibiotics and shorten the course of antibiotic therapy (21). It was noted that ampiox, benzylpenicillin and other antibiotics act much more effectively when using salmosan, which allows, if necessary, to reduce the cost of treatment, to abandon the use of expensive antibiotics of the latest generation.

When choosing drugs for the treatment of bacterial, viral and mixed infections, other auxiliary functions of IMD are also important. In particular, for infections accompanied by damage to the gastrointestinal tract (salmonellosis, enteritis of various etiologies, infectious hepatitis, panleukopenia, etc.), neutralization of toxins that abundantly enter the body due to intestinal dysfunction is of great importance. Obviously, for such diseases, IMD drugs such as fosprenil, dostim, as well as sodium nucleinate or gamavit are indicated.

In the treatment of chlamydia, good results were obtained when using IMDs such as Maxidin, Fosprenil or Immunofan in combination with Gamavit together with antibiotics (9). Apparently, this is explained by the mechanisms of action of these IMDs described above, since the decisive role in recovery from chlamydial infection belongs to the Th1 immune response, the activation products of which are IL-2, TNF? and produced by Th1-IFN?, which not only inhibits the proliferation of chlamydia, but also stimulates the production of IL-1 and IL-2.

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

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

Classification of immunomodulator drugs

All immunomodulators are divided into the following groups:

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

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

Immunomodulators of plant origin

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

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

Opinions for and against immunomodulators

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

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

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

Types of drugs that affect the immune system

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

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

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

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

How do immunomodulators and immunostimulants work?

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

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

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

Indications for the use of immunomodulators

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

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

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

Immunostimulants and immunomodulators of plant origin

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

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

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

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

Use of immunostimulants for children

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

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

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

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

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

Immunomodulators for the treatment of herpes

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

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

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

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

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

Immunomodulators are now very popular - they improve the body’s protective function and are intended for adults and children. But these medications must be used wisely: improper use can cause serious harm to a person. In this article, the reader will learn how immunomodulators affect the body of adult women and men, including children. The text contains the characteristics of specific drugs and reviews of people who assessed their effects, which are freely available on various Internet sites.

What kind of immunomodulator medicine is this and what effect does it have?

A person can be congenital or acquired. The first type of defense is depleted very quickly and is not able to resist the pathogen for a long time. The acquired one is activated after the innate resources have been exhausted; it has memory: in many cases, having once had an illness, a person tolerates re-infection more easily, because the acquired immunity has remembered an effective antibody to a given pathogen.

Attention! This principle is used in vaccination, when a weakened pathogenic microorganism is injected into a person, allowing the immune system to analyze the pathogen and develop effective protection.

When the body is unable to cope with the disease, immunomodulators are used. These are drugs that change the characteristics of the human immune system. There are 2 groups of immunomodulators:

• immunostimulants– force the defense system to act more actively;
• immunosuppressants has a depressing effect on the immune system, lowering it.

There is a difference between immunomodulators and immunostimulants: the former contain useful substances that help a person’s defenses overcome the disease, strengthen it, while stimulants artificially activate the immune system, forcing the use of internal reserves to fight.

The following groups of diseases can be distinguished for the treatment of which immunomodulators are used:

• chronic infections;
• allergy;
• tumors;
• immunodeficiency ().

Attention! Immunosuppressants are needed when the immune system malfunctions, causing it to act against its own body.

Reception and treatment with immunomodulators occurs when a doctor prescribes complex treatment, when the patient takes different groups of medications: antibiotics, antivirals and other drugs. This combination increases the body's defenses during active therapy.

These funds can also be used to speed up the patient’s rehabilitation period. After a course of administration, their effect continues for a long time, up to several years.

Classification of drugs, immunomodulators for children

These drugs, immunomodulators, are divided into 3 groups:

1. Endogenous– synthesis of substances occurs in the body itself.
2. Exogenous– all necessary substances and compounds come from outside with the intake of plant substances and beneficial bacteria.
3. Synthetic- completely artificial drugs.

We can distinguish herbal immunomodulators for adult women and men: many of them are used in traditional medicine recipes; since ancient times, people have discovered the healing properties of some plants. Among them, two groups can be distinguished:

• aggressive;
• soft.

The first group of plants has a more complex composition and is capable of inhibiting the defense system if used incorrectly. This group includes: licorice, yellow egg capsule, mistletoe and etc.

The second group is broader in composition; these plants help the immune system without side effects. This ginseng, Aralia, nettle, thyme, pine and nuts, garlic, figs etc.

Attention! The second group of medications can be recommended for self-medication (according to prescriptions), the first - only after consultation with a doctor and under his supervision.

It is necessary to give immunomodulators to a child very carefully, since the child’s defense system is at the stage of formation. Unreasonable use of immunomodulators and their active substances can lead to suppression of the child’s immunity.

Children over 6 years old are allowed to give immunomodulatory drugs no more than twice a year; children under 2 years old can use them only under the supervision of a doctor in difficult situations.

There are different points of view regarding the possibility of using various immunomodulators in children; for example, Dr. E. Komarovsky, a famous children's doctor, believes that children should not be given immunomodulators - this can lead to abnormal development and inability to protect themselves from the disease. Each parent is free to have their own point of view, but it is recommended to analyze all the pros and cons in advance.

You need to remember the main thing: the use of these medications, immunomodulators, immunostimulants or immunosuppressants, is possible only after consultation with a specialist. For both children and adults, it is possible to obtain a beneficial effect from taking immunomodulators only by selecting the right dose and taking into account the specific characteristics of a person’s health.

Improper use of immunomodulators can lead to a significant weakening of the immune system; in some situations, their use is contraindicated - for example, in the presence of autoimmune diseases, drugs can cause unpredictable and even fatal consequences.

The use of immunomodulators in the treatment of various diseases

1. . It is a viral disease, the causative agent of which is present in almost every person in a passive form. When comfortable conditions arise (the development of other diseases, weakening of protection), the virus begins to manifest itself as a pathogen, causing the development of the disease. Immunomodulators are used, among which the most effective are drugs from the group of interferons and certain nonspecific drugs (Cordyceps, natural immunity modulators, etc.). Treatment is most effective with simultaneous vitamin therapy.
2. Cold. Most often, the disease is of a viral nature and is associated with hypothermia. For treatment the following are used:

• antiviral immunomodulators as prescribed by a doctor;
• all natural remedies (as a complementary self-medication).

For colds, immunomodulators are used only in case of a complicated course of the disease, for example, if the high temperature persists for several days and the symptoms of acute respiratory infections do not subside. Only in this case will the attending physician prescribe an intensive course of therapy.

1. Flu. For the treatment of this disease, all natural, herbal immunomodulatory agents are indicated -, cranberry, rose hip, Melissa, . It is possible to use antiviral and anti-inflammatory immunomodulators (, etc.).

Attention! Herbal immunomodulators are allowed to be used only in the absence of contraindications (allergic reactions or concomitant diseases). It is recommended to consult a doctor before use.

1. Immunodeficiency virus (). This is a dangerous pathology that gradually deactivates the human defense system. Despite the fact that immunomodulators cannot eliminate this virus, the drugs can activate the immune system and significantly alleviate the patient’s condition. Medicines are used in conjunction with antiretroviruses and other drugs necessary for HIV-infected people. In addition to synthetic immunomodulators, natural drugs are widely used.

List of effective immunomodulators and reviews

Interferon

Interferon is an antiviral and antitumor modulator that is synthesized in the body itself. Interferon is used as:

• prophylactic agent for ARVI epidemics. The sooner you start taking a drug from the interferon group, the better the body will resist the effects of pathogens;
• to restore the body, immune system, after serious illnesses.

It is in the ranking of the most effective drugs for strengthening the immune system. The most common form of interferon release is ampoules with powder, which must be diluted with water and dropped into the eyes and nose. Also available in the form of rectal suppositories and for intramuscular injections.

Reviews of the use of Interferon:

“Interferon” perfectly increases the body’s defenses, I can say this from my husband and I’s experience. I bought it as prescribed by a doctor in the form of a dry powder in ampoules. The important thing is that you should not dilute the medicine too much, because the medicine is stored in the refrigerator for only a couple of days. This is a very good antiviral immunomodulator, protects against influenza and ARVI. It is better to use only after consulting a doctor: there are contraindications.

Anastasia, 29 years old

Not everyone talks about this, but Interferon cannot be used constantly. Yes, he helped me quickly get my child on his feet. Having seen such a miraculous effect, I instilled the drug in him every day, and when I stopped it in the spring, he immediately fell ill. It turns out that if you give the medicine for a long time, it will suppress the immune system, preventing the body from synthesizing its own interferon. So this medicine needs to be taken in moderation.

Ira, 35 years old

There are restrictions on the use of the immunomodulator Decaris for pregnant women, for example, when taken during lactation, breastfeeding is prohibited.

Children over 3 years old can use Decaris in strictly dosed doses. The cost is about 75 rubles per pack with one Dekaris tablet.

Reviews of the use of Decaris tablets:

Kirill 34 years old

Anton, 33 years old

Lycopid

In the photo, Likopid tablets are a strong immunomodulator and immunostimulant for adults and children.

Lykopid is a powerful immunomodulator and immunostimulant. Likopid is effective in the treatment of purulent-septic infections. Due to its bactericidal activity, Lykopid can be used as an antitumor drug, and is also used during therapy:

• psoriasis and other skin diseases;
• eye infections;
• hepatitis (infectious).

Attention! Likopid is considered a very strong drug, so it must be taken in doses; it is contraindicated during pregnancy and breastfeeding.

Lykopid® - instructions for use

Release form, composition and packaging White, round, flat-cylindrical tablets, with a chamfer and a score. 1 tab. glucosaminylmuramyl dipeptide (GMDP) 10 mg Excipients: lactose monohydrate – 184.7 mg, sugar (sucrose) – 12.5 mg, potato starch – 40 mg, methylcellulose – 0.3 mg, stearate – 2.5 mg. 10 pieces. – blister contour packages (1) – cardboard packs. Pharmacological action Pharmacodynamics The active substance of Lykopid® tablets is glucosaminylmuramyl dipeptide (GMDP) - a synthetic analogue of the structural fragment of the membrane (peptidoglycan) of bacterial cells. GMDP is an activator of innate and acquired immunity, strengthens the body’s defense against viral, bacterial and fungal infections; has an adjuvant effect in the development of immunological reactions. The biological activity of the drug is realized through the binding of GMDP to the intracellular receptor protein NOD2, localized in the cytoplasm of phagocytes (neutrophils, macrophages, dendritic cells). The drug stimulates the functional (bactericidal, cytotoxic) activity of phagocytes, enhances their presentation of antigens, the proliferation of T- and B-lymphocytes, increases the synthesis of specific antibodies, and helps normalize the balance of Th1/Th2 lymphocytes towards the predominance of Th1. The pharmacological action is carried out by enhancing the production of key interleukins (interleukin-1, interleukin-6, interleukin-12), TNF alpha, interferon gamma, colony-stimulating factors. The drug increases the activity of natural killer cells. Likopid® has low toxicity (LD50 exceeds the therapeutic dose by 49,000 times or more). In the experiment, when administered orally in doses 100 times higher than the therapeutic dose, the drug does not have a toxic effect on the central nervous system and cardiovascular system, and does not cause pathological changes in internal organs. Likopid® does not have embryotoxic or teratogenic effects and does not cause chromosomal or gene mutations. Experimental studies conducted on animals provided data on the antitumor activity of the drug Lykopid® (GMDP). Pharmacokinetics The bioavailability of the drug when taken orally is 7-13%. The degree of binding to blood albumin is weak. The time to reach Cmax is 1.5 hours after administration. T1/2 – 4.29 hours. Does not form active metabolites, is excreted mainly through the kidneys unchanged. Indications The drug is used in adults in the complex treatment of diseases accompanied by secondary immunodeficiency states: - acute and chronic purulent-inflammatory diseases of the skin and soft tissues, including purulent-septic postoperative complications; - sexually transmitted infections (human papillomavirus infection, chronic); - herpetic infection (incl. with ophthalmoherpes); - psoriasis (including psoriatic); - lungs. Dosage regimen Licopid® is administered orally on an empty stomach, 30 minutes before meals. Elderly patients are recommended to start treatment with half doses (1/2 of the therapeutic dose), in the absence of side effects, increasing the dose of the drug to the required therapeutic dose. If a drug dose is missed, if no more than 12 hours have passed from the scheduled time, the patient can take the missed dose; If more than 12 hours have passed from the scheduled time of administration, you must take only the next dose according to the schedule and not take the missed one. Purulent-inflammatory diseases of the skin and soft tissues, acute and chronic, severe, including purulent-septic postoperative complications: 10 mg 1 time / day for 10 days. Herpetic infection (recurrent course, severe forms): 10 mg 1 time / day for 6 days. For ophthalmoherpes: 10 mg 2 times a day for 3 days. After a break of 3 days, the course of treatment is repeated. Sexually transmitted infections (human papillomavirus infection, chronic): 10 mg 1 time/day for 10 days. Psoriasis: 10–20 mg 1 time/day for 10 days and then five doses every other day, 10–20 mg 1 time/day. For severe psoriasis and extensive lesions (including psoriatic): 10 mg 2 times a day for 20 days. Pulmonary tuberculosis: 10 mg 1 time/day for 10 days. Side effects Often (1–10%) – arthralgia (joint pain), myalgia (muscle pain); at the beginning of treatment, there may be a short-term increase in body temperature to subfebrile values ​​(up to 37.9°C), which is not an indication for discontinuation of the drug. Most often, the side effects described above are observed when taking Lykopid® tablets in high doses (20 mg). Rarely (0.01-0.1%) – a short-term increase in body temperature to febrile values ​​(>38.0°C). If body temperature rises >38.0°C, antipyretics can be taken, which does not reduce the pharmacological effects of Lykopid® tablets. Very rarely (<0.01%) – . Если любые из указанных в инструкции побочных эффектов усугубляются или пациент заметил любые другие побочные эффекты, следует сообщить об этом врачу. Противопоказания к применению - повышенная чувствительность к глюкозаминилмурамилдипептиду и другим компонентам препарата; - беременность; - период лактации (грудного вскармливания); - детский возраст до 18 лет; - аутоиммунный тиреоидит в фазе обострения; - состояния, сопровождающиеся фебрильной температурой (> 38°C) at the time of taking the drug; - rare congenital metabolic disorders (alactasia, galactosemia, lactase deficiency, lactose intolerance, sucrase/isomaltase deficiency, fructose intolerance, glucose-galactose malabsorption); - use for autoimmune diseases is not recommended due to the lack of clinical data. Likopid® 10 mg is used with caution in elderly people, strictly under the supervision of a physician. Use during pregnancy and breastfeeding Taking Licopid® 10 mg is contraindicated for women during pregnancy and breastfeeding. Special instructions When starting to take the drug Likopid® 10 mg, there may be an exacerbation of the symptoms of chronic and latent diseases associated with the main pharmacological effects of the drug. In elderly people, Licopid® 10 mg is used with caution, strictly under the supervision of a physician. Elderly patients are recommended to start treatment with half doses (1/2 of the therapeutic dose), in the absence of side effects, increasing the dose of the drug to the required therapeutic dose. The decision to prescribe Licopid® tablets 10 mg to patients with a combination of diagnoses of psoriasis and gout should be made by a doctor when assessing the risk/benefit ratio, due to the potential risk of exacerbation of gouty arthritis and joint swelling. If the doctor decides to prescribe the drug Likopid® tablets 10 mg in a situation where the patient has a combination of diagnoses of psoriasis and gout, treatment should begin with low doses, in the absence of side effects, increasing the dose to a therapeutic one. Each Licopid® 10 mg tablet contains sucrose in the amount of 0.001 XE (bread units), which should be taken into account in patients with. Each Licopid® 10 mg tablet contains 0.184 grams of lactose, which should be taken into account by patients suffering from hypolactasia (lactose intolerance, in which the body experiences a decrease in the level of lactase, the enzyme necessary to digest lactose). Influence on the ability to drive vehicles and operate machinery. Does not affect the ability to drive vehicles and complex mechanisms. Overdose Cases of drug overdose are unknown. Symptoms: based on the pharmacological properties of the drug, in case of overdose, a rise in body temperature to subfebrile (up to 37.9 ° C) values ​​may be observed. Treatment: if necessary, symptomatic therapy (antipyretics) is carried out, sorbents are prescribed. A specific antidote is unknown. Drug interactions The drug increases the effectiveness of antimicrobial drugs, and there is synergism with antiviral and drugs. Antacids and sorbents significantly reduce the bioavailability of the drug. GCS reduce the biological effect of the drug Likopid®. Conditions and periods of storage The drug should be stored in a dry place, protected from light, out of reach of children at a temperature not exceeding 25°C. Shelf life – 5 years. Do not use after expiration date. Conditions for dispensing from pharmacies The drug is dispensed with a prescription.

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Reviews of the use of tablets immunomodulatorLycopid:

I have low immunity, and the doctor prescribed me the immunomodulator “Likopid”. The medicine is sold in tablets, the price is high, and this is the only disadvantage. The effect does not appear immediately, the effect is cumulative. I took three courses, only after that I noticed that my immunity had become stronger - I endured the cold autumn and winter calmly, and never got sick, which is an amazing and rare occurrence for me!

Anna, 37 years old

At first, my relationship with this immunomodulator did not work out. When I started taking the medicine prescribed to me, I did not find any positive effect. After some time, I took another course of Lykopid, and began to feel that my health began to improve. Then I learned from the doctor that the drug does not act immediately, first the medicinal substances accumulate, and only then they strengthen the immune system. This happened in my case too; I haven’t been sick during the cold season for several years now.

Oleg, 43 years old

Arbidol

is an antiviral drug with moderate effects. Arbidol is used as a therapeutic and preventive measure for severe viral diseases (acute respiratory infections, influenza, bronchitis, etc.).

I have a large family, and every year we use Arbidol to prevent influenza and ARVI diseases. Capsules for children and adults with different dosages are sold - this is a big plus, because you want to protect children without side effects. We use it as a preventive measure, the effect is good - none of the family members have gotten sick in two years. The drug is inexpensive - this is also a plus, it helps to avoid both the disease itself and expensive treatment.

Olga, 40 years old

"Arbidol", of course, is a well-known and time-tested medicine. About ten years ago, my doctor recommended that I use this immunomodulator for prevention, and make it a rule. During all this time I have never regretted this advice. Now this is my little tradition: when autumn comes, I go to the pharmacy and take Arbidol! By the way, I get sick very rarely.

Innocent, 39 years old

Amiksin

Amiksin is an antiviral drug with a strong effect. The immunomodulator Amiksin is used in the treatment of hepatitis A, B, C and various viral infections, including influenza, acute respiratory infections, and pulmonary diseases. Children can take Amiksin no earlier than 7 years old - the effect is powerful; before this age can have a destructive effect on the developing immune system.

Reviews of the use of Amiksin tablets:

I live in the south of Russia, where the climate is mild; I once went to visit relatives in Yaroslavl in winter and almost immediately fell ill. High temperature, weakness - in a word, flu. Within an hour after taking the first Amiksin tablet, the temperature almost returned to normal, and three days later I forgot about the illness! But it must be remembered that the medicine is strong, children should be given only a small dosage and consult a doctor first.

Antonina, 41 years old

I became acquainted with this immunomodulator almost two years ago, when I was sick several times in winter and spring. At this time I had to travel around the country in connection with my work. The infection hit me powerfully and knocked me off my feet. A friend bought the drug after consulting with the seller at the pharmacy. I took only three tablets and was cured of the disease! Already on the second day I felt so healthy that I was able to return to work. Then I found out that this drug is contraindicated for those who are allergic to the constituent substances. But Amiksin really helped me!

Nikolay, 49 years old

Amiksin - instructions for use

Release form, composition and packaging Orange film-coated tablets, round, biconvex; on the cross section - the core is orange, minor darker or lighter inclusions are allowed. 1 tab. tilorone (tilaxin) 125 mg Excipients: potato starch - 46 mg, microcrystalline cellulose - 120 mg, povidone (povidone K30) - 3 mg, stearate - 3 mg, croscarmellose (croscarmellose sodium) - 3 mg. Shell composition: hypromellose (hydroxypropyl methylcellulose) – 6.81 mg, titanium dioxide – 3.563 mg, macrogol (polyethylene glycol 4000) – 0.913 mg, polysorbate 80 (Tween 80) – 0.114 mg, quinoline yellow dye (E104) – 0.247 mg, sunset yellow dye (E110) – 0.353 mg. 6 pcs. – blister contour packages (1) – cardboard packs. 6 pcs. – blister contour packages (2) – cardboard packs. 10 pieces. – blister contour packages (1) – cardboard packs. 10 pieces. – blister contour packages (2) – cardboard packs. 6 pcs. – polymer jars (1) – cardboard packs. 10 pieces. – polymer jars (1) – cardboard packs. 20 pcs. – polymer jars (1) – cardboard packs. Pharmacological action Low molecular weight synthetic interferon inducer that stimulates the formation of alpha, beta, gamma interferons in the body. The main structures that produce interferon in response to the administration of tilorone are intestinal epithelial cells, hepatocytes, T-lymphocytes, neutrophils and granulocytes. After taking the drug orally, the maximum production of interferon is determined in the sequence intestine-liver-blood after 4-24 hours. Amiksin® has an immunomodulatory and antiviral effect. Induces the synthesis of interferon in human leukocytes. Stimulates bone marrow stem cells, depending on the dose, enhances antibody formation, reduces the degree of immunosuppression, restores the ratio of T-suppressors and T-helpers. Effective against various viral infections (including those caused by influenza viruses, other pathogens of acute respiratory viral infections, viruses, herpes). The mechanism of antiviral action is associated with inhibition of the translation of virus-specific proteins in infected cells, as a result of which viral reproduction is suppressed. Pharmacokinetics Absorption After taking the drug orally, tilorone is rapidly absorbed from the gastrointestinal tract. Bioavailability is about 60%. Distribution: Binding to blood plasma proteins – about 80%. Metabolism and excretion Tiloron does not undergo biotransformation and does not accumulate in the body. It is excreted almost unchanged in feces (about 70%) and urine (about 9%). T1/2 is 48 hours. Indications In adults - for the prevention and treatment of influenza and ARVI; - for the treatment of viral hepatitis A, B and C; - for the treatment of herpes infection; - for the treatment of cytomegalovirus infection; - as part of complex therapy of allergic and viral encephalomyelitis (including disseminated encephalomyelitis, leukoencephalitis, uveoencephalitis); - as part of complex therapy of urogenital and respiratory diseases; - as part of complex therapy of pulmonary tuberculosis. In children over 7 years of age - for the treatment of influenza and ARVI. Dosage regimen The drug is taken orally after meals. In adults, for nonspecific viral prevention, the drug is prescribed at a dose of 125 mg once a week for 6 weeks. Course dose – 750 mg (6 tablets). When treating a viral infection, the dose of the drug on the first day is 125 mg 2 times a day, then switch to taking 125 mg after 48 hours. The course of treatment is 1.25 g (10 tablets). When treating acute B, in the initial phase of treatment on the first and second days, the dose of the drug is 125 mg/day, and then 125 mg after 48 hours. The course of treatment is 2 g (16 tablets). In case of protracted hepatitis B, on the first day the dose of the drug is 125 mg 2 times a day, then 125 mg after 48 hours. The course dose is 2.5 g (20 tablets). For chronic hepatitis B in the initial phase of treatment, the total dose is 2.5 g (20 tablets). In the first 2 days, the daily dose is 250 mg, then switch to taking 125 mg after 48 hours. In the continuation phase of treatment, the total dose ranges from 1.25 g (10 tablets) to 2.5 g (20 tablets), while the drug is prescribed at a dose of 125 mg per week. The course dose of Amiksin varies from 3.75 to 5 g, the duration of treatment is 3.5-6 months, depending on the results of biochemical, immunological and morphological studies, reflecting the degree of activity of the process. In acute cases, on the first and second days of treatment, Amiksin® is prescribed at a dose of 125 mg/day, then 125 mg after 48 hours. The course dose is 2.5 g (20 tablets). For chronic in the initial phase of treatment, the total dose is 2.5 g (20 tablets). In the first 2 days, the drug is taken at a dose of 250 mg/day, then 125 mg after 48 hours. In the continuation phase of treatment, the total dose is 2.5 g (20 tablets), while the drug is prescribed at a dose of 125 mg per week. The course dose of Amiksin is 5 g (40 tablets), the duration of treatment is 6 months, depending on the results of biochemical, immunological and morphological studies, reflecting the degree of activity of the process. For complex therapy of neuroviral infections - 125-250 mg/day in the first two days of treatment, then 125 mg after 48 hours. The dose is set individually, the duration of treatment is 3-4 weeks. For the treatment of influenza and other acute respiratory viral infections in the first 2 days of illness, Amiksin® is prescribed at a dose of 125 mg/day, then 125 mg after 48 hours. The course dose is 750 mg (6 tablets). To prevent influenza and ARVI, Amiksin® is prescribed at a dose of 125 mg once a week for 6 weeks. Course dose – 750 mg (6 tablets). For the treatment of herpetic, cytomegalovirus infections, the dose of the drug in the first 2 days is 125 mg, then take 125 mg every 48 hours. The course dose is 1.25-2.5 g (10-20 tablets). For urogenital and respiratory infections, Amiksin® is prescribed at a dose of 125 mg/day for the first 2 days, then 125 mg every 48 hours. The course dose is 1.25 g (10 tablets). For complex therapy of pulmonary tuberculosis, in the first 2 days the drug is prescribed at 250 mg/day, then 125 mg every 48 hours. The course dose is 2.5 g (20 tablets). For children over 7 years of age with uncomplicated forms of influenza or other acute respiratory viral infections, the drug is prescribed in a dose of 60 mg (1 tablet) 1 time/day after meals on the 1st, 2nd and 4th day from the start of treatment. Course dose – 180 mg (3 tablets). If complications of influenza and other acute respiratory viral infections develop, the drug is taken 60 mg 1 time / day on the 1st, 2nd, 4th, 6th day from the start of treatment. Course dose – 240 mg (4 tablets). Side effects From the digestive system: symptoms of dyspepsia are possible. Other: short-term chills and allergic reactions are possible. Contraindications for use: pregnancy; - period of breastfeeding; - children under 7 years of age; - increased sensitivity to the drug. Use during pregnancy and breastfeeding Amiksin® is contraindicated for use during pregnancy and breastfeeding. Use in children Contraindication: children under 7 years of age. Special instructions Amiksin® is compatible with antibiotics and traditional treatments for viral and bacterial infections. Overdose To date, cases of overdose of the drug Amiksin® are unknown. Drug interactions No clinically significant drug interactions between Amiksin and antibiotics and traditional treatments for viral and bacterial infections have been identified. Conditions and periods of storage The drug should be stored out of the reach of children, in a dry place, protected from light at a temperature not exceeding 30°C. Shelf life – 3 years. Conditions for dispensing from pharmacies The drug is available without a prescription.

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Lymphomyosot

Lymphomyosot is a homeopathic remedy with immunomodulator properties. Lymphomyosot improves the absorption of all medications, in many cases making it possible to reduce their dosage and prevent side effects. Lymphomyosot also fights edema well, has a lymphatic drainage effect, normalizing the exchange of fluids in the human body.

In addition to the effect of activating metabolic processes and strengthening the ability of the immune system to resist, Lymphomyosot removes harmful chemical compounds from the body. Used to treat diseases of the ENT organs, skin diseases, tumors, asthenia, etc.

Lymphomyosot is contraindicated in the presence of diseases of the thyroid gland and liver.