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(ISSN
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ABSTRACT
The purpose of the study was to study the role of cytokines and major interferons in children with laryngeal
papillomatosis in the dynamics of antiviral therapy in the postoperative period. To achieve this goal, 252 children with
laryngeal papillomatosis aged 3 to 9 years were examined. All children were examined and treated in the surgical
department of otolaryngology of TMA. In order to determine the effectiveness of the treatment of children, the
following division into groups was carried out: Group I - children with a continuously recurrent course of papillomatosis
of the larynx were divided into two subgroups: Subgroup I - the comparison group received standard treatment
surgery + IFN preparations (reaferon) - one course per 28 days; Subgroup I - study group surgery + IFN preparations
(alpha-IFN / inosine) - according to the scheme for 1 year. Group II - children with a frequently relapsing course of PH:
II a subgroup - received standard treatment surgery + IFN preparations (reaferon) - one course for 28 days; II in the
subgroup - surgery + IFN preparations (alpha-IFN / inosine) - according to the scheme for 6 months. Group III - children
with a rarely recurrent course of PH: III a group - surgery; Group III - surgery + licopid. It was revealed that the analysis
of the main interferons and cytokines of the immune system made it possible to establish that the changes obtained
in a comparative analysis of clinical variants of laryngeal papillomatosis are amenable to immunotropic therapy, which
is expressed by the use of an antiviral drug. Moreover, there is an improvement in the values of cytokines and
interferons, which is expressed in a decrease in the production of pro-inflammatory cytokines and in an increase in the
production of IFN-
α and IFN
-
γ, which have pronounced antiviral properties. The clinical result of therapy was a
Research Article
THE ROLE OF INFLUENCE OF THE MAIN CYTOKINES OF THE IMMUNE
SYSTEM IN CHILDREN WITH PAPILLOMATOSIS OF THE LARYNX ON THE
BACKGROUND OF ANTIVIRAL THERAPY
Submission Date:
August 14, 2023,
Accepted Date:
August 19, 2023,
Published Date:
August 24, 2023
Crossref doi:
https://doi.org/10.37547/ijmscr/Volume03Issue08-06
Sh.A. Makhamadaminova
Tashkent Medical Academy, Uzbekistan
Journal
Website:
https://theusajournals.
com/index.php/ijmscr
Copyright:
Original
content from this work
may be used under the
terms of the creative
commons
attributes
4.0 licence.
Volume 03 Issue 08-2023
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(ISSN
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decrease in the number of recurrences of papillomatosis in children, an improvement in general well-being, and clinical
and laboratory indicators of the disease.
KEYWORDS
papillomatosis of the larynx in children, interferons, cytokines, interleukins, interferon inducers.
INTRODUCTION
The problem of papillomatosis of the larynx today
remains
one
of
the
most
difficult
in
otorhinolaryngology in relation to treatment. Recently,
there has been an increase in the number of children
with larynx papilomatosis, with more than 70% of
patients having severe common recurrent forms
[4,9,11,12]. As is known, the recurrence process is
difficult to control with modern drugs , and therefore
the question of prescribing antiviral therapy along with
surgical therapy remains open. It is believed that the
cause of relapses is that in the case of surgical
treatment, only the visible pathological focus is excised
, and not the etiological factor. Remaining in the tissues
of HPV again leads to the development of the tumor
process. Most often, HPV types 6 and 11 of the virus are
detected in papillomatosis of the larynx, but the
detection of viruses of types 8, 16, 18, 30 and 31 has also
been described [9,12,15]. Researchers have no
consensus on differences in the clinical course of the
disease depending on the type of virus [12]. But the fact
that the pathological recurrent process is due to a
deficiency of immunological factors of immunity and
features of the immune response, of course, there is no
doubt. In this regard, it was shown that before the start
of treatment in children with laryngeal papillomatosis,
suppression of IFN-
α, which is a powerful antiviral
cytokine, against the background of activation of IFN-
γ
production, was found, which indicates the presence
of a pronounced inflammatory process. Also,
spontaneous and induced production of IFN-
α was
significantly reduced, indicating a low potential reserve
of antiviral cytokine and clinically indicating the
presence of persistent viral infection and recurrence of
the pathological process. Our data are consistent with
the data of a narrow number of scientists and doctors
with scientific potential, who observed the
dependence of interferon deficiency and their
production on the severity of the clinical manifestation
of the disease [1,3,6]. Therefore, a comprehensive
diagnosis of laryngeal papillomatosis in children also
requires immunological studies at various levels of
immunity, ranging from cellular to molecular. At the
same time, studies are carried out on the state of
immunoreactivity and the main interferons and
cytokines. In connection with the above, as usual, we
set a goal to study the role of cytokines and major
Volume 03 Issue 08-2023
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interferons in children with laryngeal papillomatosis in
the dynamics of antiviral therapy in the postoperative
period.
Material and research methods. 252 children with
laryngeal papillomatosis aged 3 to 9 years were
examined. All children were examined and treated in
the surgical department of otolaryngology of the
Tashkent Medical Academy (TMA). In order to
determine the effectiveness of the treatment of
children, the following division into groups was carried
out: Group I - children with a continuously recurrent
course of papillomatosis of the larynx were divided
into two subgroups: Subgroup I - the comparison
group received standard treatment surgery + IFN
preparations (reaferon) - one course per 28 days;
Subgroup I - study group surgery + IFN preparations
(alpha-IFN / inosine) - according to the scheme for 1
year. Group II - children with a frequently relapsing
course of PH: II a subgroup - received standard
treatment surgery + IFN preparations (reaferon) - one
course for 28 days; II in the subgroup - surgery + IFN
preparations (alpha-IFN / inosine) - according to the
scheme for 6 months. Group III - children with a rarely
recurrent course of PH: III a group - surgery; Group III -
surgery + licopid. The control group was represented
by 29 practically healthy children of the same age and
gender.
And studies of cytokines and interferons were carried
out against the background of therapy after surgical
removal for 6 months of therapy. Immunological
studies were carried out at the NDC "Immunogen-test"
at the RNCI of the Ministry of Health of the Republic of
Uzbekistan on the basis of a scientific agreement.
Determination of cytokines and interferons in the
serum of peripheral blood on an empty stomach was
carried out using the test systems "Vector-Best",
Novosibirsk, Russia according to the standard
instructions by ELISA.
The results obtained and their discussion. Thanks to
modern achievements in fundamental and applied
immunology, molecular biology and biotechnology,
new biologically significant indicators have now
appeared that can help in the work of a practicing
otolaryngologist, in particular in the diagnosis,
treatment and prognosis of diseases, as well as in the
selection of immunotropic drugs for complex therapy
[2,4]. In recent years, much attention has been paid not
only to the study of cellular and humoral factors of
immunity, but to the study of the behavior of
immunological components depending on the clinical
features of the disease, which are a kind of indicators
of the nature of the course of the disease, especially
against the background of a chronic long-term or
recurrent process [2]. Cytokines are proteins that are
produced mainly by activated cells of the immune
system, providing the functions of intercellular
cooperation, positive and negative immunoregulation
of the protective functions of the div [2,5,6,7]. It is
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known that cytokines regulate the amplitude and
duration of inflammatory and immune responses [2,3].
It is important to note that cytokines can be isolated
into a new independent system of regulation of the
main functions of the div, which exists along with the
nervous and endocrine systems and is primarily
associated with maintaining homeostasis [2,3]. It is
known that at the tissue level, cytokines are
responsible for the development of inflammation, and
then the regeneration of tissues of homeostasis
[8,9,13,14]. With the development of a systemic
inflammatory response, cytokines affect almost all
organs and systems of the div involved in the
regulation of homeostasis [14]. It should be noted that
in recent years, studies of cytokine levels in various
human diseases are based on the fact that cytokines
are key factors in the immunopathogenesis of a
number of immune-dependent conditions and
diseases, including infectious and proliferative ones,
such as laryngeal papillomatosis in children, where it is
quite common the role of infectious etiopathogenesis
in its development is recognized and, consequently,
the role of almost all factors of the immune system in
its development and progression [10,12]. It is known
that papillomatosis of the larynx is a serious disease
that causes a disorder of the most important functions
of the div - respiratory and voice-forming, while
recurrence of papillomas, their rapid growth, damage
to significant areas of the larynx and trachea pose a
threat to the life of the patient [3,4]. A predisposing
factor in the occurrence of papillomatosis of the larynx
is an acute infectious disease, characterized by a
selective lesion of the mucous membrane of the larynx
and a decrease in the immunobiological activity of the
organism [ 4,11]. Despite a powerful humoral and
cellular immune response in acute viral infections, a
chronic viral long-term lesion of the larynx develops,
which often has a frequently relapsing character. At
the same time, the key role in the mechanisms of virus
persistence is played by the relationship between the
virus and the factors of the immune system of the
macroorganism [5,6]. Despite a significant deepening
in the last decade of ideas in the etiology,
immunopathogenesis, course and progression of
laryngeal papillomatosis in children, many questions
regarding the mechanisms of the development of the
pathological process and its progression remain open.
As described above, in children with papillomatosis of
the larynx, particular importance is attached to the
study of the main interferons, which play an important
role in the formation of the antiviral and antitumor
process [1,9,13]. Many researchers in our country and
abroad have devoted their work to laryngeal
papillomatosis [6,7], however, despite this, there are
still problems regarding the diagnosis and especially
the treatment of children, especially with frequently
and continuously recurrent forms of the disease.
Despite the existing practice and proven mechanisms
for the development and progression of laryngeal
papillomatosis in children, today there is no way to
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clearly predict the course of the disease, the
development of relapses, their frequency and
frequency. Our analysis made it possible to identify the
following changes in the state of functioning of
cytokines, as well as interferons. The data obtained are
presented in Table 1. Thus, the analysis showed that the
serum content of IFN-
α in the dynamics of treatment in
the group of children 1a was increased by 7.1 times, and
in the group of children 1c - 8 times compared with the
group of children before treatment. In turn, IFN-
γ in
group 1a was increased by 1.22 times, while in group 1 it
was also 1.33 times higher compared to the data of
children before treatment. The level of antibodies to
IFN-
α in group 1a was suppressed by 1.05 times, while
in group 1 it was suppressed by 1.2 times. Therefore,
against the background of the existing potential, i.e.
reserve of interferons for induction and when
prescribing interferon inducers, there is a significant
improvement not only in antiviral immunity, which is
expressed in the normal production of IFN-
α, but also
in the improvement of cellular immunity, as evidenced
by an increase in IFN-
γ, which is produced by cells of
the adaptive immunity link.
Next, we reviewed the main cytokines of the immune
system that were studied before treatment - TNF-
α and
IL-6. At this stage, we have studied the levels of
cytokines in the dynamics of treatment. Thus, the
analysis showed that the level of IL-6 after treatment
compared with the data before treatment in group 1a
was suppressed 1.6 times, and in group 1c - 2.7 times.
As can be seen, the values of IL-6 in the 1a group of
children during therapy remains elevated, even against
the background of IFN therapy. And in group 1, the
level of IL-6 is significantly reduced, but does not reach
the normal value.
TNF-
α in group 1a of children with papillomatosis
decreased during therapy and was suppressed
compared to the data before treatment, where its
concentration was significantly increased, by 1.7 times,
and in group 1 it was suppressed by 2.5 times.
Therefore, the analysis showed that during therapy,
suppression of the level of TNF-
α is observed, and
against the background of IFN-therapy in combination
with inosine, a more effective immune response is
observed, which is expressed in a significant
suppression of IL-6 and TNF-
α.
Thus, for children with continuously recurrent
papillomatosis of the larynx, taking inosine against the
background of standard therapy in the complex in the
dynamics of treatment, compared with the data of the
standard group, an increase in IFN-alpha by 1.13 times,
IFN-
γ by 1.1 times was characteristic, decrease in
antibodies to IFN-
α by 1.14 times, TNF
-
α decreased by
1.5 times, IL-6 - by 1.74 times. The differences we found
were significant. The differences are all valid. Next, we
analyzed the results of the analysis of children with a
frequently recurrent form of laryngeal papillomatosis.
It was found that the content of IFN-
α in the dynamics
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of treatment in the group of children 2a was increased
by 3.5 times, and in the group of children 2c - 5.5 times
compared with the group of children before
treatment. In turn, IFN-
γ in group 2a was increased by
1.6 times, while in group 2 - by 1.98 times, also
compared with the data of children before treatment.
The level of antibodies to IFN-
α in group
2a was
suppressed 1.2 times, in group 2b - 1.5 times.
Table 1.
The study of the dynamics of cytokines in children with papillomatosis of the larynx in the dynamics of therapy,
depending on the clinical features of the disease, М± m , ng/ml
Continuously recurrent papillomatosis of the larynx
Immunologic
al indicators
Norm
Before
treatment
Group
1a
(standard
treatment + IFN)
Group
1c
(standard
treatment + IFN +
inosine pranobex)
IFN-
α
44.25±3.4
11.9±1.95*
84.5
1.92*^
95.70
1.80*#$
IFN-
γ
3.86±0.44
13.7±1.9*
16.8
±1.62* ^
18.2
±1.61* #
AT to IFN-
α
3.5±0.64
8.9±1.45 *
8 , 5
±0.58*
7.45 ±
0.32* #$
TNF-
α
4.82
0.91
21.9±2.82*
12.94
±0.73* ^
8 .62
±0.41* #$
IL-6
3.58±0.41
19.8±1.25
12.70±0.55 ^
7.3 ±1.42* #$
Frequently recurrent papillomatosis of the larynx
Immunologic
al indicators
Norm
Before
treatment
Group
2a
(standard
treatment + IFN)
Group
2c
(standard
treatment + IFN +
inosine pranobex)
IFN-
α
44.25±3.4
13.4±2.4*
46.40
1.65*^
74.20
1.94*#$
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IFN-
γ
3.86±0.44
9.2±1.9
14.32±1.22*^
18.2±0.58*#$
AT to IFN-
α
3.5±0.64
7.8±1.3*
6.52±0.35*
5.28±0.41*#
TNF-
α
4.82
0.91
23.7±4.1*
11.93±0.80*^
6.20±0.50*#$
IL-6
3.58±0.41
11.6±4.2*
8.12±0.58*^
5.21±0.41*#$
Rarely recurrent papillomatosis of the larynx
Immunologic
al indicators
Norm
Before
treatment
Group 3a
(standard
treatment
Group 3c
(standard
treatment +
lycopid)
IFN-
α
44.25±3.4
18.5±1.42*
39.70
0.88*^
42.60
1.55#
IFN-
γ
3.86±0.44
19.7±2.1*
8.98±0.42*^
6.55±0.42*#
AT to IFN-
α
3.5±0.64
6.4±1.29*
5.14±0.85*
4.42±0.63
TNF-
α
4.82
0.91
34.4±1.35*
14.30±0.81*^
7.40±1.35#$
IL-6
3.58±0.41
6.20±0.55
4.90±0.45
3.29±0.40#
Note: * - significance of differences with the data of the control group, ^ - differences of groups 1a, 2a and 3a with
values before treatment; # - differences in groups 1c, 2c and 3c with values before treatment; $ - differences between
1a and 1c, 2a and 2c, 3a and 3c groups.
There is a depletion of interferons in the group of
patients with a continuously recurrent form of
laryngeal papillomatosis. When comparing the values
of IFN-alpha between groups, it can be seen that the
lowest content of the antiviral protein IFN-alpha was in
the group of children with a continuously recurrent
form of laryngeal papillomatosis. Therefore, again, the
same picture is observed, which was revealed in the
group of children with a frequently recurrent form of
laryngeal papilomatosis, which shows a high activity of
interferons in the blood serum, which is confirmed
clinically by an improvement in the condition, and
fewer relapses. The study of TNF-
α and IL
-6 showed
that IL-6 in the dynamics of treatment compared with
the values before treatment in group 2a was
suppressed by 1.4 times, in group 2c - by 2.2 times. But
Volume 03 Issue 08-2023
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still, the values of IL-6 in both groups of children remain
elevated compared to the data of the control group.
The data obtained are presented in Table 1. TNF-
α in the
dynamics of treatment also remains elevated
compared to the data of the control group, but
significantly reduced compared to the data of children
before treatment. Thus, TNF-
α in the 2a group of
children with papillomatosis decreased 1.9 times, in the
2nd group - 3.8 times. Consequently, a decrease in the
level of TNF-
α was revealed, and against the
background of IFN-therapy in combination with
inosine, a more effective immune response is
observed, which is expressed in a pronounced anti-
inflammatory effect by suppressing pro-inflammatory
cytokines. So, for children with frequently recurrent
papillomatosis of the larynx, taking inosine in
combination with standard therapy in the dynamics of
treatment compared with the data of the standard
treatment group, an increase in IFN-alpha by 1.6 times,
IFN-
γ by 1.3 times, a decrease in antibodies to IFN
-
α by
1.2 times, a decrease in TNF-
α by 1.9 times, a decrease
in IL-6 by 1.6 times. The differences are all valid. Next,
we analyzed the results of the immunological analysis
of children with a rarely recurrent form of laryngeal
papillomatosis. It was found that the content of IFN-
α
in the dynamics of treatment in the group of children
3a was increased by 2.14 times, and in the group of
children 3b - 2.3 times compared with the group of
children before treatment. In turn, IFN-
γ in group 3a
was reduced by 2.2 times compared with the data
before treatment and practically reached the standard
values, while in group 3 it was reduced by 3 times in the
course of treatment. The level of antibodies to IFN-
α in
the 3a group was suppressed by 1.3 times, in the 3rd
group - by 1.4 times. Consequently, a greater activity of
interferons in the blood serum against the background
of standard therapy is shown, which is confirmed
clinically by an improvement in the condition and fewer
relapses. The study of TNF-
α and IL
-6 showed that IL-6
in the dynamics of treatment compared with the values
before treatment in group 3a was suppressed by 1.3
times, in group 3c - by 1.8 times. It should be noted that
it is in this group of children that IL-6 values approach
the norm and are significantly reduced. TNF-
α in the
dynamics of treatment also remains elevated
compared to the data of the control group, but
significantly reduced in comparison with the data of
children before treatment. Thus, TNF-
α in the 3a group
of children with papillomatosis decreased 2.4 times, in
the 3rd group - 4.6 times. Consequently, a decrease in
the level of TNF-
α was revealed, and against the
background of IFN-therapy in combination with licopid,
a more effective immune response is observed, which
indicates a pronounced anti-inflammatory effect of the
drug. So, for children with rare recurrent
papillomatosis of the larynx, taking against the
background of standard therapy in the complex licopid
in the dynamics of treatment compared with the data
of the standard treatment group, an increase in IFN-
α
by 1.1 times, IFN-
γ by 1.4 times was characteristic, a
Volume 03 Issue 08-2023
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)
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Publisher:
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Servi
decrease in antibodies to IFN-
α by 1.2 times, a decrease
in TNF-
α by 1.9 times, a de
crease in IL-6 by 1.4 times.
When analyzing cytokines between groups, it was
shown that the highest content of antibodies to IFN-
α
was detected in the group of children with a
continuously
recurrent
form
of
the
larynx.
Consequently, there is an increase in the formation of
antibodies to IFN-
α, which contributes to the
autoimmunization of the pathological process and its
progression. Thus, in the group of children with a
continuously
recurrent
form
of
laryngeal
papillomatosis, the highest value of antibodies to IFN-
α
is
observed,
which
in
turn
indicates
autoimmunization and clinically a continuously
recurrent process. Next, we studied the content of IFN-
γ in the blood serum of children with laryngeal
papillomatosis. The analysis showed that in all the
studied groups of children there is an increase in the
level of IFN-
γ relative to the control data (p<0.05). It
was found that the highest value of IFN-
γ was typical
for children with a rarely relapsing form of laryngeal
papillomatosis, while the lowest value was observed
with a frequently relapsing form of laryngeal
papillomatosis. Data correlations showed that in the
group of children with a continuously relapsing form of
laryngeal papillomatosis, the content of IFN-
γ was
increased by 3.5 times, with a frequently relapsing form
- by 2.4 times, and with a rarely relapsing form - by 5
times. As can be seen, the highest value of IFN-
γ is
observed in the group of children with rarely recurrent
papillomatosis of the larynx. Based on the data
obtained, we can say that as the disease progresses,
there is a suppression of IFN-
α, an increase in
antibodies to IFN-
α and a suppression of IFN
-
γ. It is
known that IFN-
α, which plays one of the main roles in
the elimination of the hepatitis virus, has a direct
antiviral
effect,
as
well
as
mediated
immunomodulatory activity. IFN-
α is produced by
almost all cells of the div, but to the greatest extent
by macrophages and lymphocytes. IFN-
α is a powerful
antiviral protein [4,6].
The highest values of TNF-
α serum concentration were
found in the group of children with a rarely relapsing
form of larynx papilomatosis, and the lowest values
were typical for children with a continuously recurrent
form of larynx papilomatosis. This picture obviously
indicates the depletion of the pro-inflammatory
potential in children with a continuous and often
recurrent problem. It has been established that
microorganisms and their products, the process of
phagocytosis itself, serve as inducers of TNF-
α
formation. Its level increases when infected with
viruses [8,14]. Obviously, TNF-
α is involved in the
implementation of the cytotoxic effect of natural killer
cells, which plays an important role in anti-infective and
antitumor immunity [8]. Based on the foregoing, it
follows that in the group of children with continuously
recurrent papillomatosis of the larynx, there is a
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(ISSN
–
2771-2265)
VOLUME
03
ISSUE
08
P
AGES
:
39-51
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
depletion of TNF-alpha reserves against the
background of a long and aggressive course of the
inflammatory process. In turn, the low content of TNF-
α in the blood once again proves and subs
tantiates the
suppression of especially cellular immunity in children
with continuously recurrent papillomatosis of the
larynx. It can be seen from the table that in the group
of children with a rarely relapsing form, the level of
TNF-
α is increased, which
confirms the intensity of
immunity and an adequate immune response. It is also
known from the literature that TNF-
α is capable of
lysing not only tumor cells, but also virus-infected cells
[2,8], which can be seen from our data, a low level of
TNF-
α contr
ibuted to apparently low functional
activity, which was often clinically manifested. - and
continuously recurrent papillomatosis of the larynx.
So, TNF-
α is a cytokine, which, according to its
properties and spectrum of biological action, is a
product of macrophages of the T-lymphocytes
themselves. Therefore, we can confidently say that
with continuously recurrent papillomatosis of the
larynx, a severe course of the disease is observed,
which is provoked by suppression of the cellular link of
immunity, activation of humoral immunity factors and
suppression of TNF-
α. Next, we studied the serum
concentrations of IL-6 in different groups of children
with laryngeal papillomatosis. It can be seen that the
concentration of IL-6 was increased in all the studied
groups. Moreover, the highest serum value was typical
for children with a continuously recurrent form of
larynx papilomatosis. And the lowest IL-6 value was
found in the group of children with a rarely recurrent
form of larynx papilomatosis and did not have a
significant difference with the value of the control
group. An analysis of the concentration of IL-6 showed
that the level of IL-6 in the group of children with a
continuously recurrent form of papillomatosis of the
larynx was increased by 5.4 times, in the group with a
frequently relapsing form - by 3.3 times, and in the
group with a rarely relapsing form - 1.4 times. It can be
seen that there is an increase in the values of IL-6.
Literature analysis shows that IL-6 is a pleiotropic
cytokine with a wide range of biological activity, which
is produced by both lymphoid and non-lymphoid cells
of the div [88,257]. It has been established that IL-6
regulates the immune and acute phase response,
inflammation, oncogenesis, and hematopoiesis [6].
One of the main functions of IL-6 is the regulation of
the maturation of antidiv-producing cells from B-
lymphocytes and the production of immunoglobulins
itself. IL-6 is involved in the activation of T-
lymphocytes, induces the synthesis of many acute-
phase proteins: fibrinogen, C-reactive protein, etc.
[1,6]. The analysis shows that obviously increased
values of IL-6 contribute to the activation of the
humoral link of immunity, which we were able to
identify, and moreover, an increased level of IL-6 has
an immunosuppressive effect on T-cell immunity.
Consequently, we found a significant increase in the
level of IL-6 in the peripheral blood serum of children
Volume 03 Issue 08-2023
49
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
08
P
AGES
:
39-51
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
with laryngeal papilomatosis, with the highest values
being typical for children with continuously recurrent
laryngeal papilomatosis, which can serve as an
important diagnostic and prognostic criterion for the
progression of the disease and the frequency of
relapses. Thus, our data on the study of TNF-alpha and
IL-6 indicate the important diagnostic value of
determining the studied cytokines in the progression
of a chronic infectious inflammatory process. Summing
up the description of the obtained results, it should be
noted that these two studied cytokines have an
important role in the pathogenesis of larynx
papilomatosis in particular. Thus, it is known that TNF-
α is one of the most well
-known and widely studied
pro-inflammatory cytokines, but despite this, our data
are top-priority in this area, because there are
practically no such studies in the literature. It should be
said that the excess content of pro-inflammatory
cytokines such as TNF-
α and IL
-6 contributes to the
maintenance of a long-term inflammatory process in
the epithelial tissue and may contribute to further
damage.
CONCLUSION
Moreover, IFN -
γ is known to h
ave a longer lifespan
compared to IFN-
α, so elevated levels can persist for a
long time. It has been proven that IFN -
γ is produced
under the action of viruses. Also, the production of IFN
-
γ is enhanced by itself, which, adding up the
information together, can explain the increased values
of IFN-
γ in serum, spontaneous and induced
production. IFN-
γ has a low antiviral, antiproliferative
effect and some immunomodulatory effect [7,8,14].
The most important function of IFN -
γ is its
participation in the implementation of the relationship
between lymphocytes and macrophages in the cellular
and humoral components of the immune response, so
it serves as a macrophage stimulator [ 7,8]. Thus, the
analysis of the main interferons and cytokines of the
immune system made it possible to establish that the
identified changes in the comparative analysis of
clinical variants of laryngeal papillomatosis are
amenable to immunotropic therapy. Moreover, there
is an improvement in the values of cytokines and
interferons, which is expressed in a decrease in the
production of pro-inflammatory cytokines and in an
increase in the production of IFN-
α and IFN
-
γ, which
have pronounced antiviral properties. The clinical
result of therapy was a decrease in the number of
recurrences of papillomatosis in children, an
improvement in general well-being, and clinical and
laboratory indicators of the disease. The cytokine
spectrum analyzed by us turned out to be an integral
indicator, the determination and analysis of which is a
necessary clinical and laboratory criterion in the
diagnosis of immunodeficiency conditions, which
include papillomatosis of the larynx in children.
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Volume 03 Issue 08-2023
50
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
08
P
AGES
:
39-51
SJIF
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FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
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Volume 03 Issue 08-2023
51
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
08
P
AGES
:
39-51
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
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