Современные вопросы медицинской паразитологии и инфекционных заболеваний
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Проблемы биологии и медицины, 2014, №3 (79)
SCREENING FOR TOXOCARIASIS OF PATIENTS WITH ALLERGIC DISEASES
M.D. Akhmedova, M.B. Ibragimov, J.A. Anvarov
Tashkent medical academy
Toxocariasis is a disease of humans caused
by larvae (immature worms) of either the dog
roundworm (Toxocara canis) or the cat roundworm
(Toxocara cati). Toxocariasis is often called visceral
larva migrans. This zoonotic, helminthic infection is
a major cause of blindness and may provoke
rheumatic, neurologic or asthmatic symptoms.
Humans normally become infected by ingestion of
embryonated eggs from contaminated sources (soil,
fresh or unwashed vegetables).
Diagnosis of toxocariasis is difficult in view
of polymorphism and uncertainty of clinical
manifestations.
Clinical
manifestations
of
toxocariasis do not have their own specific features,
complicating the diagnosis of the disease. Patients
often focus doctor’s attention on previously
established diagnosis: bronchial asthma, atopic
dermatitis and other. Eosinophilia is often severe
and sometimes represents the only sign of infection,
except in ocular and neurological forms. Therefore,
a key role in diagnosis belongs to laboratory
methods of diagnostics.
The object. Optimization of diagnosis of
toxocariasis among high risk groups.
Materials and methods. 30 patients aged 21
to 55 years (men - 17, women - 13) were under our
supervision. 19 of them were in the in-patient
Department of the specialized allergological center,
11 patients were treated in outpatient clinics
allergological center and Republic infectious
diseases clinic. We have examined for toxocariasis
30 patients with chronic allergic diseases (bronchial
asthma, urticaria, atopic dermatitis), and patients
with high level of eosinophils of unknown etiology.
During the study all the patients were carefully
analyzed for the history of the illness, accent has
been
made
on
epidemiological
anamnesis.
Collecting epidemiological history we asked about
the presence of an animal in the house, especially
the dogs and the presence of pietism (geophagia).
Clinical and laboratory examination were carried
out.
Serological testing for toxocariasis was
performed at the laboratory of immunology of
parasites, by using ELISA test system "Toxocara-
strip".
Results. Positive results were received in 14
patients from 30 examined patients. The frequency
of major clinical manifestations of toxocariasis was
presented as follows: manifestations of allergic skin
rash - 7 (50,0%), astheno-vegetative syndrome - in
11 (78,5%), intoxication syndrome - in 10 (71.4%),
pulmonary syndrome in 5 (35.7%), enlargement of
lymph nodes - 4 (28,5%), alopecia in 1 (7,1%). In
peripheral blood eosinophilia were found in 13
(92,8%) patients.
Conclusion. Based on epidemiological
analysis it was established that the key risk factors
for infection with T. canis are existence of
geophagia and/or contact with a dog (79%). The
range of clinical variants of toxocariasis course
varies to a great extent. These data coincide with the
literature data. The most frequently toxocariasis was
diagnosed in patients with allergic skin rash
(50,0%), astheno-vegetative syndrome (78,5%),
intoxication syndrome (71,4%) and high titers of
antibodies to T. canis.
THE CORELATIONS BETWEEN IMMUNOGRAM PARAMETERS IN THE PATIENTS
WITH CHRONIC VIRAL HEPATITIS C
U.P. Nabieva, T.A. Agzamova
Institute of immunology of the Academy of Sciences of the Republic of Uzbekistan,
Tashkent pediatric medical institute
The wide prevalence of hepatitis С virus
among the population, prediction to chronic process,
frequent development of the liver cirrhosis and
hepatocellular carcinoma as well as variability of
immune responses make the problem of chronic
hepatitis C one of the most important aspects in the
area not only in the hepatology but also in the whole
field of the internal medicine. The prolonged
existence of the HCV in the human div is
explained by its ability to survive under the
conditions of strength and various immune
responses. Without providing of the complete virus
elimination the immune system has significant
effect on the development of HCV-infection.
The purpose of our investigation was to study
correlations between immunogram parameters in the
patients with chronic viral hepatitis C.
There were studied 35 patients with chronic
viral hepatitis C (CVHC), mean age was 39,33±5,23
years. Out of 35 in 9 patients viral genome was PCR
(-), in 26 patients – PCR(+). Immunological
investigation was performed with use of monoclonal
Инфекционные заболевания
Биология ва тиббиёт муаммолари, 2014, №3 (79)
203
antibodies (Manufactured in Moscow, Russia). The
content of serum IgA, M, and G were measured by
Manchini method. Circulating immune complexes
(CIC) were revealed by method of precipitation with
3% and 4% solution of polyethilenglycole.
Results. In group of patients with PCR(-)
there was observed direct high dependence of CD3
from CD4, CD8; CD25 from CD20, CD16; CD95
from CD8, IgG from CD4; 3% and 4%CIC. The
direct moderate dependence: CD20 from the
lymphocytes; CD23, CD16; CD8 from the
lymphocytes, CD4, IgM, 3% and 4%CIC; CD16
from the lymphocytes, CD20; CD23 from CD20,
CD4, 3%CIC; CD95 from the lymphocytes, CD23,
4%CIC; IgG from the L and lymphocytes, CD3,
CD23; IgM from CD3, CD23, 3% and 4%CIC. The
inverse mean correlation: CD20 from the L and IgA
and M; CD16 from the L nd CD23; CD25 from the
L, CD3, CD4; IgA from the lymphocytes, CD20,
IgG; 3%CIC from the L and lymphocytes; 4%CIC
from the L and IgG.
In group of patients with HCV(+) there were
found direct high correlations between CD4 and
CD3, CD8, CD25. The direct moderate correlations:
CD8 and CD4, CD16; CD16 and CD20, IgА; CD25
and CD4, CD3, IgG, М; IgGand CD20; 3%CIC and
CD95; 4%CIC and CD20, CD23, 3%. Moderate
inverse correlations between: CD95 and the L,
3%CIC and CD16; 4%CIC and CD25, IgA.
IMMUNOGENETIC FACTORS IN ADULTS AND CHILDREN WITH CHRONIC VIRAL
HEPATITIS C INFECTION IN UZBEK POPULATION
E.U. Nazarov
Tashkent medical academy
Hepatitis C leads to severe liver damages
and one of the indications to liver transplantation
(according to WHO ~3% of worldwide population is
infected by HCV infection.) The current standard of
therapy of chronic hepatitis C (CHC) is pegylated
interferon-α (PEG-IFNα) in combined with ribavirin
(RBV). The treatment achieves a sustained viral
clearance in only approximately 50% of patients.
Recent whole genome association studies revealed
that single nucleotide polymorphisms (SNPs)
around IL-28B have been associated with response
to the standard therapy and could predict treatment
responses at approximately 80%. According to 4
independent GWAS approaches have revealed the
significant SNPs associated with response to PEG-
IFNα/RBV therapy for CHC. These significant
SNPs were found around IL-28B were rs12979860
and rs8099917 they showed the statistical
significance in each study (M. Mizokami at al.,
2011).
The purpose of research: To study
genotypes of HCV infection and polymorphisms of
gene IL28B circulation in adults and children with
CHC in Uzbek population.
Materials and methods: We studied 40
patients with CHC which were divided in to two
groups: children and comparative adults group each
included 20 patients. Diagnosis CHC was
established on the base of ELISA full marker
specter with following revelations of HCV RNA
and its genotype by PCR method. Gene IL-28B was
determined in all patients by PCR method.
Results: Research which we conducted
showed us variation of genotype of HCV infection.
In adult group we determined genotypes 1a/b (61%),
2 (11%) non revealed genotype (5%) and 3a/b
(22%) but there wasn’t 4 (0%). In children group we
exposed genotypes 1a/b (58%), 3a/b (32%), 4 (5%)
non revealed genotype (6%) but there wasn’t 2 (0%)
genotype. Also we established genotype distribution
of gene IL 28B in adults and children. We found
that most prevalent genotype in the adults group was
combination of C/C (rs12979860) and T/T
(rs8099917) (C/C T/T -45%) polymorphisms with
good prognosis in both lines (European and Asian
lines). Whereas in children group we found out that
most prevalent genotype was C/T (rs12979860) (not
as favorable as C/C European genotype) and T/T
(rs8099917) (C/T T/T- 35%). In addition, adults
revealed genotypes of gene IL28B T / T
(rs12979860), and T / T (rs8099917) (T/T T/T-5%),
that is not favorable by European line and favorable
by Asian line, as well as genotype C / C combined
with T / G genotype (C/C T/G-5%). In children we
detected T / T + G / G (5%) which has very low
therapy prognosis.
Conclusions:
1) The most prevalent genotypes of HCV in
region of Uzbekistan was 1a/b (61% in adults and
58% in children) and 3a/b (22% in adults and 32%
in children).
2) Interestingly that genotype 2 (11%) was
not exposed in children group but was determined in
adults group and conversely genotype 4 (5%) was
detected in the children group unlike adults group.
3) In Uzbek population we found both favorable
genotypes of gene IL 28B and very poor genotypes,
so there were differences among adults and children
in the distribution of polymorphisms of IL28B.
