[Local cytokine therapy of inflammation of the rhinosinusotubal area]. / Mestnaya tsitokinovaya terapiya vospaleniya rinosinusotubarnoi zony.

The objective of the present work was to elaborate a scheme for the effective combined treatment ofinflammation of the rhinosinusotubal area including the local administration of roncoleukin and cyclopheron without antibiotics. The study included 82 patients (27 men and 55 women) at the age from 25 to 55 years presenting with acute inflammation ofroncoleukin and cycloferon. They were divided into two groups. Group 1 was comprised of 39 patients dominated by those with the clinical picture of sinusitis whereas group 2 contained 43 patients in whom symptoms of catarrhal otitis media prevailed. The patients of both groups were treated by the local application of roncoleukin in combination with cycloferon inhalation, intranasal administration of decongestants and mucomodifiers. All the patients underwent, before and after the treatment, the microbiological study of the contents of the sinuses, impedancobarometry, 3D computed tomography, and measurement of the IgA, IgM, IgG, IgE, SIgA, IL-8, TNF-alpha, and albumin levels in the blood sera and lavages. The study has demonstrated the difference between the local cytokine levels in the two groups of the patients. The clinical improvement was documented within 24 hours after the onset of therapy. 93.3% of the patients recovered by day 5. Three (3.7%) of them had to be prescribed antibiotic therapy for the lack of the desired effect of the cytokine treatment. It is concluded that the local application of ronkoleukin and cycloferon in combination with elimination therapy provides a tool for the efficient treatment of the patients suffering frominflammatory pathology of the rhinosinusotubalzone due to its stimulatory action on the immune system at the inflammation site mediated through the activation of the earlier formed targeted immune response, the promotion of the accelerated elimination of the causative factor, and the termination of the pathological process.

[About the role of chronic viral infection in etiology of proliferative diseases of the ENT organs]. / K voprosu o roli khronicheskoi virusnoi infektsii v étiologii proliferativnykh zabolevanii LOR-organov.

The role of certain viruses (human papilloma virus, Epstein-Barr virus, cytomegalovirus, and herpes virus) in the development and malignization of some pre-cancer conditions in human ENT organs is considered. The results of genetic (with the use of PCR) and histological studies of tissue biopsies and surgical specimens are presented. A total of 107 patients presenting with prolifertaive diseases of ENT organ mucosa were available for tissue sampling along with 30 other patients with histologically verified cancer of the larynx, pharynx, nasal cavity, and paranasal sinuses. The clinical data obtained are discussed.

[The potential of photodynamic therapy for the treatment of recurrent respiratory papillomatosis]. / Vozmozhnosti fotodinamicheskoi terapii v lechenii retsidiviruiushchego respiratornogo papillomatoza.

The problem of recurrent respiratory papillomatosis (RRP) thus far remains unresolved despite a large number of surgical and conservative methods proposed to address it. Photodynamic therapy is an up-to-date tool for the treatment of various neoplasms based on the interaction between the light and a photosensitizing agent (PA) that gives rise to active oxygen species and causes the death of cells. The potential of photodynamic therapy for the treatment of recurrent respiratory papillomatosis remains to be elucidated. A total of 8 seances of photodynamic therapy were undertaken at the Department of Otorhinolaryngology, I.P. Pavlov Sankt-Peterburg State Medical University, during the period between 2006 and 2010 for the treatment of patients with laryngeal and tracheal lesion, two of them under local anesthesia and the remaining ones under general narcosis. Complete and partial regression of the disease was achieved in 2 and 5 cases respectively. One patient failed to benefit from the treatment. Photodynamic therapy was well tolerated by the patients and produced good functional results; none of them developed adverse effects, there were no signs of refractoriness to the treatment.

[Basic principles of immunocorrective therapy in otorhinolaryngology].

The structural and functional basis of ENT mucosa immunity, leading methods of local immunity assessment in ENT pathology are presented. The experience of the chair and clinic of I.P. Pavlov St-Petersburg State Medical University in the field of immunotropic therapy of ENT pathology is reviewed.

[Efficacy of local use of recombinant interferon alpha-2 preparations in combined treatment of recurrent respiratory papillomatosis].

Clinical-immunological examination of 41 patients with recurrent respiratory papillomatosis (RRP) included determination of phenotype CD3, CD4, CD8, CD16, CD25, CD56, HLA-DR in peripheral blood by flow cytofluorimetry, the levels of IFN-gamma, TNF-alpha, GM-CSF, IL-2, IL-4, IL-5, IL-10, IL-12, IL-13 in the laryngeal secretion by multiplex immunoassay. Interferon inhalation therapy was conducted to prevent recurrence in 23 patients after surgical treatment and in 18 patients as monotherapy. The efficacy of the monotherapy was 45.5%. Treatment with IFN-alpha raised the levels of cytokines modulating an immune response by Th1-type (IFN-gamma, IL-12, IL-2) and GM-CSF, and reduced the levels of IL-4, IL-10 and IL-13. Local treatment with recombinant IFN-alpha is effective in aggressive RRP. As prognostic markers of the treatment efficacy may serve baseline high levels of TNF-alpha and IL-4/IFN-gamma index in laryngeal secretion. Treatment efficacy can be assessed by raise of IFN-gamma, IL-2 and IL-12 in combination with reduction of IL-4/IFN-gamma index.