[Neuromyalgic syndrome in children's infections]. / Neiromialgicheskii sindrom pri infektsionnykh zabolevaniiakh u detei.

Neuromyalgic syndrome (NMS) is clinically and electroneuromyographically (ENMG) first-ever described in 50 children aged 2-13. Muscular pains and pains along peripheral nerves occur in post-infection period of acute respiratory viral infections (ARVI), intestinal and parotitoviral infections with transient (in 3-6 days), dysfunction of peripheral nervous system and muscles. NMS is characterized by predominant involvement of lower limb muscles in pathologic process and by rarely developing generalized form. There are 3 types of changes of nerve conductivity and excitability with conductive blocks absence and disturbances regression that enable to distinguish these dysfunctions from ENMG changes in polyneuropathy. Provoked by infection, transitory non-specific inflammatory muscular reaction and functional disorders of nerve conductivity and excitability may be considered as one of the possible mechanisms of NMS development. More than 20 years of clinical and research experience of in neuroinfections clinic, supports the validity of NMS distinguishing among children acute infections for further diagnostic differentiation with polyneuropathy, viral meningitis and ARVI.

[Four levels (types) of immune reponse in children with viral parotitis infections]. / Chetyre urovnia (tipa) immunnogo otveta u detei, perenosiashchikh parotitno-virusnuiu infektsiiu.

Four levels (types) of immune response, differing by expression of cytokines (TNF-alpha, IL-1 beta, IL-4, and gamma-IFN) and immunoglobulins IgG2, IgG3, IgG4, and IgE) and by expression and time course of specific cell-mediated and humoral immune response, were detected in children with different clinical forms of mumps. Types 1 and 3 immune response are predominantly cell-mediated, while types 2 and 4 predominantly humoral during the acute phase of the disease. The cytokine and antigen-specific profiles of each type of immune response correlate with the severity of clinical course of mumps.

[New data on the development of complications during epidemiological parotitis in children]. / Novoe v patogeneze razvitiia oslozhnenii pri épidemicheskom parotite u detei.

The main factors in the pathogenesis of complicated parotitis virus infection are increased virus reproduction in the salivary gland, inhibited by the production of alpha-interferon at early stages of the infectious process. Entry of the virus into the CNS is caused by slight penetration of antiparotitis antibodies through the blood-brain barrier and by poor formation of specific immune complexes at the site of primary virus reproduction and in the liquor. Interferon therapy of patients with parotitis virus infection corrects the chain of processes in the pathogenesis. In parotitic meningitis neovir stimulates gamma-interferon, which blocks the synthesis of parotitis antigen in the cell and stimulates (through antibody stimulation) the formation of specific immune complexes released with the saliva in the gland. Viferon is more active in parotitic orchitis due to prolongation of alpha-interferon activity.

[The protective role of postvaccinal immunity in mumps in children]. / Protektivnaia rol' postvaktsinal'nogo immuniteta pri parotite u detei.

The immunological study of children with infectious parotitis (IP) without complications and with such complications as pancreatitis, meningitis or orchitis in the glandular form was carried out. In accordance with the previously proposed principle, 4 types of immune response (IR) were established on the basis of differences in initial resistance and the IR profile: cell-mediated immunity (types I and III) and humoral immunity (types II and IV). The patients included nonvaccinated children, as well as children vaccinated on epidemic indications, 3-6, 7-9, 10 and more years before infection. The comparative analysis of the number of IP cases with and without complications in the groups of children, divided according to their immunization history and the type of IR, revealed that postvaccinal immunity in children vaccinated on epidemic indications (less than a month ago) or 3-6 years before infection had protective potential, sufficient for the prevention of complicated forms of IP. Immunity obtained 7-9 years ago was effective for the protection from IP complications only in cell-mediated, but not humoral IR. Postvaccinal immunity obtained more than 10 years ago did not ensure the decrease in the occurrence of complicated forms of IP (in comparison with that in nonvaccinated patients) in children with any type of IR.

[Nonspecific protection and specific immunity in various clinical forms of mumps virus infection in children]. / Sostoianie nespetsificheskoi zashchity i spetsificheskogo immuniteta pri razlichnykh klinicheskikh formakh parotitno-virusnoi infektsii u detei.

The time course of specific antibody production, interferon production in the blood and cerebrospinal fluid, and the capacity of blood cells for interferon production were compared in 270 children with glandular and neuroglandular forms of mumps virus infection (MVI). A significant decrease of antibody production in neuroglandular form of MVI and lower interferon titres in the blood in the acute period of this form of infection were noted. The severity of the course of meningitis was inversely related to interferon levels in the cerebrospinal fluid of the patients. In aseptic meningitis, the capacity of blood leukocytes for interferon production upon their repeated contact with mumps virus was disturbed while interferon synthesis induced by other interferon inducers (polyI: polyC) did not change. In patients with neuroglandular form of MVI having low interferon titres, high monocytosis in the blood was observed at the period of meningitis symptoms onset. Superimposition of acute respiratory virus infections in MVI leads to more severe course of meningitis with prolongation of meningeal symptoms and of the period required for the elimination of pathogenic agents from the cerebrospinal fluid.

[Tonsils in diphtheria and the Corynebacterium diphtheriae carrier state]. / Mindaliny pri difterii i nositel'stve korinebakterii difterii.

Investigations of 16 archive autopsy observations of diphtheria of the fauces confirmed bacteriologically revealed that Corynebacteria diphtheriae multiplied mainly on the surface of the mucous membrane. Fibrinous inflammation on the tonsillar surface is most typical for this agent. In all cases with manifestations of acute inflammation the lesion was caused by C. diphtheriae in combination with other bacteria, most frequently streptococci. The latter were harboured deep in the tonsills and caused there an inflammatory process with characteristic lesions. Examinations of the tonsills removed from 72 C. diphtheriae carriers showed that longterm persistence of the bacteria in the tonsills was primarily due to the specific structure of the cryptae, particularly great branchiness and depth contributing to the retention of the content. Long-term carrier state leads to a statistically significant increase of the degree of their plasmatization as compared with the control group. This occurs in parallel with changes in the general responsiveness of the host.