Immunomodulators - a list of effective drugs for children and adults. Immunomodulators and adaptogens

Immunostimulants are substances that stimulate immune responses at the cellular level. They are essential for us to protect the body and fight external pathogens (bacteria, microorganisms, viruses).

Immunostimulants - the list of drugs includes: vaccines, hormones, vitamins, synthetic stimulants. Most often we meet with this group for the prevention and treatment of acute respiratory viral infections.

Natural immunostimulants - list

Made with Echinacea purpurea extract. They contain active substances that help strengthen the immune system, suppress the growth and reproduction of microorganisms:

Immunal
Echinacea-ratiopharm
echinacea tincture
Echinacea compositum

Indications for use:

Uncomplicated viral infections
Prevention during epidemics
Antibiotic therapy against the background of reduced immunity

Their effectiveness in the fight against herpes and hepatitis viruses has also been proven.

Synthetic immunostimulants - list

The list includes the best immunostimulant drugs obtained in a laboratory way, but no less effective from this.

Cycloferon(acredoneacetic acid)

Stimulates the production of its own interferon in the body.
It has an immunostimulating, antiviral, anti-inflammatory and antitumor effect.
Effective against influenza, herpes, hepatitis, papilloma, HIV viruses.
Enhances the effectiveness of antibiotics and can be prescribed for intestinal infections.

Amiksin (tiloron)- immunomodulatory and antiviral agent.

Stimulates the production of interferon, enhances the formation of antibodies and inhibits the reproduction of viruses.

For the treatment of acute respiratory viral infections, preparations containing interferon directly, and not just stimulating its production, are also used.

Interferon- a whole group of specific proteins that are produced by the body during the introduction of infectious agents.

Stimulates the immune system to fight viruses by changing inside infected cells.
Suppresses the synthesis of viral proteins and prevents further reproduction of viruses.

There are several forms of release of interferon:

For nasal administration:

Nazoferon
Laferon
Laferobion

Getting on the mucous membrane, it plays the role of a substance that enhances the immune response. According to some researchers, this form of release is not effective due to the short period of exposure to cells. However, clinical trials prove the effectiveness of such use in the prevention of viral infections.

Interferon-based immunostimulant drugs listed on the list can be recommended to children almost from birth, as well as to pregnant and lactating women due to their high safety and low side effects.

Immune preparations for vaginal and rectal administration

Produced in the form of suppositories (candles). This list complements the list of effective immunostimulant drugs:

Laferobion
Viferon
Genferon

This group of immunostimulant drugs provides a longer circulation in the blood than other methods of administration. They are prescribed as part of the complex therapy of infection-inflammatory processes, urogenital infections, the treatment of chronic and acute viral hepatitis.

Intramuscular administration - used on the recommendation of a doctor if there is a need for higher doses of the substance.

Preparations immunostimulants based on lyophilizate lysates of bacteria

Their mechanism of action is similar to that of vaccines. After entering the body, they are perceived as foreign bodies, and provoke the production of specific antibodies. They include the most common pathogens of infections of the upper respiratory tract and respiratory tract.

ribo munil
Broncho-munal
broncho waxing
Imudon

Indicated for the prevention and treatment of chronic diseases of the respiratory system (otitis media, bronchitis, pharyngitis, laryngitis, tonsillitis).
It is possible to assign them to children from six months.

Now you rarely meet a person who managed to avoid a runny nose, cough, fever in the cold season. And if some people endure the disease quickly and are already on their feet in a few days, then others get out of the cold quite hard, with the development of various complications.

Immunomodulators and immunostimulants

The reason for the protracted course is a decrease in the body's resistance, which happens when immunity is insufficient. There are drugs that have some effect on the human immune system - immunomodulators. These funds stimulate defense mechanisms, while the body begins to effectively fight viruses and bacteria.

It should be said that there is confusion between concepts such as immunomodulators and immunostimulants. Many people think that these funds belong to the same group. However, there is a difference between them. Immunostimulants affect the nonspecific resistance of the body, increase the natural ability to resist infectious diseases.

Immunomodulators are used in the presence of malfunctions in the immune system and the restoration of its function. The group of immunomodulators includes immunosuppressants - drugs used to suppress the immune response. Such an action is necessary during the treatment of autoimmune and oncological diseases.

The drugs in this group have the following effect:

stimulate immune processes;
activate immunocompetent cells (these include T and B lymphocytes);
increase the body's resistance;
accelerate the processes of tissue regeneration.

The use of immunostimulants in infectious and infectious-inflammatory diseases helps a person to cope with the disease faster.

Depending on the origin, immunomodulators are:

exogenous origin - bacterial and herbal remedies;
endogenous origin;
synthetic.

Immunostimulants - herbal preparations

They are created on the basis of medicinal plants - clover, lungwort, echinacea, chicory, magnolia vine. They naturally restore defenses without negatively affecting hormonal balance.

Among the means of this group, echinacea has a powerful stimulating effect. This perennial plant has a rich composition: trace elements (selenium, calcium, silicon), vitamins. Echinacea preparations work:

anti-inflammatory;
antiviral;
antibacterial;
diuretic;
antiallergic;
detoxification.

Echinacea is a part of such medicines as Immunal, Immudon.

Immunal

The medicine consists of echinacea juice and ethanol, is available in drops. Immunal is used to increase the body's resistance to recurrent colds, during an influenza epidemic as a prophylactic measure, to prevent immunodeficiency during antibiotic treatment.

Herbal preparations are often used as immunostimulants for children (with frequent and prolonged colds). Use in pediatrics due to the fact that the funds are well tolerated and do not have a toxic effect. However, even such seemingly harmless drugs have their own contraindications. Herbal immunostimulants should not be used for autoimmune diseases, when the immune system is too active and produces antibodies against its own cells. Immunostimulants are contraindicated in leukemia, diabetes mellitus, individual intolerance, collagenoses.

Immunostimulants of bacterial origin

Effective means of this group are Immudon, IRS-19.

Immudon

The drug contains lysates of many bacteria and fungi, which are part of the tablets for resorption in the mouth. Immudon stimulates the production of lysozyme in saliva, and this substance has a detrimental effect on bacteria. It also has an immunostimulating effect.

Immudon is used for inflammatory diseases in the mouth (periodontal disease, gingivitis, stomatitis), as well as for inflammatory processes in the pharynx - pharyngitis, tonsillitis. Among the contraindications is individual sensitivity, the medicine has no side effects and is well tolerated by patients.

IRS-19

The product is produced in the form of a metered aerosol. Contains standardized lysates of inactivated bacteria. IRS-19 is used to treat respiratory diseases and inflammation in the oral cavity (rhinitis, bronchitis, sinusitis, tonsillitis), as well as to prevent complications of influenza and colds.

Immunostimulants of endogenous origin

Medicines are obtained from the thymus gland (thymus) and bone marrow. The thymus gland plays an important role in the functioning of cellular and humoral immunity. The maturation of lymphocytes and stem cells occurs in it, and the gland also secretes specific substances - hormones that affect the differentiation of lymphoid tissue cells. Extractive preparations (Timalin, Taktivin) are obtained from the thymus, which are used to treat immunodeficiencies with a predominant lesion of T-cell immunity (purulent and tumor diseases, tuberculosis, herpes).

The bone marrow preparation - Myelolid - is used to treat diseases that occur with damage to humoral immunity (leukemia, chronic infections, purulent diseases).

Endogenous stimulants also include nucleic acid preparations and cytokines. Cytokines are low molecular weight proteins that carry information about the functioning of the immune system, they are able to influence the processes of cellular interaction. There are many types of cytokines, but the most active are interleukins - substances secreted by leukocytes. Cytokines are used to treat purulent-septic diseases, wounds, burns and some types of tumors. Preparations - Betaleukin, Roncoleukin.

Synthetics

Medicines are obtained through scientific development and chemical synthesis. These include Polyoxidonium, Amiksin, Neovir.

At the beginning of spring, the weather is changeable. It is at this time that influenza epidemics begin. At this point, the body is also weakened by beriberi. In order not to get sick, you need to strengthen the immune system. How immunomodulators help to do this, we will describe in this article.

Immunomodulators are drugs that affect the functioning of the human immune system, restore its functions and stimulate or depress immune activity. According to the principle of action, immunomodulators are divided into two main groups: immunostimulants (drugs that increase immunity and stimulate the immune response) and immunosuppressants (inhibit immune responses).

By origin, immunomodulators are classified as: endogenous (isolated from the bone marrow and thymus, which are the main organs of immunity), exogenous (preparations of fungal and bacterial origin) and synthetic.

It should be said right away that immunomodulators do not treat the disease as such, they simply help the body cope with it, and the effect on the body is not limited to the period of illness and lasts for a long time. You should not expect any special miracles from immunomodulators: yes, they increase immunity, but not unlimitedly, but within the physiological norm.

Indications for the use of immunomodulators:

Slow and chronic infectious diseases

Conditions of immunodeficiency

Tumors

Autoimmune diseases are diseases in which the immune system tries to fight its own body. In this case, immunosuppressants are recommended.

Principles of using immunomodulators in the treatment of diseases:

Immunomodulators are used as part of complex therapy along with antibiotics, antifungal, antiviral and other agents.

As an independent drug, immunomodulators are prescribed at the stage of rehabilitation after the disease.

Preparations of this type are prescribed from the first day of treatment of the disease.

Treatment with immunomodulators is carried out under laboratory control: it is necessary to perform immunological blood tests during treatment.

For children, these drugs should be prescribed with extreme caution, since the child's immune system has not yet been formed. Up to 1.5 years, immunomodulators can be prescribed only as a last resort.

During pregnancy, it is advisable not to use immunomodulators, if necessary, the doctor may prescribe the only immunomodulator allowed for pregnant women - Transfer Factor.

Contraindications to taking immunomodulators:

Rheumatoid arthritis

Diabetes

Multiple sclerosis

Thyroid disease: Hashimoto's thyroiditis, diffuse toxic goiter

autoimmune hepatitis

Some forms of bronchial asthma

Glomerulonephritis

myasthenia gravis

Systemic lupus erythematosus

Self-administration of immunomodulators by a person suffering from the above diseases will lead to an exacerbation of the disease and unpredictable consequences - therefore, you should not resort to self-treatment!

Immunomodulators in the treatment of diseases

Antiviral agents: Anaferon, Arbidol, Viferon, Neovir, Amiksin, Ridostin, Grippferon, Lavomax. Despite the fact that these products are freely sold in pharmacies, you should consult your doctor before using them, as side effects are possible.

Drugs for the treatment of herpes infection: Amiksin, Leukinferon, Poludan, Viferon, Ridostin, Likopid, Tamerit. The maximum effect of taking these drugs can be achieved by combining them with multivitamins.

Drugs for the treatment of human papillomavirus (HPV): Indinol, Alpizarin, Derinat, Wobenzym, Imiquimod. These drugs are used as adjuvants.

HIV infection (used to alleviate the patient's condition and support the body as a whole): Timogen, Transfer Factor, Timopoetin, Ampligen, Ferrovir.

Certain types of immunomodulators

Likopid. A modern potent drug prescribed for ongoing and chronic infectious and inflammatory diseases of various etiology and localization. Can be used in pediatrics.

Transfer Factor. One of the most powerful and safe modern immunomodulators. It has no side effects, age restrictions and contraindications, it is made from cow colostrum.

Interferon. Protein immunomodulator synthesized in the human body. It has antitumor and antiviral properties. Contraindicated in any allergic reactions in the patient. It can be produced in powder form, as well as in the form of rectal suppositories (Genferon) and injection solution (Reaferon).

cordyceps. A fast-acting herbal preparation that can effectively regulate immunity, eliminating even its genetic disorders.

Derinat. A powerful immunomodulator of animal origin (extracted from fish milk), activates the immune system, has a wound healing and anti-inflammatory effect. Approved for use in pediatrics.

Polyoxidonium. A drug that normalizes the functioning of the immune system for any immune status can be prescribed without immunological tests. Effective in infectious diseases, able to remove toxins from the body. Approved for use in pediatrics.

In addition, there are vegetable, natural immunomodulators: honey, echinacea, ginseng, rosehip, garlic, eucalyptus, aloe, radish, walnut, Rhodiola rosea, aralia, elecampane, thyme, figs, etc.

Doctors of any specialty face clinical manifestations of immune system insufficiency (first of all, this is manifested by the presence of a chronic inflammatory process or often recurrent diseases, such as acute respiratory infections, bronchitis, herpes, furunculosis, etc.). However, many still have a prejudice regarding the advisability of using immunomodulators. This opinion was formed, on the one hand, as a result of the complexity of interpretation, and often the impossibility of performing immunological analyzes, and on the other hand, the low efficiency of first-generation immunomodulators. However, over the past 10 years, knowledge of how the immune system works has deepened and new highly effective and safe drugs have been created, without which the treatment of many diseases is impossible today.
The diagram below shows almost all immunomodulators that are actually present on the pharmaceutical market in Russia. This article gives a brief description of only a part of them, namely, domestic immunomodulators of the latest generation.
Immunomodulators - drugs with immunotropic activity, which in therapeutic doses restore the functions of the immune system (effective immune defense) (Khaitov R.M., Pinegin B.V.). The simplest and most convenient classification of immunomodulators by origin, developed at the Institute of Immunology. According to this classification, immunomodulators are divided into three groups: endogenous, exogenous and synthetic. Immunomodulators of endogenous origin include immunoregulatory peptides and cytokines, as well as their recombinant or synthetic analogues. The vast majority of exogenous immunomodulators are substances of microbial origin, mainly bacterial and fungal. The 3rd group of immunomodulators includes synthetic substances obtained as a result of directed chemical synthesis.
Immunomodulators of endogenous origin
Currently, immunoregulatory peptides derived from the central organs of immunity (thymus and bone marrow), cytokines, interferons, and effector proteins of the immune system (immunoglobulins) are used as immunomodulators of endogenous origin.
Immunoregulatory peptides derived from the central organs of immunity
Taktivin and thymalin are first-generation immunomodulators derived from thymus tissue extracts.
Taktivin- a preparation of a polypeptide nature, obtained from the thymus gland of cattle. It normalizes the quantitative and functional indicators of the T-system of immunity, stimulates the production of lymphokines and other indicators of cellular immunity. It is used in adults in the complex therapy of infectious, purulent, septic processes, with lymphoproliferative diseases (lymphogranulomatosis, lymphocytic leukemia), recurrent ophthalmic herpes and other diseases accompanied by a predominant lesion of the T-system of immunity
Timalin- a complex of polypeptide fractions isolated from the thymus gland of cattle. Regulates the number of T- and B-lymphocytes, stimulates the reaction of cellular immunity; enhances phagocytosis. It is used in adults and children as an immunostimulant and biostimulant in the complex therapy of diseases accompanied by a decrease in cellular immunity, including acute and chronic purulent processes and inflammatory diseases, burn disease, trophic ulcers, etc., as well as depression of immunity and hematopoietic functions after radiation or chemotherapy in cancer patients and other pathological processes.
All thymic preparations have a mild immunomodulatory effect, mainly associated with an increase in the number and functional activity of T-lymphocytes. But they have one drawback: they are an undivided mixture of biologically active peptides and are rather difficult to standardize. Progress in the field of immunomodulators of thymic origin has been along the line of creating drugs of the 2nd and 3rd generation, which are synthetic analogues of natural thymus hormones or fragments of these hormones with biological activity.
The first drug obtained in this direction was Thymogen- a synthetic dipeptide consisting of amino acid residues - glutamine and tryptophan. In terms of indications for use, it is similar to other thymic immunomodulators and is used in the complex therapy of adults and children with acute and chronic infectious diseases accompanied by a decrease in cellular immunity, with inhibition of reparative processes after severe injuries (bone fractures), necrotic processes, as well as with other states of immunodeficiency.
The next step in the creation of thymic preparations was the isolation of a biologically active fragment of one of the thymus hormones - thymopoietin - and the creation of a drug based on it. Imunofan representing 32-36 amino acid residues of thymopoietin. Imunofan has proved to be a highly effective means of restoring impaired immunological reactivity in chronic bacterial and viral infections, surgical infections. In addition to stimulating immunological reactivity, Imunofan has a pronounced ability to activate the body's antioxidant system. These two properties of imunofan made it possible to recommend it in the complex therapy of cancer patients not only to increase immunity, but also to eliminate toxic free radical and peroxide compounds. Imunofan is also used for hepatitis B, opportunistic infections in AIDS patients; brucellosis, non-healing wounds of the extremities, purulent-septic postoperative complications; burn shock, acute burn toxemia, concomitant trauma. Imunofan is used for immunocorrection in allergic diseases and is approved for use in pediatrics.
The 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 action, the combination of which determines its clinical effect. MP-1 restores the normal balance of T-helper and T-suppressor activity. MP-2 inhibits the proliferation of malignant cells and significantly reduces the ability of tumor cells to produce toxic substances that inhibit the functional activity of T-lymphocytes. MP-3 stimulates the activity of the phagocytic link of immunity and, consequently, increases anti-infective immunity. MP-4 affects the differentiation of hematopoietic cells, contributing to their faster maturation, i.e., it has a leukopoietic effect. . In immunodeficiency states, the drug restores the parameters of the B- and T-systems of immunity, stimulates the production of antibodies and the functional activity of immunocompetent cells, and helps to restore a number of other indicators of the humoral immunity link.
Myelopid is used in adults with secondary immunodeficiency states with a predominant lesion of the humoral immunity, including for the prevention of infectious complications after surgical interventions, injuries, osteomyelitis and other pathological processes accompanied by inflammatory complications, with nonspecific pulmonary diseases, chronic respiratory diseases in the acute stage (laryngitis, tracheitis, bronchitis, pneumonia); with chronic pyoderma, atopic dermatitis, neurodermatitis, etc., with acute lymphoblastic and myeloblastic leukemias and non-Hodgkin's T- and B-cell lymphomas.
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 (about 12), 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 invasion of microorganisms, the formation of an inflammatory reaction, the implementation of antitumor immunity, etc. In Russia, the production of two recombinant interleukins, Betaleukin and Roncoleukin, has been mastered.
Betaleukin- recombinant human interleukin-1b (IL-1). Production of IL-1 is carried out mainly by monocytes and macrophages. The synthesis of IL-1 begins in response to the introduction of microorganisms or tissue damage and launches a complex of protective reactions that make up the body's first line of defense. One of the main properties of IL-1 is the ability to stimulate functions and increase the number of leukocytes. Betaleukin increases the production of interferons and interleukins, increases the production of antibodies, increases the number of platelets, accelerates reparative processes in damaged tissues.
Indications for the use of Betaleukin as an immunostimulant are secondary immunodeficiency states that develop after severe injuries as a result of purulent-septic and purulent-destructive processes, after extensive surgical interventions, as well as in chronic septic conditions. An indication for the use of Betaleukin as a leukopoiesis stimulator is toxic leukopenia of II-IV degree, complicating chemotherapy and radiotherapy of malignant tumors.
Roncoleukin is a recombinant human interleukin-2 (IL-2). IL-2 is produced in the body by helper T-lymphocytes and plays a key role in the process of initiation and development of the immune response. The drug stimulates the proliferation of T-lymphocytes, activates them, as a result of which they turn into cytotoxic and killer cells capable of destroying a variety of pathogenic microorganisms and malignant cells. IL-2 enhances the production of immunoglobulins by B cells, activates the function of monocytes and tissue macrophages. In general, IL-2 has an immunomodulatory effect aimed at enhancing the antibacterial, antiviral, antifungal and antitumor immune response.
Roncoleukin used in the complex treatment of sepsis and severe infectious and inflammatory processes of various localization (peritonitis, endometritis, abscesses, meningitis, mediastenitis, osteomyelitis, pancreatitis, paranephritis, pyelonephritis, pneumonia, pleurisy, salpingitis, soft tissue phlegmon) as well as burn disease, tuberculosis, chronic hepatitis C, mycoses, chlamydia, chronic herpes. Roncoleukin in combination with alpha-interferon is an effective immunotherapeutic agent in the treatment of disseminated kidney cancer. High efficacy of the drug in the treatment of bladder cancer, stage III-IV colorectal cancer, brain tumors, malignant disseminated melanoma of the skin, malignant neoplasms of the mammary glands, prostate cancer, and ovaries has been established.
Interferons
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 effects of a number of other natural or synthetic compounds (interferon inducers). Interferons are factors of non-specific defense of the body against viruses, bacteria, chlamydia, pathogenic fungi, tumor cells, but at the same time they can act as regulators of intercellular interactions in the immune system. From this position, they belong to the immunomodulators of endogenous origin.
Three types of human interferons have been identified: a-interferon (leukocyte), b-interferon (fibroblast) 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 synthesis of about thirty proteins by the cell, which provide the above effects of interferon. In particular, regulatory peptides are synthesized that prevent the penetration of the virus into 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 preparations begins in 1967, the year it was first created and introduced into clinical practice for the prevention and treatment of influenza and SARS. human leukocyte interferon. At present, several modern preparations of alpha-interferon are being produced in Russia, which, according to the production technology, are divided into natural and recombinant ones.
The representative of a new generation of natural interferons is the drug Leukocyte interferon for injection containing all subtypes of alpha interferons in a natural, physiological ratio. It is used in oncology in the complex treatment of melanoma, cancer of the kidney, ovary, etc.
Leukinferon- a complex preparation containing 10,000 IU of natural alpha-interferon and a complex of cytokines of the first phase of the immune response (interleukins 1,6 and 12, tumor necrosis factor, macrophage and leukocyte migration inhibition factors). In addition to antiviral activity, the drug has a wide range of immunomodulatory effects, in particular, it is able to activate almost all stages of the phagocytic process. Leukinferon is used to treat many viral diseases, bacterial infections, including sepsis and tuberculosis, hamidia, mycoplasma, herpes infections, and oncological diseases.
Eye drops Lokferon also contain purified and concentrated human leukocyte interferon with an activity of 8.000 IU per vial. It is used in the treatment of eye diseases of viral etiology.
A new direction is the rectal administration of interferon preparations. The use of interferon in the form of suppositories provides a simple, safe and painless method of administration, helps to maintain high concentrations of interferon in the blood for a longer period. In Russia, such natural interferons are produced as with an activity of 40,000 IU in a suppository and Suppositoferon with activity of 10,000, 20,000 or 30,000 IU These drugs are used in various immunodeficiency states, acute and chronic viral hepatitis, urogenital infections, dysbacteriosis, SARS, measles, chicken pox in children and adults.
The technology for the production of natural interferons has certain limitations associated with the need for large amounts of leukomass and the difficulty of obtaining a sufficient amount of interferon with high activity. The genetic engineering method for obtaining recombinant interferon makes it possible to overcome these obstacles, in addition, the genetic engineering method makes it possible to obtain various types of interferons in pure form. 5 domestic preparations of recombinant interferon-alfa2b are produced.
In the SSC NPO "Vector" under the name Reaferon-EC recombinant interferon-alpha-2b with an activity of 1, 3 or 5 million IU is produced in an ampoule, intended for intramuscular injection. An interferon ointment is also produced here, containing 10,000 IU of interferon-alpha2b per 1 g. Recombinant interferon alfa-2 was also developed at the State Scientific Center "State Research Institute of Highly Pure Biological Products". Recombinant alpha-interferon preparations are used to treat viral infections (mainly chronic viral hepatitis), as well as in the treatment of certain oncological diseases (poki cancer and melanoma).
Viferon, which includes interferon-alpha-2b, as well as antioxidants vitamin E and ascorbic acid. Viferon is available in the form of rectal suppositories in four dosages: 150,000 IU, 500,000 IU, 1 million IU and 3 million IU in a suppository, as well as in the form of an ointment containing 200,000 IU of interferon activity in 1 g. Viferon has significantly expanded indications for use compared to other interferon preparations. It can be used for almost any infectious pathology in any age group. Viferon has the most sparing effect on the immune system in debilitated patients, newborns and premature babies with immature and imperfect mechanisms of antiviral and antimicrobial protection. Therefore, Viferon is the only interferon preparation recommended for the treatment of not only adults, but also newborns and pregnant women. This is especially true for the treatment of viral, bacterial and chlamydial infections in pregnant women and newborns, when the use of other drugs is contraindicated.
Grippferon- a new dosage form of interferon-alpha-2b, intended for use in the form of drops in the nose. Grippferon is used to prevent and treat influenza and other acute respiratory viral infections.
Kipferon- a combined preparation containing recombinant interferon-alpha-2b and a complex immunoglobulin preparation (a complex of human immunoglobulins of classes M, A, G). Kipferon is used vaginally or rectally in the complex therapy of chlamydia, herpetic infections of the genitourinary organs, papillomas and genital warts, acute and chronic prostatitis, bacterial colpitis of various etiologies (staphylococcal, trichomonas, chlamydial, etc.), vaginal dysbacteriosis, accompanying inflammatory processes of the neck, body and appendages of the uterus, preparation for planned gynecological operations and childbirth in order to prevent purulent-septic complications.
Immunoglobulins
Therapeutic sera were the prototype of modern immunoglobulin preparations, and some of them (antidiphtheria and tetanus) have not lost their clinical significance to this day. However, the development of technology for the processing of blood products made it possible to implement the ideas of passive immunization, first in the form of concentrated immunoglobulin preparations for intramuscular administration, and then immunoglobulins for intravenous administration. For a long time, the effectiveness of immunoglobulin preparations was explained solely by the passive transfer of antibodies. By binding to the corresponding antigens, antibodies neutralize them, convert them into an insoluble form, as a result of which the mechanisms of phagocytosis, complement-dependent lysis and subsequent elimination of antigens from the body are triggered. However, in recent years, in connection with the proven efficacy of intravenous immunoglobulins in some autoimmune diseases, the immunomodulatory role of immunoglobulins has been actively studied. Thus, intravenous immunoglobulins were found to be able to change the production of interleukins and the level of expression of receptors for IL-2. The effect of immunoglobulin preparations on the activity of various subpopulations of T-lymphocytes and the stimulating effect on the processes of phagocytosis was also demonstrated.
Intramuscular immunoglobulins, which have been used clinically since the 1950s, have relatively low bioavailability. Resorption of the drug is carried out from the place of administration within 2-3 days and more than half of the drug is destroyed by proteolytic enzymes. In Russia, intramuscular immunoglobulins are produced containing elevated titers of antibodies to the antigens of certain pathogens: tick-borne encephalitis virus, influenza, herpes and cytomegalovirus, HBS - antigen (Antigep).
Intravenous immunoglobulins have significant advantages, because. their use makes it possible to create effective concentrations of antibodies in the blood in the shortest possible time. At present, a number of human immunoglobulins for intravenous administration are already being produced in Russia (enterprises "Imbio", "Immunopreparat", Yekaterinburg and Khabarovsk State Enterprises for the production of bacterial preparations). However, foreign-made intravenous immunoglobulins are recognized as more effective (Pentaglobin, Cytotect, Intraglobin, Hepatect, Biochemi Immunoglobulin, Octagam, Sandoglobulin, Biaven V.I., Venoglubulin).
Intravenous immunoglobulins are used in primary immunodeficiencies (agammaglobulinemia, selective IgG deficiency, etc.), hypogammaglobulinemia in chronic lymphocytic leukemia, thrombocytopenic purpura, other autoimmune diseases, as well as in severe viral and bacterial infections, sepsis, to prevent infectious complications in premature babies.
Complex immunoglobulin preparation (CIP). CIP contains human immunoglobulins of three classes: Ig A (15-25%), Ig M (15-25%) and Ig G (50-70%). From all other immunoglobulin preparations, CIP is distinguished by a high content of Ig A and Ig M, an increased concentration of antibodies to gram-negative enteropathogenic bacteria of the intestinal group (Shigella, Salmonella, Escherichia, etc.), a high concentration of antibodies to rotaviruses, as well as an oral route of administration. CIP is used for acute intestinal infections, dysbacteriosis, chronic enterocolitis, allergic dermatosis, combined with intestinal dysfunction.
Close to immunoglobulin drugs in terms of passive transfer of immunity is the drug Affinoleukin. It contains a complex of low molecular weight proteins of human leukocyte extract capable of transferring immunoreactivity to antigens of common infectious diseases (herpes, staphylococcus, streptococcus, mycobacterium tuberculosis, etc.) and affinity binding to them. The introduction of Afinoleukin leads to the induction of immunity against those antigens, the immunological memory of which was possessed by leukocyte donors. The drug has passed clinical trials in the treatment of herpes simplex, herpes zoster, hepatitis, adenovirus infections in addition to the main therapy that did not give the expected results.
Immunomodulators of exogenous origin
Immunomodulators of exogenous origin include preparations of bacterial and fungal origin. For medical use, such agents of microbial origin as BCG, pyrogenal, prodigiosan, sodium nucleinate, ribomunil, bronchomunal, etc. are allowed. All of them have the ability to enhance the functional activity of neutrophils and macrophages.
For more than half a century, the immunomodulatory role of Mycobacterium tuberculosis has been known. The BCG vaccine currently has no independent value as an immunomodulator. An exception is the method of immunotherapy for bladder cancer, using vaccines "BCG-Imuron . The BCG-Imuron vaccine is a live freeze-dried bacteria of the BCG-1 vaccine strain. The drug is used in the form of instillations into the bladder. Live mycobacteria, multiplying intracellularly, lead to nonspecific stimulation of the cellular immune response. BCG-Imuron is intended for the prevention of recurrence of superficial bladder cancer after surgical removal of the tumor, as well as for the treatment of small tumors of the bladder, which cannot be removed.
Study of the mechanism of immunomodulatory action of the BCG vaccine. showed that it is reproduced with the help of the inner layer of the cell wall of Mycobacterium tuberculosis - peptidoglycan, and in the composition of peptidoglycan the active principle is muramyl dipeptide, which is part of the peptidoglycan of the cell wall of almost all known gram-positive and gram-negative bacteria. However, due to high pyrogenicity and other undesirable side effects, muramyl dipeptide itself turned out to be unsuitable for clinical use. Therefore, the search for its structural analogues began. This is how the drug came about. Likopid(glucosaminylmuramyl dipeptide), which, along with low pyrogenicity, has a higher immunomodulatory potential.
Licopid has an immunomodulatory effect primarily due to the activation of cells of the phagocytic system of immunity (neutrophils and macrophages). The latter, by phagocytosis, destroy pathogenic microorganisms and, at the same time, secrete mediators of natural immunity - cytokines (interleukin-1, tumor necrosis factor, colony-stimulating factor, gamma interferon), which, acting on a wide range of target cells, cause further development defensive response of the body. Ultimately, Likopid affects all three main links of immunity: phagocytosis, cellular and humoral immunity, stimulates leukopoiesis and regenerative processes.
The main indications for the appointment of licopid: chronic nonspecific lung diseases, both in the stage of exacerbation and remission; acute and chronic purulent-inflammatory processes (postoperative, post-traumatic, wound), trophic ulcers; tuberculosis; acute and chronic viral infections, especially genital and labial herpes, herpetic keratitis and keratouveitis, herpes zoster, cytomegalovirus infection; lesions of the cervix caused by the human papillomavirus; bacterial and candidal vaginitis; urogenital infections.
The advantage of licopide is its ability to be used in pediatrics, including neonatology. Likopid is used in the treatment of bacterial pneumonia in term and premature infants. Licopid is used in the complex treatment of chronic viral hepatitis in children. Since Licopid is able to stimulate the maturation of glucuronyltransferase in the liver of newborns, its effectiveness is being tested in conjugated hyperbilirubinemia in the neonatal period.
Synthetic immunomodulators.
Synthetic immunomodulators are obtained by targeted chemical synthesis. This group includes such long-known drugs as levamisole and diucifon.
Representative of a new generation of synthetic immunomodulators - Polyoxidonium(N-oxidized high molecular weight polyethylene piperosine derivative). The drug has a wide spectrum of action. It stimulates the functional activity of phagocytes, which is manifested in an increased ability of phagocytes to absorb and digest microbes, in the formation of reactive oxygen species, and an increase in the migratory activity of neutrophils. The overall consequence of the activation of natural immunity factors is an increase in resistance to bacterial and viral infections. Polyoxidonium also increases the functional activity of T- and B-lymphocytes, NK-cells. It is also a powerful detoxifier because has the ability to absorb various toxic substances on its surface and remove them from the body. This is related to its ability to reduce the toxicity of a number of drugs.
The drug showed high efficiency in all acute and chronic infectious and inflammatory processes of any localization and any origin. Its use causes a more rapid cessation of the disease and the disappearance of all pathological manifestations. Due to its immunomodulatory, detoxifying, antioxidant and membrane-stabilizing properties, Polyoxidonium has taken a leading position in urology, gynecology, surgery, pulmonology, allergology and oncological practice. The drug is perfectly combined with all antibiotics, antiviral and antifungal agents, with interferons, their inducers and is included in the complex treatment regimens for many infectious diseases.
Polyoxidonium is one of the few immunomodulators recommended for use in acute infectious and allergic processes.
Glutoxim is the first and so far the only representative of a new class of substances - thiopoietins. Glutoxim is a chemically synthesized hexapeptide (bis-(gamma-L-glutamyl)-L-cysteinyl-bis-glycine disodium salt), which is a structural analog of the natural metabolite, oxidized glutathione. Artificial stabilization of the disulfide bond of oxidized glutathione makes it possible to multiply the physiological effects inherent in natural unmodified oxidized glutathione. Glutoxim activates antiperoxide enzymes glutathione reductase, glutathione transferase and glutathione peroxidase, which in turn activate intracellular reactions of thiol metabolism, as well as the processes of synthesis of sulfur- and phosphorus-containing macroergic compounds necessary for the normal functioning of intracellular regulatory systems. The work of the cell in a new redox mode and changes in the dynamics of phosphorylation of key blocks of signal-transmitting systems and transcription factors, primarily immunocompetent cells, determine the immunomodulatory and systemic cytoprotective effect of the drug.
A special property of Glutoxim is its ability to have a differentiated effect on normal (stimulation of proliferation and differentiation) and transformed (induction of apoptosis - genetically programmed cell death) cells. The main immuno-physiological properties of the drug include activation of the phagocytosis system; strengthening of bone marrow hematopoiesis and restoration of the level of neutrophils and monocytes in the peripheral blood; increase in endogenous production of IL-1, IL-6, TNF, INF, erythropoietin, reproduction of the effects of IL-2 through induction of expression of its receptors.
Glutoxim is used as a means of prevention and treatment of secondary immunodeficiency states associated with radiation, chemical and infectious factors; in tumors of any localization as a component of antitumor therapy in order to increase the sensitivity of tumor cells to chemotherapy, including the development of partial or complete resistance; in acute and chronic viral hepatitis (B and C) with the elimination of objective signs of chronic virus carrying; to potentiate the therapeutic effects of antibiotic therapy for chronic obstructive pulmonary diseases; for the prevention of postoperative purulent complications; to increase the body's resistance to a variety of pathological effects - infectious agents, chemical and / or physical factors (intoxication, radiation, etc.).
The active component of the new immunomodulator Galavita is a derivative of phthalhydroside. Galavit has anti-inflammatory and immunomodulatory properties. Its main pharmacological effects are due to the ability to influence the functional and metabolic activity of macrophages. In inflammatory diseases, the drug reversibly inhibits for 6-8 hours the excessive synthesis of tumor necrosis factor, interleukin-1, reactive oxygen species and other pro-inflammatory cytokines by hyperactivated macrophages, which determine the degree of inflammatory reactions, their cyclicity, as well as the severity of intoxication. Normalization of the regulatory function of macrophages leads to a decrease in the level of autoaggression. In addition to affecting the monocyte-macrophage link, the drug stimulates the microbicidal system of neutrophilic granulocytes, enhancing phagocytosis and increasing the body's nonspecific resistance to infectious diseases, as well as antimicrobial protection.
Galavit is used for the pathogenetic treatment of acute infectious diseases (intestinal infections, hepatitis, erysipelas, purulent meningitis, diseases of the urogenital area, post-traumatic osteomyelitis, obstructive bronchitis, pneumonia) and chronic inflammatory diseases, including those with an autoimmune component in pathogenesis (peptic ulcer, nonspecific peptic ulcer). colitis, Crohn's disease, liver damage of various etiologies, scleroderma, reactive arthritis, systemic lupus erythematosus, Behçet's syndrome, rheumatism, etc.), secondary immunological deficiency, as well as for the correction of immunity in cancer patients in the pre- and postoperative period receiving radiation and chemotherapy to prevent postoperative complications.
Synthetic immunomodulators also include most interferon inducers. Interferon inducers are a heterogeneous family of high- and low-molecular synthetic and natural compounds, united by the ability to cause the formation of its own (endogenous) interferon in the body. Interferon inductors 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- low molecular weight interferon inductor, belonging to the class of fluoreons. Amiksin stimulates the formation in the body of all types of interferons: a, b and g. The maximum level of interferon in the blood is reached approximately 24 hours after taking Amiksin, increasing tenfold compared to its initial values. An important feature of Amiksin is the long-term circulation (up to 8 weeks) of the therapeutic concentration of interferon after a course of taking the drug. Significant and prolonged stimulation by Amiksin of the production of endogenous interferon provides 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, multiple sclerosis.
Neovir- low molecular weight interferon inducer (derivative of carboxymethylacridone). 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, viral encephalitis.
Cycloferon- a drug similar to neovir (methylglucamine salt of carboxymethylenecridone), a low molecular weight interferon inducer. The drug induces the synthesis of early alpha-interferon. In tissues and organs containing lymphoid elements, cycloferon induces a high level of interferon, which lasts for 72 hours. The main cells-producers of interferon after the introduction of Cycloferon are macrophages, T- and B-lymphocytes. Depending on the initial state, activation of one or another link of immunity takes place. The drug induces high titers of alpha-interferon in organs and tissues containing lymphoid elements (spleen, liver, lungs), activates bone marrow stem cells, stimulating the formation of granulocytes. Cycloferon activates T-lymphocytes and natural killer cells, normalizes the balance between subpopulations of T-helpers and T-suppressors. Crosses the blood-brain barrier. Cycloferon is effective against tick-borne encephalitis, influenza, hepatitis, herpes, cytomegalovirus, human immunodeficiency virus, papillomavirus and other viruses. High efficacy of the drug in the complex therapy of acute and chronic bacterial infections (chlamydia, erysipelas, bronchitis, pneumonia, postoperative complications) has been established. , urinary tract infections, peptic ulcer) as a component of immunotherapy. Cycloferon is highly effective in rheumatic and systemic diseases of the connective tissue, suppressing autoimmune reactions and providing anti-inflammatory and analgesic effects. The immunomodulatory effect of Cycloferon is expressed in the correction of the body's immune status in immunodeficiency states of various origins and autoimmune diseases. Cycloferon is the only interferon inducer available in three forms: cycloferon in solution for injection, cycloferon in tablets and cycloferon liniment, each of which has its own application features.

These drugs interact with the cells of the immune system. According to their influence, they are conditionally 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. Immunostimulants are used to stimulate natural immunity in chronic infections, allergic diseases, and immunodeficiency states. Immunomodulators are prescribed as part of complex therapy in parallel with taking antibiotics, antifungal, antiviral drugs. When using them, it is necessary to control 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 fails, and it begins to work against the cells of the body, it is required to reduce the activity of immune cells. This condition occurs in psoriasis and other autoimmune diseases. In these cases, you need to take drugs that can limit the activity of the immune system.

Classification of immunomodulating 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 SARS;

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

Immunomodulators of plant origin

These include medicinal herbs that are used in traditional medicine. This type of immunomodulators is the most preferable, because they act gently on the body, without giving sharp 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 (iris), yellow capsule, 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, rosea rhodiola, elecampane and many other herbs rich in vitamins and nutrients. To achieve the effect, immunomodulating drugs are prescribed for a long period, since their action 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 are still in consensus regarding immunomodulatory drugs. Some doctors consider it inappropriate to frequently and unreasonably prescribe these drugs, because in case of an overdose, even the safest drugs can backfire and cause the development of autoimmune diseases: diabetes mellitus, rheumatoid arthritis, toxic goiter, multiple sclerosis and other not fully understood diseases. Improper functioning of the immune system becomes their cause, therefore, 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 control the dynamics of the disease.

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