THE RESULT OF LAPAROSCOPIC AND LAPAROTOMIC TREATMENT OF PATIENTS WITH EXTERNAL GENITAL ENDOMETRIOSIS USING IMMUNE RESPONSE MODIFIER

The objective of the work was to make a comparative analysis of the result of external genital endometriosis treatment with the use of traditional surgical intervention and hormone therapy together with the use of low-molecular-weight metabolic immune response modifier 5-amino-1,2,3,4-tetrahydrophthalazine-1,4-dione of sodium salt. Materials and methods: the experimental part of the study was previously conducted on 50 female rats which consisted of studying the influence of the immune response modifier on the course of experimentally induced endometriosis in experimental animals, in particular on changes in the estrous cycle. Injection of the immune response modifier caused retrogression of endometrioid heterotopias and normalization of the estrous cycle in the animals. The comparative analysis of the results of external genital endometriosis treatment in 66 women was conducted on the basis of experimental research. 34 women, apart from surgical intervention and hormone therapy, were injected with the immune response modifier 5-amino-1,2,3,4-tetrahydrophthalazine-1,4-dione of sodium salt during the post surgical period. Cellular immunity, T- and B-lymphocytes, and equipment and instrumental methods, such as medical ultrasound of the organs of the lower pelvis and laparoscopy, were used to assess the results of treatment. As a result of the treatment with the use of the immune response modifier the indicators of cells immunity changed, pain severity decreased, menstrual function normalized, relapse frequency reduced, and the overall quality of life for patients improved. Socially significant effect of treatment of external genital endometriosis using metabolic immune response modifier is manifested in implementation of reproductive function ‒ elimination of infertility in 50 % of women during the first year of observation.

In Vitro Enhanced Skin Permeation and Retention of Imiquimod Loaded in β-Cyclodextrin Nanosponge Hydrogel

Imiquimod (IMQ) is an immune response modifier clinically used for the treatment of various topical diseases. However, its poor aqueous solubility and skin penetration capability make the topical delivery of IMQ a challenging task. This work aims at developing a nanomedicine-based topical formulation, carrying IMQ to control the scarring process for the treatment of aberrant wounds. For this purpose, IMQ was loaded in β-cyclodextrin-based nanosponges and dispersed in a hydrogel suitable for dermal application. The formulation was characterized in vitro and compared with IMQ inclusion complexes, with (2-hydroxy)propyl β-cyclodextrin(HPβCD) and carboxymethyl β-cyclodextrin (CMβCD) showing enhanced penetration properties. The hydrogel containing IMQ-loaded nanosponges could act as a drug reservoir and guarantee the sustained release of IMQ through the skin. A greater inhibitory effect on fibroblast proliferation was observed for IMQ loaded in nanosponges compared to the other formulations.

Ameliorating Effect of Oral Guggulsterone Administration in Imiquimod-Induced Psoriasis in Mice

Psoriasis is a common chronic skin condition characterized by infiltration of inflammatory cells into the epidermis and altered keratinocyte differentiation. In this work, psoriasis was induced by an imiquimod 5% cream, an immune response modifier that can induce psoriasis-like skin inflammation when applied topically in mice. Guggulsterone prepared as a suspension and has been orally given to mice before imiquimod application. The results of the current study showed that guggulsterone suspension can significantly reduce psoriasis area and severity index in (guggul suspension+imiquimod group as compared with both control group and (vehicle suspension+imiquimod ) group.

Dynamics of index of immune system after prevention of disorders in menopause of women with hyperproliferative processes of reproductive system

The objective: to evaluate the effectiveness of prevention of disorders in menopause of women with hyperproliferative processes of reproductive system (HPPRS) on the basis of investigations of the index of immune system. Materials and methods. The substitutive hormone prevention (SHP) of neurovegetative and psycho-emotional disorders in menopause (NVPDM) was conducted among 60 women aged 40 to 53 with the signs of HPPRS according to the data of ultrasound uterine and the results of histological investigations of mucosal scrapings of the uterus. and the appointment of combine estrogen-gestogen preparation with composition of valerat of estradiol and dienogest drug according to contraceptive scheme, immune response modifier with acid acridonucsusna and N metilglukamini, suppositories with inteferonum recombinant alfa 2b. To evaluate the effectiveness of prevention of HPPRS the index of the immune system was tested: the level of immunoglobulin A, G, M, (IgA, IgG, IgM) of interleukin 1.2 (IL-1, IL-2), of tumor necrosis factor (TNF) before and after prophylaxis with the use of immunofermentic method were determined. The control group included 30 women of the same age category without NVPDM and HPPRS. Results. Women with premenopause HPPRS have 38% of IgA, 21% of IgG, 37% of IgM level up, IL-1 – 2.6 times, IL-2 – 2.6 times up and TNF 47% up (р<0.05), compared with healthy women. After SHP use among women with preserving menstrual function (n=24) the levels of IL-1decreased in 2.4 times, IL – for 43%, TNF for 28%; (р<0.05). Among women with the development of menopause (n=36) – Ig A level decreased to 34%, Ig G – to 37%, IL2 to 15% in comparison with the indices before the prophylaxis.was conducted (р<0,05), The symptoms of NVPDM among 40% women disappeared. Conclusions. The use of SHP of NVPDM among women with HPPRS reduces the exertion of immunologic reaction and reduces the risk of denutrition of their compensatiory possibilities. and allows to liquidate NVPDM for 40% of women in the period of premenopause. Key words: menopausal disorders, hyperproliferative processes of reproductive system, prevention, immune system.