Our report concerns the observations made during the treatment of pneumonia with individually selected bacteriophages in HCAI patients on mechanical ventilation. 19 patients on mechanical ventilation whose condition was complicated by antibiotic-resistant pneumonia were examined. The treatment of patients was supplemented with phage therapy, bacteriophages were selected individually for each patient, taking into account the microbial etiology of the disease (Pseudomonas aeruginosa, Кlebsiella pneumoniae, Acinetobacter baumanii). Immunophenotyping of blood lymphocytes was carried out using 2-3-parameter flow cytometry. The functional activity of blood leukocytes was assessed by their ability to produce IFNα and IFNγ during cultivation. The level of interferons production in supernatants collected after cultivation was quantitatively evaluated both by their concentration (ELISA, reagents from “Vector-Best-Europe”, Russia) and by their biological activity. Statistical processing of the results was carried out using the Statistica 6 program according to the nonparametric Mann-Whitney U-test. In the course of successful phage therapy with individually selected bacteriophages overcoming of lymphopenia (if there was one) and an increase in both the number and functional activity of peripheral blood lymphocytes in all patients with pneumonia observed are noted. The relationship between the microbial load (mono- or mixed infection, the number of CFU pathogens of pneumonia, the need for repeated courses of phage therapy) and the degree of deficiency in one or another subpopulation of lymphocytes was not detected. Activation of the immune system achieved after one course of phage therapy was maintained for at least 3 weeks after phage administration was discontinued.

In the article there is presented the comparative analysis of the character of the specific humoral response to pertussis in dependence on the age, terms of the disease and vaccination history in 279 patients, among which 114 patients were under 1 and 165 patients - over 1 year of the age. In the study of the level of the production of antibodies of different isotypes in unvaccinated patients of different age in dependence on the terms of medical examination it has been revealed that in the patients under the age of 1 year there was typical the low production of all the classes of antibodies in any time of the disease, especially IgM. It has been shown that in babies aged from 0 to 3 and from 4 to 6 months old the production level of these immunoglobulins in examination at the early stages of the disease was established to be considerably lower than in the patients at the age from 7 to 12 months, and was equal to 1,1 ± 0,4 and 1,5 ± 0,1 U/ml versus 9,1 ± 3,8 U/ml correspondingly, (p

The article presents the analysis of clinical and immunological features of the combined course of pertussis and respiratory chlamydia in children. The study of the prodromal period and spasmodic cough symptoms showed that concomitant chlamydial infection did not significantly affect the severity of pertussis: 63.2% of patients had mild degree and 36.8% — moderate severity of the disease. However, in this case, the disease was delayed. Bronchitis and in some cases obstructive bronchitis was observed mainly in children under 1 year.The study of the lymphocytes subpopulation found that the content of NK cells decreased only in 10.5% of children, T helpers — in 21.1%, the ratio of CD4+ /CD8+ — in 26.3%. The function of cytokine network was characterized by more active production of such proinflammatory cytokines as IFN and TNF than their production during pertussis monoinfection. The levels of production of IL-8 and IL-6 were similar in all the studied groups. The production of IL-4 by lymphocytes in children with whooping cough in combination  with chlamydial infection was weaker then in patients with pertussis monoinfection  or in healthy children. These features are considered as immunological predictors of long reconvalescence in patients with association of pertussis and respiratory chlamydia.

The article presents a comparative analysis of the cytokine network in 161 patients with pertussis under the age of 1 year and in 180 patients over the age of 1 year. The studies revealed lower production of immunoregulatory cytokines (interferon-γ and interleukin-2) in patients under the age of 1 year at all stages of the disease and with all variants of pertussis (both mono- and mixed infections). The researchers revealed the relationship between the level of interferon-γ production and the severity of pertussis. They revealed age differences in the interferon-8 production in patients with mixed infection, which can determine clinical features and cause bronchopulmonary complications. The authors demonstrated the features of the dynamics of spontaneous and induced production of interleukin-6 and anti-inflammatory cytokines (interleukin-4, interleukin-10) in children under the age of 1 year; these features can be considered as immunological markers determining the imperfection of the humoral response in patients with pertussis in this age group.

Comparative analysis of cytokine profile was performed in 149 children aged 1.5 to 14 years, out of which 41 had suffered from pertussis as monoinfection, 53 -in combination with mycoplasma infection, 55 - with acute viral infections. Cytokine profile in patients with pertussis differs in reduction of induced production of proinflammatory cytokines, especially IFN-y. A key feature of the functioning of the cytokine network in pertussis is the active production of anti-inflammatory cytokines - IL-4 and IL-10 upward the early periods of the disease, that indicates the importance of Th-2-type response in whooping cough.