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Vol 27, No 6 (2022)

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Lymphocyte enzymes as an indicator of immune response activity in ixodid tick-borne borreliosis

Avdeeva M.G., Moshkova D.Y., Blazhnyaya L.P., Kozyreva E.V.


BACKGROUND: Acute ixodid tick-borne borreliosis tends to turn into a protracted and chronic course. This suggests studying the causes of the violation of the immune status of a sick person. The central structural unit of immunity is the lymphocyte. It is known that the formation of specific T-lymphocyte subpopulations is based on the central role of IL-2, leading to the restructuring of cellular metabolic pathways. The regulation of signaling pathways and lymphocyte metabolism primarily determines disease outcomes.

AIM: This study determines the pathogenetic mechanisms of the infectious and inflammatory processes in the erythemal form of acute ixodid tick-borne borreliosis based on the study of the lymphocytic lysosomal enzyme activity, the level of IL-2, and the clinical disease manifestations.

MATERIALS AND METHODS: The main group is represented by 609 patients hospitalized at the Krasnodar City Clinical Hospital from 2010 to 2019. The study group comprised 45 patients with an erythemal form of acute ixodid tick-borne borreliosis. In the dynamics of the disease, the level of IL-2 and the cytochemical activity of acid phosphatase and non-specific alpha naphthyl esterase of lymphocytes were determined.

RESULTS: During the height of ixodid tick-borne borreliosis, a decrease in the cytochemical activity of hydrolytic enzymes of lymphocytes was noted compared with the control group. IL-2 levels had a high dispersion and were associated with clinical disease manifestations. A low level of IL-2 correlated with a decrease in the activity of alpha-naphthyl esterase lymphocytes. During the period of convalescence, there was a restoration of lymphocytic enzymatic activity and an increase in the number of cells with a pronounced activity of alpha-naphthyl esterase, typical of T-lymphocytes with killer activity.

CONCLUSION: The hydrolytic enzymes of the lysosomes of acid phosphatase and alpha-naphthyl esterase lymphocytes enable judging the intensity of intracellular metabolic processes and, combined with clinical disease symptoms and IL-2 activity, are indicators of the state of the immune process, supplementing the results of traditional immunological studies in patients with the erythema form of acute ixodid tick-borne borreliosis. The predominance of enzymatically inactive forms of T-lymphocytes in the acute period of the disease reflects a specific deficiency of T-cell immunity.

Epidemiology and Infectious Diseases. 2022;27(6):315-326
pages 315-326 views

Assessment of humoral immunity to SARS-CoV-2 among employees of medical organizations in the Republic of Tatarstan

Minullin I.K., Eremeeva Z.G., Bogdanova E.V., Iskandarov I.R., Safina E.I.


BACKGROUND: Since the beginning of the new coronavirus infection pandemic, preventive measures aimed at combating the spread of the pathogen and preventing the development of severe forms of infection and deaths have improved. Despite the absence of a legally established, generally accepted post-vaccination protective value of antibodies to coronavirus, the study of the presence of antibodies and the determination of their amount in the blood serum of the vaccinated population continues.

AIM: This study presents the results of post-vaccination humoral immunity to SARS-CoV-2 in medical organizations regardless of their infectious disease history.

MATERIALS AND METHODS: This study involved employees of medical organizations of the State Autonomous Health Institution “Republican Clinical Dermatovenerologic Dispensary of the Ministry of Health of the Republic of Tatarstan named after Professor A.G. Ge” in Kazan and the State Autonomous Health Institution “City Polyclinic No. 3” in Naberezhnye Chelny. Three hundred ninety-three people (including 350 women) were vaccinated with the two-component vaccine GamCovidVac (Sputnik V). After a sufficient amount of time passed for the formation of an immune response, more than 21 days. The blood sera of these 393 people were examined for the determination of specific IgG to SARS-CoV-2 by enzyme immunoassay using the Vector-Best kit (Novosibirsk, Russia). Statistical analysis was performed using StatTech v.3.0.9 (developer, Stattech LLC, Russia).

RESULTS: The median age of the subjects was 47 (Q1–Q3: 39–59) years. The mean antibody titer level was 570 (Q1–Q3: 128–1150 BAU/ml). A correlation analysis of the relationship between titer levels and age at the time of vaccination was performed. According to the results, a weak direct relationship was established. There was no connection when assessing the antibody titer level dependence on vaccination duration after the second component at the time of checking the titers.

CONCLUSIONS: The ongoing pandemic of a new coronavirus infection with the emergence of new forms of the disease caused by other virus strains, the improvement in prevention methods, requires constant monitoring of the epidemiological situation with the study of the vaccine effectiveness, including the cellular level.

Epidemiology and Infectious Diseases. 2022;27(6):327-332
pages 327-332 views

Tuberculosis vaccination of young children during the COVID-19 pandemic: modern practices

Minaeva V.A., Golubkova A.A.


BACKGROUND: Reducing population immunity to vaccine-controlled infections because of low vaccination coverage at any moment could destabilize earlier epidemiological well-being against vaccine-controlled infections in the context of the COVID-19 pandemic.

AIM: This study comprehensively assessed the completeness and timeliness of TB vaccination of young children in a maternity hospital-polyclinic stages and identified resources to improve their immunization.

MATERIALS AND METHODS: Form 063/in patients born from January 1, 2020, to December 31, 2021, (3613), Registers of newborns under the supervision of the Children’s City Polyclinic (DPP) from 2020 to 2021 were obtained (3). This article uses epidemiological (descriptive-estimative and analytical) and statistical methods of analysis using the online service StatTech. Electronic discharges from the EMIAS system were used to examine the timeliness and completeness of vaccination coverage.

RESULTS: In 2020 and 2021, because of the early discharge of newborns from the maternity hospital, a significant proportion of them were not vaccinated against tuberculosis within the timeframe prescribed by the National Immunization Prevention Calendar. In 2020, 24.8% of the causes of not contracting tuberculosis in a maternity hospital were discharged early, whereas, in 2021, it was 9.6% (p <0.05). In 2020, the chances of not vaccinating against BCG because of early withdrawal were 3.12 times higher than in 2021 (95% of confidence interval 2.09–4.7). In the structure of the causes of the lack of development, the largest proportion was medical withdrawals from BCG and parental refusals, 40.7% and 40.9%, respectively. In 2020 and 2021 their number was relatively stable, and for each of the analyzed items, more than 40%. Later on, only 32.8% of those not disabled in the maternity hospital were vaccinated against tuberculosis up to the age of 2 months. The cumulative coverage of tuberculosis vaccination for children registered with DHS was 82% by the first 12 months of life, which was not in line with the WHO target of 95% immunization coverage. The reasons for this failure were parents’ refusal to be vaccinated (48.5%), their low social responsibility (39.2%), and medical defenses (12.3%). The interruption of vaccination schedules at the maternity ward during the COVID-19 pandemic due to the early discharge of newborns resulted in a delay in scheduling subsequent vaccinations. As a result, children were born in 2020 and 2021. By 12 months, 17%, whooping cough, diphtheria, and tetanus, 20.6%, polio 20.5%, pneumococcal infection 30.2%, had not been vaccinated.

CONCLUSION: Given the high incidence of morbidity among children up to the age of two and the increase in the number of home-based cases of tuberculosis, the ambiguity of the situation makes vaccination against tuberculosis a priority in the current version of the National Immunization Service. It requires control of the regulated order of the Ministry of Health of Russia from December 6, 2021. 1122h “On approval of the national calendar of preventive vaccinations, the calendar of preventive vaccinations according to epidemic indications and the order of preventive vaccinations” calendar.

Epidemiology and Infectious Diseases. 2022;27(6):333-340
pages 333-340 views


Botulinum neurotoxin is both poison and medicine: botulinum therapy and iatrogenic botulism

Nikiforov V.V.


Botulinum neurotoxin is the most potent poison known worldwide. Over the past two centuries, its structure and functions have been studied in detail, and obtained in its pure form. Knowledge of the mechanisms of action of botulinum neurotoxin has determined two directions of its possible use: negative, as a biological (toxin) weapon, and positive, as an agent that eliminates pathological muscle hypertonicity and neuropathic pain and can be used for aesthetic purposes (beauty injections).

The lecture presents the chronological development of both directions and provides a detailed analysis of the various uses of botulinum neurotoxin as a medical and cosmetic treatment. Particular attention is paid to the side effects of botulinum therapy and ways to overcome them.

Epidemiology and Infectious Diseases. 2022;27(6):341-359
pages 341-359 views


The case of food botulism F

Nikolaeva I.V., Gilmullina F.S., Kazancev A.Y., Fatkullin B.S.


This case describes a rare case of food botulism F in a 42-year-old man, which developed after he ate dried fish. The disease proceeded in a severe form with the development of ophthalmoplegia, tetraparesis, and respiratory failure. Monovalent antitoxic serums against botulinum toxins A, B, and E were administered to the patient. However, on the third day of the disease, he developed fulminant toxic myocarditis with asystole. Despite successful resuscitation, the patient developed a post-resuscitation disease and anoxic encephalopathy. The disease was complicated by severe aspiration pneumonia caused by Klebsiella pneumoniae (ESBL+). The duration of mechanical ventilation was 12 days. His hemodynamics stabilized on the eighth day of illness, and on the 19th day of illness, physical activity and a state of minimal consciousness appeared. The patient was transferred to the rehabilitation department on the 22nd day of the illness.

Doctors should be informed about the possibility of the development and severity of botulism caused by botulinum toxin type F. It is necessary to introduce polyvalent antibotulinic serum into clinical practice, including antitoxins against rare types of botulinum toxin.

Epidemiology and Infectious Diseases. 2022;27(6):360-367
pages 360-367 views

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