Low molecular weight bioregulator of bacterial origin in condylomatosis therapy optimization

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Abstract


Condylomatosis is a disease characterized by the formation on the surface epithelium of the skin and mucous outgrowths, which can reach significant sizes. The cause of the disease is DNA-containing human papillomavirus (HPV), which have a high affinity for epithelial tissues of the genital organs, esophagus, anal canal and respiratory tract. Clinicians have described various patterns of use of the drug Liсopid in the treatment of condylomatosis. Of interest is the development and further implementation of condylomatosis therapy using a drug based on glucosaminyl muramyl dipeptide in order to correct immunodeficiency states and treat papillomavirus infection. Clinical condylomatosis of the external genitalia is presented. In the study of PCR on HPV, 33 types with a high viral load were detected. Diagnosis: Papillomavirus infection. Condylomas of the external genitalia. The goals of therapy and the treatment regimen: prescribing the drug Liсopid (AO Peptek, Moscow) to activate innate immunity, which allows to get an adequately high immune response at the level of both cellular and humoral local immunity. After the therapy, condylomas of the external genital organs were not found at the examination. The patient notes an improvement, the disappearance of itching. Thus, condylomatosis therapy according to the standard 10 mg Liсopid regimen for 10 days was effective, it contributed to the disappearance of genital warts, the clinical effect persisted for the entire observation period - 3 months. The clinical effectiveness of the drug can be explained by its systemic effect on the correction of immunity through NOD2 receptors.


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Condylomatosis is a disease characterized by the formation on the surface epithelium of the skin and mucous outgrowths, which can reach significant sizes. The cause of the disease is DNA-containing human papillomavirus (HPV), which have a high affinity for epithelial tissues of the genital organs, esophagus, anal canal and respiratory tract [1]. More than 200 highly and low oncogenic types of human papillomavirus have been characterized, 13 of which are highly oncogenic, causing intraepithelial lesions of the cervix uteri or cancer, as well as squamous skin cancer in men and women [2]. Most human papillomavirus infections are asymptomatic. The incubation period of cervical cancer is diagnosed on average 20 years after infection, but more recent malignancy is often noted. Infection with one type of HPV does not prevent infection with other types of virus. In 5-30% of women, several types of HPV are detected simultaneously. The leading role of human papillomavirus (HPV) in the pathogenesis of cervical cancer determines the relevance of timely diagnosis and effective treatment of papillomavirus infection of the anogenital area. The most common treatment method is laser destruction, but its effectiveness is insufficient, since formations reappear after 6-12 months. One of the reasons for the failure of all methods of destruction is the lack of local immunity, secondary immunodeficiency states. In this regard, for the successful treatment of condylomatosis, it is necessary to include immunomodulators in the complex therapy. The immunomodulator of the first choice in this pathology is the drug Licopid (AO Peptek, Moscow) [3], which has been successfully used for more than 25 years in the treatment of diseases associated with secondary immunodeficiency states [4], psoriasis [5], allergic [6- 8] and infectious diseases of bacterial [9-11] and viral etiology [12-13], involved in the regulation of hematopoiesis [14-15]. Clinicians have described various drug Licopid regimen in the treatment of condylomatosis [16-19]. In a placebo-controlled study of the complex treatment of 100 patients with local and common condylomatosis, along with the traditional 10 mg per day regimen for 10 days after laser destruction, therapy with a dosage of 20 mg per day for 10 days after laser destruction is discussed [17]. In other studies, the traditional course of treatment with a dosage of 10 mg per day during for 10 days also showed high efficacy [18]. In this regard, the development and justification of various regimen and options for the use of the drug Licopid in the treatment of condylomatosis is of interest. As an example illustrating the effectiveness of the use of the drug Licopid with condylomatosis according to the standard regimen, we present the following clinical case. Patient A., 32 years old. One sexual partner for 1 year. Condom used protection. Anamnesis: The first lesions appeared about 6 months ago, the patient was cut with a razor during depilation. Formations reappeared after 2 weeks. Complaints Lesions on the small and large labia, with periodic itching of the external genital organs, is disturbing. Objectively On examination, single formations up to 2 mm in the region of the posterior commissure; on the right labia majora in the lower third - up to 3 mm. Examinations In the study of PCR on HPV, 33 types with high viral load were detected. Diagnosis Papillomavirus infection. Condylomas of the external genitalia. Purpose of the therapy and treatment regimen. Taking into account the patient’s complaints and the reappearance of growths, it was decided to prescribe an immunomodulating drug to activate innate immunity, which allows you to get an adequately high immune response at the level of both cellular and humoral local immunity. This is a semi-synthetic glucosaminylmuramyl dipeptide (GMDP, Licopid). Абрамашвили Ю.Г. и др. Вестник РУДН. Серия: Медицина. 2020. Т. 24. № 2. С. 163-167 Lycopid is prescribed at a dose of 10 mg orally, 1 tab once a day for 10 days; the dose was chosen by the research doctor in accordance with the instructions for the drug. Locally was recommended Epigen spray, which has a complex effect, including immunostimulating, antiviral, anti-inflammatory, antipruritic and regenerative effects. Spray treatment was carried out 2-3 times a day externally to the area of formations. Turnout after 2 weeks was recommended to address the issue of possible coagulation of formations. Results After the treatment, condylomas of the external genital organs were not found at the examination. The patient notes an improvement, the disappearance of itching. Thus, condylomatosis therapy according to the standard 10 mg Licopid regimen for 10 days was effective, it contributed to the disappearance of genital warts, the clinical effect persisted for the entire observation period - 3 months. The clinical effectiveness of the drug can be explained by its systemic effect on the correction of immunity through NOD2 receptors. It is well known, the substance of the drug Licopid is glucosaminyl muramyl dipeptide (GMDP), which is a ligand of innate immunity NOD2 receptors, involved in u huge amount of intercellular interactions [20]. The mechanism of action of the drug is well understood, there are no side effects, high efficiency and good tolerance that serve as the basis for its appointment.

About the authors

Yu. G. Abramashvili

Kuban State Medical University of the Ministry of Health of Russia

Author for correspondence.
Email: svgur@mail.ru
Krasnodar, Russian Federation

N. V. Kolesnikova

Kuban State Medical University of the Ministry of Health of Russia

Email: svgur@mail.ru
Krasnodar, Russian Federation

O. Yu. Borisova

Moscow Research Institute of Epidemiology and Microbiology named after G.N. Gabrichevsky; Shemyakin and Ovchinnikov Institute of Bioorganic Chemistry RAS

Email: svgur@mail.ru
Moscow, Russian Federation

S. V. Guryanova

Shemyakin and Ovchinnikov Institute of Bioorganic Chemistry RAS; Peoples’ Friendship University of Russia

Email: svgur@mail.ru
Moscow, Russian Federation

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Copyright (c) 2020 Abramashvili Y.G., Kolesnikova N.V., Borisova O.Y., Guryanova S.V.

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