Antibiotics in viral respiratory infections

In the world of pathogenic and potentially pathogenic microorganisms (bacteria, parasites and viruses) species homo sapiens survived due to their versatile and flawless functioning of your immune system. Some viruses, however, managed to penetrate into the cells of the body and become part of their genome. Other also currently be residing in "sleep" mode in the bodies of most healthy people. In addition to typical infectious diseases microorganisms involved in the onset and development of several noncommunicable diseases.

In order to protect from pathogenic microorganisms are used, all components of innate and acquired immunity, but rather their partial inability to protect, to the microorganisms – especially "dormant" viruses have demonstrated destructive.

In viral diseases and against "awakened" in the body help modern antiviral drugs, in the centre of defence, however, is immunotherapy. To her belongs the active immunization (vaccination) with modified viruses and their components, and passive immunotherapy, carried out by the transfer of specific natural and monoclonal antibodies and other immune factors. Very often assigned to the introduction of non-specific immunomodulatory (immunostimulatory) agents.

In the case of infection of a bacterial nature are assigned during viral infection, the antibiotics, the decision for treatment is taken by the doctor. Under normal circumstances, antibiotics and viruses are incompatible, because the drugs in this group have no effect on a viral pathogen of the disease, moreover, is even able to harm unnecessarily violating the microflora.

Bacterial and viral infection and antibiotics involves the combined use of probiotics, which aimed at the normalization of the microflora.

Antiviral immune defense

The main natural (innate) antiviral mediator is interferon type 1, which after penetration of the virus creates the vast majority of cells. It differs from "immune" interferon-gamma, which in the process acquired immune response producing CD4 + and CD8 + T-lymphocytes.

Much used the phagocytosis of viruses, which is provided by macrophages and dendritic cells. They, with the participation of TLR (Toll-like receptors) activate CTL (cytotoxic T lymphocytes) and interferons. In some viral infections play an important role in the protection of eosinophils and neutrophils, which, along with phagocytosis, release of substances such as interferons.

NK cells are a separate line of lymphocytes that destroy cells infected with virus and tumor cells. They have neither T-nor b-receptors recognize the target cells by the principle of reaction of the lectin and sugar.

Effective antivirus tool acquired immunity are antibodies in body fluids – IgM and IgG antibodies in the mucous membranes (and waste) of class IgA. They can glue the viruses (IgM), preventing their fusion with cells (IgA) that neutralize the entry of the virus into the cells and connected complement (IgG). Complement, along with opsonization, capable of killing infected cells.

Many viral infections antibodies in children and adults, provide protection from infection and protective effects of vaccines (respiratory tract infections, particularly SARS, and measles, mumps, rubella, varicella, rabies, hepatitis A and meningoencephalitis, RSV infection, rotavirus, CMV, EBV).

Failure of antiviral immune defense

If the immune system is not fully developed (as is the case in some congenital disorders of immunity and in children) or depleted (in the elderly, with some serious diseases, such as severe asthma, diabetes and malignant tumors and their treatment), immune protection can fail. This simplifies the situation for microbes and pathogens.

With infections caused by bacteria, the person can feel more secure – some of them vaccinated to protect that baby can get inearly childhood, in addition, a growing number of effective antibiotics.

In case of infections caused by viruses, the situation is less favorable. Although it is against many viruses human protects vaccination, managed to eradicate smallpox and in most of the world, also polio, but still present a serious threat of HIV that causes AIDS, avian influenza virus, viruses of hepatitis b and C and others (the causative agents of Ebola, Lhasa, Marburg, etc.) against which is not yet available quality vaccines (or absent).

It is noteworthy that the organisms in a high percentage of healthy people reside in viruses of the herpes group HSV-1 and HSV-2, the virus of Epstein-Barr (EBV), cytomegalovirus (CMV) and varicella-zoster virus (VZV).

Long latent infection with some viruses develops their ability to resist many types of cells, such as fibroblasts and leukocytes (CMV), in the epithelial cells (TSB), in nerve cells (HSV) or even in elements of the immune system. HIV, for example, settles in helper T-cells and macrophages (through the receptors CD4 and CCR5), the EBV attacks the b-cells and multiplies in them. This persistence of virus results in people with weakened immune destruction of cells and tissues, causing immunopathological processes and are able to induce tumors and cell transformation.

Cytomegalovirus

CMV refers to DNA-containing viruses. They are able to infect most cells, including leukocytes.

The protection they provide NK cells and antibodies. In particular, they can be dangerous for people with weakened immune system and cause hepatitis, pneumonia, encephalitis, and retinitis.

The treatment is Acyclovir, Ganciclovir derivatives of Guanine, Valganciclovir. Earlier often used Foscarnet and antiviral antibodies today primenjajutsja rare.

The Virus Of Epstein-Barr

EBV infects already in childhood, the majority (95%) of the population, often infection occurs without symptoms or under the picture of infectious mononucleosis, lymphadenopathy, or liver dysfunction. Failure of immune surveillance contributes to, for example, the development of hepatitis, severe congenital disorders (immunodeficiency, imposed on the X chromosome) may develop lymphoproliferative disease, is also indicated alleged involvement of EBV in the development of Burkitt's lymphoma.

Protection is ensured, in particular, NK-cells and antibodies.

In therapeutic use Acyclovir, Valacyclovir, less Floxuridine, rarely used monoclonal antibody anti-CD20.

Herpes virus

In people with immune deficiency can seriously and repeatedly manifest infections with viruses HSV-1 and HSV-2 and herpes zoster. Relevant viruses are placed in the neurons of the spinal ganglia and sensory nerves, through which migrate to the site of the lesions.

In therapeutic use Acyclovir, Famciclovir and Valacyclovir.

Rhinoviruses

Even a simple virus infection, incapable of permanent colonization, for example, by rhinoviruses – runny nose, cold – may not be negligible, these viruses enter the cells of the mucous membrane through an important immune receptor ICAM-1. With a weakened immune defenses it can lead (usually in the presence of a bacterial superinfection) for otitis media, sinusitis, severe asthma, inflammation of the lower respiratory tract, e.g. pneumonia.

The treatment is Interferon ALPHA2 (intranasal) and Pleconaril, when bacterial complications it is recommended to take drugs from the group of antibiotics.

Antiviral drug

Drugs that block the penetration of the virus into cells, include Amantadine, which is used as an effective treatment of influenza. At this stage of infection is also used Pleconaril that are effective against rhinoviruses (causing the common cold and rhinitis) and entero viruses (causative agents of diarrhoeal diseases, meningitis and encephalitis).

The viruses that have already penetrated deep into cells that are analogs of nucleotides and nucleosides (e.g., Ribavirin), as well as endogenous mediators that inhibit the viral polymerase. The prototype is Acyclovir, the most rasprostranennoe medicine for herpes virus infections, this group includes: Valacyclovir, Famciclovir, Ganciclovir and Foscarnet etc.

Drugs inhibiting viral reverse transcriptase uses Lamivudine used in the treatment of hepatitis B.

Other drugs aimed at the inhibition of transcription factors (initiate production of mRNA) for viral DNA. The molecules "anti-sense" violating the viral DNA or RNA, include, for example, Fomivirsen fomivirsen (effective for complications of AIDS caused by CMV) and other substances.

Against infections caused by hepatitis C virus and HIV, are also used ribosomes and inhibitors of viral protease.

Today managed to create drugs that affect viruses are released from cells. The drugs Zanamivir (relenza) and Oseltamivir (Tamiflu) increase the chances of control terrible pandemic caused by the avian influenza virus.

Most antiviral drugs can be taken orally in severe forms of infections chosen method of intravenous injection or inhalation (e.g., Virazole).

Active immunization – vaccination

Vaccination is the most effectiveway to protect from viral infections. For these purposes, using whole viruses (attenuated or inactivated), purified viral macromolecules, recombinant vectors, DNA (RNA) vaccines, synthetic peptides and multivalent subunit. Often, to increase the immunogenicity of the vaccines use different adjuvants, which contributes to the tendency of transition from injection to oral administration of vaccines.

Antiviral vaccines are available against most viral infections that occur in our latitudes. Regular vaccination protects against polio, hepatitis b, measles, mumps and rubella. It is also recommended vaccination against herpesviruses (HSV, shingles), influenza ("active" strains and avian influenza), encephalitis, papilloma virus, rotavirus, rabies and hepatitis A.

Improved and vaccination of children, an example is the introduction of hexavaccine that protects against tetanus, diphtheria, pertussis, Haemophilus influenzae, hepatitis and polio.

Much attention is paid to human papillomavirus (HPV). To date, vaccines are available with poor risk types of HPV, which is expected to significantly reduce the incidence of cervical cancer and cancer of other organs and tissues. It is expected that in the foreseeable future will be ready and effective HIV vaccine.

Intense research continues in the field of herpes viruses: the last time was, for example, updated guidelines for the prevention of chickenpox, and one study showed that among 38000 elderly people (who in the childhood have acquired immunity against BBO) decreased the number of reactivation of infection by 51%.

Immunomodulatory therapy

Detection of defects in cellular and humoral immunity in viral infections, initiate action for the beneficial exposure to immunomodulators that enhance the immune response by increasing the activity of NK-cells, macrophages and T - and b-lymphocytes, and an escalation in the production of certain cytokines (e.g., IFN-gamma, IL-1) and antibodies, primarily secretory IgA.

Now rarely used synthetic substances such as Levamisole (Decaris), which, moreover, do not exist on the market, or Isoprinosine (which in addition to supporting immunity, inhibits the synthesis of viral nucleic acids), in most cases, the use of bacterial lysates, especially Brankovica, Provexa, Biostim and Ribomunyl.

Significant resources that support mainly cell-mediated immunity, include dialysate factor of migration of leukocytes (Immodin, Kunar) and extracts of the thymus gland (formerly Timothy, Thymulin, today Chemunex).

Of herbal remedies the focus is on extracts of Echinacea purpurea, mistletoe, Australian tea tree, ginseng, Eleutherococcus senticosus, shiitake mushrooms and Ginkgo biloba.