Clinical and immunological changes in patients with chronic inflammatory diseases of the upper respiratory tract at different periods after administration of influenza vaccine. Message 1. The influence of parenteral influenza vaccination on the clinical condition and indicators of systemic humoral immunity in patients with chronic inflammatory diseases of the upper respiratory tract

Topicality: Today, as an assessment of the effectiveness of vaccination against influenza infection is to determine the level of antibodies against influenza virus hemagglutinin, which is determined by the reaction of inhibition of hemagglutination. It is known that the effect of vaccination with modern drugs is short-lived, compared with what remains after the disease. Therefore, there is a need for further vaccinations, which are carried out without taking into account the state of immunity in those who will be vaccinated. This raises the question of the appropriateness of this approach in individuals who, according to this indicator, can already be considered protected from influenza infection and how often such patients occur in clinical practice. Material and methods: From the autumn-winter period of 2019 to November 2020, 32 donors and 32 patients with chronic inflammatory diseases of the upper respiratory tract chronic inflammatory diseases of the upper respiratory tract of both sexes who were not vaccinated for 1 year before the study were examined. Among these patients, 11 were diagnosed with chronic rhinosinusitis, 9 with chronic tonsillitis, and 12 with chronic pharyngitis. All patients with chronic inflammatory diseases of the upper respiratory tract underwent a complete otolaryngological examination prior to influenza vaccination and were monitored for another 36 weeks thereafter. Attention was paid to their general clinical condition, cases of exacerbations of chronic inflammatory diseases of the upper respiratory tract and the number of episodes of acute respiratory viral infections during the year before vaccination according to the anamnesis and for the observation period during the post-vaccination period. Samples of serum venous blood of donors, as well as persons with chronic inflammatory diseases of the upper respiratory tract were obtained at the initial examination, and in vaccinated patients 3, 12 and 36 weeks after vaccination and stored at -20°C (Ardo, Italy) until the simultaneous detection of antibodies (Ab) to influenza A and B viruses by hemagglutination inhibition reaction with human erythrocytes 0 group. Trivalent influenza inactivated split vaccine Vaxigrip (France) was used both for vaccination and in the determination of Ab in the blood for influenza viruses. In all examinations, the titer of anti-influenza Ab and the content of immune complexes were determined in the sera of patients, and the content of total IgE was measured in patients with chronic inflammatory diseases of the upper respiratory tract before and after 12 and 36 weeks. Statistical processing of the obtained results was performed in accordance with the recommendations of Glantz. Results: In 41% of those examined protectively significant titers of antibodies to hemagglutinins of vaccine strains of influenza virus vaccine Vaxigrip were detected in the blood. Parenteral vaccination of patients with chronic inflammatory diseases of the upper respiratory tract against influenza helped to improve the course of their underlying clinical disease and reduce their incidence of acute respiratory viral infections within 36 weeks after vaccination. The effect of increasing the level of antibodies to hemagglutinins of influenza virus remained at the limit of 3 months and decreased. Influenza vaccination in patients with chronic inflammatory diseases of the upper respiratory tract with the presence of most of them at the time of vaccination of clinically significant protective titers of antibodies to hemagglutinins vaccine strains of viruses led to an increase in blood in the long term of the vaccination process levels of immune complex and total IgE relative to their initial level, while these indicators did not exceed the limits of their physiological values. Conclusion: Single parenteral influenza vaccination leads to a short-term increase in the blood of specific projective antibodies, improving the clinical condition of patients with inflammatory diseases of the upper respiratory tract, increasing the level of immune complexes and total IgE.