Are you familiar with one of the most important problems of modern pharmacy?
Do you think that this is the lack of drugs that can defeat the most severe diseases? Actually this is not true. One of the main problems is the resistance of microorganisms to existing drugs. This means that some drugs that were previously effective may no longer work over time as pathogens learn to survive exposure to the drugs. The issue of antibiotic resistance is especially acute now, as confirmed by clinical practice and numerous studies. According to WHO, every year millions of people experience infections that are resistant to one or more antibiotics. The same thing happens with other groups of drugs. One solution to this problem is to search for other universal drugs that would be able to avoid the emergence of resistance to them. Antiviral immunity is provided by interferons, a group of protein molecules.
- What are interferons (IFNs)
- History of discovery
- Interferon therapy: yesterday, today and tomorrow
- Types and effects on the body
- Preparations containing IFN
- Preparations based on IFN for the prevention of ARVI
- Complex immunomodulatory drug VIFERON
History of the discovery of interferon
Interferons (IFNs) belong to a special group of proteins that are produced by immune system cells in animals and humans. IFNs protect the body from pathogenic bacteria, parasites and even cancer cells. According to one version of scientists, thanks to interferons, humanity has not yet died from viral diseases.
The world learned about interferons not so long ago - only in the middle of the 20th century. And, despite the fact that many decades have passed since then, we can say that their discovery has become one of the most significant events in the medical world in the last and current century. In terms of scale, it is comparable only to the discovery of viruses themselves at the end of the 19th century.
Scientists were forced to think about the possible existence of some special protective barrier in the body by the phenomenon of interference, which consisted in the fact that after infection with certain viruses, cells become immune to viruses of another type. Scientists were most interested in the variant of interference in which the body, after the introduction of a non-pathogenic virus, became immune to infection by deadly pathogens. This method of protecting a person from diseases differs from the well-known vaccination, when by introducing a weakened or killed pathogenic agent they try to launch a specific system, i.e. acquired immunity.i
Interferons not only have antiviral activity (they were discovered by scientists for this reason), but also take a diverse role in the regulation of the immune response. Interferons as a system as a whole have a broader biological effect than limiting viral infection.ii
The mechanism of action of IFN is fundamentally different from antibodies. The fact is that IFNs are not specific to viral diseases and are able to fight different types of viruses. This means that medications containing interferons, which are intended for the prevention and treatment of acute respiratory viral infections, can fight not only a specific strain of influenza, for example, but all strains.
Interferon therapy: yesterday, today and tomorrow
To conduct the first studies of IFN, a group of volunteers was recruited who agreed to inject themselves with IFN obtained from the blood of monkeys. In those days when IFNs were little studied, making such a decision required a certain amount of courage. Therefore, we can say that people agreed to sacrifice themselves for the sake of science. Before the introduction of IFN, they were infected with the Coxsackie virus, which causes the common cold.
After a certain period of time, it was found that only one person from the group of volunteers became ill, despite the fact that the virus was present in all of them in the nasal washes. However, no side effects were found. This study marked the beginning of thousands of subsequent experiments, thanks to which scientists recognized the ability of IFN to protect humans from disease.
At the same time, in the 1960s, Soviet virologists also joined the study of the effect of IFN on the human body. Epidemiologist Soloviev V.D. proposed to produce IFN from placental blood taken from postpartum women. In 1969, an epidemic of Hong Kong influenza was recorded in the USSR, which was first tried to be combated with the help of interferon preparations obtained from human blood. It was found that the effectiveness of such drugs is almost 70%.
IFNs were also widely used in subsequent years - for example, in 1973, when Academician A.A. Smorodintsev began researching this type of protein. In scientific works of those years, the most effective methods of using IFN were analyzed. Thus, through the ongoing study of IFN and its effect on the human immune system, by the end of the 20th century, scientists were able to accumulate enormous experience in the use of human leukocyte IFN for the prevention and treatment of respiratory infections, including influenza, as well as some other viral diseases.
Intranasal interferon preparations have been widely used in many countries around the world, including the UK, USA, Japan and Bulgaria. In recent years, interferon has begun to be widely used in the treatment of children. For adults, this group of drugs has been used for more than half a century. With the beginning of the use of IFN, the effectiveness of protection against ARVI in preschool children, including newborns, has increased significantly. This indicated to scientists that it is necessary to study IFNs more and more deeply and strive to expand the scope of their influence, to try to fight a variety of diseases with the help of IFNs.
However, unfortunately, after the start of mass production of IFN, it quickly became clear that the composition of drugs containing interferon is inconsistent even within the production of one pharmaceutical company. The main disadvantages of drugs obtained from donor blood include the inability to purify the drug at a high level. It turned out to be difficult to remove viral particles from the drug. In addition, donated blood is a very expensive ingredient, available in large quantities only to a few pharmaceutical companies. Therefore, the company has now almost abandoned the production of leukocyte IFN. A small volume of IFN preparations obtained from donor blood is used strictly for life-saving indications, when the expected benefit significantly outweighs the possible risks.
But did scientists really abandon the production of drugs with interferons after learning about the peculiarities of leukocyte IFN? Of course not. In this case, biotechnology came to the rescue - the science of ways to create various substances using natural biological components. Thanks to it, today pharmacists produce recombinant IFNs, absolutely identical to natural ones in amino acid composition, which do not require donor blood. These drugs are produced in large quantities throughout the world and are relatively low in cost, which in turn makes prices in pharmacies quite affordable for most consumers.
IFN preparations today can be produced in the form of dried lyophysiate, which is subsequently used to obtain a solution, suppositories for rectal and vaginal use, a solution for injections and inhalations, drops, ointments, gels, aerosols, tablets and microenemas.
IFN drugs may contain different amounts of the active substance. On drug packaging, this amount is most often indicated in international units, or IU.i
The release form and dosage of the IFN drug is selected by the attending physician, taking into account the patient’s age, condition and medical history.
Classification of interferons
The name “interferon” comes from the English “to interfere”, which is quite consistent with the action of these proteins - they interfere, i.e. prevent infection.
Today, more than 20 types of human interferons are known, which can be divided into three types:
- The first type is antiviral interferons, which include interferon alpha (IFN-α), interferon beta (IFN-β), as well as some other interferons. The production of these IFNs begins when viruses, as well as some components of bacteria, enter the body. At the same time, other immune mechanisms are stimulated.
- The second type is the so-called immune IFN, interferon gamma (IFN-γ). It acts as a second level of protection, i.e. is included in the fight against the disease after the “first wave” and activation of type 1 IFN. The antiviral and antitumor properties of this IFN are less pronounced than those of the previous group of IFNs.
- The third type is represented by interferon lambda (IFN-λ), whose functions are still poorly understood. At the moment, its study is ongoing, but it has already been established that in its effect algorithm it resembles IFN alpha (IFN-α) and beta (IFN-β).
Types of interferons (types). Their effect on the body.
Scientists distinguish three types of interferons: interferons of the first, second and third types. The first type of IFN includes IFN-α, which in turn are divided into several subtypes. Type I IFN also includes IFN-β, IFN-ε, IFN-κ and IFN-ω. One type II IFN is also known – IFN-γ. At the beginning of the 21st century, a new class of interferons was discovered - the third type, represented by IFN-λ, which includes IFN-λ1, IFN-λ2 and IFN-λ3.
The IFN system, which includes interferons alpha, beta and gamma, is able to respond as quickly as possible to signals from the body indicating the penetration of infection and damage to DNA and RNA of cells. Virologists identify four main links in the functioning of the system of these proteins.
The first link is induction. The human body has an ideally tuned signaling system that detects the penetration of infection from the outside within about half an hour. The response of the cellular genome is immediately formed and the second stage begins - production, i.e. production of IFN.
The product consists of the synthesis of interferons by cells of the immune system and their secretion into the environment. Within a few hours after infection, the concentration of functionally active IFNs in the peripheral blood reaches its maximum. Thus, the body becomes fully prepared to fight infection if the immune system functions without failures. As a rule, this only happens in an ideal world, where a person has no problems with the environmental situation, and he always eats right and has no chronic diseases. Otherwise, IFN drugs may be required.
The third link is action. IFNs begin to protect the body's cells from the foreign influence of viruses and bacteria. And then, effects are connected as the fourth link. There are more than three hundred of them in total, among them are antiviral, immunomodulatory, antitoxic effects, as well as activation of natural killer cells, synthesis of prostaglandins and many other activities aimed at the fastest possible recovery.
First production of interferon
For the first time, first-generation IFN preparations were obtained from leukocytes of donor blood. And immediately scientists began their clinical use and further study.
Science in the 20th century continuously developed, and over time, the basis for the biotechnological production of second-generation drugs containing recombinant IFNs was developed, i.e. obtained through genetic engineering.
Based on the method of production, IFN can be divided into 4 types:
- leukocyte IFN, which is obtained from donor blood;
- lymphoblastic IFN, obtained from the culture of lymphoblastic cells;
- recombinant IFN, which is obtained using bacterial or fungal cultures;
- pegylated types of IFN, which are obtained by combining recombinant IFN with a substance such as polyethylene glycol. In this way, pharmacists are trying to make the effect of the drug last longer.
The first production of IFN in the USSR was launched in 1988. At that time, these drugs were intended for the treatment of viral and oncological diseases. Great hopes were placed on interferons, so the study of these proteins was formed into a separate section of biology and medicine called interferonology. The scientific community actively began to develop a promising topic, as a result of which options for methods for determining the interferon status of the body were proposed.
At the moment, IFNs are considered as sufficiently studied immune mediators that have a wide range of biological activity and can be used not only in the prevention and treatment of viral diseases, but also non-viral diseases. Pharmacists have conducted many studies, with the help of which it was possible to prove that interferons occupy a leading position during therapy for such widespread and poorly controlled diseases as ARVI, hepatitis B, C and herpes.
pharmachologic effect
Interferon preparations have an immunomodulatory effect, affecting the activity of T-lymphocytes and B-lymphocytes, as well as the formation of antibodies.
In addition, interferons, as well as inducers of interferon synthesis, have a pronounced antiviral effect.
Interferon preparations additionally have an antitumor effect.
Enisamium iodide, in addition to its immunostimulating and antiviral effect, also has anti-inflammatory, antipyretic and analgesic effects.
Are medications containing interferons suitable for children?
With acute respiratory viral infections and other viral diseases, children often experience a deficiency of interferons. For this reason, an additional source of IFN is needed to speed up recovery. Interferon, coming from outside, helps to mobilize the immune system of children and protects them from the development of complications.
Frequently ill children (FIC) require special attention, and this group includes not only preschoolers and schoolchildren who suffer from flu and colds more than 4-6 times a year, but also those who are ill for a long time - more than two weeks after each infection with ARVI. In such children, the production of natural IFN is reduced by no less than 15-20% compared to their peers. Medicines containing IFN not only fight viral diseases, but also enhance protective functions and help resist the disease.
For PBD, pediatricians recommend the use of long-term interferon therapy. Using this approach, it is possible to form a special IFN depot, due to which the cells in the body become resistant to the effects of infections.
Are all “pherons” the same?
As already mentioned, some drug manufacturers produce drugs whose names contain the ending “...feron,” which can mislead the consumer and convince him that the drug contains interferons. In fact, these drugs may be homeopathic and do not contain IFN in any form. Homeopathy refers to alternative forms of medicine that involve the use of highly diluted drugs that are believed to cause disease-like symptoms in healthy people. Proponents of homeopathy contrast the concept of treatment according to the principle “like cures like” with the principles of rational pharmacotherapy.
Currently, homeopathic medicines may not undergo a full cycle of checks before being entered into the RLS (register of medicines), since a simplified registration form applies to them.
In 2021, scientists of the Russian Academy of Sciences (RAS) recognized homeopathy as a pseudoscience and came to the conclusion that its use in medicine “contradicts the main goals of domestic healthcare and should be met with organized government opposition.”
If you do not want to make a mistake, then before purchasing the medicine at the pharmacy, you should read the instructions and make sure that IFN is present in the composition. Trust reliable brands and pharmaceutical companies that have been known on the market for many years and have already won the trust of consumers.
Features of treatment with interferon drugs
Interferon drugs often cause a flu-like syndrome - fever, chills, weakness, muscle pain. This side effect is easily eliminated by taking paracetamol.
Inducers of interferon synthesis enhance the effect of antiviral, antibacterial and antifungal agents, which makes it possible to take them together.
Enisamium iodide contains iodine, so its use in patients with thyroid diseases can lead to an imbalance of thyroid hormones. Also, the presence of iodine in the composition of the drug is associated with such a side effect as a bitter, metallic taste in the mouth.
Drugs that act on the immune system: what is the difference?
Immune drugs refer to special drugs that are of biological, plant or synthetic origin and can affect the immune system. The strength of their influence depends on the initial state of human immunity. In addition to modulators, immune drugs also include immunostimulants and immunosuppressants.
Immunostimulants strengthen the body's defenses against a particular infection. Those. the body is forced to resist, significantly strengthening cellular and humoral immunity. A distinctive feature of these drugs is the indiscriminate action of the immune system - a “shake-up” of the immune system. That is why this group of drugs must be used under the strict supervision of a doctor.
Immunosuppressants are designed to suppress the immune response. After all, sometimes immunity does not work for a person’s benefit, and then autoimmune diseases develop, in which the body’s own immune system destroys organs and tissues of the body. Immunosuppressants are also used during organ transplants to prevent rejection.
Immunomodulators are drugs that can have a targeted effect on a person’s immunity: they can increase low levels and decrease high levels, thus bringing the defenses back to normal. This is their main difference from immunostimulants and immunosuppressants. Medicines containing interferon are indicated for identified immunodeficiency of any etiology, for the treatment and prevention of various infectious and inflammatory diseases. Already today, many doctors advise the use of antiviral drugs with interferon to prevent and treat COVID-19 infection, as indicated by the national guidelines of the Ministry of Health of the Russian Federation.
The main criterion according to which a doctor prescribes immunomodulators is the clinical picture of the disease, which manifests itself as a chronic infectious-inflammatory process. Immunomodulators are also used to prevent a number of diseases.
Interferon alpha 2 b as part of the antiviral drug VIFERON
The drug VIFERON is one of the antiviral drugs that have a wide spectrum of antiviral activity and help restore immunity. This drug contains recombinant interferon alpha-2b, which prevents the spread and reproduction of viruses in the body. It is identical to human interferon alpha-2b, which is synthesized naturally in human cells in response to foreign agents, but is produced using modern technology without the use of donor blood. Recombinant interferons belong to a group of antiviral drugs that are used for therapeutic and prophylactic purposes.
The drug in the form of suppositories is used in children and adults as part of complex therapy for the treatment of many diseases. When using the drug in the form of suppositories, the liver and stomach do not experience additional stress, which is very important for young children, people suffering from gastrointestinal diseases, including gastritis, as well as for older people.
It is worth noting that VIFERON does not belong to homeopathic remedies, but is a preparation of classical medicine. That is, to begin production, it had to go through all stages of clinical trials, as well as all kinds of quality checks (more than 250 indicators).
Interferon alpha 2b human recombinant as part of the drug VIFERON Gel
VIFERON Gel containing interferon alpha-2b is used for the prevention and treatment of acute respiratory viral infections, frequent and long-term acute respiratory viral infections, including those complicated by bacterial infection. In addition, the drug is used for the prevention and treatment of recurrent stenosing laryngotracheobronchitis - inflammation of the mucous membrane of the larynx and trachea, which leads to narrowing of the airway lumen and disruption of their functioning. When applied to the skin, mucous membrane and tonsils, the gel forms a thin protective layer, which prevents the penetration of viruses and also strengthens local immunity.
Also, the drug VIFERON Gel is used to treat acute and chronic herpetic infections of the skin and mucous membranes, including its urogenital form.
Interferon alpha 2 b as part of the drug VIFERON Ointment, instructions for use
VIFERON Ointment is an immunomodulatory and antiviral agent for external and local use. The ointment is produced in the form of a yellow or yellowish-white substance, viscous, homogeneous, with a specific odor of lanolin. The drug contains human recombinant interferon alpha-2b, tocopherol acetate, anhydrous lanolin, petroleum jelly, purified water and peach oil.
The drug VIFERON Ointment is used to treat ARVI, including influenza, as well as herpes of various localizations. For herpes (Herpes simplex types 1 and 2), the use of ointment leads to the complete disappearance of skin rashes.iii
Reference and information material
Shamsheva Daria Sergeevna
General practitioner, cardiologist, Ph.D.
Sources:
i
ii https://humbio.ru/
iii A.A. Khaldin, O.V. Chistik, D.V. Ignatiev “Herpes simplex: etiology, pathogenesis, diagnosis, treatment”, Practical Medicine No. 5, 2009
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Preparations containing interferon and the spectrum of diseases sensitive to IFN
The list of diseases sensitive to IFN is extremely wide. Conventionally, it can be divided into three large groups: viral diseases, cancer and other types of diseases.
For example, interferon drugs are used to treat diseases such as herpes. And in recent years, more and more studies have begun to appear devoted to studying the effectiveness of the use of IFN in the treatment of this disease. Research conducted by scientists confirms that the use of IFN as part of complex therapy accelerates clinical recovery and contributes to the disappearance of subjective and objective symptoms of the disease. ii There was a noticeable reduction in relapse times for herpes zoster and genital herpes, a decrease in discomfort and an increase in inter-relapse periods. This allows us to speak about the high effectiveness of IFN drugs and recommend their use in the practice of dermatovenerologists.
IFNs are also used for herpetic keratitis and keratoconjunctivitis, which leads to a decrease in severity and shorter duration of the disease.
IFNs are widely used in the treatment of acute respiratory viral infections, including colds and flu. Even if the disease is complicated by bacterial infection and pneumonia, IFNs can also help you recover faster. In addition, interferon therapy is used for sexually transmitted diseases, including gardnerellosis, ureaplasmosis, chlamydia, trichomoniasis, candidiasis, vaginosis, mycoplasmosis and other infections.
Almost 80% of existing medications are not suitable for treating newborns. But some IFN drugs are included in the 20% of approved drugs that can be used to treat recently born babies, including premature babies. As part of complex therapy for newborns, IFNs are used for inflammation of the membranes of the brain and spinal cord - meningitis, as well as for sepsis and various intrauterine infections.
IFNs are also used to combat the “gentle killer”. This is what hepatitis C is often called, which skillfully disguises itself as the symptoms of other diseases and, if left untreated, can be fatal. IFN preparations as part of complex treatment improve biochemical and histological parameters, helping to rid cells of the virus. They have a pronounced clinical effect, reduce the intensity and duration of the period of intoxication, reduce the frequency of deaths and normalize the functioning of the body.
Studies have shown that in acute hepatitis C and in patients requiring blood transfusions, interferon alfa-2b drugs improve the biochemical parameters of the liver and help cells fight the virus. IFN drugs are also used in the complex treatment of hepatitis B and D. According to studies, for hepatitis B, the combination of glucocorticoids and IFN alpha can reduce the amount of viral DNA in patient samples.iii
The effectiveness of the use of IFN has been proven for papillomavirus infections (genital warts, laryngeal papillomatosis, warts), purulent-septic diseases, cytomegalovirus infection, mumps and a number of other diseases.
And of course, the attention of all scientists in the world is focused on the development of drugs against cancer and HIV infection. For cancer, IFNs are used as adjunctive therapy, which helps combine the effects of immunity and chemotherapy or other treatment methods. For HIV, IFN drugs as part of complex treatment and in combination with anti-HIV drugs have an effect on the normalization of immunological parameters.iv
Any type of treatment, both with and without the use of IFN drugs, should be used only after consultation with the attending physician.
