Seven thousand troubles – one answer
Immunotherapy will help in the treatment of many diseases
About seven thousand diseases can be found in modern medical reference books. Are there really so many mechanisms for the occurrence of various diseases? No, of course, it just can't be. But we persistently make thousands of diverse diagnoses with the aim of "more successful therapy". However, these diseases are divided into several large groups: atherosclerosis, oncopathology, autoimmune, allergic, infectious diseases, injuries, chronic diseases of inflammatory genesis (essentially secondary immunodeficiency). Finally, aging should be highlighted in a separate line, because this process can and should be treated.
Over the past 20-25 years, convincing and irrefutable evidence has accumulated that the pathogenesis of all these diseases (in the case of injuries, this refers to post-traumatic complications) is based on numerous and multi-tiered disorders of the immune system. Let's start with allergies. In the corresponding register, the specialty of the doctor is listed as "allergist-immunologist". The title recognizes that the pathogenesis of allergic diseases is based on disorders in the immune system. And if we take into account that currently almost every third inhabitant of the planet has some kind of allergy, then this is enough to study the pathogenesis and methods of immunocorrection.
There are more than 80 different forms of autoimmune diseases. But they are treated by... rheumatologists. Although it was immunology that made it possible to understand the mechanisms of development of these diseases and to develop fundamentally new treatment methods based on immunopathogenesis and the use of immunomodulatory drugs, which dramatically increased the effectiveness of the therapy. Not the last place here should be occupied by methods of cellular immunotherapy.
The social significance of the problems of oncopathology is great. It should be clearly understood that the main role in the pathogenesis of cancer is played by cells of the immune system. Only they have the ability to kill tumor cells, which they do in many cases. And only the suppression of the antitumor activity of cells of the immune system is the cause of the clinical manifestation and growth of malignant neoplasms. Therefore, their treatment should be based on immunotherapy methods aimed at stimulating the cytotoxic activity of immunocompetent cells and suppressing the activity of suppressor cells.
Atherosclerosis and its main complications – myocardial infarctions and brain strokes – are also closely associated with impaired functions of the body's immune system. The same can be said about post-traumatic complications and infectious diseases. By the way, all vaccines only induce a persistent specific immunity in the body. This applies equally to influenza, COVID-19, and Ebola.
Thus, it should be recognized that all major diseases of modern man develop as a result of immunopathology. Moreover, disorders in the immune system are caused by general biological processes: a decrease in telomere length, an increase in the level of free, extracellular DNA in peripheral blood, an increasing level of DNA hypomethylation, an increase in cellular apoptosis, an intensification of the process of homeostatic proliferation. Each of these general biological processes makes a significant contribution to the gradual formation of the human immunodeficiency state, which becomes the basis for the pathogenesis of subsequent diseases.
Accordingly, the basic methodology for the treatment of most diseases can be immunotherapy, primarily cytokines and other biologically active substances produced by different cells of the immune system; monoclonal antibodies that allow "pinpoint" attacks on specific molecules involved in the pathogenesis of a particular disease; finally, the cells of the immune system themselves. Technologies based on the use of immunocompetent cells should become a priority in the treatment of all major human diseases, and not only in oncology, where they are now recognized as the most promising methods of treating tumor processes.
First of all, the molecular-cellular arsenal should be used in the diagnosis of the most socially significant diseases. Thus, using immunodiagnostic methods, the condition of patients who have undergone COVID-19 should be assessed in order to provide for the possibility of complications and prescribe appropriate therapy. Every disease leaves traces in the human body. Unfortunately, we have not yet learned how to fully fix these traces, but we should.
Already today, a number of post-ovoid complications are being registered, the most severe of which is autoimmune pathology in its various manifestations. Given the disorders in the immune system in numerous patients, we can expect a kind of epidemic of oncological diseases in 15-20 years.
But there is no need to be limited to diagnostics, protocols for the treatment of chronic diseases should also be developed, taking into account immunotherapy. In the shortest possible time, it is necessary to change the direction of the pharmaceutical industry, since in Russia there are practically no preparations made from cytokines and monoclonal antibodies. But it is they who are beginning to occupy a leading place in world practice. If we don't do it at home, we will be left without the latest medicines.
The situation is also extremely difficult with equipment, without which neither the development of fundamental immunology nor the application of its achievements in clinical practice is unthinkable. Moreover, a country with a developed chemical industry does not produce the simplest consumables!
Taking into account the above, it is necessary to consider the possibility of changing the principles of teaching immunology in medical universities and faculties of biomedical profile. It is necessary to think about revising the nomenclature of medical specialties and, most importantly, about changing the specialization of departments in hospitals and medical centers. In my opinion, appropriate decisions should be taken at the level of the Russian Academy of Sciences, the Ministry of Science and Higher Education, and the Ministry of Health in the near future. I wouldn 't be late…
Vladimir Kozlov,
Scientific Director of the Research Institute of Fundamental and Clinical Immunology (Novosibirsk), Academician of the Russian Academy of Sciences
Portal "Eternal youth" http://vechnayamolodost.ru