IMMUNOLOGY TEXTBOOK - Merkury Podillia 2013

BASIC PRINCIPLES OF IMMUNODEFICIENCY TREATMENT

Immunorehabilitation

Immunorehabilitation (IR) represents a comprehensive set of immunological, immunocorrective, social, ecological, and biomedical preventive measures aimed at restoring (normalizing, achieving Clinical and immunological remission, eliminating or minimizing relapses in chronic conditions) altered immunological reactivity in an individual patient, a population, or a specific demographic group.

Specialized immunorehabilitation is indicated for diseases whose Pathogenesis is dominated by immunopathological symptoms (autoimmune and immunodeficiency disorders), for which immunocorrection Methods serve as the primary therapeutic approach.

Applied immunorehabilitation is employed for all other conditions where baseline therapy is required.

A comprehensive immunorehabilitation program includes the following stages:

- Clinical stage (14-45 days) - baseline immunorehabilitation utilizing immunocorrection methods aimed at restoring immune system Functions;

- Outpatient stage (up to 3 years) - restorative immunorehabilitation focused on relapse Prevention;

- Sanatorium-resort stage - supportive immunorehabilitation administered following the resolution of clinical symptoms.

Individual immunorehabilitation targets immunocompromised patients to restore reactivity, or allergic patients to reduce hypersensitivity.

Population immunorehabilitation aims to restore The Immune System of a population group. This approach can be applied to workforces in industrial environments characterized by occupational hazards that lead to altered reactivity, or immunomodulation. Such collective IR is closely linked to social IR, which entails a set of measures aimed at improving working conditions and social protection. Immunorehabilitation is particularly vital for populations residing in ecologically vulnerable regions, such as the Chornobyl zone, the Semipalatinsk test site, and other radionuclide-contaminated areas.

Ecological immunorehabilitation involves mitigating the immunotropic EFFECTS OF ENVIRONMENTAL factors that induce transient immunomodulation in healthy individuals and persistent immunomodulation in patients, manifesting as immunodeficiencies, allergies, autoimmune diseases, and lymphoproliferative syndromes. Therefore, environmental remediation measures targeting air, Water, and vegetation, alongside the provision of ecologically clean food, form the foundation of ecological IR. Relocation or change of environment, particularly for sensitive individuals, for a sustained period constitutes a key measure for the ecological immunorehabilitation of the body. When combined with improved socio-economic living conditions and health-promoting systems, these measures serve as the basis for comprehensive immunorehabilitation. In some cases, such interventions are sufficient to reverse transient, short-term adverse immunomodulatory effects.

However, in cases of persistent immunomodulation complicated by clinical manifestations of infectious, inflammatory, or allergic diseases, an additional regimen of both non-pharmacological and pharmacological interventions is required, implemented through evidence-based immunorehabilitation protocols.

The administration of immunocorrective and immunomodulatory agents must be justified by both clinical and laboratory findings from the patient's evaluation. Initially, it is preferable to use plant-derived agents, such as echinacea preparations and adaptogens, which can be combined, when necessary, with thymic immunomodulators that typically present a low risk of complications.

Each age group requires tailored approaches to immunotherapy and immunorehabilitation, reflecting the distinct characteristics of age-related immunopathology: congenital immunopathology and immunodeficiencies manifesting as viral-bacterial infections in children; Specific features of ongoing immune system maturation and modulation during adolescence; occupational and environmental pathologies in middle age; and systemic, somatic, and combined disorders in the elderly.