Вакцинопрофилактика является самым эффективным способом снижения уровня заболеваемости. Однако выраженность иммунного ответа, развивающегося после введения большинства инактивированных вакцин, недостаточна при их использовании без адъювантов. Особого внимания заслуживает вопрос иммунопрофилактики лиц с нарушением иммунного статуса, относящихся к группе повышенного риска. Оптимизировать развитие протективного иммунитета при вакцинации лиц со сниженной иммунологической активностью можно при использовании соответствующих адъювантов при вакцинации. В качестве потенциальных иммуноадъювантов можно рассматривать цитокины, которые регулируют в организме каскад иммунных реакций на любое антигенное воздействие и оказывают влияние на развитие антигенспецифического иммунного ответа. В настоящем обзоре представлен краткий анализ результатов изучения иммуноадъювантных свойств цитокинов, используемых для повышения эффективности вакцин календаря прививок и вакцин, вводимых по эпидемическим показаниям.

One of the most complicated issues of modern medicine is diagnosis, treatment and prevention of rare diseases. In the structure of rare diseases the vast majority accounts for genetically determined disorders. The introduction of genetic testing methods helped to identify a lot of hereditary diseases, that currently reach the number of 8,000 cases and according to estimations the frequency of their detection is about to increase. Medicinal products for diagnosis or treatment of rare diseases form the group of orphan drugs. Biologicals are the most effective medicinal products in the whole group, due to their ability to bind specifically with the «target receptor», which allows to use them as targeted drugs. Another advantage of biologicals, compared with preparations of chemical origin, is their low toxicity. Orphan drug provision is the most severe issue because the treatment of severe forms of rare diseases may require the prescription of an expensive drug. Manufacturing of orphan drugs may be unprofitable for the reason of the low prevalence of rare diseases. Therefore, the availability of orphan drugs for patients depends on the amount of state participation in manufacture stimulation. In various countries regulatory requirements for the recognition of a disease as a rare disease, and marketing authorization procedures for orphan drugs are developed with due regard to the social and economic characteristics of the country. The article presents the analysis of the regulatory requirements for various countries for the detection of rare diseases, and a common approach to marketing authorization procedure for the drugs used in treatment of rare diseases, exemplified by biological orphan preparations.

The paper gives consideration to the adjuvant properties of cytokines studied by using experimental models. They induced immunogenic activities by means of rabies vaccine. Combined with a complex of recombinant cytokines, the vaccine exhibited the most noticeable effects. Augmenting immune response was observed in parallel to high-level virus neutralizing antibody formation. The immunoadjuvant effects were observed when using recombinant interleukin-lb and tumor necrosis factor-α for monodrug therapy and Polyoxidonium. The research results were indicative of the possibility to apply cytokines and other immune-response modulating drugs as adjuvants capable of increasing immunogenic activities of the vaccines and highlight promising opportunities of researching into new approaches to immune response control.