Abstract. The issue of chronic adenoiditis, due to its medical and social significance, is in focus of attention for otolaryngologists, pediatricians, immunologists. According to various works, chronic adenoiditis in children comprise 20 to 56% of upper respiratory diseases. Chronic adenoiditis is characterized by relative resistance to conventional therapy, and, in pronounced cases, by low reversibility of pathological events. The studies performed have shown that the patients with chronic adenoiditis show some features of local and general immune deficiency that were exhibited as decreased serum IgA concentration and local sIgA secretion, as well as insufficient income of IgG from vascular system to the area of inflammation in patients with chronic adenoiditis. These local immune deficiencies were considered to be an indication for local immunotherapy. Dynamics of clinical symptoms and changes in immunoglobulin profile has shown that clinical efficiency of Imunofan therapy was dependent not solely on the initial clinical features of disease, but on the local immunity state. Analysis of initial immunoglobulin concentrations in nasopharyngeal lavage from the patients showing differential clinical response have demonstrated that therapeutic effect of Imunofan was most pronounced in the patients with initially moderate activity of inflammatory process, deficient IgG income from vascular system, decreased local IgA synthesis in the inflammatory foci. Certain clinical features of chronic adenoiditis, i.e., clinical course without hypertrophy of pharyngeal tonsils, local immune deficiency (decreased local IgA secretion and deficient IgG income from blood), with a background of moderate inflammatory events, may be used as a rationale for administration of local immunotherapy with Imunofan to these patients. (Med. Immunol., 2008, vol. 10, N 6, pp 551-562).

Abstract. Since decades, the aspects of chronic adenoiditis draw attention of specialists in ORL. From different data, prevalence of chronic adenoiditis is 20 to 56 per cent among children with diseases of upper respiratory ways. Chronic adenoiditis is relatively resistant to conventional therapy, and irreversible clinical course is revealed in more severe cases. The studies performed have shown that the patients with chronic adenoiditis exhibit signs of local immune deficiency that manifested into decreased local secretion of IL-4, IL-10 and GM-CSF, thus being considered as an indication for local immunocorrection procedures. To this purpose, we used Imunophan as a spray for intranasal application. Dynamics of clinical symptoms and local immune parameters showed that the efficiency of Imunophan treatment was dependent of both initial clinical features of the disorder, and on cytokine levels in oropharyngeal lavages. Therapeutic effect of Imunophan was more expressed in the patients with initial predomination of Th1 immune response and cell-type immune reactions in the area of inflammation. A set of certain clinical and laboratory data, i.e., absence of enlarged pharyngeal glands, predominance of local Th1 type response and cellular type of immune response may be used for monitoring before administration of local immunotherapy with Imunophan in the patients with chronic adenoiditis. (Med. Immunol., 2008, vol. 10, N 2-3, pp 261-268).