Intern
ati
o
n
a
l
Jo
urn
a
l
o
f
P
u
b
lic Hea
l
th Science (IJ
P
HS)
V
o
l.3
,
No
.2
,
Jun
e
2
014
, pp
. 81
~86
I
S
SN
: 225
2-8
8
0
6
81
Jo
urn
a
l
h
o
me
pa
ge
: h
ttp
://iaesjo
u
r
na
l.com/
o
n
lin
e/ind
e
x.ph
p
/
IJPHS
Immunomodulat
ory E
f
f
e
cts of
Papain in Patient
s
with Cervical
Ectopies
Dilorom Mus
a
khodjae
v
a
1
, Nikadam
Nur
a
liev
1
, Nigo
ra
Fay
z
ulla
ev
a
1
, M
a
ru
f
Uy
lda
s
h
e
v
1
,
Rano S
a
bitova
1
, Gulna
r
a
Ya
ng
ieva
2
1
Immunomorph
olog
y
DPT,
Institute of Imm
unolog
y
,
Academ
y
o
f
Scien
c
e, Uzb
e
k
i
stan
2
Department of
Obstetrics
and G
y
necolo
g
y
,
Tas
h
kent M
e
d
i
ca
l Ac
adem
ia,
Uzbek
i
s
t
an
Article Info
A
B
STRAC
T
Article histo
r
y:
Received
J
u
n 28, 2013
Rev
i
sed
D
ec 20
, 20
13
Accepted Apr 26, 2014
The st
udy
detect
ed
t
h
at in
pat
i
ent
s
wi
th cer
vical
ec
topia
p
r
o
duc
tio
n of cy
tokine
s
(TNF
α
, IL-4
и
IL-10) w
a
s
s
i
g
n
i
f
i
c
a
n
t
l
y
a
l
t
e
r
e
d
.
The degree of chang
e
depended on
th
e presen
ce or
absence of
infection.
Conducted therap
y
with
herbal en
zy
me
- papain
contributed
to
th
e cu
pping
of inflam
mation
and
normalization o
f
the con
centr
atio
n of th
e stud
ied
cy
tokin
e
s.
Keyword:
Cervical ectopi
e
s
C
y
t
oki
nes
Enzym
e
Her
b
al
Papain
Copyright ©
201
4 Institut
e
o
f
Ad
vanced
Engin
eer
ing and S
c
i
e
nce.
All rights re
se
rve
d
.
Co
rresp
ond
i
ng
Autho
r
:
R
a
no
Sa
bi
t
ova
,
Institute of
Im
m
unology,
Uzbe
kistan Ac
adem
y of Scie
nce,
74
Ya
hy
o
G
u
l
y
am
ov, Tas
h
ke
nt
1
0
0
0
6
0
,
Uz
beki
st
a
n
.
Em
a
il: ran
o
s
abito
v
a
@yah
oo
.co
m
1.
INTRODUCTION
Hi
st
ory
of t
h
e
st
udy
o
f
cer
v
i
cal
ectopia (CE) goes
back t
o
a cent
u
ry,
but in rece
nt de
cades, t
h
is
pr
o
b
l
e
m
has att
r
act
ed i
n
c
r
easi
ng at
t
e
nt
i
o
n
.
T
h
i
s
di
sease
occ
u
rs i
n
10
-1
5%
of y
o
u
n
g
w
o
m
e
n an
d t
e
e
n
age
gi
rl
s
,
and
has
ne
gat
i
v
e i
m
pact
on
r
e
pr
o
duct
i
v
e
he
al
t
h
. M
o
st
ect
opi
c a
n
d ot
her
pat
h
ol
o
g
i
cal
c
h
an
ges i
n
t
h
e
cervi
x
are rec
o
rde
d
i
n
conjunction with sexu
ally tran
sm
it
ted
in
fect
io
n
s
[1
],[2
].
Changes in the vaginal e
nvi
ronm
ent and abnorm
a
l condition of the
surface layers
of cervical
ep
ith
eliu
m
facilitate th
e p
e
n
e
t
r
atio
n
of
v
i
ruses in
to
cells.
In
th
is con
n
e
ctio
n sp
ecial im
p
o
r
tan
ce tak
e
s infectio
n
with
hu
m
a
n
p
a
p
illo
m
a
v
i
ru
s (HPV),
b
ecau
s
e th
e p
e
rsisten
c
e o
f
its o
n
c
og
en
ic typ
e
s m
a
y l
ead
to
in
traep
ith
elial
n
e
op
lasia and
can
cer, p
a
rticularly cerv
i
cal can
cer. In
f
ection
with
p
a
tho
g
e
n
s
pop
illo
m
o
-v
iru
s
in
fection (PVI)
and t
h
e l
i
k
el
i
h
oo
d
of s
u
bseq
uent
devel
opm
ent
o
f
di
sease
i
s
l
a
rgel
y
det
e
r
m
i
n
ed by
t
h
e i
m
m
une st
at
us of t
h
e
o
r
g
a
n
i
sm
. In
tu
rn, th
e v
i
ru
ses
th
em
selv
es in
it
iate th
e fo
rm
at
io
n
of imm
u
n
e
d
e
ficien
cy th
at lead
s to
p
r
o
l
on
g
e
d
persi
s
t
e
nce of
t
h
e pat
h
oge
n
i
n
t
h
e
pat
i
e
nt
an
d t
h
e
rec
u
r
r
e
n
ce of
t
h
e di
sease [
3
]
,
[
4
]
.
M
e
di
at
ors of t
h
e imm
une resp
onse - cyt
oki
nes:
i
n
t
e
r
l
euki
n-2 and gam
m
a
i
n
terferoA pl
ay
a
cert
a
i
n
rol
e
i
n
t
h
e pat
hogenesi
s of cervical
ect
opias,
t
h
ey are proi
nfl
a
mm
at
ory
and ab
l
e
t
o
lim
it
t
u
m
o
r gr
owt
h
, and cyt
oki
nes
i
n
t
e
r
l
euki
n-4 and i
n
t
e
rl
euki
n-
10 are ant
i
-
i
n
flam
m
a
t
o
ry
cyt
oki
nes and, t
h
erefore, can st
imul
ate t
u
m
o
r growt
h
[2]
,
[3]
,
[6]
.
Treatm
e
nt of c
e
rvical erosi
o
n can
be
radical
and
conse
r
vati
ve. To im
prove the
quality it is necessa
ry
to
con
s
i
d
er th
e in
itial state o
f
i
m
m
u
n
ity, co
nco
m
i
t
an
t so
m
a
tic p
a
tho
l
og
y, t
h
e
p
r
esen
ce of
mix
e
d
o
r
co
m
b
in
ed
u
r
og
en
ital infectio
n
s
, as
well as th
e l
o
calizati
o
n
of
th
e p
a
tho
l
og
ical pr
o
c
ess [4
],
[5
],
[7
].
Evaluation Warning : The document was created with Spire.PDF for Python.
I
S
SN
:
2
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-88
06
I
J
PH
S
Vo
l.
3
,
N
o
.
2
,
Jun
e
201
4 :
8
1
– 86
82
In
conn
ection
with
th
e abo
v
e
, th
e p
u
rpo
s
e
of th
is st
u
d
y
was to
in
v
e
stig
ate th
e lo
cal lev
e
l o
f
pro-and
an
ti-in
flamm
a
t
o
ry (TNF
α
, IL
-4 a
n
d IL
-
1
0
)
cy
t
oki
nes i
n
wom
e
n wi
t
h
c
e
rvi
cal
ect
o
p
i
a
i
n
t
h
e
dy
nam
i
cs of
treat
m
e
n
t
with
th
e
en
zym
e
o
f
p
l
an
t o
r
i
g
in
- pap
a
in
.
2.
R
E
SEARC
H M
ETHOD
W
e
have cond
ucted cli
n
i
c
al and l
a
borat
or
y
exam
i
n
ati
on of
124 wo
m
e
n of
reproducti
ve ag
e who have
ap
p
l
ied
fo
r
ex
a
m
i
n
a
t
io
n
s
in
th
e th
ird
c
l
in
i
c
in
Ta
sh
k
e
nt M
e
d
i
cal
A
cadem
y (
T
M
A) and i
n
cluded:
m
e
dical hi
st
ory,
gyneco
log
i
ca
l
exa
m
ina
t
ion, c
o
lposcop
y
, ba
cter
ioscop
i
c
study
of vagi
n
a
l
d
i
sch
a
rge,
survey
on sexually
trans
m
itted
inf
e
ctions (po
l
ymer
ase
cha
i
n r
eac
tion, ELISA
, bact
er
i
o
l
ogical
exam
inati
on of vag
i
nal
secr
et
i
ons)
.
18
healt
h
y
wom
e
n
wer
e
i
n
con
t
ro
l group. The
st
ud
y
i
n
cl
uded
deter
m
in
ati
on of imm
u
n
e
st
at
u
s
level i
n
t
h
e
va
gi
n
a
l
di
s
c
ha
r
g
e o
f
i
n
t
e
rl
e
u
k
i
n (T
N
F
α
, IL-4
and
IL-10)
usi
n
g
reag
en
t
k
i
ts «Cyt
ok
i
n
e"
Lt
d
.
Sai
n
t
-
Peter
s
burg
b
e
for
e
and af
ter tr
eatm
e
n
t
.
I
m
m
u
no
l
o
g
i
cal
st
ud
ies
w
e
re condu
ct
ed
at t
h
e In
stit
u
t
e
o
f
I
mmuno
l
o
g
y
, Acad
em
y
o
f
Sciences
of
Repub
li
c
o
f
U
z
b
e
k
i
s
t
a
n
.
Math
em
at
ical
p
r
o
cessing
o
f
d
a
ta was carried
ou
t b
y
meth
od
s of v
a
ri
atio
n
statistics u
s
ing
stan
d
a
rd m
a
th
ematical so
ftware
p
ack
ag
es
wi
th
th
e
d
e
fin
ition
o
f
av
erag
e, it
s errors,
Stud
en
t's t test.
3.
R
E
SU
LTS AN
D ANA
LY
SIS
Age of
our
pat
i
e
nt
s ranged fro
m
18 t
o
38
y
e
ars, average age was 23,
7 ±
0,
66 y
ears. The di
agnosi
s
of
"
c
e
r
v
i
c
a
l
e
c
t
o
p
y
"
w
a
s
f
i
r
s
t
s
e
t
i
n
9
6
w
o
me
n
.
A
surv
ey
i
n
31
patien
t
s
r
e
veal
ed
a
hu
m
a
n
p
a
p
i
ll
o
m
a
virus
(HPV
)
.
Th
e do
m
i
n
a
n
t
po
siti
on
(51
.
6%)
hel
d
t
h
e 16
ty
pe, wh
i
c
h
corr
espond
s
t
o
t
h
e d
a
ta of
o
t
h
e
r
research
er
s. HPV
18
was
found
i
n
7
cases (22.6
%
), 31
i
n
5
(16.1
%
), 33
t
y
p
e
-3 (9
.7%)
.
The age of pat
i
ent
s
wit
h
a hi
story
of HPV sh
owed t
h
at
36.1
%
of wom
e
n were i
n
t
h
e age o
f
20, 2
9
.7% -
21-2
5
y
ears, 19.8% -
26-
30
y
ears, 14.4% -
31-
35 y
ears o
l
d. It
was obse
r
ved t
h
at
wi
t
h
i
n
creasi
ng age of t
h
e
observed decrease in
the inc
i
d
e
nce of HPV in
p
a
ti
en
ts wi
th
e
c
to
p
i
a o
f
th
e
ce
rv
ix
.
To anal
yze t
h
e resul
t
s
of t
r
eatm
ent
pat
i
ent
s
were di
vi
ded int
o
t
h
ree grou
ps:
I group
(2
8 wom
e
n) -
received conventional
treatm
en
t: va
ginal cleansing and chem
ical coagulation So
lkovagina; II group (42
pat
i
ent
s
) - recei
v
ed co
m
b
i
n
ed t
h
erapy (vaginal
cl
ean
si
ng and chem
ical
coagul
at
i
on and
candl
es Sol
kovagi
na
prokt
ozan) . Group I
II-(5
4 wom
e
n) recei
v
ed co
m
b
i
n
ed therapy
:
Vag
i
nal
,
d
i
at
her
m
ocoagul
at
i
on, hor
m
onal
contraception, and 5 days afte
r co
agulation - vaginal a
pplique plant enz
y
me
papain for 7-8
days.
The
s
u
r
v
ey
w
a
s c
o
nd
uct
e
d
be
f
o
re
t
r
eat
m
e
nt
,
at
t
h
e e
n
d
o
f
t
h
era
p
y
a
n
d a
f
t
e
r t
h
e
ne
xt
m
e
nst
r
ua
l
p
e
riod.
At t
h
e tim
e o
f
treatm
en
t was
reco
mm
en
d
e
d
th
e ex
cl
u
s
i
on of
sexu
al li
fe, and
t
h
en
- b
a
rr
ier
con
t
racep
tion for
t
h
e
p
e
r
i
od
of
ob
serv
ati
o
n and
con
t
r
o
l
test
s.
The dom
i
nance of T
h
1 cytokines is a
ssociated
with v
i
ral lo
ad.
Howev
e
r, several au
tho
r
s
dem
onst
r
at
ed t
h
at
t
h
e i
n
fl
am
m
a
t
o
ry
proces
s
i
n
t
h
e cervi
x m
a
y
i
nvol
ve t
h
e sim
u
l
t
a
neous
i
n
crease i
n
t
h
e l
e
vel
of
Th
1 a
n
d T
h
2 cy
t
o
ki
nes
[
2
]
.
We inv
e
stig
at
ed
th
e lev
e
ls
o
f
cytok
i
n
e
s in
th
e
v
a
g
i
n
a
l
secretio
ns of
wo
m
e
n
,
d
e
p
e
nd
ing
on
t
h
e
prese
n
ce or
a
b
sence of
HP
V in ce
rvical ectopy.
As can
be seen
from
Fi
gur
e 1,
t
h
e l
e
vel
of t
h
e st
udi
ed cy
t
o
k
i
nes was si
g
n
i
f
i
cant
l
y
di
ffere
nt
fr
om
t
h
e
cont
rol
gr
o
u
p
.
Th
us, t
h
e
pr
o
duct
T
N
F
α
, wh
ich
b
e
long
s t
o
th
e cytok
i
ne with
d
i
rect antiv
iral activ
ity
an
d is
pr
o
duce
d
by
N
K
- cel
l
s
i
n
pat
i
e
nt
s wi
t
h
C
E
was 1.
2
5
t
i
m
e
s hi
ghe
r t
h
a
n
i
n
t
h
e cont
rol
g
r
o
up (
P
> 0.
0
5
)
.
An
d i
n
t
h
e gr
o
up
of
p
a
t
i
e
nt
s wi
t
h
C
E
and
HP
V -
1
.
7 t
i
m
es hi
gher
t
h
an t
h
at
o
f
w
o
m
e
n i
n
t
h
e co
nt
r
o
l
gr
o
up
(P
> 0.
01
).
Id
en
tificatio
n
o
f
an
in
crease in
v
a
g
i
n
a
l
secretio
ns level o
f
TNF
sho
w
s t
h
e de
vel
o
pm
ent
of
l
o
cal
in
flammatio
n
.
It
shou
ld
b
e
n
o
te
d
th
at in
creased
lev
e
ls of TNF
wi
t
h
ect
o
p
i
a
am
ong
w
o
m
e
n agai
n
s
t
cervi
cal
HP
V
det
ect
ed i
n
63
%
of ca
ses
(a
n a
v
era
g
e
of
4
2
,
3
±
2,
8
vs.
24
,6
±
0
,
5
p
g
/
m
l
i
n
cont
rol
s
,
P> 0
,
01
),
w
h
e
r
eas
am
ong
w
o
m
e
n wi
t
h
ce
r
v
i
cal
ect
opi
a
wi
t
h
out
HP
V i
n
3
8
%
(
3
1
,
0
2
±
2,
6
pc
/
m
l
, P> 0.
0
5
)
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
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PH
S
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:
225
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0
6
Immuno
mod
u
l
a
t
o
r
y Effects o
f
Papa
in
i
n
Pa
tien
t
s with
Cervi
c
a
l
Ectop
i
es (
D
ilo
ro
m
Mu
sakh
od
ja
eva
)
83
Fi
gu
re
1.
Dy
na
m
i
cs of cy
t
o
ki
ne l
e
vel
s
i
n
va
gi
nal
fl
ui
d
o
f
wom
e
n s
u
r
v
ey
ed
(p
g /
m
l
)
As a res
u
lt of the release of TNF
, cap
illary p
e
rm
eab
ili
ty is in
creased, v
a
scu
l
ar en
do
th
eliu
m
is
d
a
m
a
g
e
d
,
in
trav
ascu
lar th
ro
mb
o
s
is arised
. In
add
itio
n
,
TNF
, p
e
rfo
rm
in
g
k
illin
g
of cells in
fected
with
th
e
virus, t
hus
causing
virem
i
a and inf
ection
of ne
w lym
phoc
ytes. Our
resul
t
s confirm
e
d by literature dat
a
show
t
h
at
t
h
e exp
r
es
si
on o
f
t
h
i
s
cy
t
oki
ne i
n
d
u
ces
vi
ruses
.
At
t
h
e sam
e
tim
e hi
gh c
once
n
t
r
at
i
ons
of t
h
i
s
cy
t
oki
ne
may increase i
n
flamm
a
tion, a
n
d run the
ac
tiv
atio
n m
ech
an
ism
s
o
f
apop
to
sis.
At
t
h
e sam
e
tim
e, we
st
udi
ed
t
h
e
level
s
of
infl
amm
a
t
o
r
y
cyt
oki
nes - IL-4
and IL-10 i
n
t
h
e v
a
gi
na
l
secr
et
i
ons of w
o
m
e
n
wit
h
cerv
i
cal
ect
opia. Th
e
l
e
vel of
i
n
ter
l
euki
ns had been elevated con
t
rol
val
u
es.
M
o
r
e
over,
wo
m
e
n wit
h
ect
opia of t
h
e cer
vi
x and HPV h
a
d l
e
vels of IL-4 hi
gher t
h
an cont
rol
val
u
es
at 1.66 t
i
m
e
s (P> 0.01).
IL-4 i
s
produced predo
m
i
n
antly
by
T
l
y
m
pho
cytes bel
ongi
ng
t
o
t
h
e Th2 subset
. The
m
a
i
n
f
uncti
on of IL-4
- i
s
t
h
e
cont
ro
l
of pro
l
iferati
on, di
ff
er
enti
ati
on and f
uncti
on of
B
-
lym
phocyt
es,
i
e
anti
bod
y
resp
onse. IL-4 r
e
d
u
ces
t
h
e
expressi
on of FcR
of all
t
y
p
e
s, t
hus
i
nhi
b
iting ant
i
bod
y
-
dependent
cyt
o
t
oxi
city
. IL-4 bl
o
c
ks t
h
e producti
on of
proi
nflamm
at
or
y
cy
t
o
k
i
nes,
w
h
i
l
e i
n
cr
easi
ng t
h
e
producti
on
of G-C
SF and
M
-
C'SF, as w
e
ll
as t
h
e producti
on of
superoxi
de r
a
dical
s
and PGE2, and also st
im
u
l
ates
t
h
e producti
on of PAF.
I
t
h
a
s
a
l
o
c
a
l
a
n
t
i
-
t
u
mo
r
a
c
t
i
v
i
t
y
.
I
t
s
elevated le
vels observe
d
in many infla
m
m
a
tory
pr
ocesse
s i
n
t
h
e
o
r
gani
sm
[
5
]
.
An
alysis of th
e resu
lts
o
f
t
h
e
stu
d
y
th
e lev
e
l o
f
IL-10 s
h
owed it increase
d
in wom
e
n with ectopia
of
t
h
e cer
vi
x
,
whi
c
h
on
ave
r
a
g
e
am
ount
e
d
t
o
1
6
,
3
±
1
,
0
p
g
/
m
l
(P> 0.
0
5
)
,
but
i
n
wom
e
n
wi
t
h
C
E
a
g
ai
n
s
t
HP
V
l
e
vel
s
of I
L
-
1
0
was 2.
4 t
i
m
es
hi
g
h
er t
h
a
n
i
n
t
h
e co
nt
r
o
l
gr
o
u
p
(P>
0.
00
1
)
and
1.
7 t
i
m
e
s hi
ghe
r t
h
a
n
i
n
w
o
m
e
n
with
CE (P>
0
.
0
5
). It is kno
wn
t
h
at th
e
activ
ity o
f
IL
-10 is
us
ually associated wit
h
t
h
e s
u
ppress
ion of
an
tiv
iral imm
u
n
ity, lead
ing
t
o
chronic
diseas
e [2].
In s
u
ch a way
in all groups of wom
e
n with CE re
vealed an increase
d
synt
hesi
s o
f
cy
t
oki
nes
,
bu
t
in
creasing
severity d
e
p
e
nd
ed on
th
e ex
ten
t
o
f
lesi
o
n
s
of
t
h
e cerv
i
x.
It is p
r
ecisely th
is
in
ab
ility to
d
e
v
e
lop
a
bal
a
nce
d
p
r
o
-
i
n
fl
am
m
a
t
o
ry
cy
t
oki
nes seem
t
o
pl
ay
a si
gni
f
i
cant
rol
e
i
n
t
h
e
m
a
i
n
t
e
nance
or
pr
o
g
ressi
on
of t
h
e
CE and dete
rmines the characteristics of
orga
nism
s
that
su
pp
ort th
e in
flamm
a
to
ry p
r
o
cess. T
h
e
r
e
s
u
l
t
s
o
f
st
ud
i
e
s
conducted
af
t
e
r t
h
e t
r
eatm
en
t
showed that
t
h
e t
r
ea
tm
e
n
t
wit
h
pap
a
i
n
the heal
i
ng was
observed for 14 days,
whereas w
i
t
h
traditi
onal
t
h
er
apy
and co
m
p
ari
s
on group on
t
h
e 30t
h day
.
In addi
ti
on to t
h
e cl
i
n
i
cal
effect
(reducti
on of
em
issi
ons af
ter
coagulat
i
on,
t
h
e absence of
p
a
i
n
), C
o
l
posco
pi
c p
i
ct
ur
e of
the regen
e
rati
on of t
h
e
cerv
i
x
was m
o
re
pronounced i
n
t
h
e co
m
b
i
n
ed
t
h
er
apy.
A
n
a
l
y
s
i
s
o
f
r
e
p
e
a
t
e
d
s
t
u
d
y
o
f
c
y
t
o
k
i
n
e
l
e
v
e
l
s
i
n
p
a
t
i
e
n
t
s
with ect
opi
a
of the c
e
rvi
x
a
f
te
r treatm
e
nt showe
d
t
h
at a
ll t
r
eatm
en
ts h
a
d
an im
p
act on
the con
c
en
t
r
ati
o
n
of the
stud
ied
cytok
i
nes. Th
er
e have b
e
en
so
m
e
ch
ang
e
s. How
e
v
e
r
,
th
e m
o
st p
r
onoun
ced
chang
e
s w
e
re ob
serv
ed in
th
e
com
p
lex therapy wit
h
pa
pai
n
.
As can be see
n
from
T
a
ble 1, there was
a
ten
d
e
n
c
y
to
d
ecre
a
s
e
th
e
lev
e
l o
f
TNF
α
i
n
t
h
e group of
pati
en
t
s
recei
v
ing standard
t
r
eatm
en
t
(group 1). And t
h
e wo
m
e
n
i
n
group 2 who recei
v
ed co
m
b
i
n
ed t
h
erap
y
(vagi
n
al
cl
ean
sing and chem
ical
co
agulat
i
on
and candles So
lkovagi
na proktozan TNF
α
concen
tra
t
ions
de
c
r
eas
ed
Evaluation Warning : The document was created with Spire.PDF for Python.
I
S
SN
:
2
252
-88
06
I
J
PH
S
Vo
l.
3
,
N
o
.
2
,
Jun
e
201
4 :
8
1
– 86
84
by
1.2 t
i
m
e
s (
P
<0.05), whereas
i
n
wo
m
e
n
recei
v
i
ng co
mbi
n
ed t
h
er
ap
y
wi
t
h
t
h
e i
n
cl
u
s
i
on of papai
n
TNF
α
decreased by
1.3 tim
es (
Р
<0,05).
T
a
b
l
e
1
.
Dy
n
a
m
i
cs of cyt
oki
ne
level
s
i
n
t
h
e vag
i
nal
secreti
ons of
surveyed wo
m
e
n
(
М
±m
)
Cy
t
o
ki
ne
s,
pg
/m
l
C
ontr. Gr
oup
Be
fo
re
trea
t
m
ent
P
a
ti
en
ts
af
t
e
r
t
r
ea
tme
n
t
Group
1
Group
2
Group
3
TNF
α
2
4
,
8
±
1
,
2
31,
0
±
1,
6*
30,
7
±
1,
5*
29,
1
±
0
,
9
*
^
26,
3
±
1
,
1
*
^
I
L
-
4
7,
3
±
0
,
6
1
3
,
5
±
0
,
8
*
11,
2
±
0
,
7
*
10,
3
±
0,
8*^
9,
4
±
0,
7*^
I
L
-
1
0
11,
7 ±
0
,
8
23,
7 ±
1,
1*
21,
6 ±
1,
1*
19,
2 ±
1,
0*^
14,
9 ±
0,
8*^
Note
:*
- the
d
i
ffer
e
nc
e is clear
and
s
i
gn
ifican
t to the contro
l
group
^-
t
h
e d
i
ffer
e
nce
i
s
cl
ear and
si
gn
i
f
i
c
ant
t
o
group before
t
r
eatm
e
n
t
(
Р
<0,05 – 0,0
01)
In
all
group
s,
on
e m
o
n
t
h
af
ter
t
r
eatm
en
t was
ob
serv
ed
r
e
du
cti
o
n
of
an
ti
-
i
nf
lamm
ato
r
y cyt
o
k
i
n
e
s (IL-4
and
I
L
-10). In
t
h
e Ist g
r
oup
t
h
e
change
i
n
concentr
ati
o
n
of
IL-4 and
IL-10
w
a
s no
t si
gn
ifican
t
.
Th
is r
a
ti
o
i
s
li
kely
to
ind
i
ca
te
a
la
ck
of
e
ffe
c
t
iv
e th
er
ap
y and
ma
y
b
e
a
pred
is
posi
n
g fact
or for
t
h
e de
vel
o
pm
ent of re
c
u
rre
n
t di
s
eas
e.
W
h
i
l
e
in
th
e
g
r
o
u
p
o
f
p
a
t
i
en
t
s
i
n
wh
o
m
t
r
e
a
t
me
n
t
w
a
s
co
n
n
ect
e
d
w
i
th
Pap
a
in
,
,
th
ere
w
a
s
a
s
i
g
n
if
i
can
t
r
e
d
u
c
ti
o
n
in
inflam
m
a
to
ry
cytok
i
n
e
s (
Р
<0,01).
I
m
p
l
em
entati
on of cont
rol
cli
n
i
cal
and
l
a
boratory
ex
a
m
i
n
ati
o
ns, whi
c
h
i
n
cl
u
d
ed detecti
on of HPV and
colposcopy
sho
w
ed that in group III, HPV
is found in 2
pa
tient
s
, ie
the effectiven
e
ss of therapy
was 93.5
%
. In
Group II t
h
ere
were 9 posit
i
v
e sam
p
l
e
s,
t
h
e
ef
fi
ciency
- 71.8
%
.
W
i
t
h
c
o
l
p
os
co
py
c
o
m
p
l
e
t
e
epi
t
h
e
l
i
a
l
i
zat
i
o
n
o
f
t
h
e
wound
surf
ace w
a
s observ
e
d
i
n
28 p
a
ti
en
ts o
f
group I
II
and
25
- I
I
group
.
Rep
e
ated d
e
st
ructi
o
n
of
t
h
e
ect
op
i
c
sit
e
s
w
a
s carr
ied ou
t
to on
e p
a
ti
en
t
i
n
G
r
oup III
and
5 -
i
n
group
II.
4.
CO
NCL
USI
O
N
Therefore, treatment of cervic
a
l ec
t
opy
wi
t
h
t
opi
cal
papai
n
in t
h
e co
m
p
lex therapy is pathogenetically
just
i
f
i
e
d and hi
g
h
l
y
prom
i
s
i
ng.
C
o
m
b
i
n
ed t
h
erapy
has si
gni
fi
cant
ant
i
-
i
n
fl
ammat
o
ry
and im
m
u
nom
odul
at
ory
effect
s,
contributes to the acceleration
of reparative proce
sses.
REFERE
NC
ES
[1]
B
o
r
z
e
n
k
o
E
.
V
.
, Simkina T. V., “The effectiveness of
the met
hod of argon-plasma coagulatio
n for treatment
of
benign diseases
of the cerv
i
x”, P
r
oceed
ings of the Russian Natio
nal Congress "Man and m
e
dicin
e
. Ural 2007, in t
h
e
Journal of Med
i
cal S
c
ien
c
e and
Education
of th
e Urals
, 2007.
[2]
Kashuba E. A.,
B
o
r
z
e
n
k
o
E
.
V
., Kurlovich N. A., “Spont
aneous and stimulated pr
oduction of
cy
to
kines of cerv
i
cal
secret
ions in wom
e
n with abnor
m
a
l cervi
cal
”, Pr
oceed
ings
of the
Interna
tiona
l C
ongress of Reha
bilit
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i
c
i
ne
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im
m
unorehabilit
ation
,
in the
journal Allergy
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.
[3]
B
o
r
z
e
n
k
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E
.
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the
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a
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e
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h
e
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” Proceed
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ngs of th
e
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ation
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l
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[4]
Prilepskay
a
V.
N., Rud
a
kova E. B.,
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erosio
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pp. 175
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[5]
Yur
y
ev
S. Yu., Chernecova N. A.,
Kurlovich
N. A., B
o
r
z
e
n
k
o
E
.
V
.
,
“Immunological p
a
rameters of
cervical
s
ecret
ions
in pat
i
ents
with
ectop
i
a
of the
cerv
i
x
with concomitan
t genita
l infectio
n
patholog
y
”
,
M
e
dica
l Science a
n
d
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e Urals,
pp. 14-1
7
, 2009
.
[6]
Ca
uc
i S.
, Gua
s
chi
no S.
, Dri
u
ssi
S.
,
e
t
a
l
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,
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e
c
t
Di
s
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. 1614-1
620, 2002
.
[7]
Shay
kov K.
L.,
“Sta
tus of loca
l immunity
of the
c
e
r
vix
in infl
a
mma
tory
dise
a
s
e
s
of the
pelvic orga
ns a
nd me
thods of
its corr
ection b
y
kipferon
immun
o
modulator: Abs
t
ract”,
th
esis
, C
a
ndidat of medical sciences
, pp
. 2
4
, 2004
.
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I
J
PH
S
I
S
SN
:
225
2-8
8
0
6
Immuno
mod
u
l
a
t
o
r
y Effects o
f
Papa
in
i
n
Pa
tien
t
s with
Cervi
c
a
l
Ectop
i
es (
D
ilo
ro
m
Mu
sakh
od
ja
eva
)
85
BIOGRAP
HI
ES OF
AUTH
ORS
Dilorom Musakhodjaev
a, Doctor of
Biolo
g
ical Science is th
e Chief of
th
e
Im
m
uno
m
o
rphol
og
y
DPT of t
h
e Institut
e
of
Im
m
unology
,
Uzbekistan’s A
cadem
y
of
Sc
ie
nce
.
He
r sc
ie
ntific
inte
re
sts a
r
e
in the
funda
me
nta
l
a
nd a
pplie
d immunology
,
immunophisiolog
y
,
immune mechanisms of in
flammation, develo
ping
tumors and ophalmic
diseases, endocr
i
nolog
y
,
r
e
produ
ctiv
e
and
ped
i
atr
i
c immunolog
y
as
well.
Phone: +998
71
2330113 (of)
e
-
ma
i
l
:
di
ly
m@xne
t
.
uz
Dr.
Nikadam Nuraliev,
M
D
,
Doctor o
f
M
e
dica
l S
c
i
e
nc
e,
is
a
m
e
m
b
er of
th
e
Immuno
morphol
og
y
DPT stud
y
team. He has
scie
ntific in
ter
e
sts in the fundamental an
d
appli
e
d im
m
unolog
y
as well
. To
gether with the s
c
ien
tifi
c
work he is engaged in the tea
c
hing
work within
Tas
hkent Med
i
ca
l A
cadem
ia
.
Dr. Nigora Fay
z
u
l
laeva, MD, Candidate of
M
e
dica
l S
c
ie
nce,
the m
e
m
b
er of the
Immuno
morphol
og
y
Dep
e
rtment stud
y
team an
d
immunologist with number of y
e
ars with
clinical and
scientific exp
e
rien
ce. Her scientific interests in
clinical immunolog
y
,
especially
in m
a
tern
al
and
child
hea
lth
Dr. Maruf Yuld
ashev, MD,
the
member of th
e I
mmuno
morphol
og
y
Dep
e
rtment
stud
y
team
.
He has number of
y
e
ars of clinical exp
e
ri
en
ce, pr
acticing
g
y
necolog
y
and
providing
screening
services for early
d
e
tection of
th
e ce
rv
ical neop
lasia.
He
is plann
i
ng to conduct
a
com
p
rehensive
stud
y
on
c
e
rvic
al n
e
oplasi
a
.
Hi
s scient
ific
int
e
rests in fund
am
enta
l an
d
apllied immunolog
y
.
Rano Sabitov
a
,
MD, MPH, is a public h
e
a
lth
s
p
eci
alist wi
th e
x
tensive
exper
i
e
n
ce of th
e
nation
a
l health r
e
form
that curr
entl
y
join
ed th
e r
e
search
team
of the Institu
te of I
m
m
unology
of the Uzb
e
kis
t
an Acad
em
y
of
S
c
ienc
e.
S
h
e is
a gradu
a
t
e
of
t
h
e Tas
h
k
e
nt S
t
a
t
e M
e
di
ca
l
Institute (MD, 1
988) and the Universit
y
of
Ari
z
o
n
a (MPH, 2006)
She is cooperati
ng with the
stud
y
team of th
e Immunomorph
ol
og
y
DPT as
well for
the r
e
sear
ch on
the cervical ectopia.
Evaluation Warning : The document was created with Spire.PDF for Python.
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:
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06
I
J
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S
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l.
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,
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o
.
2
,
Jun
e
201
4 :
8
1
– 86
86
Gulnara Yangieva, MD, Candidate
of Medical Science, is
experien
ced obstetrician and
g
y
ne
colog
i
s
t
, th
e le
ctur
er of
Tas
hkent M
e
d
i
cal Ac
adem
ia
.
S
h
e is
coll
abor
ating wi
th
Im
m
uno
m
o
rphol
og
y
Depertm
e
n
t
of the Institu
te of Imm
unolog
y
on resear
ch concerning
women’s health/ cervical ectopia matters. Her
scientific in
teres
t
s in applied immunolo
g
y
with s
p
ec
ial
em
p
h
as
is
on wom
e
n’
s
canc
e
rs
.
Evaluation Warning : The document was created with Spire.PDF for Python.