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<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="review-article" dtd-version="1.2" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">Russian Journal of Biotherapy</journal-id><journal-title-group><journal-title xml:lang="en">Russian Journal of Biotherapy</journal-title><trans-title-group xml:lang="ru"><trans-title>Российский биотерапевтический журнал</trans-title></trans-title-group></journal-title-group><issn publication-format="print">1726-9784</issn><issn publication-format="electronic">1726-9792</issn><publisher><publisher-name xml:lang="en">Publishing House ABV Press</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">1625</article-id><article-id pub-id-type="doi">10.17650/1726-9784-2026-25-2-32-50</article-id><article-categories><subj-group subj-group-type="toc-heading" xml:lang="en"><subject>REVIEWS</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="ru"><subject>ОБЗОРЫ ЛИТЕРАТУРЫ</subject></subj-group><subj-group subj-group-type="article-type"><subject>Review Article</subject></subj-group></article-categories><title-group><article-title xml:lang="en">The effectiveness of recombinant interleukin-2 preparations in secondary immunodeficiency developing in destructive pulmonary tuberculosis. Systematic review</article-title><trans-title-group xml:lang="ru"><trans-title>Препараты рекомбинантного интерлейкина 2 в лечении вторичной иммунной недостаточности при деструктивном туберкулезе легких: систематический обзор</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5751-215X</contrib-id><name-alternatives><name xml:lang="en"><surname>Kozlov</surname><given-names>Viktor K.</given-names></name><name xml:lang="ru"><surname>Козлов</surname><given-names>В. К.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>Viktoriia.Stelmakh@szgmu.ru</email><xref ref-type="aff" rid="aff1"/><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7942-1227</contrib-id><name-alternatives><name xml:lang="en"><surname>Stelmakh</surname><given-names>Viktoriya V.</given-names></name><name xml:lang="ru"><surname>Стельмах</surname><given-names>Виктория Валерьевна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>Viktoriia.Stelmakh@szgmu.ru</email><xref ref-type="aff" rid="aff3"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-9694-5687</contrib-id><name-alternatives><name xml:lang="en"><surname>Kozlov</surname><given-names>Ivan G.</given-names></name><name xml:lang="ru"><surname>Козлов</surname><given-names>И. Г.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>Viktoriia.Stelmakh@szgmu.ru</email><xref ref-type="aff" rid="aff4"/></contrib></contrib-group><aff-alternatives id="aff1"><aff><institution xml:lang="en">Scientific and Clinical Center of Toxicology named after Academician S. N. Golikov, FMBA of Russia</institution></aff><aff><institution xml:lang="ru">ФГБУ «Научно-клинический центр токсикологии им. академика С. Н. Голикова» ФМБА России</institution></aff></aff-alternatives><aff-alternatives id="aff2"><aff><institution xml:lang="en">Saint Petersburg State University</institution></aff><aff><institution xml:lang="ru">ФГБОУ ВО «Санкт-Петербургский государственный университет»</institution></aff></aff-alternatives><aff-alternatives id="aff3"><aff><institution xml:lang="en">Mechnikov North-West State Medical University, Ministry of Health of Russia</institution></aff><aff><institution xml:lang="ru">ФГБОУ ВО «Северо-западный государственный медицинский университет им. И. И. Мечникова» Минздрава России</institution></aff></aff-alternatives><aff-alternatives id="aff4"><aff><institution xml:lang="en">Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)</institution></aff><aff><institution xml:lang="ru">ФГАОУ ВО Первый МГМУ им. И. М. Сеченова Минздрава России (Сеченовский Университет)</institution></aff></aff-alternatives><pub-date date-type="pub" iso-8601-date="2026-07-15" publication-format="electronic"><day>15</day><month>07</month><year>2026</year></pub-date><volume>25</volume><issue>2</issue><issue-title xml:lang="en"/><issue-title xml:lang="ru"/><fpage>32</fpage><lpage>50</lpage><history><date date-type="received" iso-8601-date="2026-07-17"><day>17</day><month>07</month><year>2026</year></date><date date-type="accepted" iso-8601-date="2026-07-17"><day>17</day><month>07</month><year>2026</year></date></history><permissions><copyright-statement xml:lang="en">Copyright ©; 2026, ABV-Press</copyright-statement><copyright-statement xml:lang="ru">Copyright ©; 2026, АБВ-пресс</copyright-statement><copyright-year>2026</copyright-year><copyright-holder xml:lang="en">ABV-Press</copyright-holder><copyright-holder xml:lang="ru">АБВ-пресс</copyright-holder><license><ali:license_ref xmlns:ali="http://www.niso.org/schemas/ali/1.0/">https://creativecommons.org/licenses/by/4.0/</ali:license_ref></license></permissions><self-uri xlink:href="https://bioterapevt.abvpress.ru/jour/article/view/1625">https://bioterapevt.abvpress.ru/jour/article/view/1625</self-uri><abstract xml:lang="en"><p><bold>Background.</bold> Secondary immunodeficiency in patients with pulmonary tuberculosis has a significant impact on the course and outcome of the disease. Recombinant (rIL-2) interleukin-2 (IL-2) preparations are considered the most promising for pathogenetic immunotherapy.</p> <p><bold>Aim.</bold> Systematization of data confirming the association of secondary immune deficiency and IL-2 deficiency with the pathogenesis of pulmonary tuberculosis and evaluation of the results of using rIL-2 as a pathogenetically substantiated means of immunocorrection.</p> <p><bold>Materials and methods.</bold> Medline / PubMed, eLibrary, and CyberLeninka were used to search for scientific publications. Articles relevant to the review objective were identified for the period from 1997 to 2025 using the following terms: tuberculosis, <italic>Mycobacterium tuberculosis</italic>, and immunity.</p> <p><bold>Results. </bold>A systematic review based on a literature search for sources characterizing the state of immunoreactivity in patients with destructive pulmonary tuberculosis and the effectiveness of combined use of anti-tuberculosis chemotherapy and rIL-2 showed that secondary immune deficiency is associated with various forms of destructive pulmonary tuberculosis and manifests itself in the form of lymphopenia, cellular immune deficiency, including a quantitative deficiency of CD4<sup>+</sup> and / or CD8<sup>+</sup> lymphocytes, suppression of their functional activity, and production of IL-2. Twenty studies were devoted to the use of rIL-2 in combination with standard polychemotherapy for pulmonary tuberculosis, in which bacteriological, immunological, and radiological research outcomes were assessed along with clinical symptoms. All studies were randomized, 2 of which were double-blind, randomized, placebo-controlled studies. The studies included a total of 2,730 patients suffering from various forms of destructive pulmonary tuberculosis. Various doses, routes of administration of rIL-2, and durations of immune therapy were used. The use of rIL-2 in combination with anti-tuberculosis chemotherapy helps to correct secondary immunodeficiency, restore quantitative and functional immune parameters, and increase the frequency of abacillization, leading to positive radiological dynamics and improved clinical outcomes.</p> <p><bold>Conclusion.</bold> The inclusion of cytokine therapy with rIL-2 in the standard anti-tuberculosis polychemotherapy is pathogenetically justified, reliably increases the effectiveness of treatment and has a good safety profile.</p></abstract><trans-abstract xml:lang="ru"><p><bold>Введение.</bold> Вторичный иммунодефицит у больных туберкулезом легких (ТБЛ) оказывает существенное влияние на течение и исход заболевания. Препараты рекомбинантного (rIL-2) интерлейкина 2 (IL-2) рассматриваются как наиболее перспективные для проведения патогенетической иммунотерапии.</p> <p><bold>Цель исследования</bold> – систематизация данных, подтверждающих сопряженность вторичной иммунной недостаточности и дефицита продукции IL-2 с патогенезом ТБЛ, и оценка результатов применения rIL-2 как патогенетически обоснованного средства иммунокоррекции.</p> <p><bold>Материалы и методы.</bold> Для поиска научных публикаций применяли базы данных Medline / PubMed, eLibrary, CyberLeninka. Статьи, соответствующие цели обзора, были отобраны за период с 1997 по 2025 г. по следующим терминам: «туберкулез», «микобактерии туберкулеза», «иммунитет».</p> <p><bold>Результаты.</bold> Систематический обзор, проведенный на основании поиска источников литературы, характеризующих состояние иммунореактивности при деструктивном ТБЛ и эффективность сочетанного применения противотуберкулезной полихимиотерапии с rIL-2, показал, что вторичная иммунная недостаточность, характерная для различных форм деструктивного ТБЛ, проявляется количественным дефицитом CD4<sup>+</sup>- и / или CD8<sup>+</sup>-лимфоцитов, угнетением их функциональной активности, снижением эндогенной продукции одного из главных факторов роста и дифференцировки Т-лимфоцитов – IL-2. Применению rIL-2 в сочетании со стандартной полихимиотерапией ТБЛ посвящено 20 работ, в которых наряду с клинической симптоматикой оценивались бактериологические, иммунологические, рентгенологические исходы. Все исследования были рандомизированными, 2 – двойные слепые рандомизированные плацебо-контролируемые. Исследования суммарно включали 2730 пациентов, страдающих различными формами деструктивного ТБЛ. Использовались различные дозы, пути введения rIL-2 и продолжительность иммунотерапии. Применение rIL-2 на фоне противотуберкулезной полихимиотерапии способствует коррекции вторичного иммунодефицита, восстановлению количественных и функциональных иммунных показателей, что приводит к увеличению частоты достижения абациллирования, положительной рентгенологической динамике, улучшению клинических показателей.</p> <p><bold>Заключение.</bold> Включение цитокинотерапии rIL-2 в состав стандартной противотуберкулезной полихимиотерапии патогенетически обоснованно, достоверно повышает эффективность лечения и имеет хороший профиль безопасности.</p></trans-abstract><kwd-group xml:lang="en"><kwd>pulmonary tuberculosis</kwd><kwd>immune deficiency</kwd><kwd>immunotherapy</kwd><kwd>recombinant interleukin-2</kwd><kwd>cytokine therapy</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>туберкулез легких</kwd><kwd>иммунная недостаточность</kwd><kwd>иммунотерапия</kwd><kwd>рекомбинантный интерлейкин 2</kwd><kwd>цитокинотерапия</kwd></kwd-group><funding-group/></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><mixed-citation>Слогоцкая Л.В., Ловачева О.В., Клевно Н.И. 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