Possibilities of recombinant interferon α-2b drugs in the complex therapy of mucosal candidiasis infection in patients at risk
Authors:   RUDN University, Moscow, Russian Federation, Zlobin D.E. , Gureeva M.A. ,   RUDN University, Moscow, Russian Federation,   M.F. Vladimirskiy Moscow Regional Research and Clinical Institute, Moscow, Russian Federation, Molochkov A.V. ,   RUDN University, Moscow, Russian Federation,   M.F. Vladimirskiy Moscow Regional Research and Clinical Institute, Moscow, Russian Federation, Misnikova I.V. ,   M.F. Vladimirskiy Moscow Regional Research and Clinical Institute, Moscow, Russian Federation, Polesko I.V. ,   Pirogov Russian National Research Medical University, Moscow, Russian Federation, Guseva T.S. ,   N.F. Gamaleya National Research Center of Epidemiology & Microbiology, Moscow, Russian Federation
Published: October 2024

Background: despite the availability of various antifungal medications, achieving complete relief of fungal infections can be challenging, particularly in cases where Candida spp. exhibit resistance to antimycotic agents or in patients who are at increased risk of developing candidiasis, such as those with immunosuppression, decompensated diabetes mellitus, or undergoing prolonged antibacterial treatment. The limited success of antifungal monotherapy in treating candida infections highlights the necessity for alternative treatment tactics. Aim: this study aims to assess the impact of recombinant interferon α-2b combined with antioxidants, administered as rectal suppositories, on extending the relapse-free period in high-risk patients following successful antifungal treatment of oral and genital mucosal candidiasis. Patients and Methods: the study comprised 50 patients with different forms of oral and genital mucosal candidiasis, all having insulin- independent diabetes mellitus and suboptimal glycated hemoglobin levels. Initial antifungal treatment involved drugs from the imidazole or triazole groups. Patients were then randomized into two cohorts: one receiving recombinant interferon α-2b with antioxidants (n=17) and the other receiving a placebo (n=18). Clinical outcomes and microbial content of Candida fungi were evaluated pre- and post-treatment. Results: the median age of participants was 55.5 years, with females constituting 56% (28 patients) of the cohort. Vulvovaginal candidiasis was the most prevalent diagnosis, affecting 42% of patients. The initial mean microbial load of Candida was 1.4×105 CFU/ml. Post initial antifungal treatment, 70% (35 patients) exhibited full symptom regression and marked reduction in CFU levels. The group treated with interferon α-2b experienced a mean clinical remission duration of 53.6±7.5 days, with 76.5% (13 patients) maintaining remission throughout the 60-day follow-up and CFU levels dropping below 1×103. In contrast, the placebo group had a mean remission duration of 30.1±9.6 days post- antimycotic therapy. Conclusion: integrating recombinant interferon α-2b with antioxidants into the treatment regimens for oral and genital mucosal candidiasis in high-risk patients significantly extends clinical remission periods. These findings suggest that this combination therapy could be a promising option for rehabilitation and potentially preventive interventions for patients susceptible to candida infections. KEYWORDS: Candida spp., mucosal candidiasis, diabetes mellitus, interferon alpha-2b. FOR CITATION: Zlobin D.E., Gureeva M.A., Molochkov A.V., Misnikova I.V., Polesko I.V., Guseva T.S. Possibilities of recombinant interferon α-2b drugs in the complex therapy of mucosal candidiasis infection in patients at risk. Russian Medical Inquiry. 2024;8(7):433–438 (in Russ.). DOI: 10.32364/2587-6821-2024-8-7-10.