FEATURES OF THE PHARMACOLOGICAL ACTION AND USE OF DIPYRIDAMOLE IN THE PREVENTION AND TREATMENT OF VIRAL INFECTIONS

Аннотация

The review presents current information on the molecular mechanisms of antiplatelet, vasodilatory, angioprotective, antifibrotic and immunomodulatory effects of dipyridamole. The paper presents data from domestic studies devoted to testing the efficacy and safety of dipyridamole (Curantil) in the prevention of acute respiratory viral infections and the treatment of recurrent stress-induced opportunistic infectious diseases, which show that dipyridamole is an effective combination drug with a good safety profile and the ability to exert a positive effect on blood vessels in metabolic disorders in patients with a complicated medical history, and allows foreffective preventionof acute respiratory viral infections in high-risk patients. Kеywоrds: dipyridamole, molecular mechanisms of action, prevention and treatment of acute respiratory viral infections, organoprotective action. INTRОDUСTIОN The most common infectious disease is acute respiratory viral infection (ARVI). The number of complications with ARVI, especially with influenza, reaches 20-30% during epidemics. The main causes of complications are dysfunction of the body's immune system with a decrease in antibacterial resistance and the addition of a bacterial infection in high-risk patients. Etiotropic antiviral therapy existsonlyfor thetreatment ofinfluenza: neuraminidase inhibitors (oseltamivir), M2protein blockers (adamantanes) and a fusion inhibitor(umifenovir). For other types of ARVI, drugs ofpathogenetic and symptomatic types ofaction are used [1]. MАTЕRIАLSАND MЕTHОDS The best way to combat complications of ARVI is to prevent the disease itself. The development ofinfection can be prevented bytargeted activation of oneofthe mostancient mechanisms of the body's defense - the interferon system (IFN). IFN is a family of local regulation proteins that can activate intracellular processes and intercellular interactions that ensure the body's resistance to viral infections, enhance the innate and acquired immune response, and modulate the processes of development and death of unchanged and tumor cells. The body's resistance to viral infections and a number of other diseases largely depends on the activity of IFN genes. The effects of IFN are indirect – activation of IFN specific receptors causes a cascade of cellular processes leading to the induction of genes encoding the synthesis of many proteins that provide the antiviral effects, antitumor and antiproliferative action of IFN. Proteins induced by IFN include: enzymes, receptors, transporters, cytokines, chemokines and other factors. The production of IFN by cells is transient, temporary – normally “silent” IFN genes are induced under the influence of products ofviral and microbialorigin and chemical inductors (high-and low-molecular)[2]. RЕSULTSАNDDISСUSSIОN For the prevention of ARVI, IFN preparations, IFN inducers and other immunomodulators are often used. Popular IFN preparations have a number of drawbacks from a pharmacological point of view, the most important of which is the problem of bioavailability (this does not apply to injectable IFN, but this method of administration is not used for the prevention of ARVI). A fairly large peptide molecule of IFN will be destroyed and lose its properties when taken orally, and when applied locally, it will not be able to overcome tissue barriers. Nevertheless, local use ofIFN has a right to exist, since in the mucous membrane they stimulate local immunity, thereby https://ijmri.de/index.php/jmsi volume 4,issue3,2025 354 strengthening the protection of potential infection gates. A more popular class of drugs for the prevention of viral infections are low-molecular IFN inducers, which can be taken orally. The problem of drug prevention and treatment of ARVI is that high-risk patients, i.e. For those who especially need medications, medications included in the treatment standards are often contraindicated. In particular, pregnant women, overweight patients and patients with diabetes, older patients, and children are at risk of severe and complicated influenza. Therefore, among IFN inducers, a special place is occupied by dipyridamole, a well-studied drug with a favorable safety profile, which is widely used in clinical practice as an antiplatelet agent, vasodilator, and IFN inducer. To exhibit IFN-inducing activity, dipyridamole must be administered in significantly smaller doses (4–8 times smaller than generally accepted therapeutic doses) according toa special regimen adopted formost low-molecular IFN inducers (once aweek) [3]. The antiplatelet effect is associated with several events. Firstly, dipyridamole causes an increase in the concentration of adenosine in tissue by inhibiting the reuptake of adenosine by cells (nucleoside transporter ENT1) and blocking its catabolism – adenosine desamenase (P. Gresele, 1986; P. Ferrandon, 1994; C. Wang, 2013). Adenosine exhibits the properties of a platelet inhibitor (stimulates adenylate cyclase – AC through A2A