Clinical outcomes and pathogenetic mechanisms of adjunctive ribonucleic acid therapy in adult patients with measles during the period of increased incidence in 2025–2026
DOI:
https://doi.org/10.11603/1681-2727.2026.3.16753Keywords:
кір, ускладнення, лікування, рибонуклеїнова кислота, гематологічні індекси, прогноз, предиктори тяжкого ступеняAbstract
To evaluate the clinical effects of adjunctive ribonucleic acid therapy in adults with measles and its association with changes in oxidative protein modification, glutathione-dependent antioxidant defense, and cytokine response.
Patients and Methods. This single-center, prospective, open-label, randomized comparative study included 80 adults with laboratory-confirmed moderate-to-severe measles, divided into two groups of 40 patients. The intervention group received ribonucleic acid (500 mg three times daily for 6 days) in addition to standard supportive therapy. The comparison group received standard supportive therapy alone. Clinical outcomes and changes in oxidative protein modification (OMP), glutathione peroxidase, glutathione reductase (GR), IL-1β, and IL-10 were evaluated. Major clinical outcomes were also assessed using multivariable analysis adjusted for clinically relevant baseline characteristics.
Results. Adjunctive ribonucleic acid therapy was associated with a shorter febrile period after treatment initiation (2 [2–3] vs 4 [4–5] days; p<0.001) and a shorter hospital stay (7 [7–8] vs 9 [8–11] days; p<0.001). After adjustment for age, vaccination status, measles severity, pneumonia at inclusion, and time from rash onset to study inclusion, the adjusted mean difference was −1.61 days (95 % CI −1.94 to −1.28; p<0.001) for fever duration and −2.08 days (95 % CI −3.11 to −1.04; p<0.001) for hospital stay. The main group showed greater decreases in OMP356, OMP370, and OMP430 and a greater increase in GR activity. By day 6, IL-10 had returned close to baseline in the main group but remained elevated in the comparison group (Holm-adjusted p<0.001).
Conclusions. Adjunctive ribonucleic acid therapy in adults with measles was associated with shorter fever duration and hospital stay. It was also associated with greater changes in selected markers of oxidative protein modification, glutathione-dependent antioxidant defense, and cytokine response.
References
1. World Health Organization. (2025). Measles. Retrieved July 29, 2026, from https://www.who.int/news-room/fact-sheets/detail/measles
2. World Health Organization Regional Office for Europe, & United Nations Children’s Fund. (2025, March 13). European Region reports highest number of measles cases in more than 25 years. https://www.who.int/europe/news/item/13-03-2025-european-region-reports-highest-number-measles-cases-more-25-years-unicef-who-europe
3. World Health Organization Regional Office for Europe, & United Nations Children’s Fund. (2026, February 11). Measles cases dropped in Europe and Central Asia in 2025 compared to the previous year, but the risk of outbreaks remains. https://www.who.int/europe/news/item/11-02-2026-measles-cases-dropped-in-europe-and-central-asia-in-2025-compared-to-the-previous-year-but-the-risk-of-outbreaks-remains-unicef-and-who
4. Moss, W. J., & Griffin, D. E. (2024). What’s going on with measles? Journal of Virology, 98(8), e00856-24. https://doi.org/10.1128/jvi.00856-24 DOI: https://doi.org/10.1128/jvi.00758-24
5. Winter, A. K., & Fox, S. J. (2025). Measles is resurging in the Americas and the world is watching. Nature Reviews Microbiology, 23(7), 407–408. https://doi.org/10.1038/s41579-025-01198-3 DOI: https://doi.org/10.1038/s41579-025-01198-3
6. Wang, W., O’Driscoll, M., Wang, Q., Zhao, S., Salje, H., & Yu, H. (2024). Dynamics of measles immunity from birth and following vaccination. Nature Microbiology, 9, 1676–1685. https://doi.org/10.1038/s41564-024-01694-x DOI: https://doi.org/10.1038/s41564-024-01694-x
7. Центр громадського здоров’я Міністерства охорони здоров’я України. (2025). Хвороби відступили, але не зникли: вакцинація завжди актуальна. Retrieved July 29, 2026, from https://phc.org.ua/news/khvorobi-vidstupili-ale-ne-znikli-vakcinaciya-zavzhdi-aktualna-istorichniy-kontekst
8. Міністерство охорони здоров’я України. (2025). Захворюваність на кір: перші симптоми та алгоритм дій для батьків у разі хвороби. Retrieved July 29, 2026, from https://moz.gov.ua/uk/zahvoryuvanist-na-kir-pershi-simptomi-ta-algoritm-dij-dlya-batkiv-u-razi-hvorobi
9. Gungor, K., Bukavaz, S., & Ekuklu, G. (2024). Measles outbreak in the adult age group: Clinical, laboratory, and epidemiological features of the 11 patients admitted to the hospital. Journal of Medical Virology, 96(4), e29583. https://doi.org/10.1002/jmv.29583 DOI: https://doi.org/10.1002/jmv.29583
10. Niculae, C.-M., Matoru, R.-M., Brîndușe, O., Ioniță, A.-V., Gorea, M.-E., Țîrlescu, L.-G., Constantin, R.-A., Moroti, R., & Hristea, A. (2024). High rates of hepatic involvement associated with new epidemic measles strains in Romania. Journal of Medical Virology, 96(10), e70001. https://doi.org/10.1002/jmv.70001 DOI: https://doi.org/10.1002/jmv.70001
11. Pryshliak, O. Y., Dykyi, B. M., Matviiuk, O. Y., Boichuk, O. P., Prokopovych, M. V., Kobryn, T. Z., & Miziuk, R. M. (2020). Problems of “controlled infection”: Peculiarities of measles in adults in Ivano-Frankivsk region. Wiadomości Lekarskie, 73(4), 782–785. https://doi.org/10.36740/WLek202004130 DOI: https://doi.org/10.36740/WLek202004130
12. Au, S., Saini, S., Dela Cruz, W., & Venketaraman, V. (2026). Measles: An updated literature review of the host response, pathogenesis, complications, prevention measures, and recent outbreaks. Current Issues in Molecular Biology, 48(2), 206. https://doi.org/10.3390/cimb48020206 DOI: https://doi.org/10.3390/cimb48020206
13. Matviiuk, O. Y. (2024). Dynamics of hematological indices of endogenous intoxication in adult patients with measles of different disease severity. Bukovinian Medical Herald, 28(4), 53–60. https://doi.org/10.24061/2413-0737.28.4.112.2024.9 DOI: https://doi.org/10.24061/2413-0737.28.4.112.2024.9
14. Matviiuk, O., Pryshliak, O., Boichuk, O., Vaskul, N., Ersteniuk, A., & Domina, N. (2026). Oxidative stress, glutathione system activity, and zinc/selenium imbalance in adult measles of varying severity according to vaccination status. Infection and Drug Resistance, 19, 589101. https://doi.org/10.2147/IDR.S589101 DOI: https://doi.org/10.2147/IDR.S589101
15. BMJ Best Practice. (2025). Measles: Diagnosis and management. BMJ Publishing Group.
16. Pryshliak, O., Matviiuk, O., Boichuk, O., & Nedostup, U. (2022). Laboratory and clinical peculiarities of the measles course in adult patients against the background of the use of a ribonucleic acid medicine in a comprehensive approach to treatment during the 2017–2019 outbreak period. The Pharma Innovation Journal, 11(10), 147–150. https://doi.org/10.22271/tpi.2022.v11.i10b.16893 DOI: https://doi.org/10.22271/tpi.2022.v11.i10b.16893
17. Papanikolopoulou, A., Tseliou, I., & Maltezou, H. C. (2026). Measles: A narrative review of current therapeutic options and implications for the future. Viruses, 18(8), 816. https://doi.org/10.3390/v18080816 DOI: https://doi.org/10.3390/v18080816
18. Melnichuk, N., Zarubaev, V., Iosyk, I., Andreychyn, M., Semernikova, L., & Tkachuk, Z. (2018). Pre-clinical and clinical efficiency of complexes of oligoribonucleotides with D-mannitol against respiratory viruses. Pharmaceutics, 10(2), 59. https://doi.org/10.3390/pharmaceutics10020059 DOI: https://doi.org/10.3390/pharmaceutics10020059
19. Мельнічук, Н. С. (2026). Противірусна активність олігорибонуклеотидів та їх комплексів з D-манітолом: Можливі механізми дії проти вірусу грипу та коронавірусу. Вісник Національної академії наук України, (6), 67–72. https://doi.org/10.15407/visn2026.06.067 DOI: https://doi.org/10.15407/visn2026.06.067
20. Cemek, M., Bayiroğlu, F., Çaksen, H., Cemek, F., & Dede, S. (2005). Anti-oxidant activity in measles. Annals of Tropical Paediatrics, 25(3), 175–178. https://doi.org/10.1179/146532805X58094 DOI: https://doi.org/10.1179/146532805X58094
21. Cemek, M., Dede, S., Bayiroğlu, F., Çaksen, H., Cemek, F., & Mert, N. (2007). Oxidant and non-enzymatic antioxidant status in measles. Journal of Tropical Pediatrics, 53(2), 83–86. https://doi.org/10.1093/tropej/fml068 DOI: https://doi.org/10.1093/tropej/fml068
22. Solmaz, A., İlter, S., Koyuncu, İ., & Gümüş, H. (2022). A predictor of oxidative stress in the children with measles: Thiol–disulfide homeostasis. Turkish Archives of Pediatrics, 57(2), 200–204. https://doi.org/10.5152/TurkArchPediatr.2022.21150 DOI: https://doi.org/10.5152/TurkArchPediatr.2022.21150
23. Fraternale, A., Zara, C., De Angelis, M., Nencioni, L., Palamara, A. T., Retini, M., Di Mambro, T., Magnani, M., & Crinelli, R. (2021). Intracellular redox-modulated pathways as targets for effective approaches in the treatment of viral infection. International Journal of Molecular Sciences, 22(7), 3603. https://doi.org/10.3390/ijms22073603 DOI: https://doi.org/10.3390/ijms22073603
24. Shmarakov, I. O., Marchyshak, T. V., Borschovetska, V. L., Marchenko, M. M., & Tkachuk, Z. Y. (2015). Hepatoprotective activity of exogenous RNA. Ukrainian Biochemical Journal, 87(4), 37–44. https://doi.org/10.15407/ubj87.04.037 DOI: https://doi.org/10.15407/ubj87.04.037
25. Marchyshak, T., Yakovenko, T., & Tkachuk, Z. (2020). Effect of oligoribonucleotides with D-mannitol complexes on oxidative stress indicators against thioacetamide-induced liver fibrosis. ScienceRise: Biological Science, 3(24), 35–40. https://doi.org/10.15587/2519-8025.2020.214418 DOI: https://doi.org/10.15587/2519-8025.2020.214418
26. Yamabe, T., Dhir, G., Cowan, E. P., Wolf, A. L., Bergey, G. K., Krumholz, A., Barry, E., Hoffman, P. M., & Dhib-Jalbut, S. (1994). Cytokine-gene expression in measles-infected adult human glial cells. Journal of Neuroimmunology, 49(1–2), 171–179. https://doi.org/10.1016/0165-5728(94)90193-7 DOI: https://doi.org/10.1016/0165-5728(94)90193-7
27. Griffin, D. E. (2010). Measles virus-induced suppression of immune responses. Immunological Reviews, 236(1), 176–189. https://doi.org/10.1111/j.1600-065X.2010.00925.x DOI: https://doi.org/10.1111/j.1600-065X.2010.00925.x
28. Melnichuk, N., Kashuba, V., Rybalko, S., & Tkachuk, Z. (2018). Complexes of oligoribonucleotides with D-mannitol modulate the innate immune response to influenza A virus H1N1 (A/FM/1/47) in vivo. Pharmaceuticals, 11(3), 73. https://doi.org/10.3390/ph11030073 DOI: https://doi.org/10.3390/ph11030073
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