- Features of immune correction in children with pyelonephritis depending on the manifestations of undifferentiated connective tissue dysplasia
Features of immune correction in children with pyelonephritis depending on the manifestations of undifferentiated connective tissue dysplasia
SOVREMENNAYA PEDIATRIYA.2017.7(87):85-89; doi 10.15574/SP.2017.87.85
Melnychuk L. V.
Ivano-Frankivsk Regional Children's Clinical Hospital, Ukraine
Pyelonephritis is a common kidney disease, which has a tendency towards chronization and formation of complications. An adequate managment of patients with pyelonephritis should consider etiological factors and symptoms of the disease as well as individual risk factors and pathogenetic mechanisms.
The objective of the research was to study the efficacy of combination therapy with inclusion of multivitamin and multienzyme preparations in children with pyelonephritis depending on the presence of undifferentiated connective tissue dysplasia manifestations.
Material and methods. The study included 96 children with pyelonephritis aged from 3 to 15 years (the average age was 8.6±1.4 years). The control group included 20 apparently healthy children of the same age. The studied patients were divided according to the presence of connective tissue dysplasia and the method of treatment.
Results and discussion. In children with pyelonephritis and signs of undifferentiated connective tissue dysplasia, after the routine treatment the level of tumor necrosis factor-alpha reduced insignificantly (p>0.05), while the dynamics of endotoxemia indicators, such as interleukin 10, interleukin 8, underwent significant changes (p<0.05). The latter was noted on the background of multivitamin preparation usage (p<0.05). However, the best dynamics of the cytokine status and endotoxemia was observed in children receiving multienzyme and its combination with multivitamin and basic treatment — in undifferentiated connective tissue dysplasia (p<0.01) and without it (p<0.001).
Conclusions. In both groups of children with pyelonephritis and undifferentiated connective tissue dysplasia signs and those with pyelonephritis and no signs of undifferentiated connective tissue dysplasia, therapeutic complexes using multienzyme preparation, as well as its combination with multivitamin preparation on the background of basic therapy, turned out to be the most effective in reducing systemic immunoinflammatory response and endotoxemia. In the presence or absence of connective tissue dysplasia, under the influence of these therapeutic complexes, the production of interleukin 10 increased, while the synthesis of interleukin 8, tumor necrosis factor and endotoxemia reduced.
Key words: pyelonephritis, connective tissue dysplasia, cytokines, treatment.
1. Chernyshova LI, Volokha AP, Kostiuchenko LV et al. (2013). Pediatric immunology: a textbook. Kyiv: VSV Medytsyna: 720.
2. Dudar IO, Driianska VYe, Hryhorieva YeM. (2013). Interleukin 10, body mass index and serum albumin in patients with stage 5 chronic kidney disease. Ukrainian Journal of Nephrology and Dialysis. 4: 30-33.
3. Kadurina TI, Gorbunova VN. (2009). Connective tissue dysplasia: a guide for physicians. Elbi-SPb, St Petersburg: 704.
4. Pochynok TV et al. (2010). Clinical and immunological features of children with the manifestations of undifferentiated connective tissue dysplasia. Sovremennaya pediatriya. 4: 226.
5. Remezov AP, Knorring HYu. (2003). Systemic enzyme therapy as a method to potentiate the effect of antibacterial agents. Antibiotiki i khimioterapiya. 3: 30-32.
6. Timofeyeva EP, Kartseva TV, Ryabichenko TI, Skosyreva GA. (2012). Present-day views of undifferentiated connective tissue dysplasia syndrome. Rossiyskiy vestnik perinatologiyi i pediatriyi. 57; 4-1: 112-116.
7. Franchuk OA. (2001). Effectiveness of using Wobenzym in combination therapy of gestational pyelonephritis. Medychna khimiia. 1: 54-56.
8. Tsymbalista OL, Dekhtiar VB, Savchuk LYa. (2008). Effect of Kardonat on clinical and immunological parameters in children with bronchial asthma on the background of undifferentiated connective tissue dysplasia. Sovremennaya pediatriya. 5: 21-24.
9. Knight A, Weiss P, Morales K et al. (2014). Depression and anxiety and their association with healthcare utilization in pediatric lupus and mixed connective tissue disease patients: a cross-sectional study. Pediatric Rheumatology. 12: 42. https://doi.org/10.1186/1546-0096-12-42; PMid:25242900 PMCid:PMC4169806
10. Femia A, Vieugels A. (2013). Pediatric autoimmune connective tissue diseases: an update on disease characteristics, associations, and management. Current Dermatology Reports. 2: 216-229. https://doi.org/10.1007/s13671-013-0058-6
11. Akl K. (2011). Re: a guideline for the inpatient care of children with pyelonephritis. Ann Saudi Med. 31(1): 93-94. https://doi.org/10.4103/0256-4947.75792; https://doi.org/10.5144/0256-4947.2011.93; PMid:21245607 PMCid:PMC3101736
12. Melnychuk LV, Tsymbalista OL. (2017). Features of systemic immune-inflammatory response in children with pyelonephritis depending on the manifestations of undifferentiated connective tissue dysplasia. The Pharma Innovation Journal. 6(3): 168-171.