- Features of physical development and immunological reactivity in children with recurrent respiratory pathology with concomitant gastroesophageal reflux disease
Features of physical development and immunological reactivity in children with recurrent respiratory pathology with concomitant gastroesophageal reflux disease
SOVREMENNAYA PEDIATRIYA.2018.7(95):27-33; doi 10.15574/SP.2018.95.27
Pochinok T. V., Zhuravel O. V., P'yankova O. V., Voronina S. S., Stamboli L. V.
Вogomolets National Medical University, Kyiv, Ukraine
Children's Clinical Hospital No.9 Podilskyi District м. Kyiv, Ukraine
SI Institute of Pediatrics, Obstetrics and Gynecology named after academician O. Lukyanova of the National Academy of Medical Sciences of Ukraine, Kyiv
Objective: to investigate the features of physical development and some indicators of immunological reactivity in children of pubertal age with recurrent respiratory pathology with concomitant gastrooesophageal reflux disease (GERD) of grade II.
Patients and methods. 150 children aged 10–16 years with frequent respiratory diseases (FRD) were examined. All children were divided into three groups: the first group (90 persons) with frequent respiratory diseases (FRD) with GERD II degree, the second group (30 persons) — children with FRD without GERD and the third control group (30 persons) of practically healthy children. All children were evaluated for physical development by the method of centile standard: distribution of height and body weight, depending on the age of the child. Immunological reactivity investigation state included determination of indicators of functional activity of peripheral blood neutrophils according to phagocytosis and NBT tests, determination of serum and saliva concentrations of the major classes of immunoglobulins (G, A, M) and, in addition, in saliva, the level of secretory immunoglobulin A (sIgA) Separately the level of circulating immune complexes (CIC) in serum was determined.
Results Among children with FRD and GERD growth retardation was observed in 80% of cases, body weight retаrdation — 75.6% which corresponds to disharmonious physical development above average at 74.4% of the examined. The inhibition of phagocytic activity of neutrophils was revealed, namely, a significant decrease in the activity of phagocytosis and reduction of reserve capacity of neutrophils under conditions of their stimulation (p<0.01), which is more common in children with FRD and GERD. In group of children with FRD in the 1st and 2nd groups, there is an increase in the content of circulating immune complexes and IgG concentration (p<0.01) was revealed, which is more pronounced in children with concomitant gastroesophageal reflux disease. A probable decrease in the parameters of local immunity for the content of sIgA, IgA (p<0.05) was verified with the increase of IgG level in saliva (p<0.01) with concomitant gastroesophageal reflux disease.
Conclusions. The study allows children with FRD and GERD to be included in the «Adaptive Risk» group in order to develop certain preventive and therapeutic measures to improve the methods of rehabilitation of ARD in children with FRD n taking into account the changes that have been identified in the state of the immune system of the examined children.
Key words: children with FRD, gastroesophageal reflux disease, physical development, phagocytosis, NBT-test, immunoglobulins of class G, A, M, CIC, sIgA.
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Article received: May 17, 2018. Accepted for publication: Oct 29, 2018.