• Impairment of immunity in children of growing age suffering from recurrent respiratory diseases
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Impairment of immunity in children of growing age suffering from recurrent respiratory diseases

SOVREMENNAYA PEDIATRIYA.2019.1(97):39-45; doi 10.15574/SP.2019.97.39

Pochinok T. V., Stamboli L. V., Slipachuk L. V., Zhuravel O. V.
Bogomolets National Medical University, Kyiv, Ukraine
SI «Institute of Pediatrics, Obstetrics and Gynecology named after academician О.М. Lukyanova of the National Academy of Medical Sciences of Ukraine», Kyiv

Objective: to define the diagnostic value of immunological resistance parameters in children suffering from recurrent respiratory diseases, to analyse the microflora of mucous membranes of a mouth in this category of children.

Materials and methods. 60 children at the age of 10–16 years with the recurrent respiratory diseases (RRD) were examined. All children were divided into two groups: the main group included 30 children with RRD (6–8 times per year), the control group included 30 children with 2–4 episodes of respiratory diseases per year. All children were examined for physical development by the method of сentilny standards, also, all-clinical methods researches were conducted; the analysis of the children and their parents given to the anamnesis was also, carried out. The microbiological research of material from the surface of mucous membrane of the oral cavity and a pharynx was conducted. The immunological check-up included indicators of peripheral blood neutrophils functional activity according to a phagocytosis and the NBT-test, the maintenance of circulating immune complexes (CIC), concentration of immunoglobulins of G, A, M and secretory immunoglobulin A (sIgA) classes and lysozyme, by radial immunodiffusion method, and concentration of interleukin-6 (IL-6) and interleukin-4 (IL-4) by ELISA method.

Results. According to clinical and medical history data, children with RRD suffered from pharyngitis, laryngitis, tonsillitis much more often. Among children, with RRD, against the background of the increased identification of opportunistic flora, compared to control group, the inhibition of phagocytic activity of neutrophils was revealed, specifically, a significant decrease in the activity of phagocytosis and reduction of reserve capacity of neutrophils under conditions of their stimulation (р<0.01). Group of children with RRD showed reliable increase in concentration of IgG, the CIC and lysozyme concentrations in blood serum, were also established (р<0.05). Also, reliable decrease in parameters of local immunity (such as IgA, lysozyme) against the background of increase in the IgG level in saliva, was verified (р<0.01). It was shown that at children with RRD, the concentration of IL-6 exceeded control values, at the same time concentration of IL-4 was outside sensitivity of a test system (<0.4 pg/ml) in both groups of children.

Conclusions. Among risk factors which promote formation the group of children of growing age with RRD, the main factors are recurrent respiratory diseases in parents, symptoms of the postponed rickets, varicella and measles in children; operational intervention with the general anesthesia, impairment of immunity and dysbiosis of mucous membranes of a mouth and a pharynx, as well. All above-induced results can act as predictors of formation of chronic pathology of the upper airways and serve as predictive criterion at assessment of risk of reactivation of inflammatory process in this category of children.

Key words: children of growing age with RRD, a microbiocenosis of mucous membrane of the oral cavity and a pharynx, immunity.


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Article received: Sep 15, 2018. Accepted for publication: Feb 12, 2019.