- Impairment of immunity in children of growing age suffering from recurrent respiratory diseases
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.
1. Abramova NA, Savenkova MS, Abramov AD. (2014). The role of intrafamily infection of frequently ill children. Children's infections. 13; 1: 52—58.
2. Baranov AA. (2009). Pediatrics: National Leadership: In 2 t. Moscow: GEOTAR-Media.
3. Burdina OM, Repetskaya MN, Timchenko TN. (2014). Clinical and immunological characteristics of frequently ill children. Family Health – 21st Century. 2:31–39.
4. Gordiyenko SM. (1983). Comparative evaluation of the test results of nitroblue tetrazolium reduction in microscopic and spectrophotometric variants of the method with different tetrazolium salts. Laboratory work. 2:21–23.
5. Znamenskaya AA, Fomina VL, Uchaykin VF еt al. (2011). Treatment and prevention of acute respiratory infections in frequently ill children. Attending physician. 1.
6. Motavkina NS, Kovalev VM, Sharonov AS. (1979). Micromethod of quantitative determination of lysozyme. Laboratory work. 12: 722—724.
7. Petrov VI, Anapchenko VG, Ishmukhametov AA et al. (1983). Determination of circulating immune complexes in the blood of healthy donors and patients with bronchial asthma before and after hemosorption. Immunology. 3: 57—59.
8. Pochinok TV, Zhuravel OV, P'yankova OV, Voronina SS, Stamboli LV. (2018). Features of physical development and immunological reactivity in children with recurrent respiratory pathology with concomitant gastroesophageal reflux disease. Sovremennaya pediatriya. 7(95): 27—33. https://doi.org/10.15574/SP.2018.95.27
9. Chernishova LI, Yakimovich SA, Donskoy BV, Galazyuk LV. (2012). Protective role of local immunity in the prevention of the upper respiratori tractdiseases in children. Sovremennaya pediatriya. 4(44): 104—107.
10. Bozzetto S, Pirillo P, Carraro S et al. (2017). Metabolomic profile of children with recurrent respiratory infections. Pharmacol. Res. 115: 162—167. https://doi.org/10.1016/j.phrs.2016.11.007; PMid:27888158
11. Kwong CG, Bacharier LB. (2017). Microbes and the Role of Antibiotic Treatment for Wheezy Lower Respiratory Tract Illnesses in Preschool Children. Curr. Allergy Asthma Rep. 17; 5: 34.
12. Montella S, Cotcione A, Santamaria F. (2017). Recurrent Pneumonia in Children: A Reasoned Diagnostic Approach and a Single Centre Experience. Int J Mol Sci. 18; 2: 296.
13. Nilolai A, Frassanito A, Nenna R et al. (2017). Risk Factors for Virus-induced Acute Respiratory Track Infections in Children Younger That 3 Years and Recurrent Wheezing at 36 Months Follow-Up After Discharge. Pediatr Infect Dis J. 36; 2: 179—183. https://doi.org/10.1097/INF.0000000000001385; PMid:27798551
14. Teijeiro A, Badellino H, Raiden MG et al. (2017). Risk factors for recurrent wheezing in the first year of live in the city of Cordoba, Argentina. Allergol Immunopathol.45; 3: 234—239. https://doi.org/10.1016/j.aller.2016.08.009; PMid:27863815
15. Toivonen L, Karppinen S, Schuez-Havupalo L et al. (2016). Burden of Recurrent Respiratory Tract Infection in Children: A Protective Cohort Study. Pediatr Infect Dis J. 35; 12: 362—369. https://doi.org/10.1097/INF.0000000000001304; PMid:27455443
Article received: Sep 15, 2018. Accepted for publication: Feb 12, 2019.