- Pathogenetic mechanisms of respiratory pathology with comorbid gastroesophageal reflux disease in frequently ill children
Pathogenetic mechanisms of respiratory pathology with comorbid gastroesophageal reflux disease in frequently ill children
PERINATOLOGY AND PEDIATRIC. UKRAINE. 2018.1(73):98-104; doi 10.15574/PP.2018.73.98
Pochinok T. V., Zhuravel O. V., Voronina S. S., Gurieva O. V.
O.O. Bogomolets National Medical University, Kyiv, Ukraine
Objective – to analyse the literature data on common pathogenetic mechanisms of respiratory pathology associated with gastroesophageal reflux disease in frequently ill children.
Methods. Methods of semantic evaluation, comparison, system as well as structural-logical analysis were used.
Results and conclusions. Two leading mechanisms are distinguished: microaspirating and reflexly vagal. It has been established that in the development of inflammation with frequent acute respiratory diseases associated with gastroesophageal reflux disease in children and adolescents, the dysfunction of the local immune system (MALT) (mucosa associated lymphoid tissue) plays a significant role, and the pathological process in the airways of patients with associated gastroesophageal reflux disease, is caused by the immune system changes, including a violation of the T- and B-lymphocyte ratio, imbalance of C3, C4 and C5 components of the complement IgG, IgM, IgA. It is indicated in the literature that in case of the respiratory pathology with comorbid gastroesophageal reflux disease, the vegetative and endocrine regulation in children of pubertal age should be taken into account. It was found that in the combination of respiratory pathology and gastroesophageal reflux disease, endocrine endothelial activity and the intensity of lipid peroxidation processes are of great importance. The researches has shown that the main pathogenetic contribution of gastroesophageal reflux disease to the development of respiratory pathology is the decreased functioning of the antireflux barrier and reduced oesophageal clearance, which cause the development of reflux-associated bronchial obstruction. In such comorbidity, a vicious circle is formed and the mutual burdening of diseases takes place.
Key words: gastroesophageal reflux disease, respiratory disease, frequently ill children, pathogenetic mechanisms.
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