Role of the TORCH complex in the nosomorphosis of congenital structural defects of digestive system in children 
 

Veselyi S. V., Klimanskyi R. P. 
Donetsk National Medical University named after M. Horkyi, Krasnyi Lyman, Ukraine

The objective of the study — to examine the infection rate of persistent intracellular pathogens in children with congenital obstructive malformations of the gastrointestinal tract, and their influence on the course of the pathological process.

Materials and methods. The study is based on the analysis of a survey of 87 children who were treated for congenital malformations of digestive system. All patients underwent surgical correction of malformation of the gastrointestinal tract. In order to detect contamination with persistent intracellular pathogens (Herpes simplex virus 1, 2, Cytomegalovirus, Epstein-Barr virus, Chlamydia trachomatis, Toxoplasma gondіі) and to identify them, we used real-time polymerase chain reaction. Detection of DNA of these pathogens was carried in intraoperative biological material (saliva, the contents of the esophagus, stomach, small and large intestine) and the blood serum of the observed children. Clarification of the degree of infection activity was performed by the detection of specific IgG using immunoenzymatic assay. It was also carried out a test to determine the avidity of specific IgG.

Results and discussion. The results of immunoenzymatic assay of the blood serum in 87 patients showed that 43 of them (49.4%) with congenital malformations of digestive system had specific ІgG to persistent intracellular pathogens. At the same time, 28 patients (32.2%) with developmental disabilities have specific ІgG to one pathogen, and 15 examinees (17.2%) with congenital malformations — to two or more pathogens. Among the surveyed group of patients, the active stage of infection caused by persistent intracellular pathogens was detected in 21 persons (24.1%). And replicative phase of mixed infection was found in only 4 patients (4.6%). Complicated postoperative period occurred in 31 children (35.6%), of whom 26 (83.9%) were infected by persistent intracellular pathogens.

Conclusions. The results showed a correlation between intrauterine infection and congenital malformation of the gastrointestinal tract. According to our data, in 49.4% of children with birth defects of the intestinal tube, malformations are associated with TORCHinfection. Isolation of viral nucleic acids from intraoperative biological material of newborns can serve as reliable marker of infection course. Pathogens of persistent intracellular infections for a long time are stored in the affected organs that implies a chronic course of infection and the possibility of infection activation in the late postnatal period.

Key words: intrauterine infection, congenital malformations, gastrointestinal tract, children.

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