RESUMO
The aim of the study is to evaluate a preventive effectiveness of food products with elevated content of biologically active substances by community-acquired pneumonia with unknown causative agent. The authors studied two groups of youngsters (18 years old) during period of adaptation to conditions of organized group: with normal nutritional status [with body mass index (BMI) = 19.5-22.9 kg/m2] and decreased one (with BMI = 18.5-19.4 kg/m2). Tumor necrosis factor (TNFα) and interleukin 1α (IL-1ß) levels in blood serum were criteria of degree of inflammatory process. Functional activity of phagocytes was also evaluated with the use of nitroblue tetrasol test (NTT-test). To prevent pneumonia natural concentrated food product made of vegetable raw materials (3.0 g per day) by cryogen technology was added in diet of persons with normal nutritional status during two periods (15 days) with an interval (30 days). But persons with decreased nutritional status got the product made of protein-vegetable raw materials during 15 days only and additionally product made of protein-vegetable raw materials by cryogen technology one time per day (35.0 g) during 15 days. The persons with normal nutritional status were divided in three group: persons (480 men) in the first group got the product only, persons (100 men) of the second group underwent vaccination with polysaccharide polyvalent «Pneumo-23¼ vaccine only, persons (316 men) of the third group underwent vaccination in combination with the product intake. The persons (231 men) with decreased nutritional status composed one group and got the food product only. Control group consisted of 263 men with normal nutritional status. The authors evaluated incidence rates during three months of observation and duration of in-patient treatment. The results were compared with data obtained in baseline period (the same time periods during three years before the study). The authors received data on the decrease of a reserve ability of phagocytes; it provided evidence about an initial deficiency of immune protection factors in persons with decreased nutritional status. In adaptation period, this phenomenon was observed in persons with normal nutritional status too. The including of protein-vegetable product in diet promoted the increase of bactericidal function of neutrophils and body weight among youngsters with decreased nutritional status; but including of vegetable product kept bactericidal function of neutrophils on normal level. In adaptation period, TNFα levels increased in both groups by 21.0 and 35.1%, respectively; IL-1ß level did not significantly change in group with normal nutritional status, but increased 2.25 fold in persons with decreased nutritional status. The levels of studied cytokins decreased to baseline values in 30 days after the product intake. To this time, TNFα increased 1.8 fold and IL-1ß increased 2.86 times in control group. A preventive effectiveness of the especially created products in nidus with unknown causative agent was confirmed by the decrease of incidence rate (82.4-78.4%) in persons with normal and lower nutritional status that coincided with effectiveness of a vaccinal prevention only. The food product with antioxidant properties potentiated a vaccinal prevention. The positive effect consisted in lack of fatal outcomes and outbreaks of the disease; mean bed-day decreased on 3.5 days; predominance of mild form of the disease in clinical picture in comparison with same parameters during basic period of observation.
RESUMO
Efficacy of pneumococcal polysaccharide vaccine "Pneumo 23" or its combination with food products prepared from vegetative material for prevention of community-acquired pneumonias has been compared. Advantages of combined method of prophylaxis in setting where pneumonia caused by different pathogens have been noted. Variability in etiology of community-acquired pneumonia was demonstrated by serological tests of patients' blood. During spring-summer season antibodies to Mycoplasma pneumoniae, Chlamydia pneumoniae, and Streptococcus pneumoniae were detected in 25.9, 2.5, and 7.0% of the patients respectively. During autumn-winter season antibodies to M. pneumoniae and S. pneumoniae were detected in 30.0 and 50.0% of the patients respectively.