Dynamic indicators of acute respiratory diseases treatment in children after correction.

OBJECTIVE: Aim: To study the Respiratory pathology of the upper respiratory tract, markers of the inflammatory response of the organism, Oxidative stress, Metabolic adaptation and possibilities of correction. PATIENTS AND METHODS: Materials and Methods: The study group (n=111) included school-aged children (10-14 years old). The general group of inflammatory diseases of the respiratory tract (J000-J06) was considered, with a diagnosis of acute respiratory infection (ARI) of viral and bacterial origin and included local inflammationof the upper respiratory tract with presentation of acute pharyngitis (68.0%), acute bronchitis (22,0%), acute tonsillitis (10,0%). RESULTS: Results: Dynamic observation of groups of children who received optimized (group 1, n=60) and basic (group 2, n=51) treatment was carried out. The level of the erythrocyte pool correlated with IL-1 (r=-0,29, p=0,03), IL-4 (r=0,32, p=0,01), TNF-α (r=-0,35 , p=0,006). Creatinine value correlated with IL-10 (r=0,3, p=0,005), γ-IFN (r=0,42, p=0,001), TNF-α (r=0,25, p=0,05). Correlations of ferritin presented positive correlation values with the level of total protein (r=0,26, p=0,04) and TNF-α (r=0,41, p=0,001). CONCLUSION: Conclusions: After the optimized treatment, there was a significant decrease in the reliable levels of CRP and γ-IFN by 7 and 4,4 times (by groups) and 5,8 and 3,2 times (by groups), respectively. Correlation relationships of urea levels with IL-2,4 were detected. The level of the erythrocyte pool correlated with IL-1,4, TNF-α, Ferritin presented positive correlation values with the level of total protein,TNF-α .

RESPIRATORY MICROBIOME AND ITS RELATIONSHIP WITH INFLAMMATORY MARKERS.

OBJECTIVE: The aim: This study aims to investigate and analyze the microbiome of the nasopharyngeal zone in acute respiratory infections (ARI) and their relationship with inflammatory markers. PATIENTS AND METHODS: Materials and methods: Examination of 112 children (10-14 years old) with acute respiratory infections (ARI) of the upper respiratory tract was carried out. The control group consisted of 25 healthy children identical in age and examination parameters. RESULTS: Results: When analyzing the microflora of the nasopharynx of patients, 29,0% of strains were gram-positive bacteria and 71,0% were gram-negative bacteria (Escherichia coli representing 37,0%). Biochemical examination of the biomaterial revealed the presence of sucrase (n=69), maltase (n=87), lactorepoxidase (n-89) and alcohols - sorbitol (hexahydric alcohol, n=102), mannitol (hexahydric alcohol, n=84), xylitol (pentahydric alcohol, n=86). Regarding the markers of inflammatory response, the following dynamics was noted: increase in the level of IgM (3,91 ± 1,79 g/l, p<0,01) by 2,2 times, elevation of Ig G level by 10 times (145, 91 ± 53,04 g/l, p< 0,01), slightly higher than the reference values IgE level. In addition, increased IL-1, IL-4, IL-6, γ-IFN, TNF-α, Neopterin levels were detected. The level of Thyroid stimulating hormone (TSH) was significantly different compared to the control group (0,62 ± 0,57 vs. 1,98 ± 0,30 mIU/ ml, p< 0,01), but within the reference values. CONCLUSION: Conclusions: Predominance of Gram-negative bacteria in the nasopharyngeal microflora of patients along with elevated inflammatory markers and lactop-eroxydase enzyme predominance was detected in the study.

INFLAMMATORY RESPONSE AND METABOLIC ADAPTATION IN CHILDREN WITH ACUTE RESPIRATORY PATHOLOGY.

OBJECTIVE: The aim: To investigate the parameters change of the general immune responds and endocrine metabolism in the children with Acute Respiratory Pathology and their correlational relationship. PATIENTS AND METHODS: Materials and methods: The study group included: school-age children (10-14 years old) with a diagnosis of acute respiratory disease (ARI) as a general group of respiratory tract inflammatory diseases, of viral and bacterial origin (n=40), which included local inflammatory lesions of the respiratory tract and presented with acute pharyngitis (60.0%), acute bronchitis (20%), acute tonsillitis (22%) and a control group (n=25), identical in age and sex. The research was conducted at the clinical base of the CNE «UCChH¼ of the Uzhhorod City Council. General clinical, immunological studies, inflammatory response of the child's body were conducted. Statistical analysis of the results of the examination of patients was carried out using the Statistics for Windows v.10.0 computer program (StatSoft Inc, USA). The evaluation of the obtained results was carried out using parametric and non-parametric methods. RESULTS: Results: The inflammatory response parameters of the child's organism present indicative increases in the levels of cytokines with a significant predominance in comparison with the data of the children control group: the level of IL-1 increased in 2 times, IL-4 - in10 times, IL-6 - in 1.5 times, γ-IFN - in 3 times, TNFα - in 25 times, Neopterin - in 9 times. The data of the general immune response indicate a 2-times increasing in the level of IgM (3.85 ± 1.89 g/l, p<0.01) and IgG level increased in 10 times (147, 35 ± 56.12 g/l, p< 0.01). The, according to the obtained data but, in comparison with the data of the control group. There are significant differences in the levels of Leptin (р< 0.01), C-peptide (р< 0.01), Thyroid stimulating hormone ( p<0.01), Free thyroxine (p=0.002). The Leptin level, which is at the upper limit of the reference, the level of Thyroid stimulating hormone at the lower limit of the reference, and the slight predomi¬nance of the C-peptide level are noteworthy. Predominance of reliable correlations of pro-inflammatory cytokines IL 1, 4, 6 of varying degrees (r=0.34-0.45) are observed. Only IgG with Free triiodothyronine (r=0.45,p=0.004), IgE with Thyroid peroxidase antibody (r=-0.45,p=0.004) were identified as statistically significant correlations with high reliability. CONCLUSION: Conclusions: The obtained date presents the increasing of the levels Cytocines (Il -1,4,6) in 2-10 times. The IgG level increased in 10 times and IgM - in 2 times. The indicators of endocrine metabolism are within the reference values. Reliable correlations of pro-inflammatory cytokines IL 1, 4, 6 of varying degrees (r=0.34-0.45) are observed. IgG with Free triiodothyronine (r=0.45,p=0.004) have significant reasonableness.

INFLAMMATORY RESPONSE STATUS IN INFANTS WITH INTRAUTERINE INFECTION FROM MOTHERS WITH IDENTIFIED TORCH INFECTION.

OBJECTIVE: The aim: To investigate the status and possibilities of markers of the inflammatory response of organism in infants with identified IUI born to mothers diagnosed with TORCH infection. PATIENTS AND METHODS: Materials and methods: The study group included: infants diagnosed with IUI (n = 40), born to mothers (age 31.31 ± 2.08 years) with the diagnosis of TORCH infection and a control group (n = 25 infants). Childbirth in all newborns was physiological. The average weight of newborns was 1877.69 ± 981.78 g (min - 600 g; max - 4000 g). Gestational age: 32.25 ± 5.15 weeks. Observation and treatment of newborns lasted up to 7 days (included stay in the emergency department of the Uzhhorod maternity hospital in the Zakarpattia region). Cytokine profile, γ-IFN, TNF-α, Pg E2, serum neopterin and procalcitonin levels were studied. RESULTS: Results: The values of the parameters of the cytokine profile (IL-1, IL-6, IL-8, IL-10) varied within the reference values, but with significant differences with the values of the control group, which was 1,2; 4; 10; 6 times, respectively. The levels of inflammatory mediators (γ-IFN Procalcitonin Neopterin TNF-α Pg E2) differed significantly from the data of the control group of infants and exceeded the upper limit of the reference values by 1,3; 3; 25; 4 times, respectively. According to the correlation analysis, there are positive correlations of medium level: IL 1 and procalcitonin (r = 0.33); IL 6 and IL10 (r = 0.44); IL 10 and prostaglandin E2 (r = 0.44); neopterin and prostaglandin E2 (r = 0.39), which indicates synergism in the performance of biologically active processes. Negative correlations of moderate degree were observed between the following parameters: IL 1 and gestational age of infants (r = -0.36); IL 6 and IL 8 (r = -0.34); γ-IFN and TNF-α (r = -0.43), which indicates the diversity of interactions between participants in the inflammatory response of the organism. CONCLUSION: Conclusions: Various infectious agents can act as «primary affect¼ of sepsis as a complex pathological process involving the organism, and each of the infections has its own characteristics of the pathological process, therefore curent changes in infectious circumstances make new demands on research. It has been proven that intrauterine infection has a negative effect on the homeostatic parameters of infants, in particular, on the indicators of the inflammatory response of the child's organism. Symptomatic inflammatory biomarkers can be used to identify the pathological condition of the infant, in addition to routine laboratory tests, for early correction of VUI. This delay in identifying affected infants can lead to long and unnecessary therapy, the emergence of resistant strains of microorganisms, increased treatment costs and, in particular, a higher risk of complications such as cerebral palsy or intraventricular hemorrhage.