Prediction of exacerbation chronic bronchopulmonary diseases in children with influenza

The objective: To develop a method for predicting exacerbation of chronic illness in children with asthma and cystic fibrosis, patients with influenza, based on the study of the dynamics of cytokines. Materials and methods: Were examined 52 patients with bronchial asthma and 45 children with cystic fibrosis at the age from 1 year to 12 years, located in infectious pulmonary Department at the planned treatment of underlying pathology, in which influenza was in-hospital infection. Control group observations included 40 patients with the flu, without concomitant pulmonary disease. The etiology of viral infection was established by detection of viral RNA in nasopharyngeal swabs by PCR. Among the influenza viruses were identified influenza АH1N1, АH3N2, influenza B, and in 2009–2010 the predominant antigen was the pandemic influenza virus АH1N1pdm09. Determination of the concentration of serum interleukins IL-1β, IL-4, IL-8, IL-10, ТNF-α, IFN-γ was performed in the 1st and 3rd day of hospitalization cytokines by the solid-phase immune-enzyme assay. Analysis of the results performed using statistical package SPSS 17.0 EN for Windows. Results: The flu caused the aggravation associated bronchopulmonary pathology in 2/3 of children, as MV patients, and patients with BA (65,4%-66,7%, respectively). With an increase of the ratio of IL-4 / IFN-γ and IL-10/IFN-γ, at least 5-6 times, influenza can be considered a trigger of exacerbation of chronic bronchopulmonary pathologies that require amplification of the therapy of bronchial asthma and of сystic fibrosis. The growth of prognostic coefficients in 2-3 times allows using for treatment of influenza in these patients only antiviral agents. Conclusion: The study has shown a method for predicting exacerbation of bronchial asthma and cystic fibrosis in children at an early stage of influenza by calculating the ratio of IL-4/IFN-γ and IL-10/IFN-γ in children aged from 1 year to 12 years

Прогнозирование обострения хронических бронхолёгочных заболеваний при гриппе у детей

The objective: To develop a method for predicting exacerbation of chronic illness in children with asthma and cystic fibrosis, patients with influenza, based on the study of the dynamics of cytokines. Materials and methods: Were examined 52 patients with bronchial asthma and 45 children with cystic fibrosis at the age from 1 year to 12 years, located in infectious pulmonary Department at the planned treatment of underlying pathology, in which influenza was in-hospital infection. Control group observations included 40 patients with the flu, without concomitant pulmonary disease. The etiology of viral infection was established by detection of viral RNA in nasopharyngeal swabs by PCR. Among the influenza viruses were identified influenza АH1N1, АH3N2, influenza B, and in 2009–2010 the predominant antigen was the pandemic influenza virus АH1N1pdm09. Determination of the concentration of serum interleukins IL-1β, IL-4, IL-8, IL-10, ТNF-α, IFN-γ was performed in the 1st and 3rd day of hospitalization cytokines by the solid-phase immune-enzyme assay. Analysis of the results performed using statistical package SPSS 17.0 EN for Windows. Results: The flu caused the aggravation associated bronchopulmonary pathology in 2/3 of children, as MV patients, and patients with BA (65,4%-66,7%, respectively). With an increase of the ratio of IL-4 / IFN-γ and IL-10/IFN-γ, at least 5-6 times, influenza can be considered a trigger of exacerbation of chronic bronchopulmonary pathologies that require amplification of the therapy of bronchial asthma and of сystic fibrosis. The growth of prognostic coefficients in 2-3 times allows using for treatment of influenza in these patients only antiviral agents. Conclusion: The study has shown a method for predicting exacerbation of bronchial asthma and cystic fibrosis in children at an early stage of influenza by calculating the ratio of IL-4/IFN-γ and IL-10/IFN-γ in children aged from 1 year to 12 years. Цель: разработать способ прогнозирования обострения основного заболевания при гриппе у детей, больных бронхиальной астмой и муковисцидозом, на основании изучения динамики цитокинов. Материалы и методы: обследованы 52 пациента с бронхиальной астмой и 45 детей с муковисцидозом в возрасте от 1 года до 12 лет, находившихся в инфекционно-пульмонологическом отделении на плановом лечении основной патологии, у которых грипп являлся госпитальной инфекцией. Контрольную группу наблюдений составили 40 пациентов с гриппом, но без сопутствующих бронхолегочных заболеваний. Этиология вирусной инфекции устанавливалась определением вирус-специфической РНК в носоглоточных смывах методом ПЦР. Среди вирусов гриппа определялись АH1N1, АH3N2, В, а в 2009–2010 гг. преобладающим антигеном являлся вирус пандемического гриппа АH1N1pdm09. Определение содержания в сыворотке крови интерлейкинов IL-1β, IL-4, IL-8, IL-10, ТNF-α, IFN-γ проводилось в 1-й и 3-й день госпитализации «сэндвич»-методом твердофазного иммуноферментного анализа. Статистическая обработка результатов выполнена с применением программы SPSS 17.0 RU for Windows. Результаты: грипп вызывал обострение сопутствующей бронхолегочной патологии у большинства детей, больных как муковисцидозом, так и бронхиальной астмой (65,4% и 66,7% соответственно). При увеличении коэффициента соотношения IL-4/IFN-γ и IL-10/IFN-γ как минимум в 5–6 раз грипп может считаться триггером обострения сопутствующей хронической бронхолегочной патологии. Нарастание прогностических коэффициентов в 2–3 раза позволяет ограничить лечение гриппа у данной категории больных противовирусными средствами. Заключение: представлен способ прогнозирования обострения бронхиальной астмы и муковисцидоза у детей на ранней стадии гриппа с помощью расчета коэффициентов соотношения IL-4/IFN-γ и IL-10/IFN-γ у детей в возрасте от 1 года до 12 лет.