The role of human β-defensin 2 (HbD-2) and cathelicidin (LL-37) in the local protection of the upper respiratory tract in children with allergic rhinitis and bronchial asthma

Allergic diseases of the respiratory system seriously affect the psychological, physical and social aspects of the live of sick children, morally and financially exhausting members of their families as well. It is known that exacerbations of allergic diseases of the respiratory tract occur due to interaction with numerous triggers, one of which is a respiratory viral infection. At the same time, it is widely known that patients with allergic respiratory diseases are more prone to to acute respiratory infections. One of the reasons for this tendency often is an insufficient activity of non-specific factors of local immunity of the respiratory system – endogenous amphiphilic antimicrobial peptides, in particular the most studied their representatives - the family of defensins and human cathelicidin. Current research proves that these antimicrobial peptides are characterized by broad antiviral, antimicrobial and immunomodulatory activity. The aim of this study was to study the concentrations of local immune factors - human HbD-2 and LL-37 - in the secretion of the mucous membranes of the upper respiratory tract in children with asthma and allergic rhinitis and to clarify their role in protection against respiratory viral infections in this contingent of patients. We performed laboratory and clinical examinations of 76 children aged 7 to 18 years, of whom 24 were diagnosed with allergic rhinitis, 28 children - bronchial asthma, and 24 - bronchial asthma and allergic rhinitis. The control group consisted of 20 healthy children of the appropriate sex and age. In addition to general clinical methods, patterns of respiratory morbidity were analyzed and concentrations of antimicrobial peptides were determined: by ELISA human cathelicidin (LL-37), β-defensin 2 (HbD-2) in the secretion of the upper respiratory tract, statistical analysis was performed. It was found that children with allergic diseases of the respiratory tract are characterized by a higher frequency of acute respiratory infections with more frequent involvement of the lower respiratory tract, which led to an increase in the duration of the disease compared to their healthy peers. In children with allergic rhinitis and bronchial asthma, there was revealed a significant decrease in the concentrations of antimicrobial peptides in the secretion of the upper respiratory tract compared with the control group

Modern trends in the health status of the children's population of Ukraine

We have performed statistical analysis of the morbidity and prevalence of childhood illnesses and its significant differences in the regions of Ukraine

Dynamics of the incidence rate of pneumonia in children in Ukraine over the past 20 years

Pneumonia ranks third in the structure of hospital mortality in infants after perinatal pathology and congenital malformations in Ukraine. Over the past 20 years in Ukraine, there has been a 33,7% increase in the incidence of pneumonia in children (p˂0.01), with the predominant detection of this pathology in children from regions of the country who have problematic issues in the proper provision of pediatric services. The highest incidence of pneumonia in all age groups was observed in children of Ivano-Frankivsk, Rivne, Kyiv and Vinnitsa regions. Thanks to the progressive development of domestic pediatrics and the introduction of modern medical and diagnostic technologies, in particular, vaccine prophylaxis, over the past 20 years, the death rate of children from acute infections of the upper respiratory tract, pneumonia and influenza has decreased by almost 5 times. Changes in recent years in the incidence of pneumonia in children correspond to the dynamics of the spread of influenza and acute respiratory viral infection, especially during the epidemics 2009-2010 and 2015-2016. Assessing the dynamics of this indicator in subsequent periods is extremely important in the context of the COVID-19 pandemic, which continues

Mucolytic Therapy for Respiratory Diseases in Children

Pathogenetic mechanisms of mucociliary clearance disorders at respiratory pathology in children had been discussed. The analysis of drugs with mucolytic action, their effectiveness and safety had been carried out

Насморк у детей

В статье отмечены значимость и распространенность острых ринитов у детей, сопровождающихся насморком и затруднением носового дыхания. Описан метод безопасного и эффективного лечения ринитов у детей — ирригационная и элиминационная терапия растворами солей моря

New Approaches to Antibiotic Therapy for Acute Tonsillopharyngitis in Children

In recent years, a trend for reduced efficacy of treatment for acute tonsillopharyngitis with antibiotics of peni­cillin group in children has been observed. This is due to the changes in the etiology of the disease: in the genesis of acute tonsillopharyngitis, associations of β-hemolytic streptococcus with Gram-negative and Gram-positive microflora are involved. The use of II generation cephalosporins significantly improves the efficacy of therapy and reduces the risk of complications

Topical Therapy of Acute Pharyngitis in Children

The paper discusses the methods of topical antiinflammatory therapy for acute pharyngitis in children. The analysis of the complex of mechanisms (antiinflammatory, local analgesic ones) of Tantum Verde® action and method of its application are provided

Risk Factors for Pathology of the Upper Gastrointestinal Tract in Children with Bronchial Asthma

Матеріали і методи. Обстежено 120 дітей із бронхіальною астмою, з них у 78 виявлена супутня патологія верхніх відділів травного тракту. Усім дітям проведено загальноклінічне та лабораторно-інструментальне обстеження. На підставі аналізу первинної медичної документації (медичних карт стаціонарного хворого (ф-003/о) та історій розвитку дитини (ф-112)) ретроспективно виставлена оцінка даних анте-, пери- і постнатального періоду, даних клінічних проявів атопії та супутньої соматичної патології. Результати. На підставі проведеного регресійного аналізу виділені фактори ризику розвитку хронічної гастродуоденальної патології у дітей із бронхіальною астмою: стать дитини, тривалість захворювання, тяжкість перебігу та рівень контролю симптомів астми, а також тривалість грудного вигодовування, харчова сенсибілізація, інфекція H.pylori, наявність патології травної системи в батьків дитини. Розроблено кілька моделей прогнозування ризику розвитку хронічних захворювань верхніх відділів травного тракту (у тому числі й деструктивних) у даного контингенту хворих, заснованих на клініко-лабораторних показниках. Наведені прогностичні моделі мають достатній рівень чутливості, прості у використанні і можуть бути рекомендовані для роботи лікарям первинної ланки

Vitamin D level and peculiarities of IFN-γ and IL-4 production in young children with recurrent broncho-obstructive syndrome

Background. Broncho-obstructive syndrome (BOS), particularly, its recurrent course in young children, is an important question of modern pediatrics. The burdened allergic history, manifestations of atopy are traditionally considered as risk factors for recurrent episodes of BOS, which, however, are not present in all cases. Recently, the possible role of vitamin D (VD) in susceptibility to recurrent episodes of BOS is discussed due to its anti-infective effect that is provided by activating immune mechanisms. Thus, purpose of the research was to study VD level and peculiarities of interferon gamma (INF-g) and interleukin (IL) 4 production in the blood serum of young children with recurrent episodes of BOS. Materials and methods. 120 children aged 6 months to 3 years with a clinical diagnosis of acute obstructive bronchitis (J20) were examined, they were divided into two groups (group I — 60 patients with episodic BOS, group II — 60 children with recurrent BOS). The control group consisted of 30 clinically healthy children from 6 months to 3 years old. All patients were evaluated for anamnestic data, including the level of insolation, the severity of BOS according to a 12-point scoring scale, general clinical examination, pulse oximetry, and the asthma predictive index (API) was calculated. Laboratory studies included determination of 25-hydroxyvitamin-D (25(OH)D) concentration in the blood serum on days 2 and 3 of the disease using an electrochemiluminescence method on the Cobas e411 analyzer (serial number 1041-24, manufactured by Roche Diagnostics GmbH, Germany), serum concentrations of IFN-g, IL-4 by enzyme-linked immunosorbent assay method using IFA-Best sets (manufactured by Vector-Best, Russian Federation) and total calcium (Ca) according to the generally accepted method. Nonparametric statistical criteria were used in the analysis of the obtained data. The difference between the compared indicators was considered to be significant at a rate of p 0.05). API was negative in 78.3 % of patients of group II. The severe course of BOS was observed among children of group II two times more often than in group I (23.3 and 10.0 %, respectively, c2 = 4.50, p = 0.034). The mean of 25(OH)D in the blood serum in children of group I was 33.0 (28.19; 41.97) ng/ml and group II — 13.68 (7.96; 19.51) ng/ml (p < 0.001). The level of VD in 75 % of children in group II was considered as deficiency while in group I this indicator was 6.6 % (c2 = 57.98, p < 0.001). The inverse correlation was found between VD level and the incidence (r = 0.27, p = 0.002) and severity of BOS (r = 0.24, p = 0.008). The level of total Ca in the blood serum in both groups was within the normal range. The mean level of IFN-g in children of group I was 22.69 (8.98; 41.44) pg/ml and in group II — 21.08 (8.57; 37.03) pg/ml, both of which were higher than in the control group (12.18 (5.31; 12.92) pg/ml (p = 0.016 for both parameters). We revealed that the study groups differed by the level of VD supplementation, which was 60 % in group I and only 5 % in children of group II (p < 0.001). The mean serum level of IL-4 in group I was significantly higher in comparison to the corresponding parameters of group II and control group (p = 0.012 according to the Mann-Whitney U test for both indicators). The inverse correlation between the incidence of BOS and IFN-g level in the blood was found in children of group I (r = –0.45, p < 0.001), and between severity of BOS and the serum IL-4 concentration — in group II (r = –0.28, р = 0.030). Direct correlation between IL-4 and IFN-g (r = 0.41, p < 0.001) was revealed in patients with recurrent BOS. No correlation between VD and immunological indicators was found. Conclusions. BOS has predominantly viral etiology in young children. The severe course of the disease is more common in children with recurrent episodes of BOS although most of them have negative asthma predictive index. In 3/4 of patients with recurrent BOS, the level of VD is within the deficiency level. VD inversely correlates with severity and the incidence of BOS episodes. Vitamin D level in young children mostly depends on level of its supplementation. The course of BOS in young children is accompanied by increasing serum level of IFN-g in the acute period of the disease regardless of the incidence of BOS episodes in the past medical history. Study groups do not differ from each other in the blood serum levels of IL-4 while in the presence of recurrent episodes, this indicator is directly correlated with IFN-g. Thus, IFN-g and IL-4 do not significantly affect the incidence and severity of BOS in young children, as opposed to vitamin D, which might be considered as a predictor of the severe course of BOS and development of its recurrent episodes