T.G. MALANICHEVA², E.V. AGAFONOVA², S.S. MOZHGINA¹

¹Children’s Republican Clinical Hospital of the Ministry of Health of the Republic of Tatarstan, 140 Orenburgskiy Trakt, Kazan, Russian Federation, 420138

²Kazan State Medical University, 49 Butlerov Str., Kazan, Russian Federation, 420012

Malanicheva T.G. — D. Med. Sc., Professor of the Department of propaedeutics of childhood diseases, and departmental pediatrics with the course of childhood diseases of the department of general medicine, tel. (843) 268-58-21, e-mail: [email protected]

Agafonova E.V. — Cand. Med. Sc., Assistant of the Department of propaedeutics of childhood diseases, and departmental pediatrics with the course of childhood diseases of the department of general medicine, tel. (843) 268-58-21, e-mail: [email protected]

Mozhgina S.S. — Deputy Chief Physician at the medical unit, tel. (843) 268-68-11, e-mail: [email protected]

The state of mucosal immunity in 53 children aged 3 to 7 years with community-acquired pneumonia (CAP) occurring against a background of recurrent respiratory diseases is examined. The main group constitutes of 30 children with community-acquired pneumonia, occurring against a background of recurrent respiratory diseases, the comparison group — 23 children with community-acquired pneumonia who do not belong to a group of frequently ill children, the control group — 25 children without acute respiratory diseases. Mucosal immunity is studied by evaluating the cellular composition of induced sputum, cytomorphological cell profile, functional activity of neutrophils of induced sputum, and some parameters of the cytokine status (IL-8, IL-10, TNF-α, IFN-γ). It was revealed that in case of community-acquired pneumonia against a background of recurrent infections violation of cytokine balance (decreased IL-8, IFNγ and increased TNF-α) leads to restriction of the output of neutrophil population in bronchial contents and alveolar secret and to increase of the number of neutrophils and epithelial cells with pronounced destructive changes of nuclei and cytoplasm. Secondary dysfunctions of mucosal immunity against a background of redistribution, morphocytological changes in cell populations and the formation of a neutrophil phenotype with low phagocytic capacity, requiring differentiated correction, are being developed.

Key words: children, community-acquired pneumonia, recurrent respiratory diseases, mucosal immunity.

REFERENCES

1. Vnebol’nichnye pnevmonii u detey: rasprostranennost’, diagnostika, lechenie, profilaktika. Nauchno-prakticheskaya programma [Community-acquired pneumonia in children: prevalence, diagnosis, treatment, prevention. Scientific-practical program]. Moscow: Original-maket, 2010. 63 p.
2. Lyutina E.I., Manerov F.K. Morbidity and mortality from community-acquired pneumonia in children and adolescents who live in the Kuzbass. Pediatriya, 2015, no. 2, pp. 203-206 (in Russ.).
3. Vnebol’nichnaya pnevmoniya u detey. Klinicheskie rekomendatsii [Community-acquired pneumonia in children. Clinical guidelines]. Moscow: Original-maket, 2015. 64 p.
4. Geppe N.A., Malakhov A.B., Dronov I.A., Khabibullina E.A. Community-acquired pneumonia in children: diagnostic issues, treatment and prevention. Doktor. Ru, 2015, no. 13, pp. 28-30 (in Russ.).
5. Mateyko G.B., Pylyuk I.I. Features of clinic and risk factors for pneumonia in children with frequent episodes of acute respiratory illness. Mezhdunarodnyy zhurnal prikladnykh i fundamental’nykh issledovaniy, 2015, no. 8, pp. 55-58 (in Russ.).
6. Kulichkov V.I., Mizernitskiy Yu.L., Rybakova O.G., Minina E.E., Zhakov Ya.I. A method for producing induced sputum in children to assess the extent and nature of the bronchial mucosa inflammation, no. 2008116364; appl. 24.04.2008; publ. 20.08.2009, Byul. no. 23. 10 p.
7. Matveeva L.A. Mestnaya zashchita respiratornogo trakta u detey [Local protection of the respiratory tract in children]. Tomsk: Izd-vo Tomskogo un.-ta, 1993. 276 p.
8. Ketlinskiy S.A., Simbirtsev A.S. Tsitokiny [Cytokines]. Saint Petersburg: OOO “Izdatel’stvo Foliant”, 2008. 552 p.
9. Reuter S., Heinz A., Sieren M.et al. Mast cell-derived tumor necrosis factor is essential for allergic airway disease. Eur. Respir. J, 2008, vol. 31 (12), pp.773-782.
10. Cazzola M. Anti-TNF-alpha and Th1 cytokine-directed therapies for the treatment of asthma. Curr. Opin.Allergy Clin.Immunol, 2006, vol. 6, pp. 43-50.