E.V. VOLYANYUK¹, A.I. SAFINA¹, KH.M. VAKHITOV², A.M. ZAKIROVA², F.F. RIZVANOVA³, E.V. YAZDANI¹, E.L. RASHITOVA⁴

 ¹Kazan State Medical Academy — branch of the Russian Medical Academy of Continuous Professional Education, Kazan

²Kazan State Medical University, Kazan

³Institute of Fundamental Medicine and Biology, Kazan (Volga Region) Federal University, Kazan

⁴National Medical Research Center for Pediatric Hematology, Oncology and Immunology named after Dmitry Rogachev, Moscow

Contact details:

Zakirova A.M. — PhD (Medicine), Associate Professor, Department of Propaedeutics of Childhood Diseases and Faculty Pediatrics

Address: 49 Butlerov St., 420012 Kazan, Russian Federation, tel.: +7 (843) 236-06-52, e-mail: azakirova@gmail.com

The purpose — based on the indicators of neutrophil oxygen metabolism and endotoxinemia, to assess the severity of neonatal adaptation in late premature infants in order to optimize patient management tactics.

Material and methods. A total of 108 newborn infants between 34 0/0 and 36 0/7 gestational ages were examined, including 72 infants with severe adaptation (the study group) and 36 infants with moderate adaptation (the comparison group). The control group included 23 generally healthy full-term infants born between 39 0/0 and 41 0/7 weeks of gestation. Anti-endotoxin immune reactivity was assessed using enzyme-linked immunosorbent assay to measure antibody concentrations to glycolipid antigens. Neutrophil oxygen metabolism was measured using luminol-dependent chemiluminescence in both spontaneous and induced modes. Statistical analysis was performed using IBM SPSS Statistics-23.

Results. We found that the concentration of antibodies to gram-negative bacterial antigens in infants with severe adaptation decreased not only relative to the control group (p < 0.001) but also relative to the comparison group (p < 0.01). In cases of severe adaptation, the metabolic profile of phagocytes is disrupted, and active forms of the process occur slowly, which reduces their biocidal generating potential and leads to colonization of gram-negative flora in the intestine (a source of lipopolysaccharides) and the entry of increased concentrations of endotoxin into the bloodstream. A positive correlation was established between spontaneous chemiluminescence indices and the concentration of antiglycolipid antibodies (p = +0.43, p < 0.01), which reflects bacterial endogenous stimulation of neutrophils under dysbiotic shifts in the intestinal microbiome. The analysis showed a maximal negative association between the indicators of induced chemiluminescence and antiendotoxin immunity (p = –0.77, p < 0.001).

Conclusion. An integrated assessment of the specific and phagocytic immunity links reflects the state of the adaptation background of newborns 34 0/0–36 0/7 weeks of gestation, the nature of the course of the neonatal period and expands diagnostic capabilities in optimizing the tactics of managing late premature infants.

Key words: late premature infants, specific antiendotoxin immunity, neutrophil oxygen metabolism, adaptation

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