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    World of Medicine and Biology / №2(64), 2018 / ASSESSMENT OF IMMUNOLOGICAL DISORDERS IN THE GENESIS OF BRONCHIAL ASTHMA IN CHILDREN WITH DIFFERENT DEGREES OF THE DISEASES CONTROLLABILITY
    Lytvynets L.Ya., Lytvynets-Golutyak U.Ye., Chopyak V.V.

    ASSESSMENT OF IMMUNOLOGICAL DISORDERS IN THE GENESIS OF BRONCHIAL ASTHMA IN CHILDREN WITH DIFFERENT DEGREES OF THE DISEASES CONTROLLABILITY

    About the author: Lytvynets L.Ya., Lytvynets-Golutyak U.Ye., Chopyak V.V.
    Heading CLINICAL MEDICINE
    Type of article Scentific article
    Annotation The study involved 87 children aged 6 to 18 years, patients with BA who were hospitalized in Ivano-Frankivsk Regional Pediatric Hospital at Allergic department during 2009-2010. The diagnosis of asthma was verified in accordance with the Protocol of diagnosis and treatment of BA in children № 868 from 03.10.2013. According to the level of controllability for asthma, taking into account the results of BA control test (GINA, 2009) the children were divided into two groups: 28 patients – with partially controlled asthma (PCBA), 22 patients – with uncontrolled asthma (UCBA) and 22 patients – with controlled asthma (CBA). The control group consisted of 10 children who live in different parts of Ivano-Frankivsk region, selected by random sampling. We studied cellular and humoral immunity using methods of direct rosette developing with erythrocytes coated with monoclonal antibodies to CD3 +, CD4 +, CD8 +, CD22 + (Production of Vitebsk Medical University, Belarus), CD4/CD8 values of immunoregulatory index and phagocytic immunity. State of nonspecific resistance was studied by determining the phagocytic activity of neutrophils (PA) and oxygen dependent metabolism in spontaneous NBT-test, functional reserve in terms of phagocytic cell numbers (PCN), an index of neutrophil activation in stimulated NBT test, made by the quantitative spectrophotometric method for T. Gentle i R. Thompson ("Renal", Hungary). The concentration of cytokines (IL-6 and IL-4) in serum were determined by ELISA in the machine "STAT-Fax 303 Plus" (USA) using test system of "Diaclone" (France) according to the manufacturer's instructions. Children with asthma have insufficient capacity of nonspecific protection that is determined by the severity of illness and is the most significant factor in patients with nonkontrol bronchial asthma (р<0,05). An important factor in forming the immune response is the activation of humoral component. Low number of T-lymphocytes in the blood in asthma may be caused by the accumulation of these cells in the airways and is a predictor of inflammation in the bronchi. As for cytokine status, the maximum level of serum IL-4, which is characteristic in NKBA, is a manifestation of severe allergic component in the pathogenesis of the disease in this category of patients and indicates the mechanism of Th2-allergic response and inflammation, it switches the synthesis of level of serum IL-6 and СD4+ and СD8+ (р<0,05) (r=0,79, p<0,05) thus significantly affecting the severity of asthma. Stimulated NBT test showed a low potential activity of phagocytic cells and completeness of phagocytosis in patients with NKBA in comparison with those in the healthy group (Pn<0,05). We found that oxygen dependent microbiocidal neutrophils increased in patients with NKBA and PCBA, (P <0.05), which gives reason to confirm the presence of the relationship between activation of blood neutrophils and the development of chronic inflammation in the bronchi in patients with bronchial asthma. The level of immunological changes in patients with bronchial asthma can serve as a marker of systemic violations of cellular metabolism: there is a decrease in cellular link and stress regulatory component of humoral immunity. In terms of spontaneous NBT-test revealed an insufficient degree of stimulation of phagocytic cells and their low capacity for keeling in patients with NKBA and PCBA.
    Tags bronchial asthma, children, immunity
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    Publication of the article «World of Medicine and Biology» №2(64), 2018 year, 057-061 pages, index UDK 613.955+616-08
    DOI 10.26724/2079-8334-2018-2-64-57-61