Syndrome of system inflammation in the pathogenesis of respiratory syncitial viral infection

The aim of the study was to obtain new biochemical data on the pathogenesis of respiratory syncytial viral infection (RSVI) in children.Object and methods: 60 children aged 1 month to 5 years, treated in the clinic of Pediatric Research and Clinical Center for Infectious Diseases, from which in 50 patients RNA RSV was isolated in smears from the oropharynx. The comparison group consisted of 10 children who failed to verify RSVI by laboratory methods. All children at admission and before discharge from the hospital (after-7-9 days) underwent a clinical blood test a Sysmex XP-300 hematology analyzer (Japan). Alpha-1-antitrypsin and alpha-2-macroglobulin were determined in blood serum by quantitative immunoturbidimetry on a biochemical analyzer CLIMA-15 (Spain) using Sentinel test systems (Italy). Determination of the amount of total protein, albumin and C-reactive protein in serum was carried out on an automatic analyzer Taurus (Instrumentation Laboratory, Italy) using reagents of the company «Vector-best» (Russia). The study of protein fractions in blood serum was carried out by capillary electrophoresis on the device Minicap company Sebia (France) with the help of test systems «Minicap Protein(e) 6» of the same manufacturer. The levels of cytokines (IL-6, IL-10) in serum were determined by ELISA on ELISA analyzer «INFINITI» (TECAN, Austria) using reagents firm «Vector-best» (Russia).Results: RSVI occurs with lesions of the lower respiratory tract in 42% of cases, with the development of complications in 44% of sick children. The study revealed a prolonged increase in serum alpha-2 fraction of globulins, immunoregulatory cytokines with pro-inflammatory (IL-6) and anti-inflammatory (IL-10) action and, which may indicate the presence of subacute inflammatory process associated with the persistence of RS-virus. Lower levels of gamma-globulin fraction, including the main specific and nonspecific immunoglobulins, in children with PCR-proven RSVI, both in the acute period and in the period of convalescence, probably can cause repeated RSV-diseases, as well as an increase in the risk of atopic diseases.Conclusion. The long-term increase in the level of subacute inflammation markers, established in the course of the study, even against the relieve of clinical picture of the disease, makes the question of developing an etiopathogenetic treatment of respiratory syncytial viral infection with the use of drugs with antiviral and anti-inflammatory action relevant.

Modern Approaches in management of Children with Acute Bronchiolitis

The experts of the Union of Pediatricians of Russia have developed up-to-date clinical guidelines on management of children with acute bronchiolitis. Around 150 million cases of bronchiolitis (11 cases per 100 infants) are registered annually, 7–13 % of all cases require hospital treatment and 1–3 % require management in intensive care unit. Almost all children of the age under 2 years old (90 %) undergone respiratory syncytial viral infection. In 20 % of them they have bronchiolitis due to various factors. This article covers the issues of epidemiology, pathogenesis, differential diagnostics, treatment based on the principles of evidence in detail.

IMMUNIZATION OF BRONCHOPULMONARY DYSPLASIA PATIENTS AGAINST RESPIRATORY PATHOGENS

Prevention of exacerbations of bronchopulmonary dysplasia (BPD) directly affects the outcome of the disease and belongs to the priority areas of pulmonology of early childhood age. Seasonal immunoprophylaxis of the severe course of respiratory syncytial viral infection (RSVI) with palivizumab and vaccine prophylaxis of pneumococcal and hemophilic infections in children who have formed BPD has been established to allow to reduce the frequency of hospitalization, resuscitation and death. The authors present their own data on results of passive and active immunization of BPD children against pathogens of the respiratory spectrum.