CYTOKINE PROFILE OF CHILDREN WITH ATYPICAL PNEUMONIA

Abstract

Resume: The original article presents the results of studying the cytokine profile in children with atypical pneumonia (АР) and develops a matrix of differential diagnosis taking into account clinical and laboratory parameters. The results of the study are recommended for widespread implementation in the practical activities of pediatricians of family polyclinics and central district polyclinics of primary health care.

The aim of the study was to study the cytokine status and develop a matrix for the differential diagnosis of atypical pneumonia in children.

Materials and methods of research. The sick children were divided into groups (all 124 children): 1-a group of sick children with AP aged 1-3 years (32 sick children); 2-a group of sick children with AP aged 4-7 years (32 sick children); the control group consisted of 60 healthy children, of whom 30 were aged 1-3 years and 30 children aged 4-7 years old. For the quantitative determination of cytokines IL-8, IL-17A, IL-13 and PCT in blood serum, a set of reagents from ZAO VectorBest was used. The calculation of the results was carried out graphically with the construction of a calibration curve. Statistical processing methods used to assess the reliability of the results obtained were carried out using Microsoft Excel and AtteStat software packages. The analysis included the determination of the arithmetic mean (M), the standard deviation (σ), and the error of the mean (m).

Results. The results of the study showed an increase in IL-8 synthesis: in young children with AP by 2.3 times; in children with AP aged 4-7 years by 3.0 times (P<0.05), relative to healthy children. There is also an increase in the level of IL-13 in the blood of patients: group 1 by 1.29 times; group 2 by 1.1 times (P<0.05), relative to the indicators of healthy children.

Conclusion. Thus, the study of the cytokine profile in children with AP showed an increase in the synthesis of IL-8 by 2.3-3.0 times, IL-13 by 1.3 times, IL-17A by 3.0-4.0 times, which indicates a comorbid course of AP in children.

Among all the above clinical and laboratory parameters for the diagnosis and differential diagnosis of AP in preschool children (4-7 years old), the determination of PCT and IL-17A in the blood is more informative.  And for young children, IL-13 is a more informative laboratory immunological indicator, an increase in its level excludes atypical pneumonia in young children.