CHARACTERISTICS OF CYTOKINE STATUS OF CHILDREN WITH ACUTE BRONCHIOLITIS

Abstract

The original article presents the results of a clinical and laboratory study, as well as a study of the cytokine profile in young children with acute bronchiolitis. Changes in the content of interleukins are recommended to be used as markers for predicting the severity of the disease.

Purpose of the study: Study of the features of cytokine status in young children with acute bronchiolitis.

Materials and methods of research: 36 children with acute bronchiolitis aged 1-12 months, hospitalized in the period 2022-2023, were examined. in the departments of emergency pediatrics and pediatric intensive care. All children had bronchial obstruction of varying severity. To assess the prognosis of the severity of bronchiolitis, a scoring scale was used based on clinical and auscultatory signs of ESBA(J.M. Ramos Fernаndez et all, 2013). All patients underwent laboratory and instrumental examination: general blood test blood gas study, oxygen saturation (SpO2), chest x-ray. To determine the level of IL-6, IL-8, TNF ά, the enzyme-linked immunosorbent assay method was used.To detect viral antigen (RSV, adenovirus, rhinovirus, parainfluenza), a real-time polymerase chain reaction was performed using commercial kits “Reverta” and “Amplisense-200” (Russia). To determine the causative agent of infections (Chlamydia pneumonia, Mycoplasma pneumonia), an enzyme-linked immunosorbent assay (ELISA) was performed using a standard commercial set of reagents “CHEMA” (Russia).

The results: For the first time in the region, the Acute Bronchiolitis Severity Scale (ESBA) was used, which includes clinical parameters, with the help of which the child’s condition is assessed during the initial examination by a doctor, before the use of instrumental research methods. The study of interferon status showed that the highest pathological level of interleukins was observed when RSV was combined with Chlamydia pneumonia (n=3) (IL-8 - 39.66±0.66 ng/ml, IL-6 - 47.33±1.20 ng/ml, TNFα 69.0±9.6 ng/ml), while the level of interleukins during RSV monoinfection (n=19) also remained at a high level, not significantly different from the previous group (IL-8 - 39.021±0, 92 ng/ml, IL-6 – 43.68±1.75 ng/ml, TNFα 60.7±3.68 ng/ml).

Conclusion. A relationship was revealed between the expression of interleukins and the severity of acute bronchiolitis, which is characterized by an increase in the concentration of IL-6, IL-8 and TNFα depending on the severity of the disease. Changes in interleukins are recommended to be used as markers for predicting the severity of the disease.