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"Child`s Health" 7 (58) 2014

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Features of the inflammatory process at infants with different forms of acute bronchitis

Authors: Abaturov A.Е., Rusakova Е.A. - State Institution «Dnipropetrovsk State Medical Academy of Ministry of Public Health of Ukraine»

Categories: Pediatrics/Neonatology

Sections: Clinical researches

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The aim of the research: to explore the features of some of the molecular mechanisms of the inflammatory process at infants, depending on the clinical form of acute bronchitis.

Materials and methods. We have examined 60 children aged from 6 months to 3 years.  There were 40 patients with acute obstructive bronchitis and signs of respiratory insufficiency of the I-II degree (the first group of observations). The second group of observations consisted of 20 children with acute simple bronchitis. We determined the concentration of total IgE, content of IFN-γ, IL-4 and IL-13 in serum by ELISA and the expression of the transcription factor NF-κB in lymphocytes of peripheral blood by flow cytometry at all the children. Начало формы

Results. The infants with obstructive bronchitis had significantly low levels of IFN-γ in serum compared to those children with simple bronchitis both in the acute stage of the disease and during convalescence. Average values ​​of content of IL-4 and IL-13 in serum of both groups did not differ significantly. 60% of children with simple bronchitis and 54.5 % of children with obstructive bronchitis had high concentration of IgE in the acute stage of the disease. During convalescence the proportion of these children was 50% and 31.6 % of cases respectively. In both phases of the disease development the patients with obstructive bronchitis had significantly higher value of IgE than the children with simple bronchitis. The relative number of lymphocytes expressing the transcription factor NF-κB, and the expression of nuclear factor κB did not depend on the clinical forms of acute bronchitis and the stage of the disease. In acute period of simple bronchitis the level of expression of transcription factor NF-κB determined the concentration of IgE in serum (r = + 0.58; p ≤ 0.05). So there was an allergic mechanism of inflammation, which was controlled by a strong inverse correlation between NF- κB and anti-inflammatory IL-13 (r = -0.52; p ≤ 0.05). IL-13 reduced the whole activity of the inflammatory process. The acute stage of obstructive bronchitis was characterized by a lot of the correlative relationships between the inflammatory markers. So the level of expression of the transcription factor NF-κB defined levels of pro-inflammatory cytokine IFN-γ (r = + 0.40; p ≤ 0.05) and the concentration of IgE in serum (r = + 0.59; r≤0.05), which formed the activity of the inflammatory response. The inflammation had an allergic orientation, reinforced by the correlative relationships between concentrations of IgE and IL-4 (r = + 0.32; p ≤ 0.05), IL-4 and IFN-γ (r = + 0.42; p ≤ 0.05). The structure of relations between the parameters, which were being defined, changed in the period of convalescence of obstructive bronchitis. The relations between the level of expression of the transcription factor NF-κB and IFN-γ, as well as between the concentrations of IFN-γ and IL-13 disappeared. In addition, the inverse relationship between the level of expression of NF-κB and IL-13 became stronger, and a relationship between concentrations of Th2-associated interleukins 4 and 13 appeared (r = + 0.40; p ≤ 0.05). The period of convalescence of simple bronchitis was characterized by the lack of correlation between the studied parameters. Thus, we can state that an allergic component of inflammation took place in the beginning of acute bronchitis at infants independent of it’s clinical form, which was controlled by anti-inflammatory mechanisms in simple bronchitis and was supported by the development of an active inflammatory process with the formation of Th2-associated response in obstructive bronchitis.


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