Volume 67 • Number 4 • Desember 2021
Influence of intestinal microbiota on the immunopathogenesis of atopic dermatitis in children
A. V. Zhestkov, O. O. Pobezhimova
Particular attention is paid to atopic dermatitis (AD) as one of the earliest and most frequent clinical manifestations of allergy in children. AD is a multifactorial disease, the development of which is closely related to genetic defects in the immune response and adverse environmental influences. It was found that the action of these factors determines the rate of development of AD, especially in young children. One of these factors is a violation of the intestinal microbiota, which plays an essential role in the development of the child’s immune system and has a protective effect in the formation of atopy. It has been shown that 80-95% of patients with AD have intestinal dysbiosis, while, along with a deficiency of lactobacilli and bifidobacteria, there is an excessive growth of Staphilococcus.
The use of modern molecular genetics technologies made it possible to obtain a fairly complete understanding of the number, genetic heterogeneity and complexity of the bacterial components of the intestinal microbiota, while clinical studies have shown the importance of its interactions with the host organism in the formation of various forms of pathology. It has been established that the human intestinal microbiota is an evolutionary set of microorganisms that exists as a balanced microecological system in which the symbiotic microflora is in dynamic equilibrium, forms microbial associations that occupy a certain ecological niche in it, and is one of the most important factors affecting human health.
The gut microbiota plays an important role in the pathogenesis of atopic dermatitis, which causes immunosuppression, but the exact mechanism of its action is still unclear. It is widely known that probiotics act on the immune system. These are living microorganisms with immunomodulatory effects that stimulate Th1 cytokines and suppress Th2 responses, which are being investigated for the treatment of several diseases. The most commonly used probiotics are part of the intestinal microflora such as lactobacilli, bifidobacteria and enterococci.
The purpose of this article: to systematize the information available today on the influence of the composition of the intestinal microflora on the immunopathogenesis of atopic dermatitis.
Predictive significance of pro-inflammatory interleukins at newborns with hypoxic-ischemic encephalopathy
L.Yu. Barycheva, A. S. Idrisova, E. S. Kuzmina, O. V. Agranovich, K. S. Mezhidov
Relevance. Hypoxic-ischemic damage to the central nervous system is accompanied by overproduction of pro-inflammatory interleukins in newborns. Perinatal inflammatory responses contribute to unfavorable outcomes.
Methods of investigation. The analysis of the cytokine profile in the blood serum was performed in 45 full-term newborns by the method of enzyme-linked immunosorbent assay within 4–96 hours after birth. 32 children had the signs of HIE stage 2, 13 children — HIE stage 3. Unfavorable neurological consequences were formed in 47,4% of children.
Research results. Revealed an increase in the levels of IL1β — 17,7 [13,6; 25,4] and IL6 35,2 [24,9; 45,0] in newborns with HIE. A significant increase in pro-inflammatory cytokines was found in patients with unfavorable outcomes compared with favorable ones. When predicting the disabling consequences of DIE, a high predictive value was established for IL1β and IL6.
Conclusion. In newborns with hypoxic-ischemic encephalopathy, an increase in serum IL1β and IL6 is observed. It is advisable to use an increase in IL1β >19,4 pg/ml (OR=12,80; 95% CI: 2,90–56,58) and IL6 >40,1 pg/ml (OR=11,33; 95% CI: 2,46–52,15).
Questions of immunodiagnostics in the teaching of phthisiology for students of the pediatric faculty
E. P. Eremenko, A. V. Kalinkin, B. E. Borodulin, E. A. Amosova, E. S. Vdoushkina, T. E. Akhmerova
The quality of training of medical specialists is laid down during training at a medical university, where basic knowledge and the ability to manipulate them are laid, and, on the basis of the acquired competencies, to form practical skills. The issues of tuberculosis infection occupy a significant part in the work of a pediatrician. First of all, these are the issues of screening the child population for tuberculosis, early detection and specific prevention of tuberculosis. For the effective preparation of students of the pediatric faculty, it is necessary to lay theoretical knowledge in the program, to form practical skills and abilities. Since the detection of tuberculosis patients is carried out in medical institutions of the general pediatric network, it is necessary to master professional competencies. The preparation of students within the framework of the basic specialty “phthisiology” has its own nuances due to the specifics of medical education, the diversity of tuberculosis infection, the peculiarities of the organization and provision of anti-tuberculosis care to the child population. Training in the specialty “phthisiology” requires a large amount of special knowledge, skills, improvement of the interdisciplinary approach, in accordance with the requirements of the federal state educational standard. The article provides an analysis of the ongoing training system for students of the pediatric institute in the online system, presents the experience of the department in teaching students during the period of distance education during the spread of a new coronavirus infection. The assessment of the results of practical training among 6th year students of the pediatric faculty (n = 123). It was revealed that it is not always possible to predict in advance the degree of understanding of the educational material, and even the depth of understanding the questions in the test problems. The use of scientific evidence-based statistical methods for evaluating test items helps in optimizing and objectifying knowledge control and understanding the educational material.
Clinical, immunomodulating and anti-recidive effects of ozone therapy in persistent allergic rhinitis in children
Ya. Yu. Illek, I. G. Suetina, N. V. Khlebnikova
Research оbjective. To determine the effect of ozone therapy on clinical indicators and the state of immunity in children with moderate persistent allergic rhinitis.
Material and methods. The study included children aged 5-10 years with moderate persistent allergic rhinitis, which were divided into two groups depending on the therapy. The first group of patients with allergic rhinitis received complex conventional therapy, the second group of patients with allergic rhinitis received complex treatment in combination with ozone therapy. Clinical parameters were studied in patients with allergic rhinitis, parameters of immunological reactivity were investigated during periods of exacerbation of the disease and clinical remission.
Results. It was found that the inclusion of ozone therapy in the complex treatment of patients of the second group ensured a faster onset of complete clinical remission (3.7 days earlier than in the first group of patients) and normalization of most immunity parameters, and also increased the expression of toll-like receptors on leukocyte cells. The duration of complete clinical remission in the group of patients with allergic rhinitis who received complex treatment in combination with ozone therapy (9.3 + 2 months) more than doubled (2.4 times) its duration in the group of patients with allergic rhinitis who received complex conventional therapy (3.9 + 0.3 months).
COMMUNICATIONS AND CORRESPONDENCE
Change in the microbiota of bronchial tree in children with bronchial asthma from past to our days
I.A. Fedorov, O.G. Rybakova