EFFICIENCY OF ANTI-INFLAMMATORY AND IMMUNOMODULATORY THERAPY OF COMMUNITY-ACQUIRED PNEUMONIA IN CHILDREN WITH RECURRENT RESPIRATORY DISEASES

Objective: to improve the methods of treatment of community-acquired pneumonia in children with recurrent respiratory diseases, taking into account the state of mucosal immunity. The authors examined 65 children from 3 to 7 years with community-acquired pneumonia and recurrent respiratory diseases. The main group consisted of 25 children receiving Fenspiride (4 mg / kg for 7 days) and immunomodulator Azoximer bromide (sublingually, 6 mg tablets twice a day for 10 days) in the complex anti-inflammatory therapy. The comparison group included 20 children receiving only Fenspiride (4 mg / kg for 7 days) as part of complex therapy. Control group included 20 children receiving only traditional therapy. We determined the levels of pro-inflammatory (IL-8, IL-1, α-factor tumor necrosis) and regulatory cytokines (IL-10 and γ-interferon) in induced expectoration by an immune enzyme analysis. We found that due to the therapy the imbalance of both pro-inflammatory and regulatory cytokines was leveled in the main group against a background of positive clinical efficacy that is manifested by reduction of the febrile period, faster relief of respiratory syndrome and local pulmonary changes, and 2 times reduction in the frequency of recurrent respiratory diseases.

children, community-acquired pneumonia, recurrent respiratory diseases, cytokines, mucosal immunity, treatment

1. Geppe N.A., Malakhov A.B., Dronov I.A., Khabibullina E.A. Community-Acquired Pneumonia in Children: Diagnosis, Treatment and Prevention Challenges. Doctor. RU 2015; 13: 28–30. (in Russ)

2. Mizernitsky Yu.L. Childhood pulmonology: advances, tasks, and prospects. Ros vestn perinatol i pediatr (Russian Bulletin of Perinatology and Pediatrics) 2014; 59(2): 4–12. (in Russ)

3. Kendig and Chernick`s Disorders of the respiratory tract in children. Eighth edition. Elsevier Saunders, USA, 2012; 1142.

4. Mateiko G.B., Pylyuk I.I. Features of the clinic and risk factors for the development of pneumonia in children, often suffering from acute respiratory diseases. Mezhdunarodnyj zhurnal prikladnyh i fundamentalnyh issledovanij ( International Journal of Applied and Fundamental Research) 2015; 8: 55–58. (in Russ)

5. Community-acquired pneumonia in children. Clinical recommendations. Moscow: Layout original 2015; 24–25. (in Russ)

6. Malanicheva T.G., Mozhgina S.S. Morbidity and age structure of community-acquired pneumonia in children. Ros vestn perinatol i pediatr (Russian Bulletin of Perinatology and Pediatrics) 2017; 62(4): 127. (in Russ)

7. Galimova L.F., Pikuza O.I., Zakirova A.M., Suleymanova Z.Ya. Features of the cytokine profile in community-acquired pneumonia in children caused by atypical pathogens. Reproduktivnoe zdorov’e detej i podrostkov 2017; 2: 56–64. (in Russ)

8. Mizernitski Yu.L., Kabulov G.G. J. Problems of an immunology in pulmonology children (the opinion of a Clinician). Azerb Allergy Clin Immunol 2013; 1: 36–41. (in Russ)

9. Generalova E.V., Vahitov H.M., Gayfullina R.F., Rizvanova F.F., Vahitova L.F. Minimally Invasive Methods of Diagnosis of Bronchitis Severity in Children. Res J Pharm Biol Chem Sci 2016; 7(6): 2879.

10. Malanicheva T.G., Mozhgina S.S., Agafonova E.V. Effective mechanisms of mucosal immunity and the possibility of their correction in children with community-acquired pneumonia in association with the syndrome of increased incidence of viral infections Ros vestn perinatol i pediatr ( Russian Bulletin of Perinatology and Pediatrics) 2017; 62(5): 139–143. DOI: 10.21508/1027-4065-2017-62-5-139-143 (in Russ)

11. Malanicheva T.G., Mozhgina S.S., Agafonova E.V. Imbalance of pro- and anti-inflammatory cytokines in children with community-acquired pneumonia, taking place against a background of reduced resistance of the organism and the possibility of its correction. Pediatria. Journal named after G.N. Speransky 2017; 5: 90–96. (in Russ)