Журнал «Здоровье ребенка» 1 (60) 2015

The article presents information on the impact of persistent intracellular infections on the disease and the immune system in children with asthma. We describe the clinical course of asthma, a condition of sensitization, levels of proinflammatory (IL-1, IL-2, IL-6, IL-8, IFN-α, IFN-γ, TNF-α) and anti-inflammatory (IL-4, IL -10) cytokines in serum.

As a result, the data group 2 were tested children. The main group (I group) consisted of 256 children with asthma background on intracellular infections: herpes, in particular herpes simplex virus types I and II, cytomegalovirus, Epstein-Barr-virus, Mycoplasma pneumoniae and Chlamydophila pneumoniae. A control group (group II) included 72 children with asthma are not infected with intracellular infections. The control group consisted of 50 healthy children of the same age.

In the study of children with bronchial asthma in 256 (78,1%) revealed the presence of IgM and / or IgG to various intracellular pathogens persistent - herpes simplex virus types I and II, cytomegalovirus, Epstein-Barr virus, Mycoplasma pneumoniae, Chlamydophila pneumoniae. Antibodies to herpes simplex virus types I and II were detected in 80 (31,3%), cytomegalovirus - in 124 (48,4%), Epstein-Barr virus - in 66 (25,8%), Chlamydophila pneumoniae - 71 (66,8%), Mycoplasma pneumoniae - 33 (12,9%) children.

In 72 (21,95%) were observed in children with asthma were not detected IgM and / or IgG antibodies to various viruses, and therefore the patients were assigned to group II - the comparison group.

Analysis of the clinical course of the disease suggests that children infected with herpesviruses, during the exacerbation of asthma longer, and the need for higher doses of inhaled corticosteroids. Lack of efficacy of the treatment of the disease may be associated with the course of the disease, combined with the addition of persistent intracellular infection. In children with asthma, occurring against the backdrop of the active intracellular infection marked longer and frequent development of exacerbations of the disease with a combination of obstructive and intoxication syndrome. These same children characterized by a mixed type of disorders of respiratory function compared to uninfected patients, which is dominant for obstructive respiratory failure type.

Analysis of Ig E, histamine and serotonin revealed higher values in the group of asthmatic children infected with intracellular pathogens.

We obtained data on the significant reduction in the level of IFN-α in serum of children with asthma, as infected and non-infected by intracellular pathogens. Reduction of IFN-α indicates a violation of antiviral immunity, violation of stimulation of cells having cytotoxic activity.

The content of the level of IFN-γ in the serum of children with asthma, flowing in the background and without infection with intracellular pathogens, 3 times higher than in healthy children. High levels of IFN-γ production associated with the persistence of the immune response to intracellular pathogens, promotes chronic infection, inflammation and increased risk of chronic systemic, including autoimmune disease.

For patients with asthma were characterized by higher levels of TNF-α in serum compared with healthy children. More pronounced this indicator was observed in the group of children infected with intracellular viruses.

In the main group and the comparison group showed an increase levels of IL-1 in the blood serum. Deviations of this cytokine overproduction confirm its dependence on antigen load in children with asthma, which is exacerbated in patients infected with intracellular pathogens, especially with the active during the infectious process.

Analysis of the level of IL-10 in the serum of patients with bronchial asthma children indicates statistically significant reductions compared to the healthy children.

Persistent intracellular infection can be treated as a trigger factor leading to an increase in bronchial hyperresponsiveness, worsening of asthma in children who have compromised immune status, which necessitates the introduction of complex examination of children to determine the level of immunoglobulin classes M and G in serum, as well as DNA of herpes simplex virus types I and II, cytomegalovirus, Epstein-Barr virus, and Mycoplasma pneumoniae Chlamydophila pneumoniae in the mucus scrapings from the mucous membrane of the mouth and, in case of active infectious process flow, of a specific causal treatment.