Pediatrics & Therapeutics
Open Access
ISSN: 2161-0665
+44 1478 350008
ISSN: 2161-0665
+44 1478 350008
Berezhnaya Irina Vladimirovna and Zakharova Irina Nikolaevna
Russian Medical Academy of Continuous Professional Education, Russia
Posters & Accepted Abstracts: Pediatr Ther
Objectives: To study the infectious status in children with diff erent variants of colitis. Methods: 101 children were examined with colitis from 1.5 to 15 years of age, of which 34 preschool children and 67 schoolchildren. In the main group, 59 children with IBD were identifi ed, of which 22 patients with ulcerative colitis (UC), 5 with Crohn's disease (CD) and 32 with undiff erentiated colitis. When examined in 42 patients, according to the morphological conclusion, eosinophils formed the basis of the colon mucosa infi ltrate and these children were assigned to the group with eosinophilic colitis (EC). Th e control group consisted of 101 children with chronic constipation and intestinal microbiota disorder. In the control group of preschool children 34 children and 67 school-age children. To study the infectious status in children with diff erent variants of colitis, an examination of the intestinal microbial landscape, shigela, yersinia and salmonella antibodies in the blood by ELISA to CMV, the Epstein Barr virus was carried out. In therapy against the background of standard therapy with the preparation of 5-ASA, the interferon-�?�?�?± preparation was used according to the scheme. Results: Since it is now proven that patients with autoimmune diseases have a high HLA-B27 leukocyte antigen, which has an antigenic similarity to Yersinia, we examined patients with IBD, EC and comparison groups for the presence of intestinal infections. In the stools of pathogens, pathogenic microorganisms have not been identifi ed. According to the RPGA, titers 1: 400 - 1: 800 are considered diagnostic for salmonellosis and yersiniosis. In the group of children with IBD and EC, elevated titles to Yersinia were more oft en detected in 47 children with IBD (79.6%) and EC in 31 children (73.8%), while in the comparison group only 24.7% (p <0.001). High ATs to nuclear AG and relatively low AT to capsid AG in the main group were detected in 100% of children, while in the comparison group only in a quarter (p <0.005). Th is may indicate an incomplete immune response to infection with EBV and the possibility of forming a chronic course of the disease in children with colitis. Th ere was no signifi cant diff erence in these parameters in children with IBD and EC. In the study of the cytokine status of patients with colitis, excessive secretion of IFN-�?�?�?³ (44.39 �?�?�?± 22.56 pg / ml) and an increase in the induction of IL-1 and TNF-�?�?�?± synthesis were revealed, may be a consequence of immuno-infl ammatory process in the intestine, signifi cant diff erences in children with IBD and EC were not detected (p <0.5). Th ese eff ects were not observed in children in the comparison group (p <0.001). Signifi cantly �?¢�?�?�?�? IL-4 explains �?¢�?�?�?�? phagocytosis (�?¢�?�?�?�? approximately 30% below normal) and �?¢�?�?�?�? total Ig E (�?¢�?�?�?�? more than twice) in children with IBD and EC, even without weighting allergic anamnesis. A signifi cant �?¢�?�?�?�? endogenous IL-1 IL-1RA antagonist and IL-10 in a group of children with IBD and EC (p <0.05) was noted as a compensatory mechanism that occurs against the background of an increase in pro-infl ammatory cytokines. In the group of children with IBD and EC, �?¢�?�?�?�? IgG (15 �?�?�?± 3.06 g/l) and �?¢�?�?�?�? IgM (1.63 �?�?�?± 0.39 g/l) are noted in the serum, with �?¢�?�?�?�? serum IgA (0.76 �?�?�?± 0,19 g/l). In the comparison group, IgM and IgG values are within the age limit, whereas IgA �?¢�?�?�?�? (p <0.001). Conclusions: Th e inclusion of recombinant IFN-�?�?² in the therapy of IBD and EC is accompanied by a signifi cant decrease in the level of proinfl ammatory cytokines IL-8, 6, TNF-�?�?�?± and normalization of the level of immunoglobulins (IgA, IgM, IgG, IgE) in the blood. In children who received 2 courses of interferon-�?�?�?± for 2 years, a signifi cant decrease in the frequency of respiratory infections was noted, compared with the previous two years of follow-up. During the follow-up (10 years) of children with EC, 12 years aft er 3 years of diagnosis of UC, in 5 children with ulcerative colitis aft er 5 years - CD.
Berezhnaya Irina Vladimirovna is an Associate Professor of the Department of Pediatrics of the Russian Medical Academy of Continuing Vocational Education.