Клиническое значение интегральной регистрации маркеров эндотоксического иммунитета и колонизационной резистентности буккальных эпителиоцитов при рецидивирующем бронхите у подростков

Abstract

Recurrent bronchitis (RB) occupies one of the key places in the structure of nonspecific diseases of the respiratory tract and remains a significant medical and social problem in healthcare. The purpose — to investigate and evaluate the clinical significance of integral registration of markers of endotoxic immunity and colonization resistance of buccal epithelial cells (BE) in RB in adolescents. Material and methods. The study included 117 children (12–17 years old), including 78 with RB — the main group, 29 with acute bronchitis (AB) — the comparison group and 23 conditionally healthy children — the control group. The analysis of anamnestic, clinical, paraclinical data, verification of etiologically significant viruses, registration of artificial colonization of buccal epithelial cells (BE), colonization index (CI), micro-LAL test were carried out. Statistical processing of the results was carried out using the SPSS program. Results. A significant difference in markers of colonization resistance and anti-endotoxin protection was revealed in recurrent inflammation in the respiratory tract in comparison with AB in peers. In RB, the initial degree of Candida albicans adhesion to BE was significantly higher in relation to AB (p = 0.0427) and upon discharge from the hospital did not reach normative values, being significantly different from patients with AB (p = 0.0391). The high index of artificial colonization indicates the activation of allochthonous flora and disruption of the microbiota in the oral cavity, which negatively affects the body reactivity. In patients with RB, the titer of antiglycolipid antibodies significantly decreased and in 75% the values did not return to normal, while in AB they did not differ from the control. High levels of endotoxin were noted in RB compared to AB (p = 0.0317). Such patients were diagnosed with a more severe course of the disease with symptoms of endogenous intoxication and a long hospitalization period. Using the method of correlation analysis, a high direct relationship was established between artificial colonization and endotoxin concentration (r = 0.71). The relationship between these parameters in AB was significantly less pronounced (r = 0.3). The results obtained indicate close integration and mutual modulation of the local oral immunity and antiendotoxin defense. Conclusion. Integral registration of the markers of reactivity of specific anti-endotoxin immunity and colonization resistance reflect the severe inflammatory process in the respiratory tract and predict the risk of a chronic pathological process in the bronchopulmonary system.