Abstract
Aim. The substantial incidence of acute enteric infection rate among children, especially associated with such bacterial pathogen as Shigella, makes the search for new methods of management and improved therapeutic approaches a matter of high priority in current medical science. Moreover, prior infection with Helicobacter pylori is considered to be one of the factors which impacts the course of the shigellosis in children. As the course of shigellosis and its consequences depend on balanced action of pro-inflammatory and anti-inflammatory interleukins and at present it is of a great concern, study is focused on assessment of anti-inflammatory interleukins content in blood serum of children with shigellosis and infected with H. Pylori.Methods. The study enrolled 113 children aged from 3 months to 3 years who were divided into two groups: Group 1 (37–32.74 %) represented by patients infected with H. pylori and Group 2 (76–67.26 %) made up by patients without laboratory markers of Helicobacter infection. The levels of IL-1β, TNF-α and IL-4 of blood serum were assessed for all children by means of solid-phase enzyme immunoassay in the acute period and during early convalescence.Results. It has been established that at the peak of the disease the IL-1β and TNF-α levels in patients of both groups were well higher than the indices of healthy children. At the same time in the children of Group 2 the concentration was well higher than the corresponding indices of Group 1 patients. Insignificantly increased levels of IL-4 as well as higher IL-4 content levels in children without background infection in comparison with those infected with H. pylori were revealed. However, in both cases this difference was not relevant. The convalescence period was not characterized by relevant difference of IL-1β and TNF-α indices between the study groups as well as by comparison of these indices in Group 2 and the control group. In the meantime, a significant difference between IL-1β and TNF-α levels is observed between the patients of Group 1 and the control group in the acute period. IL-4 content in blood serum of the children with shigellosis without background infection in the period of convalescence turned out to be well higher in comparison with that in apparently healthy children as well as in the patients infected with H. pylori who had higher IL-4 content, however the difference was not relevant.Conclusions. Present infection with H. pylori has a significant impact on the indices of pro- and anti-inflammatory interleukins of blood serum of the children with shigellosis both in the acute period and at the stages of early convalescence. The data obtained make it possible to deepen the idea concerned with immune pathogenic mechanisms of development and course of shigellosis in children infected with H. pylori and afterwards can be applied for improvement of therapeutic methods
Highlights
Acute enteric infection rate in children is high up to the present day [1, 2]
An assessment of IL-1β, TNF-α and IL-4 of the blood serum was provided over time for all children involved in pathological process by means of enzyme-linked immunosorbent assay and reagent kit produced by Vector-Best (Russia)
The obtained data are indicative of the fact that in еру acute phase of shigellosis, both groups were characterized by increased level of pro-inflammatory IL-1β, TNF-α in blood serum, that corresponded to the findings of the previous studies [5, 13], but in patients of Group 2 this increase was more substantial (1.7 times more) and it was significantly different in comparison with patients of Group 1 (p0.05)
Summary
Acute enteric infection rate in children is high up to the present day [1, 2]. According to the data provided by the World Health Organization, over the last years viral diarrhea is considered to be prevailing in the structure of acute enteric infection. The combined action and balance between proinflammatory (TNF-α, IL-1β and others) and anti-inflammatory cytokines effects are supposed to be critical for development and outcome of infection process as well as to influence its severity and long-term prognosis. In other words, they play a significant role in immunopathogenesis of the disease and the concentration of them in blood serum reflects immune reactions which occur locally and/or in a consistent manner [6, 7]. IL-1β initiates and regulates inflammatory, immune processes, activates neutrophils, T- and B-lymphocytes, stimulates the synthesis of acute phase proteins, other cytokines (IL-2, 3, 6, TNF-α), adhesion molecules, procoagulants, prostaglandins. The role of TNFα and IL-1β in the development of fever as pyrogens, which through the bloodstream cross the blood-brain barrier and interact with neurons of the hypothalamus thermoregulation center, has been proved [10, 11]
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