THE DYNAMICS OF THE IMMUNE STATUS IN CHILDREN WITH RECURRENT RESPIRATORY TRACT INFECTIONS DURING IMMUNE REHABILITATION IN REMISSION

Abstract

Objective: to assess the immune status of children who frequently and continuously suffer from recurrent respiratory tract infections with diverse clinical manifestations in dynamics in the course of immune rehabilitation. Materials and methods. Neutrophil and lymphocyte subpopulations of peripheral blood were studied by flow cytometry method based on monoclonal antibodies (CD3, CD8, CD11a, CD18, CD19, CD28, CD154, LPS) as well as G, M, A, E immunoglobulins of peripheral blood were studied by turbodymetric method in 78 children aged 2-6. The group of the children included those who frequently and chronically suffered from respiratory infections. They were distributed into 3 groups according to the clinical variants of acute respiratory infections. All the studies were performed three times: before the immune rehabilitation, 10 days later and 2 months later after the course of the immune rehabilitation. Results. The study detected an increase in the relative number of neutrophils expressing CD18 + receptor in all the clinical subgroups and CD11a + receptor in the subgroups with recurrent upper respiratory tract infections without complications and with ENT complications. The groups with ENT (LPS + CD19 + ) and bronchopulmonary complications (LPS + CD19 + , LPS + CD3 + ) observed reduction of the lipopolysaccharide-binding activity of lymphocytes. The group with recurrent upper respiratory tract infections without complications observed reduction of CD154 + -subpopulation of lymphocytes. The immune rehabilitation performed in remission brought positive effect on the immunological characteristics of the patients from the group of frequently and chronically infected: increased LPS + and CD154 + lymphocyte level and decreased excessive activation of the immune system in the form of lower overexpression of adhesion CD11a + and CD18 + receptors on neutrophils. Conclusion. The detected changes can serve as a criterion of forming risk groups of relapse cases of acute upper respiratory tract infections with ENT and bronchopulmonary complications as well as justify the need for further immune rehabilitation and laboratory monitoring in this group of the patients.