Blood Plasma Of Children Research Articles

Clinical value of serum interleukin-13 levels in vincristineinduced polyneuropathy in children with acute lymphoblastic leukemia

Vincristine polyneuropathy is the leading neurotoxic effect when treating pediatric acute lymphoblastic leukemia (ALL). Recent studies have demonstrated involvement of immune system in pathogenesis of peripheral nervous system damage. Over recent years, there have been reports examining the relationship between interleukin-13 (IL-13) and development of toxic effects of chemotherapeutic drugs. Our objective was to assess clinical value of IL-13 level in children with vincristine polyneuropathy. The study included 27 children with ALL aged from 3 to 17 years, who received chemotherapy according to the conventional protocol. Plasma IL-13 levels were determined, and the values in two subgroups have been compared taking into account development of vincristine polyneuropathy. IL-13 content was assessed by multiparametric immunofluorescent analysis with magnetic microspheres (xMAP technology, Luminex 200, USA) and using ProcartaPlex Human Cytokine/Chemokine test system (Invitrogen, USA). Vincristine polyneuropathy in the study group was registered in the majority of children (n = 15) manifesting mainly at the induction stage of chemotherapy and presenting as predominance of sensory disorders. In a comparative analysis of IL-13 plasma levels in patients with vincristine polyneuropathy, we observed a statistically significant increase of its concentration, in contrast to patients without signs of peripheral nervous system damage (p = 0.042). The diagnostic sensitivity of this index was 75%, specificity – 100%, the integral index characterizing the accuracy of the test was 0.89. IL-13 changes were found to correlate with higher relative risk level, indicating its significant relationship to the development of vincristine polyneuropathy. The results of the study on the IL-13 content in blood plasma in children with vincristine polyneuropathy allowed us to consider it a predictive biological marker of peripheral nervous system damage.

The influence of selenium on the course of inflammatory diseases of the upper gastrointestinal tract in children

Background. Impaired homeostasis of the essential microelements in the body of children plays a significant role in the etiology, pathogenesis and therapy of a number of diseases. Studies on the exchange of bioelements in gastrointestinal diseases, in particular, the content of selenium (Se), have not been conducted enough. Aim: to evaluate selenium influence on the course of inflammatory diseases of the upper gastrointestinal tract in children. Materials and methods. The study included 112 school-age children with inflammatory diseases of the upper gastrointestinal tract (55 with chronic gastritis (CG), 57 with chronic gastroduodenitis (CGD)) as the main group and 20 practically healthy children of the corresponding age as the comparison group. Verification of CG and CGD diagnosis was based on clinical and endoscopic data according to the Houston modification of the Sydney classification of chronic gastritis (1996) with assessment of topography and morphology. Quantitative determination of Se in blood plasma was carried out using mass spectrometry. Results. The average level of Se in blood plasma of children with inflammation of the gastric and duodenal mucosa was (75.82 ± 11.23) μg/l, in children of the comparison group — (85.42 ± 9.44) μg/l (p > 0.05). We did not find gender and age differences in Se plasma levels. Deficiency of Se in the blood of children with CG and CGD was found in 78 cases (69.6 %), while in the comparison group, a decrease in Se level was observed in only 4 children (20 %). There were no significant differences in the content of Se in children with CG and CGD. However, the analysis of indicators depending on the activity of the inflammatory process revealed probable differences: with the first degree of the activity of the inflammatory process in the mucous membrane, the level of Se in the blood plasma was significantly lower ((66.2 ± 6.1) μg/ml), while with the second it was (78.5 ± 7.3) μg/ml (p < 0.05) and with the third — (86.9 ± 9.3) μg/ml (p < 0.01). Conclusions. The concentration of selenium, the essential trace element, in the blood plasma of children with chronic inflammatory diseases of the upper gastrointestinal tract was found to be probably lower than that of healthy children. The level of selenium in the blood plasma of these children probably positively correlated with the degree of inflammation in the mucous membrane of the gastroduodenal region. Changes in the concentration of selenium can affect the general condition of children, the duration and severity of the disease, which must be taken into account during the treatment of inflammatory diseases.

СЕРОСОДЕРЖАЩИЕ АМИНОКИСЛОТЫ И РИСК РАЗВИТИЯ АРТЕРИАЛЬНОЙ ГИПЕРТЕНЗИИ У ДЕТЕЙ

Introduction. Currently, sulfur-containing amino acids are potential candidates as risk factors for cardiovascular disease. The purpose: to establish the role of sulfur-containing amino acids and their derivatives in the risk of developing arterial hypertension in children. Matherial and methods. 111 children aged 14 to 18 years were examined. All patients were divided into 3 groups: the 1st group (n=51) consisted of children with arterial hypertension, the 2nd group (n=30) – with high normal blood pressure, the 3rd group – 30 healthy children. The content of sulfur-containing amino acids and their derivatives in blood plasma was determined by high-performance liquid chromatography. Result. The concentration of sulfur-containing amino acids methionine, homocysteine, cysteine and cysteinylglycine in the blood plasma of children with arterial hypertension tend to increase in comparison with the group of healthy children. Pathological decrease in endothelium-dependent vasodilation accompanied by an increase in the concentration of methionine, homocysteine, cysteine, cysteinylglycine, glutathione in blood plasma and a decrease – taurine. A prognostic model has been developed based on the determination of the concentration of homocysteine and cysteinylglycine in the blood plasma of children. With a calculated value of p≥0,44, makes it possible to predict a high probability of arterial hypertension with a sensitivity of 90,2%, a specificity of 66,7% and a diagnostic efficiency of 82,1%. Conclusions. The concentration of sulfur-containing amino acids methionine, homocysteine, cysteine and cysteinylglycine in the blood plasma of children with arterial hypertension tend to increase in comparison with the group of healthy children.

Патоморфоз хронічного гастродуоденіту в дітей на тлі дефіциту селену

Purpose - to investigate the clinical and paraclinical features of the course of chronic gastroduodenitis (CGD) in children against the background of selenium deficiency. Materials and methods. Clinical and laboratory examination of 63 children (main group) aged from 7 to 18 years old, patients with CGD and 20 healthy children (comparison group) of the appropriate age was carried out. Quantitative determination of selenium in blood plasma was carried out using inductively coupled plasma mass spectrometry (ICP-MS) on an Optima 2000 DV spectrometer (Perkin Elmer, USA). Results. The average level of selenium in the blood plasma of children with inflammation of the gastric mucosa and duodenum was 73.45±4.21 μg/l, in children of the comparison group - 85.42±5.44 μg/l (p<0.05). 14 children had a selenium concentration within the normal range, and 49 patients had a significantly reduced selenium level (p<0.05), while 9 had the lowest level and was 57.2±3.5 ng/ml. Moderate erythema was recorded 3 times less often and a pronounced degree of erythema was recorded 4.6 times more often, in 4 people (8.1%) atrophy of the mucous membrane of the stomach and/or duodenum was detected, subatrophy was more often recorded (16.3%), 36.7% were diagnosed with the second degree of granularity. Was typicalhad nocturnal and «hungry» pain (22.4%). Conclusions. In the vast majority of children (77.7%), CGD occurs against the background of selenium deficiency in blood plasma. A direct correlation between the concentration of selenium in the blood plasma of sick children and the stage and activity of gastroduodenitis was established. The longer the course of the disease, the lower the levels of selenium in children's blood plasma. There is a pathomorphosis of CGD in children against the background of selenium deficiency: night and «hungry» pain, diffuse damage to the mucous membrane with erosions and subatrophy, a long course with high inflammatory activity are more common. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

THE LEVEL OF ZINC IN BLOOD PLASMA AND THE COURSE OF GALLSTONE DISEASE IN CHILDREN

Determining the zinc level in children's blood plasma is an urgent problem, given its possible participation in the formation of cholelithiasis.Aim. To investigate the level of zinc in the blood plasma and the clinical course of gallstone disease (GSD) in children.Methods. 69 children aged 10-17 years and 25 children without biliary tract pathology were selected by the method of simple randomization. Verification of the diagnosis was carried out by applying dynamic ultrasound examination and X-ray examination of the organs of the abdominal cavity. Quantitative determination of zinc in blood plasma was carried out using mass spectrometry.Results. Dysfunction of the biliary tract according to the hyperkinetic type occurred in 55.1±7.1% of children and according to the hypokinetic type in 44.9±3.9%. The asymptomatic variant of housing and communal services was observed in 23.9%, painful - in 54.3% of patients, paroxysmal - in 21.7% of patients. The plasma concentration of zinc in children with gastrointestinal diseases was 1.87 times lower than in children of the comparison group and 1.37 times lower than in children with hyperkinetic gallbladder dysfunction, while there was a probable difference between these indicators in children with housing and communal services and in children with the hypotonic type of gallbladder dysfunction (p<0.05).Conclusions. 1. The leading syndromes of gallstone disease in children were pain and dyspepsia. 2. Gallstone disease in children occurs against the background of gallbladder dysfunction with a predominance of the painful course, the formation of solitary bilirubin-derived concretions and minor changes in biochemical blood analysis. 3. The concentration of zinc in the blood plasma of children with gallstone disease is probably lower than in children of the comparison group and does not depend on age and gender.

Establishment of reference intervals of platelet aggregation using inductors in blood plasma in children on the analyzer Sysmex CS-5100

Establishment of reference intervals of platelet aggregation using inductors in blood plasma in children on the analyzer Sysmex CS-5100

Антимікробні пептиди (HNPs 1-3 та LL-37) як біомаркери активності запального процесу в дітей, хворих на H. pylori-асоційовану виразку дванадцятипалої кишки

Various gastrointestinal and extragastrointestinal diseases are associated with H. pylori in children and adolescents, but the strongest recommendations for testing and treatment are made only in children and adolescents with duodenal ulcer (DU). The inability of natural immune mechanisms to recognize and eliminate H. pylori leads to the development of acute inflammation. The most promising developments so far are studies of the antibacterial effect of endogenous antimicrobial peptides (AP), among which defensines 1-3 (human neutrophil peptides, HNPs 1-3) and cathelicidins (LL-37) are the most important for the human body. Purpose - to investigate the concentration of HNPs 1-3 and LL-37 in the blood of children with DU in order to determine the activity of the inflammatory process of the mucous membrane. Materials and methods. 65 children aged 7-18 years, suffering from DU and 25 healthy children of the corresponding age (comparison group) were examined. The level of HNPs 1-3 and LL-37 was determined in blood plasma by enzyme-linked immunosorbent assay according to the manufacturers instructions. Results. Patients were divided by age, sex, location and size of the ulcer, presence of the H. pylori bacterium. A toxigenic strain of H. pylori was detected in 80.9% of examined children, and the level of HNPs 1-3 in blood plasma was 3 times higher and the level of LL-37 was 2.5 times higher in children with H. pylori-associated DU than in healthy children (p=0.01). Concentrations of HNPs 1-3 and LL-37 in blood plasma were higher in patients with an active inflammatory process in the mucous membrane and were positively correlated with the degree of inflammation activity (r=0.67, p=0.05 and r=0.69, p=0.01). After eradication therapy, AP levels decrease, while the degree of decrease directly depends on the activity of the inflammatory process. Conclusions. Probably higher concentrations of HNPs 1-3 and LL-37 were found in the blood plasma of children with H. pylori-associated DU. Considering the direct correlations between the levels of HNPs 1-3 and LL-37 and the degree of activity of the inflammatory process, these indicators can be used as biomarkers of the adverse course of H. pylori-associated DU. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of all participating institutions. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

The effect of endogenous antimicrobial peptides (HNPs1-3 and LL-37) on the course of duodenal ulcer in children

Introduction. Duodenal ulcer in children is characterized by a significant prevalence, frequent development of serious complications and the need for large financial allocations for the implementation of treatment programs. Antimicrobial peptides have an immunomodulatory function and can be used as markers of the severity of the inflammatory process.Aim. To investigate the concentration of HNPs 1-3 and LL-37 in children with duodenal ulcer.Methods. A study of 47 children with duodenal ulcer, aged 7–18 years, was conducted with the determination of the CagA HR antigen in feces by enzyme-linked immunosorbent assay, the levels of HNPs 1-3 and LL-37 in blood plasma by enzyme-linked immunosorbent assay on the "PrisMatic" IN013 model 4301 analyzer test systems "MyBioSource, Inc.", USA. All children underwent a complex clinical and instrumental laboratory examination (topographic intragastric pH-metry, endoscopic examination with targeted biopsy for morphological examination and determination of HP). Results. 76.6% of people with DU were infected with HP. 80% had a toxigenic CagA strain of HP. In the vast majority of children with DU, small ulcerative defects were diagnosed. II and III degrees of inflammatory activity occurred with almost the same frequency (44.6% and 34% of people), while I degree occurred only in 21.3% of cases. The average level of HNP1-3 in children with DU was 46.56 ± 8.52 ng/ml, LL-37 - 269.9 ± 26.53 ng/ml. Direct probable connections between the levels of HNP1-3 and LL-37 and the severity of the course and the activity of the inflammatory process were established.Conclusion. Elevated levels of LL-37 and HNPs 1-3 were found in the blood plasma of children with duodenal ulcers associated with CagA strains of Helicobacter pylori. Significantly higher levels of LL-37 and HNPs 1-3 were registered with a severe course of the disease and an active inflammatory process, which indicates a direct influence of antimicrobial peptides on the course of the pathological process.

An interaction between growth hormone/insulin-like growth factor-1 and vitamin D in children with short stature

There are disorders in the growth hormone (GH)/growth factors system in a significant part of patients with short stature; first of all, this concerns such diseases as growth hormone deficiency, where there is a sharp decrease in GH, insulin-like growth factor-1 (IGF-1). The association between vitamin D and GH/growth factor system remains unclear. It was found that vitamin D is able to increase IGF-1 level in healthy individuals. Linear growth is accelerated after treatment of vitamin D deficiency in children, which may indicate the linking role of vitamin D between the proliferative cells of the growth plate cartilage and GH/growth factor system.Research objective: to determine 25-hydroxyvitamin D level in blood plasma in children with short stature, depending on the state of GH/IGF-1 system.Materials and methods. Study included 101 children with short stature: 33 children with partial somatotropic insufficiency (group 1); 44 children with complete somatotropic insufficiency (group 2); 24 children with syndrome of biologically inactive GH (group 3). Patients in groups 1 and 2 had a confirmed GH deficiency and a decrease or sharp decrease in of IGF-1 level; patients in group 3 had a normal stimulated release of GH against the background of a reduced IGF-1 level. GH, IGF-1, 25-hydroxyvitamin D, thyroid-stimulating hormone, and free thyroxine were determined in all children.Results. The average level of vitamin D in three groups corresponded to the vitamin deficiency according to international standards and was 52.24 ± 5.99 nmol/l in patients with partial somatotropic insufficiency, 67.6 ± 5.35 nmol/l in patients with complete somatotropic insufficiency and 58, ± 7.91 nmol/l in patients with syndrome of biologically inactive GH. A direct correlation was found between vitamin D and background GH level, stimulated GH level in children with both partial and complete somatotropic insufficiency. A direct correlation between vitamin D and IGF-1 level in this group of patients was also detected.Conclusions. It is advisable to determine the serum 25(OH)D in all children with short stature. Vitamin D levels should be taken into account in insulin/clonidine diagnostic tests in order to obtain a realistic indication of stimulated GH and IGF-1 levels.

Concentration of alpha-defensins in the blood plasma of children with Helicobacter pylori – associated peptic ulcer of the duodenum

Introduction. Various gastrointestinal and extragastric diseases are associated with H. pylori in children and adolescents, but the strongest testing and treatment guidelines are only for children and adolescents with peptic ulcer. The most promising developments now are the study of the antibacterial effect of endogenous antimicrobial peptides (AP), among which the most important are defenses 1-3 (human neutrophil peptides, HNPs1-3). Objective. To investigate the concentration of HNPs 1-3 in children with H. pylori-associated peptic ulcer of the duodenum (DU). Methods. A study of 65 children with DU (47 children with H. pylori-associated DU, 18 children with H. pylori-negative DU) and 25 healthy children aged 7-18 years with the determination of HNPs 1-3 levels in plasma. Results. More common was H. pylori in the group of children with III grade of inflammation than in the group of children with II grade (χ2:p<0.0001). A significant association was found between mucosal inflammation activity and the presence of H. pylori (r=0.66, p<0.0001). The mean level of HNP1-3 in healthy children was 13.67±0.96 ng/ml, in children with DU it was probably higher and was 104.88±11.5 ng/ml (p=0.005). There is a direct correlation between the level of HNP1-3 and the severity of DU in children (r=0.67, p>0.05), as well as between HNP1-3 and the activity of the inflammatory process (r=0.73, p>0.01). In children with H. pylori-associated DU, HNP1-3 values were significantly higher (107.34±16.18 [98.45-119.22]) ng/ml than those in children with DU not associated with H. pylori infection (66.70±11.31 [59.54-73.29]) ng/ml and in healthy children (13.67±0.96 [7.27-18.91] ng/ml). Conclusion. Elevated plasma HNP1-3 levels in children with DU in the presence of H. pylori are likely to be a protective response to limit infection that can be used as a potential biomarker of adverse events.

Comparison of blood tryptophan and glutamate levels in children and adolescents with autism and healthy controls

Studies show that there are significant increments of glutamate levels in individuals with autism spectrum disorders, which suggests that this amino acid could be a potential biomarker. We aimed to evaluate the concentration tryptophan and glutamate in the blood plasma of children with autism and their correlation with symptoms severity in children and adolescents diagnosed with autism. We assessed the plasma tryptophan and glutamate levels in the 35 children with autism and 31 unrelated healthy controls. The plasma amino acid analysis was performed by a high-pressure liquid chromatograph (HPLC). The Gilliam Autism Rating Scale (GARS-2) was used to evaluate autism severity. Compared with the control group, the autism group had higher levels of plasma glutamate (p = .005), and there was a negative correlation between stereotyped patterns score, total score of GARS-2, and plasma tryptophan levels in the autism group (p = .012, r = -0.42 and p = .034, r = -0.36 respectively). There was also a positive correlation between stereotyped patterns score and plasma glutamate levels in ASD boys (p = .050, r = 0.39). Our findings provide evidence of elevated plasma glutamate levels and for correlations between tryptophan, glutamate and severity of symptoms in children with autism.

Порушення метаболізму нейромедіаторів у дітей із розладами аутистичного спектра (огляд літератури та власні дані)

Тоді, коли збільшується число дітей, хворих на розлади аутистичного спектра (РАС), зростає кількість досліджень, в яких вивчаються клінічні особливості перебігу, патогенез, етіологічні фактори і методи лікування даного захворювання. Єдиної думки щодо етіології та патогенезу РАС на сьогодні не існує. У статті подано сучасні дані літератури, що висвітлюють проблему порушень обміну нейромедіаторів у дітей із РАС. Також наведені дані, отримані при визначенні концентрації гамма-аміномасляної кислоти (ГАМК) в плазмі крові дітей із когнітивною епілептиформною дезінтеграцією (n = 45) і дітей із РАС без епілептичних нападів (n = 15). За результатами дослідження відзначалося зниження середньої концентрації ГАМК у дітей із когнітивною епілептиформною дезінтеграцією порівняно з контрольною групою (n = 12). Істотних відмінностей у середній концентрації ГАМК між групою дітей із РАС без епілептичних нападів і контрольною групою виявлено не було (p < 0,001). Отримані нами результати і огляд літературних даних дозволяють стверджувати про необхідність застосування в лікуванні дітей із РАС препаратів, що регулюють метаболізм нейромедіаторів, особливо ГАМК.

Genome-wide analysis of circular RNAs and validation of hsa_circ_0086354 as a promising biomarker for early diagnosis of cerebral palsy

BackgroundCerebral palsy (CP) is a spectrum of non-progressive motor disorders caused by brain injury during fetal or postnatal periods. Current diagnosis of CP mainly relies on neuroimaging and motor assessment. Here, we aimed to explore novel biomarkers for early diagnosis of CP.MethodsBlood plasma from five children with CP and their healthy twin brothers/sisters was analyzed by gene microarray to screen out differentially expressed RNAs. Selected differentially expressed circular RNAs (circRNAs) were further validated using quantitative real-time PCR. Receiver operating characteristic (ROC) curve analysis was used to assess the specificity and sensitivity of hsa_circ_0086354 in discriminating children with CP and healthy controls.Results43 up-regulated circRNAs and 2 down-regulated circRNAs were obtained by difference analysis (fold change > 2, p < 0.05), among which five circRNAs related to neuron differentiation and neurogenesis were chosen for further validation. Additional 30 pairs of children with CP and healthy controls were recruited and five selected circRNAs were further detected, showing that hsa_circ_0086354 was significantly down-regulated in CP plasma compared with control, which was highly in accord with microarray analysis. ROC curve analysis showed that the area under curve (AUC) to discriminate children with CP and healthy controls using hsa_circ_0086354 was 0.967, the sensitivity was 0.833 and the specificity was 0.966. Moreover, hsa_circ_0086354 was predicted as a competitive endogenous RNA for miR-181a, and hsa_circ_0086354 expression was negatively correlated to miR-181a expression in children with CP.ConclusionHsa_circ_0086354 was significantly down-regulated in blood plasma of children with CP, which may be a novel competent biomarker for early diagnosis of CP.

A Reference Range for Plasma Levels of Inorganic Pyrophosphate in Children Using the ATP Sulfurylase Method.

PurposeGeneralized arterial calcification of infancy, pseudoxanthoma elasticum, autosomal recessive hypophosphatemic rickets type 2, and hypophosphatasia are rare inherited disorders associated with altered plasma levels of inorganic pyrophosphate (PPi). In this study, we aimed to establish a reference range for plasma PPi in the pediatric population, which would be essential to support its use as a biomarker in children with mineralization disorders.MethodsPlasma samples were collected from 200 children aged 1 day to 18 years who underwent blood testing for medical conditions not affecting plasma PPi levels. PPi was measured in proband plasma utilizing a validated adenosine triphosphate (ATP) sulfurylase method.ResultsThe analytical sensitivity of the ATP sulfurylase assay consisted of 0.15 to 10 µM PPi. Inter- and intra-assay coefficients of variability on identical samples were below 10%. The standard range of PPi in the blood plasma of children and adolescents aged 0 to 18 years was calculated as 2.36 to 4.44 µM, with a median of 3.17 µM, with no difference between male and female probands. PPi plasma levels did not differ significantly in different pediatric age groups.Main ConclusionsOur results yielded no noteworthy discrepancy to the reported standard range of plasma PPi in adults (2-5 µM). We propose the described ATP sulfurylase method as a diagnostic tool to measure PPi levels in plasma as a biomarker in the pediatric population.

Вміст інсуліноподібного фактора росту 1 та есенціальних мікроелементів у плазмі крові в дітей із різними формами низькорослості

Вивчено вміст інсуліноподібного фактора росту 1 та есенціальних мікроелементів (цинк, селен, мідь, марганець, хром) у плазмі крові в дітей із низькорослістю залежно від етіології захворювання. Установлено наявність суттєвого дисбалансу есенціальних мікроелементів у пацієнтів із низькорослістю, перш за все обумовленою дефіцитом гормону росту та інсуліноподібного фактора росту 1. Виявлено вірогідно слабкий кореляційний зв’язок між показниками інсуліноподібного фактора росту 1 та середнім рівнем цинку в плазмі крові дітей із низькорослістю загалом по групі. У той же час у дітей з ізольованою соматотропною недостатністю, повною або частковою, виявлено вірогідно сильний кореляційний зв’язок між показниками інсуліноподібного фактора росту 1 та цинку в плазмі крові. Кореляційного зв’язку між показниками інсуліноподібного фактора росту 1 у плазмі крові та показниками селену, марганцю, хрому, міді в плазмі крові не встановлено.

Вміст греліну в плазмі крові дітей із синдромом біологічно неактивного гормона росту

Актуальність. У світовій літературі відомості про стан системи «гормон росту/ростові фактори» (ГР/інсуліноподібний фактор росту 1 (ІФР-1)), зокрема щодо відношень ГР/ІФР-1/грелін (Ghr), у пацієнтів із низькорослістю вкрай обмежені. Мета роботи — визначення особливостей секреції греліну в пацієнтів із синдромом біологічно неактивного гормона росту порівняно із секрецією греліну в дітей із соматотропною недостатністю. Матеріали та методи. Ghr визначали в 33 хворих із низькорослістю, серед них 22 пацієнти — із соматотропною недостатністю і 11 хворих — із синдромом біологічно неактивного гормона росту. Паспортний вік всіх обстежених пацієнтів відповідав діапазону статевого дозрівання. Кістковий вік в обох групах відставав від паспортного більше ніж на 2 роки. Відставання в рості всіх дітей становило від мінус 2SD. Контрольну групу становили 6 здорових дітей. У всіх обстежених дітей визначали базальний рівень ГР, ІФР-1 й рівень ГР під час нічного викиду та стимуляційного тесту з клонідином. Одночасно отримували зразки крові для дослідження рівня Ghr. Результати. Найсуттєвіші зміни показників рівня Ghr були виявлені через 120 хвилин після засинання у всіх обстежених. Установлено значне підвищення рівня Ghr у дітей із синдромом біологічно неактивного гормона росту, соматотропною недостатністю, а також у групі контролю порівняно з базальними показниками та максимальним викидом при проведенні клонідинового тесту. Так, нічний рівень Ghr перевищував базальний в 1,4 раза в дітей із соматотропною недостатністю, у 3,4 раза — у дітей із синдромом біологічно неактивного гормона росту та у 2,8 раза — у дітей контрольної групи. Ми не встановили зв’язку між показниками ІФР-1 та Ghr у всіх обстежених дітей. Висновки. У пацієнтів із синдромом біологічно неактивного гормона росту та соматотропною недостатністю встановлено суттєвий викид греліну в перші години після засинання. Не виявлено взаємозв’язку між рівнями греліну та ІФР-1 у пацієнтів із синдромом біологічно неактивного гормона росту, соматотропною недостатністю та в здорових дітей. Введення клонідину не викликає суттєвих змін рівня греліну в низькорослих та здорових дітей.

Vitamin D content in children with short stature due to intrauterine growth restriction against normosomatotropinemia

Background. There are no data about the status of vitamin D and its effect on the growth hormone/growth factors axis in prepubertal children with intrauterine growth restriction (IGR). Of particular interest is a group of patients who remain significantly short on the background of a decrease in insulin-like growth factor 1 (IGF-1) levels and normal stimulated release of growth hormone (GH). The purpose of our study was to determine the levels of 25-hydroxycalciferol in the blood plasma of prepubertal children with short stature due to IGR on the background of normosomatotropinemia. Materials and methods. We examined 34 prepubertal children (14 girls and 20 boys) with short stature (average age — 6.95 ± 0.46 years) who had signs of IGR at birth. A symmetrical type of IGR was found in 15 (44.2 %) patients, an asymmetrical type — in 19 (55.8 %). According to the results of functional tests all patients had a normal GH peak release (&gt; 10 ng/ml). Thyroid-stimulating hormone, free thyroxine levels in the blood plasma were determined by the immunoradiometric assay with standard Immunotech® kit (Czech Republic). At the time of examination, all patients were euthyroid. GH, IGF-1 and insulin-like growth factor binding protein 3 (IGFBP-3) levels were determined by enzyme-linked immunosorbent assay using Immulite 2000 Xi kits (Siemens, USA). 25-hydroxycalciferol level was determined by the immunochemiluminescent method (Abbott, USA). The results were evaluated according to the guidelines of the International Society of Endocrinology (2011). Results. It was found that in prepubertal children with IGR signs at birth, the average height standard deviation score (SDS) at the time of the examination was –2.83 ± 0.12. There were no significant differences between the height and body weight in patients with a symmetrical and an asymmetrical types of IGR at the time of examination (p &gt; 0.05). Vitamin D content in the blood plasma of children with IGR signs was 49.70 ± 2.17 nmol/l in the whole group. Vitamin D insufficiency below 75 nmol/l was found in 16 (47 %) patients, and vitamin D deficiency below 50 nmol/l — in 18 (53 %). No significant differences were found between vitamin D values in girls and boys with signs of IGR (51.79 ± 3.38 nmol/l and 48.36 ± 2.86 nmol/l, respectively, p &gt; 0.05). Height SDS in the group of patients with an asymmetrical type of IGR weakly correlates (r = 0.38) with vitamin D content. Vitamin D level significantly differed depending on IGR type (in a symmetrical type — 44.1 ± 3.2 nmol/l, in an asymmetrical type — 54.20 ± 2.56 nmol/l, p &lt; 0.05). IGF-1 SDS in the group of patients with an asymmetrical type of IGR weakly correlated (r = 0.36) with vitamin D level. On the background of a significant decrease in IGFBP-3 content in children with an asymmetrical type of IGR compared to those with a symmetrical type (–1.32 ± 0.07 SDS and –1.00 ± 0.14 SDS, p &lt; 0.05), there was a reduction in IGF-1 levels (–1.62 ± 0.10 SDS and –1.34 ± 0.14 SDS, p = 0.05). Conclusions. Patients born with signs of IGR, even against normosomatotropinemia, may still have significant growth deficit, a sharp decrease in IGF-1 and IGFBP-3 for a long time after birth. The results obtained indicate the presence of hypovitaminosis D in all prepubertal patients who were born with the signs of intrauterine growth restriction. No correlation was found between vitamin D level and the maximum peak of stimulated growth hormone release. However, patients with an asymmetrical type of IGR have a weak correlation (r = 0.36) between IGF-1 SDS and vitamin D content, a significant decrease in the content of IGF-1, IGFBP-3, as well as vitamin D compared to its level in a symmetrical type of IGR. It is recommended to include the determination of vitamin D level in the blood plasma irrespective of the type of disease and the state of somatotropic function in the list of studies for the examination of children with short stature who were born with signs of intrauterine growth restriction.

Вміст греліну та лептину в плазмі крові в дітей та підлітків із дисфункцією гіпоталамуса

Мета дослідження — проведення порівняльного аналізу рівнів лептину та греліну в плазмі крові дітей і підлітків залежно від форми та ступеня ожиріння на тлі дисфункції гіпоталамуса. Матеріали та методи. Обстежено 39 дітей віком від 10 до 18 років із дисфункцією гіпоталамуса. Серед них 16 пацієнтів (41,03 %) — із вісцероабдомінальним ожирінням, 23 пацієнти (58,97 %) — із глютеофеморальним ожирінням та 14 здорових дітей відповідного віку та статі. У всіх пацієнтів проводили вивчення анамнезу життя, оцінку антропометричних параметрів (маса тіла, індекс маси тіла, окружність талії та стегон, їх співвідношення). Рівень лептину у крові визначали імуноферментним методом із використанням наборів фірми Roche Diagnostics GmbH Mannheim (Німеччина). Рівень греліну визначали радіоімунологічним методом із використанням наборів фірми DLAsource ImmunoAssays S.A. (Бельгія). Результати. Надлишкова маса тіла встановлена у 15 із 39 пацієнтів (38,5 %), ожиріння I ступеня — у 8 дітей (20,5 %), II ступеня — у 10 дітей (25,6 %), III ступеня — у 6 дітей (15,4 %). Середній рівень лептину в дітей із вісцероабдомінальним ожирінням становив 47,20 ± 5,54 нг/мл (індекс маси тіла — 35,20 ± 5,07 кг/м2) і виявився вірогідно вищим, ніж у дітей у групі з глютеофеморальним ожирінням (26,50 ± 7,13 нг/мл, p &lt; 0,05) у поєднанні з аналогічними метаболічними порушеннями. Рівень греліну в дітей з ожирінням був вірогідно нижчим, ніж у контрольній групі, і залежав від ступеня ожиріння. При ожирінні III ступеня рівень греліну був найнижчим — 582,58 ± 59,37 нг/мл. Висновки. Ожиріння на тлі дисфункції гіпоталамуса в дітей та підлітків супроводжується низьким рівнем греліну та високим рівнем лептину в плазмі крові. Незалежно від статі в дітей і підлітків гіперлептинемія та гіпогрелінемія значною мірою пов’язані зі ступенем та формою ожиріння. При вісцероабдомінальній формі ожиріння (порівняно з глютеофеморальною формою) зафіксовано істотно нижчий рівень греліну та вищий рівень лептину.

The status of chemical elements in the blood plasma of children with autism spectrum disorder in Tunisia: a case-control study.

Autism spectrum disorders (ASDs) are a group of neurodevelopmental disorders defined by a deficit in social interactions and the presence of restricted and stereotypical behaviors or interests. The etiologies of autism remain mostly unknown. Many genetic and environmental factors have been suspected. Among these environmental factors, exposure to several chemical elements has been previously studied. The purpose of this study was to compare the levels of trace elements in the blood plasma of children with ASD with typically developed children (TDC). The participants in this study consisted of 89 children with ASD (14 girls and 74 boys) and 70 TD children (29 girls and 41 boys). The levels of 33 chemical elements have been analyzed by inductively coupled plasma spectrometry (ICP-MS). We detected significant differences in the levels of eight elements between the two groups, among which there were three rare earth elements (REEs): Eu, Pr, and Sc (p= 0.000, p= 0.023, and p< 0.001 respectively); four heavy metals: Bi, Tl, Ti, and V (p= 0.004, p< 0.001, p= 0.001, and p = 0.001 respectively); and one essential element: Cu (p= 0.043). Children with ASD had higher levels of Er, Pr, Sc, Bi, Tl, Ti, and V, and lower levels of Cu in comparison with the TD group. The children exposed to passive smoking had lower levels of lead (Pb) compared with children without exposure (p= 0.018). Four elements (Cr, Er, Dy, and Pr) were negatively correlated to the severity of ASD. The level of Cu was significantly associated with autistic children's behavior (p= 0.014). These results suggest that children with ASD might have abnormal plasma levels of certain chemical elements (including Er, Pr, Sc, Bi, Tl, Ti, and V, and Cu), and some of these elements might be associated with certain clinical features.

Исследование содержания 11-оксикортикостероидов в плазме крови у детей, больных увеитами

Исследование содержания 11-оксикортикостероидов в плазме крови у детей, больных увеитами