Blood Serum Of Children Research Articles

Влияние избыточной массы тела и ожирения на спирометрические, гематологические показатели, уровень общего иммуноглобулина Е и интерлейкина-6 в сыворотке крови у детей и подростков с бронхиальной астмой

There is undoubtedly insufficient number of studies dedicated to the interleukin-6 (IL-6) in blood serum of children and adolescents with bronchial asthma (BA) and those are contradictory. Connection between the IL-6 serum level and systemic markers of type 2 inflammation in BA in children and adolescents depending on the nutritional status remains a subject to discussion as well. The purpose of this research was to study the effect of excess body weight (BW) and obesity on spirometric, hematological parameters, total immunoglobulin E (IgE), IL-6 levels in blood serum of children and adolescents with BA. Materials and methods used: a single-center observational cross-sectional pilot study of 76 adolescents aged 6 to 17 y/o (75% (57) boys) with BA was conducted. All were measured for anthropometric and spirometric parameters, body composition, hematological parameters, total IgE and IL-6 levels in blood serum. Dysanapsis was diagnosed when three conditions were simultaneously met: 1. high or high-to-normal zFVC (above 0.674), 2. normal zFEV1 (above -1.645), and 3. low FEV1/FVC index (below 80%). Results: the number of monocytes (109/l) in peripheral blood and the serum IL-6 level (pg/ml) were statistically significantly higher in the group of patients with overweight and obesity compared to patients with underweight/normal BW (0.55 [0.49; 0.77] v 0.51 [0.42; 0.58], p=0.043 and 1.99 [1.20; 5.78] v 1.28 [0.31; 2.43], p=0.002, respectively). In patients with excess BW and obesity, an inverse statistically significant relationship was found between the serum IL-6 level, zFEV1/FVC and the dysanapsis ratio (R=-0.53, p=0.009, R=-0.61, p=0.002, respectively). Conclusion: formation of an obstructive pattern in children and adolescents with BA with excess BW and obesity may be associated with non-T2-dependent inflammatory mechanisms.

Blood cytokines in children with erosive gastritis

Aim: To evaluate the cytokine profile of blood serum in children with erosive gastritis depending on the activity of the inflammatory process, bacterial invasion of H. pylori and family predisposition to peptic ulcer disease. Gastroscopy was performed with the collection of biopsy material from the gastric mucosa in 168 children aged 7-17 years with gastroenterological complaints. Subsequently, a morphological examination of biopsy specimens confirmed the diagnosis of gastritis in all examined patients and determined H. pylori invasion. The content of cytokines in the blood serum (IL-2, IL-4, IL-6, IL-8, IL-10, IL-18, IL-1β, IFNα, TNFα) was determined using the enzyme immunoassay method. When analyzing cytokine levels in schoolchildren infected with H. pylori, there were no differences in cytokine concentrations (p 0.05). While in uninfected children in the presence of erosive changes, a decrease in IL-2 content was noted (p = 0.026). In individuals with a family history of peptic ulcer disease with erosive gastritis, an increase in the content of IL-8 was observed (p = 0.006), which is known to play an important role in maintaining innate immunity. Whereas, in the absence of a family predisposition, schoolchildren with erosive gastritis showed a decrease in IL-2 (p = 0.027), which is similar to the level of IL-2 in schoolchildren with erosive gastritis without H. pylori infection. IL-2 is considered an activator of the antitumor response and this property is being actively studied in patients with gastric cancer. In the context of these data, it can be assumed that in individuals with erosive gastritis, even without a family predisposition and H. pylori infection, inhibition of IL-2 synthesis is observed. What causes this influence is an open question. Thus, the variety of components of the cytokine profile involved in the regulation of the inflammatory process and the influencing negative factors create difficulties in assessing and, even more so, predicting the role and significance of changes in the content of a particular cytokine in the blood serum in children with erosive gastritis.

Evaluation of apoptosis markers in patients with atopic dermatitis

The purpose of the study was to analyze indicators of apoptosis in patients with atopic dermatitis (AD). Patients (N = 88) aged from 12 months to 3 years with varying degrees of disease severity were involved into trial. SCORAD indices were: 68.14±2.63 – in patients with severe AD; 32.03±1.43 – with moderate; and 12.12±1.43 – with mild AD, respectively. Determination of apoptosis markers (Caspase 8, Caspase 9, sCD153, sFas-L, Annexin 5) in blood serum was performed using an enzyme-linked immunosorbent assay (ELISA) using commercial kits from Bender MedSystems® (Austria). A study of apoptosis markers in the blood serum of children with AD revealed a significant decrease (p 0.05) in the concentration of Annexin 5 compared to standard values (by 20 times). A statistically significant decrease (p 0.05) in the concentration levels of Caspase 8 and Caspase 9 in the serum of AD patients was revealed. Thus, the concentrations of Caspase 8 were reduced on by 3 times, and Caspase 9 by 8 times compared to the norm. Also In addition, when determining sFas-L indicators, a statistically significant (p 0.05) decrease in concentration was noted compared to standard indicators. The content of sCD153 in the blood serum in AD patients was significantly higher (p 0.05) than the normative values by 5 times (not detected normally). The most pronounced disturbances in apoptosis indicators were observed in patients with severe atopic dermatitis, (p 0.05), highlighting the importance of studying apoptosis in the context of AD and the possible link between disruptions in this process and the severity of clinical manifestations in patients. The study demonstrates the peculiarities of apoptosis processes in children with AD. On the one hand, these patients have significantly increased activation of signaling systems, on the other hand, the elimination of altered immunocompetent cells does not occur properly, which contributes to the progression and chronicity of immune inflammation in the skin.

Autism spectrum disorder: difficulties in diagnosis and microRNA biomarkers.

We performed a PubMed search for microRNAs in autism spectrum disorder that could serve as diagnostic biomarkers in patients and selected 17 articles published from January 2008 to December 2023, of which 4 studies were performed with whole blood, 4 with blood plasma, 5 with blood serum, 1 with serum neural cell adhesion molecule L1-captured extracellular vesicles, 1 with blood cells, and 2 with peripheral blood mononuclear cells. Most of the studies involved children and the study cohorts were largely males. Many of the studies had performed microRNA sequencing or quantitative polymerase chain reaction assays to measure microRNA expression. Only five studies had used real-time polymerase chain reaction assay to validate microRNA expression in autism spectrum disorder subjects compared to controls. The microRNAs that were validated in these studies may be considered as potential candidate biomarkers for autism spectrum disorder and include miR-500a-5p, -197-5p, -424-5p, -664a-3p, -365a-3p, -619-5p, -664a- 3p, -3135a, -328-3p, and -500a-5p in blood plasma and miR-151a-3p, -181b-5p, -320a, -328, -433, -489, -572, -663a, -101-3p, -106b-5p, -19b-3p, -195-5p, and -130a-3p in blood serum of children, and miR-15b-5p and -6126 in whole blood of adults. Several important limitations were identified in the studies reviewed, and need to be taken into account in future studies. Further studies are warranted with children and adults having different levels of autism spectrum disorder severity and consideration should be given to using animal models of autism spectrum disorder to investigate the effects of suppressing or overexpressing specific microRNAs as a novel therapy.

Features of supply and approaches to the use of vitamin D in children in the post-COVID period

Vitamin D is an important component of immune function, and deficiency in childhood is associated with an increased risk of acute respiratory viral infections. Purpose. To assess the dynamics of vitamin D supply in children after a new coronavirus infection with the use of cholecalciferol. Material and methods. We examined 55 children aged 0–17 years (10.0 [9.2; 10.6] years), 52.7 % boys with COVID-19, who received cholecalciferol in a dose of 1000 to 3000 IU for 30 days in depending on the concentration of 25(OH)D. After 30 days of taking vitamin D3, the levels of total vitamin D in the blood serum were re-determined. Results. The median 25(OH)D level in children with COVID-19 was 24.5 [23.9; 26.7] ng/ml. 34.5 % of children had vitamin D deficiency status (≤ 20 ng/ml), 32.7 % had insufficiency (21–30 ng/ml), a third of patients had normal vitamin D status (≥ 30 ng/ml). As a result of treatment with cholecalciferol, the number of children with hypovitaminosis D decreased by 2 times (35.4 %, p < 0.05), with an adequate level — doubled (65.5 %, p < 0.05). Depending on the level of 25(OH)D, no statistically significant differences were found in the severity of coronavirus infection (χ² = 0.872, p = 0.929). Conclusion. In 2/3 of cases, children infected with SARS-CoV-2 had hypovitaminosis D. Children under 6 years of age were more likely to have vitamin D insufficiency, while patients 7–17 years of age had a deficiency. The distribution of vitamin D levels did not differ depending on the severity of coronavirus infection. Doses of cholecalciferol taken for 30 days were sufficient to increase the concentration of vitamin D in the blood serum of children with deficiency but did not reach standard values in patients with vitamin D deficiency.

Role of interleukin-17 in juvenile idiopathic arthritis

Joint diseases is a pressing problem of pediatrics. Juvenile idiopathic arthritis is a common chronic systemic inflammatory disease of the joints in children; its etiological factors remain completely unknown. The disease can affect children of any age and is characterized by a long progressive course, leading to the development of contractures and functional failure, and thereby disability. According to the authors of the article, the content of the interleukin-17 in the blood serum of children with juvenile idiopathic arthritis depends on the duration of the disease, as well as its severity.

Autoreactive processes in children in the initial period of multisystem inflammatory syndrome associated with SARS-CoV-2 and after rehabilitation

BACKGROUND: The problem of the pathogenesis of the multisystem inflammatory syndrome (MIS-C), associated with SARS-CoV-2, remains relevant, but is still far from being resolved. In this regard.
 AIM: The aim our research was to study and evaluate the levels of autoantibodies to native and denatured DNA in the blood serum of children who underwent MIS-C, associated with SARS-CoV-2, in comparison with the initial period of the pathological process.
 MATERIALS AND METHODS: 101 children aged 2 to 17 years old were examined, 77 of them was with a confirmed diagnosis of MIS-C associated with SARS-CoV-2. We have formed 3 groups: group 1 — children with MIS-C upon admission to the hospital; group 2 — children who underwent MIS-C after a course of rehabilitation; group 3 — comparison group. All children underwent determination of the concentrations of IgG-autoantibodies to native and denatured DNA in blood serum, which was performed by EIA ELISA using commercial test systems of Vector-Best LLC (Russia) according to the manufacturer’s instructions. Statistical processing of the obtained results was carried out using the Statistica v. 10.0 application package. Statistical processing used the Newman–Keuls multiple comparison test.
 RESULTS: It was noted that both in the initial period of MIS-C and after rehabilitation, an increased content of autoantibodies to nDNA and dDNA was determined compared to the control group. At the same time, there was a significant excess of the levels of indicators in the post-rehabilitation period compared with the initial period of MIS-C. During a clinical examination of children who underwent MIS-C, most of them noted the appearance of pain in the joints. The results obtained indicate the persistence of inflammatory reactions with the development of an autoreactive component. This requires both the search for risk markers for the development of MIS-C and further monitoring of children who have undergone MIS-C to prevent autoimmune complications, including arthritis, damage to the vascular endothelium with the possible formation of thrombotic complications.
 CONCLUSIONS: In the acute period of MIS-C and after rehabilitation, increased levels of the average content of autoantibodies to nDNA and dDNA were noted compared to the control. Individual values of autoantibodies to nDNA and dDNA exceeded normative levels of the indicator were found in a significantly larger number of children in the post-rehabilitation period after MIS-C, and this excess was more pronounced compared to the acute period of the process. When assessing the clinical condition of children after MIS-C, most of them showed pain in the joints during exercise, abdominal and neurological disorders, and decreased tolerance to physical activity, which indicates persistent inflammatory reactions.

Оценка обеспеченности витамином D и эффективности его саплементации у детей, находящихся длительно на безмолочном типе питания

The purpose — to determine the level of vitamin D availability and to evaluate the effectiveness of its supplementation in children who have been on a dairy-free diet for a long time. Material and methods. At the first stage of the study, the availability of vitamin D and calcium in children were assessed. 62 children were examined who had been on a dairy-free diet (group I). The control group consisted of 30 conditionally healthy children who did not keep any restrictive diets. At stage II, a scheme of vitamin D supplementation was proposed, which consisted in taking an aqueous solution of cholecalciferol in a therapeutic dose during one month, depending on the initial level of calcidiol in blood serum: at the level of 11–20 ng/ml (vitamin D deficiency), 3000 IU/day was prescribed, at the level of 21–29 ng/ml (insufficient vitamin D) — 2000 IU/day, switching to the dose of 1000 IU/day. Children with adequate provision of vitamin D were prescribed a prophylactic dose of cholecalciferol — 1000 IU/day. Subgroup Ia consisted of 32 children who received cholecalciferol supplementation. Subgroup Ib included 30 children who had no supplementation. The importance of daily consumption of foods rich in calcium and vitamin D was explained to children of both subgroups and their parents. The assessment of vitamin D and calcium availability was repeated after 4 months of follow-up. Results. The proportion of children with insufficient vitamin D in group I was 62.9%, which was statistically significantly higher (p < 0.001) relative to the proportion of children with normal concentration or deficiency of vitamin D in blood serum. A decrease in serum calcium levels among patients of this group was found in 64.5% of children, which was statistically significant (p < 0.001) relative to children of the control group. After the course of cholecalciferol supplementation in subgroup Ia, insufficient vitamin D was found in 18.8%. Normal micronutrient availability was established in 81.2%. Among children of subgroup Ib, the proportion of children with normal vitamin D availability at the control visit was 33.3%, which was less (p < 0.01) relative to subgroup Ia. Normal values of calcium in blood serum against the background of complementation were found in 78.1% of children of subgroup 1a and in 36.7% of children in subgroup 1b. Conclusions. For children who follow a dairy-free diet, insufficient vitamin D and calcium levels are characteristic. Supplementation with an aqueous solution of cholecalciferol has shown its effectiveness in normalizing the level of calcidiol and calcium in the blood serum of children on a dairy-free diet.

КЛИНИЧЕСКАЯ, ЭПИДЕМИОЛОГИЧЕСКАЯ И ЛАБОРАТОРНАЯ СПЕЦИФИКА НОВОЙ КОРОНАВИРУСНОЙ ИНФЕКЦИИ У ДЕТЕЙ

Background. COVID-19 is characterized by high contagiousness in all population groups, however, children are more likely to carry the infection both asymptomatically and in a mild form. The characteristics of COVID-19 in children require analysis and a search for a risk factors for severe course. Objective. To study the clinical, epidemiological, and laboratory specifics of the new coronavirus infection in children permanently resident in Bronnitsy, Moscow region, to conduct a comparative analysis of the occurrence of the main factors affecting the severity of COVID-19, including the level of body supply with vitamin D and iron. Methods. Among the patients examined, school age children predominated (61.3%). The disease was predominantly mild and infection in 89.1% of cases in family centers as a result of close contact with sick family members. The symptoms of the disease were nonspecific in nature of upper respiratory tract lesions (fever, cough, symptoms of nasopharyngitis). Patients with moderate COVID-19 had lower hemoglobin, erythrocytes, lymphocytes, platelets, and ESR (p<0.05). A decrease in iron and 25(OH) levels was revealed in the blood serum of children with COVID-19. Results. School-age children predominated among the examined patients (61.3%). The disease was predominantly mild and infection in 89.1% of cases in family centers as a result of close contact with sick family members. The disease was predominantly mild and the symptoms were nonspecific in nature, catarrhal inflammation of the upper respiratory tract (fever, cough and signs of nasopharyngitis). Patients with moderate COVID-19 had lower hemoglobin, erythrocytes, lymphocytes, platelets, and ESR (p<0.05). A decrease in serum iron and 25(OH)D concentration indices was revealed in children who had undergone COVID-19. Conclusions. Among those infected with COVID-19, school-age children with asymptomatic and mild disease prevailed. The infection clinic presented with catarrhal symptoms, including fever, cough, and signs of nasopharyngitis. In the moderate course of COVID-19, the chances of anemia in children increased (OR= 2.56), as well as the indicators of iron availability and VD status decreased, which requires further study.

Evaluation of Blood Nitrotyrosine and Nitric Oxide Levels in Acute Mercury Intoxication in Children

Aim: Multiple processes have been demonstrated to elucidate the biological toxicity of mercuric chloride, among which oxidative stress has been identified as a contributing factor. The superoxide radical has the potential to induce peroxidation of lipid membranes, alter the activities of proteins and antioxidant enzymes, and modulate gene transcription. Additionally, it has the ability to swiftly deactivate Nitric Oxide (NO), resulting in impairment of endothelial function and causing harm to macromolecules, membranes, and DNA by generating more harmful radicals including peroxynitrite and hydroxyl radicals. The formation of nitrotyrosine occurs through the interaction between peroxynitrite and tyrosine residues found in proteins. Nitrotyrosine serves as a useful marker for assessing the possible cytotoxic impacts of nitric oxide. While there have been previous animal tests undertaken, the existing literature we have reviewed does not provide evidence regarding the impact of direct mercury exposure and mercury toxicity on nitrotyrosine and NO. In order to achieve our research objectives, we have devised a plan to investigate the presence of nitrotyrosine and NO in the blood serum of children who have been exposed to mercury in our study. Materials and Methods: Our study included 65 patients, 42 girls and 23 boys, who had accidentally come into contact with mercury in the laboratories of some schools in Kahramanmaraş and Gaziantep provinces, and whose blood mercury level was over 10 μg/l and/or whose urine mercury level was over 15 μg/l. The control group of the study included a total of 23 children, 17 girls and 6 boys, who applied to the pediatric clinic with various complaints, without intoxication or neurological findings, and from whom blood samples would be taken for different diagnoses. Results: Nitric Oxide and Nitrotyrosine levels were found to be higher in children exposed to mercury than in the control group (p<0.01). Nitric Oxide, Nitrotyrosine and mercury levels in the patients were high in both genders, and no gender-related difference was detected (p>0.05). The mean duration of mercury exposure was 45 minutes. Of the 65 patients, 20 were asymptomatic and 40 were symptomatic. The most common symptoms were headache and nausea. Conclusion: The existing body of research predominantly focuses on investigating the association between mercury poisoning and oxidative stress biomarkers through animal studies, with a limited number of studies conducted on human subjects. Our study has made a valuable contribution to the existing literature by successfully detecting elevated levels of NO and Nitrotyrosine in children who have been diagnosed with mercury poisoning.

Associations of vitamin D receptor gene polymorphism with idiopathic hypercalciuria in children

Introduction. Idiopathic hypercalciuria (IH) is one of the most common metabolic disorders in children and can lead to the development of urolithiasis over childhood. In this regard, studying the etiology of this pathological condition will help to prevent the development of IH and reduce the risk of developing urolithiasis.
 Study purpose: to study the role of genetic polymorphisms of the VDR gene in the development of IH in children and their relatives of the first and second lines of kinship.
 Materials and methods. The study included 68 people, including 35 children aged of 3 to 17 years with identified hypercalciurine and 33 first- and second-line relatives with IH and urolithiasis. A study of the level of 25-OH vitamin D in blood plasma and a genetic study for the presence of polymorphisms of the vitamin D receptor gene VDR were carried out including: BsmI Polymorphism IVS10+283G>A, A-3731G (Cdx2), FokI Polymorphism; Ex4+4T>C. To compare the frequency of occurrence of vitamin D receptor (VDR) genotypes, samples of conditionally healthy individuals permanently residing in Kemerovo and natives of the European part of the Russian Federation were taken. At the same time, for the VDR G283A (BsmI) gene, a healthy sample consisted of 232 people from Kemerovo and 96 cases from the European part of Russia, for the VDR A-3731G gene — 269 and 243 people, and for the VDR FokI TC gene — 172 and 96 people, respectively. 
 Results. Reducing the content of 25(OH)D in the blood of less than 30 ng/ml was detected in 33 (48.5%) IH children. 25 (OH)D level below 20 ng/ml was detected in 15 (22.1%) patients. In IH patients and level 25(OH)D in the blood of less than 20 ng/ml, the homozygous variant 283 GG of the VDR gene (BsmI) was found in 20% of the examined versus 51% (p = 0.028) of conditionally healthy individuals. The heterozygous genotype of 283 PA of the VDR gene (BsmI) was determined in 73.3% of IH patients versus 41.7% of conditionally healthy individuals (p = 0.027). The heterozygous Ex4+4TC genotype of the VDR Fokl gene was recorded in 66.7% of the examined IH patients and low serum vitamin D levels (< 20 ng/ml) when compared with the level in conditionally healthy individuals (p = 0.030). In patients with low vitamin D levels against IH background, the proportion of the minor allele A 283 of the VDR gene (BsmI) was determined significantly more often than in healthy individuals (p = 0.044).
 Conclusion. A relationship was identified between polymorphism of the vitamin D receptor gene VDR (polymorphic marker BsmI (rs1544410) of the VDR gene 283G>A; polymorphic marker Fokl (rs2228570) of the VDR gene Ex4+4T>C) with IH and deficiency of 25(OH)D levels in the blood serum of children.

PATHOPHYSIOLOGICAL ASPECTS OF HABILITATION AND REHABILITATION OF CHILDREN FROM CHILDREN’S HOMES WITH NEURODEVELOPMENTAL DELAY OF PSYCHOSOCIAL GENESIS

Background. Psycho-emotional stress in institutionalized children leads to significant tension in regulatory systems. Justification for using a complex of habilitation and rehabilitation measures aimed at reducing the stress factor and cre-ating conditions for “catch-up” development is an urgent problem. The aim of the study. To create and to test the effectiveness of a complex of habilitation and rehabilitation measures aimed at reducing deprivation pressure and environmental stress. Material and methods. The study included 114 children from children’s homes of Donetsk and Makeevka and 44 chil-dren from families aged 3 to 7 years. The complex of habilitation and rehabilitation measures included optimization of the daily routine, conditioning exercises, music, toy and fairy tale therapy, sessions of individual play and play in small groups of 2–3 people in a separate playroom, phototherapy with bright solar spectrum lamps, enriched sensory envi-ronment, increased physical activity, differentiated drug support with L-carnitine, glycine, hopantenic acid, magnesium and pyridoxine complex. Neuropsychic development was studied using the Denver Screening Test and the Formalized Card for the Study of Psychoneurological Functions according to I.A. Skvortsov and N.A. Ermolenko. The functions of regulatory systems were assessed by the level of cortisol and melatonin in saliva, and brain-derived neurotrophic factor in blood serum. Conclusion. A comparison of the results of assessing the parameters of neuropsychic development confirmed the effec-tiveness of the proposed complex of habilitation and rehabilitation measures. Restoration of the function of regulatory systems was confirmed by normalization of the rhythms of cortisol and melatonin synthesis, as well as by a significant (3-fold) increase in the content of brain-derived neurotrophic factor in the blood serum in children of the main group.

Peculiarities of cytokine and chemokine content in blood serum of children with psoriasis vulgaris

Psoriasis is a chronic auto-inflammatory skin disease with a hereditary predisposition due to the activation of T-lymphocytes and the synthesis of pro-inflammatory cytokines. The pathogenesis involves populations of Th1 and Th17 lymphocytes that produce TNFa, IFNy, IL-17, IL-21 and IL-23. The aim of the study was to identify the features of the content of cytokines and chemokines in the blood serum of children with psoriasis. 88 children with psoriasis of varying severity were examined. The level of circulating cytokines was determined by the multiplex method on the Bio-plex 200 device using the MILLIPLEX MAP Human Th17 kit. In children with psoriasis, increased levels of IL-23, IL-22, IL-12p70, IL-27, IL-17E, IL-17F and TNFa were detected. The consistency of the functioning of the cytokine network in children with psoriasis was shown, which was expressed in the high strength of the connection between cytokines of the IL-17 family and cytokines of the IL-12 family, between IL-31 and IL-33, as well as in significant correlations between GM-CSF and cytokines IL-2, IL-5, IL-9, IL-10, IL-15 and TNFa. In children with psoriasis, the dependence of the level of IL-17A, TNFa, IL-2, IL-6, IL-9, CCL20/MIP3a with the severity of the disease according to PASI was revealed. The study confirmed the pathogenetic role of the cytokine network in the development and maintenance of an inflammatory response in children with psoriasis. The data obtained substantiate the need for targeted anti-cytokine therapy. The level of proinflammatory cytokines in children with psoriasis can be used as an additional laboratory criterion for the severity of the condition and monitoring the effectiveness of therapy.

Serotonin and 5-hydroxyindoleacetic acid are involved in the pathogenesis of COVID-19 in children

Background. The new coronavirus infection COVID-19 is a pressing health problem around the world. This disease affects the respiratory, cardiovascular and other systems. The role of serotonin as one of the key factors in COVID-19 is discussed in the literature.
 Aim. Determination of the concentration of serotonin and its metabolite 5-hydroxyindoleacetic acid in the blood serum of children in the acute period of COVID-19 for use as a diagnostic criterion for the severity of the disease.
 
 Material and methods. A study that included 141 children aged 0 to 17 years was conducted: 92 patients hospitalized in a hospital with a diagnosis of COVID-19 without concomitant pathology made up the study group, 49 healthy children were included in the control group. The subjects were divided into two age groups: younger (0–2 years) and older (3–17 years). The groups of patients and children from the control group were comparable in age and gender. A study of the concentration of serotonin and its metabolite — 5-hydroxyindoleacetic acid — in the blood was carried out using high-performance liquid chromatography, and the results of laboratory and instrumental research methods (obtained from medical records) were evaluated. Based on the results of computed tomography, the proportion of involvement of the lung parenchyma in the pathological process was calculated: CT0 — absence of lung damage; CT1 — less than 25%; CT2 — 25–49%; CT3 — 50–74%; CT4 — more than 75%. Quantitative data were described using median (Me) and lower and upper quartiles (Q1–Q3). To analyze the data, the Pearson χ2 test, nonparametric Kruskal–Wallis and Mann–Whitney tests, as well as the ROC curve method were used. A correlation analysis was carried out using the Spearman coefficient and an assessment of the dependence of a quantitative variable on factors using the linear regression method.
 Results. In children with COVID-19 aged 0–2 years, the concentration of serotonin (969.41 pmol/ml) in the blood serum was statistically significantly higher by 49.1 times, in the group of 3–17 years (637.87 pmol/ml) — by 24.5 times compared to age-matched controls (19.74 pmol/ml; p 0.001 and 26.0 pmol/ml; p 0.001, respectively). The concentration of 5-hydroxyindoleacetic acid in patients 0–2 years old (204.90 pmol/ml) was 4.7 times higher relative to healthy children (43.56 pmol/ml; p=0.003), and in the older age group (78.25 pmol/ml) — 2.4 times higher (32.65 pmol/ml; p=0.012), which suggests increased breakdown of serotonin under the influence of monoamine oxidase A. Maximum concentrations of serotonin in blood serum were detected in children aged 0–2 years (1808.79 pmol/ml) with damage to the lung parenchyma from 50 to 74% (grade 3 according to computed tomography). However, in children aged 3–17 years, the maximum concentrations of serotonin (2036.95 pmol/ml) were detected with lung damage ranging from 25 to 49% (grade 2 according to computed tomography). In patients with COVID-19, when the concentration of serotonin in the blood was above 1046.5 pmol/ml, grade 2–4 lung lesions were predicted according to computed tomography, sensitivity 62.5%, specificity 75%.
 Conclusion. With COVID-19, a significant increase in the concentration of serotonin and 5-hydroxyindoleacetic acid in the blood was detected in children.

Changes of immunological biomarkers in pediatric patients with seasonal allergic rhinitis

Background. Seasonal allergic rhinitis shows a constant upward trend not only among the adults but also in the children’s population. A significant percentage of patients have a moderate and severe course of the disease, which leads to a significant deterioration in their quality of life. Since the pathogenesis of allergic rhinitis is represented by a complex cascade of immunological reactions involving a number of cytokines that play a role in the development of allergic inflammation of the upper respiratory tract, the priority direction of our work was an in-depth study of the pathogenetic mechanisms of this disease. The purpose was to investigate the levels of interleukin-33 (IL-33) and its suppression of tumorigenicity 2 (ST2) receptor in the blood serum of children with hay fever, depending on the age and severity of the disease, followed by the determination of correlations of these indicators with various clinical and immunological parameters of seasonal allergic rhinitis. Materials and methods. Forty-two patients aged 6–17 years with seasonal allergic rhinitis and 26 healthy children (controls) took part in the study. Severity of nasal and extra-nasal symptoms of allergic rhinitis was determined using a visual analog scale. Skin prick testing was performed according to generally accepted standards during remission using a standard pollen panel. Quantitative measurement of serum indicators of interleukin-33 and ST2 was carried out by the method of solid-phase enzyme immunoassay. A mandatory condition for conducting the study was the presence of written informed consent from the parents. Results. The study of serum levels of IL-33 and ST2 showed statistically higher concentrations in the group of children with a severe course of seasonal allergic rhinitis, a direct correlation of medium strength between content of the above cytokines in children with a mild SAR (τ = 0.65; p < 0.05) and a strong dependence in patients with moderate (τ = 0.76; p < 0.01) and severe (τ = 0.80; p < 0.05) course. When comparing the mean values of IL-33 and ST2, no significant changes were found depending on age and the presence of mono- or polysensitisation among patients with allergic rhinitis. In children with seasonal allergic rhinitis and concomitant bronchial asthma, there was a statistically significant tendency towards a more severe course of the disease with correspondingly higher values of IL-33 and ST2 compared to patients with isolated seasonal allergic rhinitis. Conclusions. The obtained results of the immunological study made it possible to emphasize the diagnostic significance of IL-33 and its receptor ST2 as potential biomarkers in the development of allergic inflammation in pediatric patients with seasonal manifestations of rhinitis.

CLINICAL AND IMMUNOLOGICAL ASPECTS OF BRONCHIAL ASTHMA WITH ATOPIC DERMATITIS IN CHILDREN

This article presents the results of a clinical and immunological examination of 68 children with allergic bronchial asthma and 22 children with atopic dermatitis. The purpose of the work is to determine the concentrations of IgA, IgM, IgG to identify clinical and immunological features in the blood serum of children with allergic asthma and AD and to identify clinical and immunological features in groups of these patients. Methods. At the allergy department of the VDOCH, 68 children with allergic asthma and 22 children with AD aged from 4 to 14 years (of which 53 boys and 37 girls) were examined. All children were examined clinically and laboratory (complete blood count, general urine test, biochemical blood test, nasal swab for eosinophils, stool test for helminth eggs, scraping for enterobiasis), and a carefully collected medical history. Results and conclusions: Taking into account the number of acute respiratory infections in the history, we identified significant differences in these groups of patients (p = 0.017). The concentrations of IgA, IgM, IgG in the blood serum of the examined patients were determined using an enzyme-linked immunosorbent assay (ELISA). We found that 33.8% of children with asthma and 36.4% of children with atopic dermatitis have low IgA levels. We also determined low IgG concentrations in more than half of the examined patients both in the group with bronchial asthma and in the group with atopic dermatitis (58.8% and 59.1%, respectively), which, in combination with low levels of other immunoglobulins, can be regarded as transient immunodeficiency in children.

LEVELS OF IL-4 AND Γ- INTERFERON IN CHILDREN’S BLOOD SERUM AS PREDICTORS OF ASTHMA FORMATION

Introduction. The prevalence of asthma continues to increase every year. Asthma is the leading chronic disease. Infl ammation,both acute and chronic, is closely related to the action of cytokines (pro- and anti-infl ammatory). T-helper 2 lymphocytesrelease IL-4, which triggers the production of immunoglobulin E (IgE) antibodies, which set the stage for allergy and activateinfl ammatory cells. The regulators of this process are T helper-1 lymphocytes, which produce cytokines (IFN-gamma) thatsuppress Th-2 activity. Disturbances in the ratio of Th-1/Th-2 lymphocyte clones are a subject of debate in the early detectionof asthma and the prediction of the development of this disease.The aim of the study was to evaluate the levels of IL-4 and γ-interferon in the blood serum of children with transient wheezeand asthma..Material and methods. 121 children were included in the study. The patients were divided into groups: group 1 – childrenwith transient wheezing (TW) (n = 81), group 2 – children with doctor- diagnosed asthma (DDA) (n = 15), group 3 – healthychildren (n = 25).IL-4 and γ-interferon in blood serum were analyzed by ELISA using commercial kits (human IL-4 and human γ-interferon“Vector Best- Ukraine”). Data were analyzed using Statsoft Statistica version 8 (Tulsa, OK) and the MedCalc version 17.2statistical program.The planned clinical trials were conducted after obtaining the approval of the local ethics committee (date: February 1, 2015;number: 2015/01) and were conducted in accordance with the principles of the Declaration of Helsinki, as amended in October 2013.This article was conducted within the framework of the Department of Pediatrics No. 2 of Kharkiv National MedicalUniversity «Medical and biological aspects of adaptation of children with somatic pathology to modern conditions. Predictionof asthma control in children taking into account infl ammatory markers and the state of the airway barrier of the lungs» (stateregistration number 0120U102471).Results. It was found that in children of the fi rst and second groups, in the midst of clinical manifestations of wheezing, IL-4levels signifi cantly increased and serum γ-interferon levels decreased. The highest levels of IL-4 and the lowest levels of serumγ-interferon were found in patients with DDA.Serum levels of IL-4 above 15.33 pg/mL and γ-interferon below 98.62 pg/mL in children with wheezing episodes may beconsidered as a possible indicator of asthma development.Conclusions. Serum IL-4 and γ-interferon are involved in the regulation of allergic infl ammatory processes in the body.A statistically signifi cant increase in IL-4 levels and a decrease in γ-interferon levels in the blood serum of patients with asthmais likely to indicate the development of a chronic form of infl ammation.

Роль магнію в організмі здорової людини в перебігу і реабілітації після респіраторної інфекційної патології та COVID-19 (відомості літератури, власні дані)

Magnesium is a macroelement that plays an important role in the regulation of many physiological processes. In the case of insufficient intake of magnesium, which does not meet the needs of the child's body, its deficiency develops. Clinical manifestations of magnesium deficiency are nonspecific and may be similar to symptoms of various diseases, including asthenic syndrome. In turn, asthenic syndrome is common in children who have suffered infectious diseases, COVID-19, influenza, and other acute respiratory infectious pathology. In such children, excessive anxiety, rapid fatigue, sudden mood changes, sleep disorders, and emotional lability can be detected. Given that the leading role in ensuring the proper functioning of most of the body's enzyme systems, tissue respiration, energy exchange, and synthetic processes belongs to magnesium, it is assumed that the development of the described symptoms may be related to its deficiency. Purpose - to summarize literature data on the role of magnesium in the body of a healthy person, the peculiarities of its metabolism, its importance in the course and rehabilitation after respiratory infectious pathology and COVID-19, signs of deficiency, and methods of its correction; evaluate the results of own research. Materials and methods. General clinical (analysis of anamnesis data), laboratory (determination of magnesium level in blood serum), statistical, bibliographic, and information-analytic research methods were used. 60 children aged 9 to 18 took part in the study, among them 35 children who had COVID-19 (the first group) and 25 children who did not have COVID-19 (the second group). Results. It was established that the average value of magnesium level in blood serum in children of the first group was lower than in children of the second group (p=0.005). Individual analysis showed that 31.4% of patients in the first group, who had a term of 4-5 months after COVID-19, noted the presence of post-COVID-19 symptoms, such as excessive fatigue, headache, muscle weakness, impaired sleep, appetite, which coincides with the data of the literature. Conclusions. The data of our study may indicate the effect of transferred COVID-19 on the level of magnesium in the blood serum, which may be one of the reasons for its deficiency and, accordingly, the development of post-COVID-19 symptoms in children. It is advisable to carry out laboratory determination of the magnesium level in children who had acute respiratory infectious pathology, including COVID-19, to establish the causes of the development of individual symptoms that aggravate the general well-being, prevent the development of magnesium deficiency and find additional ways of rehabilitation after respiratory infectious pathology and COVID-19. No conflict of interests was declared by the authors.

Significane of determining antinuclear antibodies in systemic connective tissue disorders in children

Systemic connective tissue diseases (SCTD) are characterized by systemic autoimmune inflammation and are accompanied by development of antinuclear antibodies (ANA). Our aim was a comparative analysis of ANA in blood serum in children with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). The study included 50 patients with SLE, 50 patients with RA who were treated at the National Medical Research Center of Childrens Health. Median age was 12,2 y. o. (9-15.5). The titers of ANA and the cell fluorescence type were determined with the indirect immunofluorescence reaction (IFR) using the HEp-2 cell line (Immco Diagnostics, Inc, USA), as well as the concentration of antibodies to double-stranded DNA (adsDNA) in blood serum samples of the children detected by immunochemiluminescence (ICM) woth Elia dsDNA (Thermo Fisher Scientific, USA). A positive ANA titer and adsDNA were found, respectively, in 98% and in 48% in children with SLE. A positive ANA titer and adsDNA was detected in 100% and in 4% of children with RA, respectively. Highly positive ANA titers ( 1/1280) have been detected in 68% of children with SLE, and in 30% of children with RA. None of the RA patients with highly positive ANA titers had adsDNA. But, in patients with SLE, highly positive ANA titers and a positive dsDNA level were simultaneously detected in 16% of cases. There are both single types of cell fluorescence and their combinations in children with SLE and RA. Nuclear dot-like fluorescence was more common in children with SLE, cytoplasmic type, in children with RA, nucleolar type of glow was found only in children with RA. The revealed combinations of ANA and adsDNA titers in children with SLE and RA confirm the need for simultaneous use of RNIF and ICM.

MicroRNAs as potential biomarkers for diagnosis of attention deficit hyperactivity disorder.

Inappropriate levels of hyperactivity, impulsivity, and inattention characterize attention deficit hyperactivity disorder, a common childhood-onset neuropsychiatric disorder. The cognitive function and learning ability of children with attention deficit hyperactivity disorder are affected, and these symptoms may persist to adulthood if they are not treated. The diagnosis of attention deficit hyperactivity disorder is only based on symptoms and objective tests for attention deficit hyperactivity disorder are missing. Treatments for attention deficit hyperactivity disorder in children include medications, behavior therapy, counseling, and education services which can relieve many of the symptoms of attention deficit hyperactivity disorder but cannot cure it. There is a need for a molecular biomarker to distinguish attention deficit hyperactivity disorder from healthy subjects and other neurological conditions, which would allow for an earlier and more accurate diagnosis and appropriate treatment to be initiated. Abnormal expression of microRNAs is connected to brain development and disease and could provide novel biomarkers for the diagnosis and prognosis of attention deficit hyperactivity disorder. The recent studies reviewed had performed microRNA profiling in whole blood, white blood cells, blood plasma, and blood serum of children with attention deficit hyperactivity disorder. A large number of microRNAs were dysregulated when compared to healthy controls and with some overlap between individual studies. From the studies that had included a validation set of patients and controls, potential candidate biomarkers for attention deficit hyperactivity disorder in children could be miR-140-3p, let-7g-5p, -30e-5p, -223-3p, -142-5p, -486-5p, -151a-3p, -151a-5p, and -126-5p in total white blood cells, and miR-4516, -6090, -4763-3p, -4281, -4466, -101-3p, -130a-3p, -138-5p, -195-5p, and -106b-5p in blood serum. Further studies are warranted with children and adults with attention deficit hyperactivity disorder, and consideration should be given to utilizing rat models of attention deficit hyperactivity disorder. Animal studies could be used to confirm microRNA findings in human patients and to test the effects of targeting specific microRNAs on disease progression and behavior.