ACUTE OBSTRUCTIVE BRONCHITIS IN "FREQUENTLY ILL CHILDREN": SATUS OF SYTOKINES

Аннотация

Acute obstructive bronchitis remains one of the most prevalent and severe respiratory diseases in children. Understanding the pathogenetic role of immune status and cytokines can provide deeper insight into the mechanisms underlying the development of AOB. This knowledge is essential for developing effective diagnostic and treatment strategies for frequently ill children. The primary focus of scientific research is to investigate the mechanisms of disease progression, identify the clinical features, and assess the impact of immune status and cytokines in acute obstructive bronchitis among frequently ill children. The goal is to develop pathogenetically based treatment methods and preventive measures. In our country, extensive efforts are being made to ensure early diagnosis and prevention of somatic diseases in children, with particular emphasis on bronchopulmonary pathology. Keywords: obstructive bronchitis, cytokines, immunity, frequently ill children. Relevance. In pediatric practice, one of the key modern diagnostic markers for identifying "frequently ill children" is the assessment of local and systemic immune parameters, as well as inflammatory and anti-inflammatory cytokines. However, their role in the development of pathological processes is primarily considered from the perspective of their interactions. It is well established that recurrent respiratory illnesses in children, including acute obstructive bronchitis, disrupt compensatory-adaptive mechanisms, leading to chronic recurrent infections and impairments in both cellular and humoral immunity [1,3,8]. In children, viral infections often result in a weakened respiratory defense system, allowing viruses to persist and replicate in the epithelium. In allergic reactions affecting the respiratory mucosa, inflammatory metabolites trigger the release of inflammatory mediators. Meanwhile, immune system alterations contribute to the formation of cytotoxic antibodies within the bronchial submucosa, ultimately leading to obstructive syndrome [6,9]. Several researchers highlight the significance of cytokine profiling in patients with obstructive bronchitis, as an imbalance in cytokine levels is a key driver of inflammation in the respiratory tract [2,4]. The investigation of cytokines’ role in disease pathogenesis remains highly relevant today [7,11]. Cytokines are glycosylated polypeptides that regulate immune responses. Based on their biological activity, they are classified into regulators of humoral and cellular immunity, mediators of allergic reactions, or modulators of immunosuppressive responses [5,12]. Their role in controlling inflammation is crucial in the pathogenesis of obstructive bronchitis [10]. 29 ResearchBib IF - 11.01, ISSN: 3030-3753, Volume 2 Issue 6 Objective of the study. To examine the cytokine profile in children with acute obstructive bronchitis who experience frequent illness. Materials and methods. To assess correlations with cytokine profile indicators, a study was conducted involving 120 patients diagnosed with acute obstructive bronchitis. The participants were divided into two groups: Group I – 40 patients with acute obstructive bronchitis classified as "episodically ill children. "Group II – 80 patients with acute obstructive bronchitis belonging to the "frequently ill children" category. Results. Interleukins play a crucial role in various biological processes, including the activation, differentiation, and proliferation of immune cells, as well as in the regulation of innate and adaptive immune responses and inflammation. The rise in cytokine levels results from the impact of infectious agents that trigger acute obstructive bronchitis. Their equilibrium plays a crucial role in determining the disease progression and prognosis. The elevated IL-1 levels in Group I, considering its involvement in inflammatory responses, contribute to airway swelling and narrowing, a hallmark of obstructive bronchitis in children. IL-4, primarily secreted by T-lymphocytes and basophils, promotes IgE synthesis, thereby intensifying allergic reactions in the bronchi during acute obstructive bronchitis. In children with episodic disease, the moderate elevation of IL-6 in the bloodstream confirms the presence of inflammatory and infectious processes in the respiratory tract. However, excessive IL-6 levels may amplify the inflammatory response and worsen disease symptoms. The IL-8 concentration in episodic acute obstructive bronchitis patients increased to 19.85 ± 0.73 pg/ml, reflecting an inflammatory reaction in the respiratory tract. This activates neutrophils, which play a critical role in immune defense and indicate a dominance of cellular immunity over humoral immunity. However, excessive neutrophil activation may exacerbate pathological inflammation, leading to lung tissue damage. An increased IL-10 level in children with acute obstructive bronchitis may suggest the body's attempt to regulate and mitigate inflammation. Additionally, the el