Clinical and immunological effectiveness of an immunotropic drug in children with acute respiratory infections with bronchial obstructive syndrome
Introduction. The incidence of bronchial obstructive syndrome (BOS) against the background of acute respiratory infections (ARI) in young children remains high. This group of children, according to previous studies, revealed a reduced immune response to infection. Thus, it is advisable to use immunomodulating therapy in children with bronchial obstructive syndrome in ARI.
Aim of the study - to evaluate the clinical and immunological effectiveness of the use of the drug alpha-glutamyl-tryptophan spray in children with bronchial obstructive syndrome in acute respiratory infections.
Material and methods. The article presents the results of a randomized, double-blind, placebo-controlled study conducted in the infectious-pulmonological department of the St. Petersburg Children’s Hospital. The study involved children under the age of 6 years with the presence of 2 or more episodes of biofeedback on the background of ARI. Alpha-glutamyl-tryptophan was prescribed after stopping the acute picture of the disease for 5 days in the form of a spray at a dose of 25 pg for children under 3 years old and 50 pg for older than 3 years. Clinical efficacy was assessed by comparing baseline clinical history data with follow-up data 6 months after therapy. The evaluation criteria were the frequency and characteristics of the course of acute respiratory infections and biofeedback, the number of hospitalizations. An immunological study was carried out twice: in the acute period of the disease and not earlier than the 18th day after taking the drug or placebo. The absolute and relative number of lymphocytes and their subpopulations CD3+, CD4+, CD8+ (T-lymphocytes), CD19+ (B-lymphocytes) were determined. Functional activity of polymorphonuclear neutrophils, phagocytic index (AF) and phagocytic number (PS), phagocytosis completion index (PZF) were estimated.
Results. The use of alpha-glutamyl-tryptophan intranasally in the form of a spray in the complex treatment of children with biofeedback led to a reduction in the frequency and duration of acute respiratory infections, helped to reduce the number of episodes of biofeedback against ARI and improved immunological parameters that normalize CD4+-T-cells level, normalize the CD4+/CD8+ ratio, a decrease in the level of pro-inflammatory cytokine TNFα.
Conclusion. Identified positive effects of the drug on the frequency, severity and duration of ARI in children with biofeedback. Favorable changes in immunological parameters allow the use of alpha-glutamyl-tryptophan spray in the treatment of ARI in children with biofeedback and for the prevention of their recurrent course.
Keywords:children; acute respiratory infections; bronchial obstructive syndrome; alpha-glutamyl-tryptophan; clinical efficacy; immunological effectiveness
For citation: Tikhomirova A.R., Ruleva A.A. Clinical and immunological effectiveness of a immunotropic drug in children with acute respiratory infections with bronchial obstructive syndrome. Immunologiya. 2019; 41 (3): 249-55. DOI: 10.33029/0206-4952-2020-41-3-249-255 (in Russian)
Funding. The study had no sponsor support.
Conflict of interests. The authors declare no conflict of interests.
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