Immune and Genetic Aspects of Anti-Inflammatory Therapy of Acute Obstructive Bronchitis in Infants

Abstract

The objective of the study was to improve the treatment of acute obstructive bronchitis in infants by optimizing the anti-inflammatory therapy based on the evaluation of its clinical, immunological and molecular genetic efficiency. Materials and methods. We have carried out a comprehensive examination of 80 children aged 6 months to 3 years with acute obstructive bronchitis. Patients were divided into two groups: children of the first group (n = 40) received systemic glucocorticosteroids, children of the second group (n = 40) were treated with inhaled glucocorticosteroids. Before and after the treatment, in all children we have studied the content of IFN-γ, IL-4 and IL-13 in the blood serum using enzyme linked immunosorbent assay, the concentration of total IgE — by means of electrochemiluminescent immunoassay. The level of expression of the transcription factor NF-κB in peripheral blood lymphocytes was determined using flow cytometry. Results. Transcription factor NF-κB, having almost the same effect on the concentration of IFN-γ and IgE in the blood serum, determines the characteristics of inflammation, mainly local, in acute obstructive bronchitis. Glucocorticosteroid therapy leads to the disappearance of NF-κB influence on the content of proinflammatory cytokines. Inhaled glucocorticosteroids, in addition, help to reduce the concentration of IgE in the blood serum and inhibition of the activity of pro-inflammatory intracellular cascades that, at high clinical efficacy and safety profile, justifies the appropriateness of their use in the treatment of acute obstructive bronchitis in infants as pathogenetic therapy.

Keywords

• acute obstructive bronchitis
• immune status
• glucocorticosteroids
• infants