Adjuvant therapy of chronic gastroduodenitis in children with dysplasia of connective tissue

Abstract

Chronic gastroduodenitis (CGD) hold one of main places among leading diseases of gastro-intestinal tract (GIT) in childhood. A special category is children who have CGD against the background of connective tissue (CT) dysplasia (DCT). CGD in such children is characterized by early appearance, aggressive, gradient course with frequent acute conditions and recurrences with evident symptoms of nonspecific intoxication manifestations. Defect of collagen synthesis leads to pronounced morphological changes of proximal GIT mucous membrane (MM) and decline in its cytoptotecive abilities. Challenges related to the qualitative and quantitative local ecosystem changes can aggravate immune and metabolic local processes and enhance the destruction of proximal GIT mucous membrane. Aforesaid defines the need to include multiprobiotics into the treatment schemes of patient with CGD, associated with congenital fibrogenesis disorders, as adjuvant therapy with complex therapeutic action; they positively influence the CT metabolism, improve reparative processes in MM, normalize immune processes and maintain composition and functions of physiological microbiota. Purposes – improvement of CGD treatment efficiency in children with DCT through inclusion of the multiprobiotic Symbiter® forte-M into the treatment schemes. Materials and methods. There were examined 33 children with CGD on the background of DCT and 32 healthy children (control) from 11 to 17 years old. The state of the mucous barrier was estimated by certain mucin constituents (fucose, glycosaminoglycans, sialic acids) assessing, antimicrobial peptides (ß2-defencins), non-specific humoral factors of the local immunity (immunoglobulins, lysozyme) in mucous secretions (saliva, coprofiltrate (CF)) before and after probiotic therapy. Results. Increased concentrations of ß2-defencins (psaliva = 0.03, pCF = 0.03), sialic acids (P = 0.04) and lysozyme (P = 0.01) and decreased of fucose level (P = 0.03) in mucous secretions under application of multicomponent probiotic preparation were observed. Conclusions. In children with DCT and CGD development, mucins, forming protective homeostatic barrier between residential microbiota and basic immune intestinal cells, contain in their composition increased quantity of fucose-containing glycoproteins and low amount of sialic acids; this influences microbiota and activity of cytoprotective and reparative processes in MM. Inclusion of the multiprobiotic Symbiter® forte-M into the standard treatment scheme leads to the normalization of some mucus glycoproteins and non-specific humoral local immunity factors. Due to its complex composition with high probiotic and immunomodulatory properties and natural mineral gel (smectite) inclusion, the multiprobiotic improves cytoprotective and reparative properties of GIT mucous membrane and reduces the likelihood of severe destructive processes in children with CGD and DCT development.

Keywords

• children
• hypertrophic gastroduodenitis
• connective tissue diseases
• treatment
• probiotics