Журнал инфектологии (Sep 2014)
Role of genetic factors in the development of metabolic and immune response in the cases of acute respiratory infections complicated by pneumonia in the conditions of the far north in various ethnic groups
Abstract
This is the first-time comparison of pneumonia course severity in two different ethnic groups of children in the conditions of the Far North with the account of acetylatory phenotype and intensity of free-adical oxidation. Genetic polymorphism on activity of N-cetyltransferase (N-АТ) enzyme is present in the majority of human populations as some have fast and others slow form of enzyme. According to this there are phenotypically distinguished people with slow and fast acetylatory phenotype, so-called slow and fast acetylators (SА and FА). SА-сhildren are to a greater degree the subject to complications in the cases of infectious diseases and do not easily response to therapies. The purpose of our research was to estimate the value of acetylatory phenotype of a child during the development of an acute respiratory infection complicated by pneumonia in both populations of children of Sakha Republic (native population – Yakuts and arrived population – Russians). There has been performed the examination of 112 children with acute respiratory infections complicated by pneumonia, and 49 practically healthy ones in the conditions of the Far North (Sakha). It is demonstrated that both Yakuts and Russians have to fight with pneumonia by free-radical oxidation activation (at the expense of “respiratory burst” reactions). It has been revealed that in the conditions of the Far North both hormones of stress, cortisol and somatotropic hormone work actively. The level of growth hormone was 2 times higher even in healthy Russian children to compare with Yakuts, (the level of growth hormone was 1,5 times higher among FА comparing with SА). The subpopulation structure of blood lymphocytes in SА-patients to a less degree depends on the intensity of free-radical oxidation to compare with FA-patients, especially in Yakuts population. Two independent parameters – speed of acetylation and free-radical oxidation intensity, regulating cell activation, synthesis of protection mediators and the level of hormones in blood, as well as cytotoxic properties of lymphocytes interact with each other, influencing the regulation of metabolism and separate mechanisms of immune response. This type of influence is to a greater degree expressed in children of Yakuts to compare with Russians. Depending on the combination of acetylation type and free-radical oxidation level during an acute phase of acute respiratory infection there is a change of a profile of immune protection due to the activation of cellular Th1-response or IgA production in mucous membranes. It is demonstrated that the stimulation of cellular response is more characteristic for Yakut-children, and humoral one for Russian-children. There have been revealed the features of pneumonia course, the metabolic laws of the development of adaptation response to infectious stress and the maintenance of immune homeostasis with taking into account a genophenotype of acute respiratory infection complicated by pneumonia in children of the Far North. The value of the research of N-АТ activity level in cases of acute respiratory infection complicated by pneumonia in ill children (Yakuts and Russians) in the conditions of the Far North is underlined as the reason for its further use as a marker of the predisposing factor for complicated acute respiratory infection and other infections.
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