Yakymovych S. Clinical effectiveness of mucosal immunity correction in immunocompetent and immunocompromised children with recurrent respiratory infections

The dissertation was done to study the differences in concentration of innate and adaptive mucosal immunity factors in immunocompetent and immunocompromised children with recurrent respiratory infections, possibilities to impact the investigated indicants using bacterial lysates (IPC-19) as well as estimate the clinical effectiveness of their correction depending on immunocompetence of children and respiratory illnesses frequency. The specific features of mucosal immunity functioning in immunocompetent children (without detected antibody deficiency), with frequency of respiratory diseases more than 6 times per year was analyzed , videlicet the unbalance of connections between the indices of innate and adaptive immunity and decrease of Mip 1 alfa and IgG concentrationwas discovered. There were also shown, that much lower levels of both adaptive and innate immunity factors occur in saliva of children with primary antibody deficiencies in comparison with immunocompetent children. Simultaneously, the increase of TNFa level was found in saliva of all immunocompromised patients that may testify the persistence inflammatory process in nasopharynx. Also was discovered, that epithelial cells in children with total absence of immunoglobulin secretion - inherited hypogammaglobulinemia synthesize a large amount of protein - secretory component (Sc). On the basis of investigation the advisability and effectiveness of using the bacterial lysates in recurrent respiratory infections was proved in both immunocompetent and immunocompromised patients. Besides, the factors of mucosalimmunity, influenced by local bacterial lysates, videlicet TNF а, Mip1 alfa, IgG, IgA and sIgA/Sc were specified. New mechanisms of bacterial lysates (ІРС-19) action were discovered and the increase of initially decreased protecting factors of mucosal immunity, the normalization of increased factors of mucosal immunity and also the recovery of direct relations between the specific factors of mucosal immunity in immunocompetent children after bacterial lysates using were detected. It was specified, that intranasal use of bacterial lysates in immunocompromised children leads to increase of initially decreased factors of adaptive immunity, TNFа level decrease and in children with selective IgA deficiency also the level of lactoferrin decrease, which may indirectly indicate the decreasing of inflammatory processes in nasopharynx.