Kalichevskaya M. Clinical and immunological characteristics and treatment of children with asthma and concomitant disorders of the upper gastrointestinal traсt

The thesis is devoted to increasing the effectiveness of treatment and long-term control of bronchial asthma (BA) in children with upper gastrointestinal tract (UGIT) pathology by GIT diseases therapy optimization and development of risk prediction models for these diseases, based on the evaluation of clinical and immunological characteristics. 120 children and adolescents with asthma aged from 6 to 18 years were the object of the study. It has been shown that children with asthma have a high incidence of UGIT comorbidities (65%), which is mainly organic in nature with the presence of multiple lesions of the digestive tract. Against the background of this pathology BA is accompanied by more severe course with low control of symptoms. It's the first time features of IFN-? and allergic inflammation interleukins (IL 4, 5, 13) production have been studied in children with asthma and UGIT comorbidities. It is shown that in presence of GIT mucous membrane inflammation children with asthma have significantly higher serum concentrations of IFN-? and IL 4, and in presence of destructive lesions and Helicobacter pylori infection ? also higher IL 13 levels compared with patients with asthma but without UGIT comorbidities. It's the first time it has been scientifically proved the expediency and studied the effectiveness of inclusion cytoprotectives (sucralfate for 4 weeks) into the complex therapy of UGIT diseases in children with asthma, which contributed to prolongation of remission of UGIT disease, normalization of immunological parameters and improved asthma symptom control.The basic biomedical risk factors for occurrence of chronic gastro duodenal pathology in children with asthma were determined and mathematical models for predicting the risk of developing these diseases were created on this basis.