Mazulov O. Pathogenetic role of surfactant protein В in the formation of bronchopulmonary pathology in children.

The aim of the study was to improve the treatment of children with asthma based on new scientific data on the pathogenic role of antimicrobial peptides and vitamin D. The dissertation is devoted to the study of increasing the effectiveness of diagnosis of bronchopulmonary disease in children born prematurely, on the basis of new scientific data on the pathogenetic role of surfactant protein B and its gene polymorphism. In Ukraine, the number of children who develop bronchopulmonary dysplasia in the neonatal period, have respiratory disorders and dependence on oxygen. The catamnestic observation of such children indicates that they have acute and chronic respiratory system diseases in about 30% of cases. The course of bronchial asthma in such children has a more severe course compared with children who have not been exposed to respiratory support during the neonatal period. With the help of a comprehensive examination of premature infants, the role of surfactant B protein and its gene polymorphism in the development of bronchopulmonary diseases and the relationship with the degree of severity of bronchopulmonary disease are established. On the basis of the obtained results, the peculiarities of surfactant protein B content, depending on the clinical form of bronchopulmonary pathology and their influence on the course of the disease, have been established. The relationship between the content of surfactant B protein in the blood serum and the peculiarities of the perinatal period in children, which subsequently formed the pathology of the respiratory organs, was established. As a result of the study, diagnostic and prognostic value of serum surfactant B content was determined to determine the possible formation of bronchopulmonary disease and its severity.With the help of genetic examination, the features of the gene polymorphism of surfactant protein B have been determined, depending on the bronchopulmonary pathology in children aged 5 years. As a result of this study, the diagnostic and predictive value of the gene polymorphism of surfactant protein B was determined to determine the possible formation of bronchopulmonary pathology and its severity. Scientific data on genetic peculiarities of the polymorphic site of the surfactant protein В С1580Т are supplemented: the sequence of the nucleotides of the СT in the polymorphic region of the gene was diagnosed in 42,0% of children, the sequence of СС - in 34,0% of patients, and in the TT - in 24,0% of patients. It has been established that the CС-C1580T polymorphism is found to be 3 times more common in children, who subsequently have recurrent episodes of obstructive bronchitis (p = 0.04426), the ТТ polymorphism C1580T is found in 6 times more often in children, in which further bronchial asthma was diagnosed (p = 0.05487), and homozygote TT has protective properties in relation to the formation of BPD and repeated episodes of obstructive bronchitis. The genotype CT is protective against the development of congenital pneumonia. The method of diagnosis of broncho-pulmonary pathology in children is suggested by determining the content of surfactant protein B in serum, which allows the children of the high-risk group to form diseases of the respiratory organs and to form a complex of preventive measures for this cohort of children in a timely manner.