Pohribna A. Prevention of anemia of inflammation in young children with acute inflammatory bacterial diseases of the respiratory system

The purpose of this study was to increase the effectiveness of preventive activities aimed at preventing and predicting the development of anemia of inflammation in infants with acute inflammatory bacterial respiratory diseases, based on the research of developmental mechanisms and comprehensive assessment of its clinical and laboratory features. The dissertation is based on the results of own observations, clinical, instrumental, laboratory and biochemical, as well as special research methods of patients. 141 children (mean age 1.8 ± 0.4 years) were examined during the study. The main group of the study consisted of 72 patients with acute inflammatory bacterial respiratory diseases, which depending on the hematologic condition were divided into subgroups. Subgroup 1 was represented by 38 patients who were diagnosed with anemia from the inflammatory disease onset. Subgroup 2 included 34 patients with acute inflammatory bacterial respiratory diseases without anemia. The experimental group consisted of 33 children who were diagnosed with iron deficiency anemia. The control group included 36 relatively healthy children. The life record data of all patients under observation were studied. During the first day after hospitalization, laboratory and instrumental examinations were performed. The role of ferroptosis in the pathogenesis of anemia of inflammation in young children with acute inflammatory bacterial respiratory diseases was shown for the first time, the conditions under which the process of iron sequestration becomes pathological were determined. The pathogenetic role of IL-6, hepcidin, TLR-4, vitamin D3 in the development of anemia of inflammation in infants with acute inflammatory bacterial respiratory diseases has been clarified; data on the peculiarities of pathogenetic links in the development of anemia of inflammation in infants with acute inflammatory bacterial respiratory diseases were added. Scientific data on the incidence of anemia of inflammation in young children with acute inflammatory bacterial respiratory diseases have been supplemented. The activity of apoptosis process, oxidative stress, iron metabolism against the background of inflammatory process of bacterial genesis in young children was evaluated. It is shown that the decrease in iron content against the background of the inflammatory process of bacterial genesis in the respiratory system is protective in nature, aimed at limiting the viability of pathogens and the implementation of hepcidin-dependent defense mechanisms of the macroorganism. A mathematical model to predict the development of anemia of inflammation and prevent its manifestation has been formulated, which has favorable prognostic features to anticipate complications and decrease the severity of acute inflammatory bacterial respiratory disease. A method for diagnosing anemia of inflammation in infants with acute bacterial respiratory diseases (Ukrainian utility model patent No. 138545 dated November 25, 2019) is proposed. In order to predict the development of anemia of inflammation in infants with acute bacterial respiratory diseases, it is recommended to use a mathematical model according to the developed method. The use of the presented mathematical model taking into account certain prognosis criteria allows to predict the occurrence of anemia of inflammation and prevent its manifestation, which has favorable prognostic features to anticipate complications and reduce the severity of acute inflammatory bacterial respiratory disease