Acute viral bronchiolitis is one of the common causes of hospitalization and mortality, especially among children in the first year of life who have risk factors (prematurity, congenital heart defects, bronchopulmonary dysplasia, immunosuppression). As factors associated with the severe course of bronchiolitis, along with the traditional ones, single nucleotide polymorphisms of the genes of the immune response molecules can be considered.The aim. Based on the analysis of clinical, laboratory and molecular genetic parameters, to identify prognostic criteria for the severe course of acute viral bronchiolitis in children.Materials and methods. The study included 106 children with acute viral bronchiolitis (severe course – 34, mild course – 72), the etiology of which in 67.9 % was respiratory syncytial virus. Forty-seven anamnestic, clinical, traditional laboratory and molecular genetic parameters were assessed as prognostic criteria. Determination of SNP genes of cytokines IL-4 (C-589T), IL-10 (G-1082A), IL-10 (C-592A), IL-10 (C-819T), TNF-α (G-308A), IL-17A (G197A), IL-17F (His161Arg), TLR2-753ArgGln, TLR6-Ser249Pro in venous blood was carried out by the polymerase chain reaction method.Results. An additional criterion for the risk of developing a severe course of bronchiolitis can be the mutant genotype (AA) SNP of the IL-10 gene (C-592A), which was detected exclusively in the group of patients with severe bronchiolitis, increasing the risk of developing a severe disease by 16.11 times (OR = 16.11; 95 % CI: 0.81–121.22, p = 0.02) in conjunction with already established modifying factors: the presence of congenital heart disease, bronchopulmonary dysplasia, prematurity, birth weight < 1500 g. Based on a comprehensive assessment of the established risk factors, a method has been developed that allows calculate the likelihood of developing a severe course of acute viral bronchiolitis. Conclusion. The use of the developed prediction method will not only increase the likelihood of developing severe acute viral bronchiolitis in children, but also determine the priority group among children with predictors of severe viral bronchiolitis for priority immunoprophylaxis against RS-virus infection.
The aim of research: To investigate the genetic polymorphism of immune response molecules (TNFα-308G> A (rs1800629), IL4-589C>T (rs2243250), IL10-592C> A (rs1800872), IL10-819C> T (rs1800871), IL10-1082G>A (rs1800896), IL-17A-197G> A (rs2275913), IL- 17F-161His> Arg (rs763780), TLR-2-753Arg>Gln (rs5743708), TLR-6-249Ser>Pro (rs5743810) and assess their prognostic value in the development of acute virus-induced bronchiolitis.Materials and methods. The study included children of the first year of life, whose average age was 4.2 ± 3.7 months. The main group consisted of 106 patients with moderate and severe acute viral bronchiolitis, more often associated with respiratory syncytial virus (56.6%). The control group consisted of 100 healthy children of the same age who had no signs of acute respiratory infection at the time of examination and did not receive passive immunoprophylaxis of respiratory syncytial infection. Genotyping was performed using the polymerase chain reaction method. The analysis of the results included the compliance with the Hardy-Weinberg law, the χ 2 test, the relative chance, and its 95% confidence interval. To assess the distribution of the claimed gene polymorphisms and their alleles, we used the general (χ2 test, df =2) and multiplicative (χ2 test, df =1) inheritance models.Results. It was revealed that the risk of developing acute viral bronchiolitis is increased compared to the healthy population in carriers of the following genotypes: CC, ST gene IL10-819C> T (rs1800871), GG, AA gene IL-17A-197G> A (rs2275913), HisHis gene IL-17F-161His> Arg (rs763780), SerSer, SerPro gene TLR-6-249Ser> Pro (rs5743810), GG gene TNF-α-308G>A (rs1800629). The TT genotype of the IL10-819C>T (rs1800871) gene is associated with a high risk of developing bacterial complications (pneumonia) in viral bronchiolitis. Carriers of genotypes AA, CC of the IL10-592C> A (rs1800872) gene have an increased likelihood of a severe course of viral bronchiolitis.Conclusion. Genetic analysis of gene polymorphism IL10-592C> A (rs1800872), IL10-819C> T (rs1800871), IL-17A-197G> A (rs2275913), IL-17F-161His> Arg (rs763780), TLR-6-249Ser> Pro (rs5743810), TNF-α-308 G>A (rs1800629) can be used as a personalized developmental criterion acute virus-induced bronchiolitis in children, determining the severity of its course and the likelihood of complications.
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