The aim of the research is to improve the diagnosis of disturbances of cell energy in children with chronic nonspecific pulmonary diseases (CNPD) in the remission stage by the methods of detection of cytochemical changes of the energy status and recording the percentage of immune-competent cells of blood with the low membrane potential of mitochondria (MPM). 77 children were examined, including 66 (83%) with lung malformations, and 11 children (17%) with chronic nonspecific lung diseases as an outcome of acute/chronic lung diseases. The presence of energy deficient states was assessed by the level of activity of oxidative-reduction enzymes of succinate dehydrogenase, alpha-glycerophosphate dehydrogenase, lactic dehydrogenase in lymphocytes of the peripheral blood and percent ratio of lymphocytes with low MPM. It was found out that in 53.2% of the examined children even in the remission stage there were identified the signs of mitochondrial insufficiency when the parameters of metabolic activity of enzymes in lymphocytes were significantly lower than the norm. The cluster analysis of the obtained data allowed identifying the parameters typical for energy deficient states of the organism of the child that demand the correction by energotropic medications.
In order to study the seasonal effects on the energy supply of immunocompetent blood cells (IBC) in pregnant women living in different conditions of the Amur region, and to substantiate additional methods of diagnosis, prevention and treatment of the identified disorders, a study of the mitochondrial membrane potential (MMP) by flow laser cytometry was conducted in 198 subjects. The data of different types of IBC (lymphocytes, granulocytes and monocytes) at early gestation of women living in urban (Khabarovsk) and rural (Jewish Autonomous region) areas of the Amur region were analyzed. Eight (8) groups were formed according to seasons: winter, spring, summer and autumn. The results of a comprehensive survey indicate some features of intracellular bioenergy processes of IBC depending on the environmental conditions in different seasonal periods. Conditions of women from urban areas are characterized by a significant increase in lymphocytes with reduced MMP which was more pronounced in winter, and by a tendency to increase monocytes in spring-and-summer season. The state of low energy supply of IBC in rural residents differs significantly by means of granulocytes in all presented periods of a year, combinations of various types of IBC in winters and tendency to simultaneous increase in the number of all IBCs with the reduced MMP. The number of IBC with optimal MMP content in urban environment was observed in pregnant women in autumn (23.3%), in rural areas in summer (57.1%). Thus, the study has shown the need to expand the range of diagnostic methods for the formation of pregnancy complications risk groups. Determination of the substrate-energy value in the cells of the immune system is an indication for the individual selection of complex vitamin and mineral medications taking into account seasonal changes. MMP studies allow to monitor the dynamics and evaluate the effectiveness of preventive and therapeutic prescriptions.
The role of viral infection in bronchial asthma (BA) is well-known being reflected particularly in GINA. An effect of pneumotropic intracellular persistent herpesviruses on the course of BA is of particular interest. The most common viruses of this group are cytomegalovirus (CMV), EpsteinBarr virus (EBV), and human herpesvirus 6 (HHV-6). The CMV role has been discussed in our previous publications allowing us to focus here on EBV and HHV-6. We examined 167 children with BA that was diagnosed and clinically assessed in accordance with the current national clinical guidelines. Patients with controlled asthma (70 patients), partially controlled and uncontrolled asthma (97 patients) were stratified into several groups. The detection of EBV and HHV-6 DNA was carried out in throat swabs by PCR; the level of total and virus-specific IgA, IgM, IgG, IgE as well as serum level of IL-4, IL-5, IL-6, IL-7, IL-8, IL-9, IL-10, IL-8 and TNF was assessed by enzyme linked immunosorbent assay; lymphocyte subpopulations were analyzed by flow cytometry. The dose of topic GCS was taken into account with reference to the fluticosone equivalent; the function of external respiration was studied by spirometry. It was revealed that EBV DNA was found in 14.2% of cases, whereas HHV-6 in 19.0% of cases, but 14.4% and 52.4% of patients, respectively, shed no pathogen-linked DNA. At the same time, patients with uncontrolled BA are significantly more likely to shed the pathogen DNA, so that EBV is released in 17.1% vs 4.5% of patients with controlled BA, HHV-6 in 19.5% vs 13.6%. On the contrary, children with controlled BA were significantly more often (63.6% vs 51.2%) negative for viral DNA shedding. Moreover, virus shedding was paralleled with higher levels of IL-5: it was as high as 0.91 pg/ml and 0.29 pg/ml for EBV and HHV-6, respectively; those shedding DNA of both pathogens vs no shedding had IL-5 at level of 0.25 pg/ml vs 0.11 pg/ml. Similar pattern was observed for higher total IgE: 184.5 IU for EBV, 113.1 IU for HHV-6, and 371.7 IU shedding both viruses vs 95.2 IU in without DNA pathogen shedding; lower level of FEV1: EBV 96.6%, HHV-6 98.8%, and 106.2% in patients shedding both viruses vs 109.8% in patients not shedding the pathogen DNA. Patients shedding EBV DNA require higher doses of topic GCS to achieve disease control: EBV 325.0 mg, HHV-6 186.4 mg; shedding both viruses 328.1 mg of topic GCS vs 198.6 mg in patients without pathogen DNA shedding. Thus, activation of both EBV and HHV-6 worsens BA control and aggravates its course, but EBV persistence has a more pronounced effect on the course and control of the disease.
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