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The study aimed to assess the effect of inhaled bacteriophage therapy on oral mucosal immunity in children with acute tonsillitis. Materials and methods. We examined 212 patients aged 4 to 15 years old with acute tonsillitis and 110 age-matched apparently healthy children. Research methods: calculating the Neutrophil to lymphocyte ratio (NLR), saliva diagnostics - secretory immunoglobulin (sIgA) and the pro-inflammatory cytokine (TNF-). Taking into account the scheme of the treatment, the patients were divided into mutually comparable groups: the first group included patients with acute tonsillitis who received the standard generally accepted treatment depending on the clinical form of the pathology, without using bacteriophage therapy - n=107 (50.5%), the second group - patients receiving a course of bacteriophage therapy - n=105 (49.95%), nebulizer bacteriophage therapy using liquid complex pyobacteriophage (PCL, produced by Microgen, Russia) from the first days of the disease along with standard treatment. Results. During bacteriophage therapy, on the 6th day of treatment, an increased sIgA level up to 97.2% was observed particularly in younger and adolescent patients up to 97.2% (p0.05). At the same time, this parameter reached 75.8% and 81.6%, respectively (p0.05), in patients who received only standard treatment. The following difference between the two study groups was observed: between patients in the younger age subgroup - 21.4%, in the older age subgroup -16.1% (p0.05 relative to control group), which indicates a more effective drug-related effect in patients from the younger age group groups. Similar changes are observed while analyzing level of the pro-inflammatory cytokine (TNF-). Conclusion. The use of inhaled bacteriophage therapy in the combination treatment of children with acute tonsillitis helps to shorten the period of general and local clinical manifestations of the disease by 1.4-fold and improve mean local immunity from 5.7% up to 16.1% (p0.05).
The study aimed to assess the effect of inhaled bacteriophage therapy on oral mucosal immunity in children with acute tonsillitis. Materials and methods. We examined 212 patients aged 4 to 15 years old with acute tonsillitis and 110 age-matched apparently healthy children. Research methods: calculating the Neutrophil to lymphocyte ratio (NLR), saliva diagnostics - secretory immunoglobulin (sIgA) and the pro-inflammatory cytokine (TNF-). Taking into account the scheme of the treatment, the patients were divided into mutually comparable groups: the first group included patients with acute tonsillitis who received the standard generally accepted treatment depending on the clinical form of the pathology, without using bacteriophage therapy - n=107 (50.5%), the second group - patients receiving a course of bacteriophage therapy - n=105 (49.95%), nebulizer bacteriophage therapy using liquid complex pyobacteriophage (PCL, produced by Microgen, Russia) from the first days of the disease along with standard treatment. Results. During bacteriophage therapy, on the 6th day of treatment, an increased sIgA level up to 97.2% was observed particularly in younger and adolescent patients up to 97.2% (p0.05). At the same time, this parameter reached 75.8% and 81.6%, respectively (p0.05), in patients who received only standard treatment. The following difference between the two study groups was observed: between patients in the younger age subgroup - 21.4%, in the older age subgroup -16.1% (p0.05 relative to control group), which indicates a more effective drug-related effect in patients from the younger age group groups. Similar changes are observed while analyzing level of the pro-inflammatory cytokine (TNF-). Conclusion. The use of inhaled bacteriophage therapy in the combination treatment of children with acute tonsillitis helps to shorten the period of general and local clinical manifestations of the disease by 1.4-fold and improve mean local immunity from 5.7% up to 16.1% (p0.05).
The review article is devoted to the problem of the variability of the intestinal microbiota in children with various diseases of the gastrointestinal tract (GIT) of non-infectious origin, which is one of the current areas of modern pediatric gastroenterology. More often, in practical pediatrics, during the treatment of non-infectious diseases of the gastrointestinal tract, doctors often do not prescribe medications for the intestinal microbiota. In connection with this, complications subsequently develop in functional activity in this system, which is most often classified as a separate, unrelated pathology. The scientific articles by Russian and foreign authors devoted to the study of intestinal microbiota variability in children with non-infectious diseases of various origins were analyzed. According to the results of the study, it was noted that in non-infectious inflammatory processes, as a result of endogenous and exogenous factors, there is a decrease in the quantity and quality of microorganisms, mainly producing SCFA, which affects the course of the underlying disease. At the same time, the question of rational prescription of biotechnological and gene therapeutic drugs, together with traditional drugs containing live bacteria and substances that provide the necessary conditions for the growth and development of normal intestinal microbiota (pro-, pre-, syn- and symbiotics), also remains open. Analysis of scientific and literary data has shown that in children with non-infectious gastrointestinal diseases of various origins, there is a decrease in the quantitative composition of the intestinal microbiota due to microorganisms producing SCFA, such as Clostridium spp. and Faecalibacterium prausnitzii, against the background of a decrease in probiotic bacteria. These changes lead to disproportions in the qualitative composition of the intestinal microbiota. Therefore, these patients should be treated with biologics containing Lactobacillus rhamnosus, Lactobacillus gasseri, Lactococcus lactis, Leuconostoc mesenteroides, and Bifidobacteria.
Context In pediatrics, there is an increasing interest in the therapeutic efficacy of inhaled bacteriophages for treating infectious diseases of the upper respiratory tract in children. Aim To analyze the effectiveness of inhaled bacteriophage therapy in children with acute tonsillitis (AT). Settings and Design Clinical observation of patients was based on a randomized, controlled research method. Methods and Material A total of 212 sick children aged 4–15 years who had AT were examined. Bacteriophage therapy was carried out by nebulizer inhalation using the liquid polyvalent piobacteriophage. Patients were divided into two groups based on the treatment method. One group of patients received a course of bacteriophage therapy against the background of standard treatment. Results When patients sought medical help, during the general clinical examination, the following were noted: cervical lymphadenopathy (98.6%), hyperemia of the tonsils and hyperplasia (98.1%), against the background of hyperthermia. Bacteriological analysis of the pharynx mucus showed that the main causative agents of AT in children were the bacteria Streptococcus pyogenes, Staphylococcus aureus, Streptococcus pneumoniae, and Haemophilus influenzae. Patients who underwent inhaled bacteriophage therapy in the early stages of treatment experienced a 1.4-fold greater disappearance of objective signs of pathological processes in the tonsils against the backdrop of rapid improvement in the well-being of sick children. Moreover, the use of a combination of antibiotic therapy and bacteriophage therapy led to a decrease in the detection of pathogenic bacteria, and the effectiveness of drug treatment increased four times. Conclusion The use of bacteriophage therapy in the complex treatment of AT in children contributes to a more rapid relief of the acute period against the background of an improvement in the subjective assessment of well-being by up to 25%, and a decrease in the detection of pathogenic bacteria.
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