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CYTOKINE STATUS INDICATORS AS MARKERS OF INFECTIOUS PROCESS IN NEWBORNS
Turdieva Dilfuza Erkinovna, Tashkent Pediatric Medical Institute Alieva Nigora Rustamovna Tashkent Pediatric Medical Institute Tabibova Mavluda Valievna Department of Hospital Pediatrics with the basics of alternative medicine,
1-City Clinical Hospital E-mail: [email protected]
CYTOKINE STATUS INDICATORS AS MARKERS OF INFECTIOUS PROCESS IN NEWBORNS
Abstract: The study of IL-6 and IL-8 cytokines have been designed to confirm the levels of the disease. It has been found in the neonates during the postnatal period. Absence of IL-8 hyperproduction, possibly, immunocompetent cells of neonates.
Keywords: newborn, infection, cytokines, maternal health, pregnancy, postnatal period, especially.
The problem of intrauterine infections (IUI) is the subject of attention of modern perinatology. According to the results of a number of studies, the frequency of IUI among newborns ranges from 27.4-36.6 to 65.0%; in the structure of early neonatal mortality, intrauterine infections, along with congenital malformations, occupy the leading position and reach 25.0 ± ± 0.5% [1; 2]. Infectious pathology is often hidden under the mask of asphyxia, intracranial injury, intrauterine hypoxia of the fetus. The results of neonatal autopsies show that in 37.5% of cases the infection was the main cause of death or complicated the course of the underlying disease [2; 3].
Newborns are the most susceptible group regarding to the occurrence of infectious and inflammatory diseases. These diseases can develop in the early stages of ontogenesis [6]. A large role in the occurrence of these diseases in newborns belongs to the pathology of immunity, the influence of pro-inflammatory cytokines IL-6 and IL-8 [4; 5]. The combination of the properties of IL-6 as a factor of differentiation puts it in a single series with the most important endogenous regulators of immune and inflammatory processes in the body [7]. Intrauterine infection does not always lead to the realization of the infectious process in the fetus. At the same time, immunological tolerance to the pathogen can lead to prolonged persistence and the development of a slow infection.
The objective of the research is studying the indicators of the cytokine system IL-6 and IL-8 in newborns to confirm the presence of infection and the risk of infectious and inflammatory diseases (IVZ).
Materials and methods. The research work was conducted on the basis of the Tashkent City Clinical Children's Hospital No. 1. 55 newborns and their mothers were examined. Depending on the clinical and anamnestic data, the children were divided into two groups: 20 newborns constituted the
comparison group - newborns without clinical manifestations of infections, whose mothers were diagnosed with an infectious pathology; 35 newborns (main group) were diagnosed with the clinical manifestations of an infectious process -pneumonia, omphalitis, conjunctivitis, nonspecific enterocolitis, sepsis.
Particular attention was paid to the collection of obstetric history, the nature of the course of pregnancy and childbirth, extra - and intragenital pathology of mothers of the examined children. When examining newborns, somatic, clinical and neurological status was assessed daily, clinical tests of blood, urine, feces, bacteriological examinations were conducted weekly, according to indications, X-ray diagnostics of pathological processes.
Concentrations of proinflammatory cytokines (IL-6, IL-8) in newborns of both groups were determined on the basis of the "sandwich" method of enzyme-linked immunosorbent assay (Protein Contour LLC, Tsitokin LLC, Russia). Immunological studies in the early neonatal period were carried out on days 1-3 of the children of the comparison group and 5-7 days in the main group.
Research results and discussion. In the obstetric history of all examined women, the facts of stillbirth (12%), medical abortions (25%), spontaneous miscarriages (23%), non-developing pregnancy (3% of cases) were revealed. Antenatal development of newborns was complicated by exacerbation of hotbed of chronic infection in the mother (48.3%), the presence of anemia (77.0%), acute respiratory infection (70.0%), threatened abortion (75.3%). Childbirth among women estimated in 43.2% of cases, a prolonged anhydrous period (more than 18 hours) and infection of the amniotic fluid was observed, in 19.4% of women delivery was made by caesarean section, 50.3% of newborns had chronic fetal
Medical science
hypoxia. 26% of full-term babies were born with intrauterine growth retardation.
All observed newborns were breastfed. The overwhelming majority of children were born with an Apgar score of 5-7 on the 1st minute of life, 25% ofchildren had a rating of4-5, in 10% of cases 0-3 points, respectively. When analyzing the clinical picture of persons in the main group, multiple lesions ofvarious organs and systems as a result of the infectious process were revealed. The most frequent symptoms were intense jaundice (58.4%), anemia (66.7%), and a neutrophilic index of 72.3%. Newborns showed CNS damage in the form of depression syndrome in 24.3% of cases, hyperirritability syndrome - in 55.2% of individuals. Signs of congenital pneumonia and sepsis were observed in a significant number of children.
The study of the mechanisms of cytokine regulation contributes to a deep understanding of the immunopathogenesis of diseases, provides information about the functional activity of various types of immunocompetent cells, the severity of the inflammatory process, and also allows you to study the state of the body's immune system in clinical practice.
The study showed that the presence oflVI in women during pregnancy determined the peculiarity of the immune status of their children. IL-6 overproduction was typical for newborns of the main group (88.4 ± 22.8 pg/ml), rather than for the comparison group, who were born from mothers with IVP (7.99 ± 1.51 pg/ml). These data testify antigenic stimulation of the fetus during pregnancy and stimulation of immunoregulatory mechanisms, therefore IL-6 is involved in the development of inflammatory and immune reactions and has proinflammatory activity.
The concentration of IL-8 was reduced in both groups. In children of the comparison group, the content of IL-8 was 2.17 ± 0.05 pg/ml, in the group of newborns of the main group, the indicator was 31.04 ± 5.70 pg/ml.
These data suggest that IVI formation in newborns occurs against the background of low rates of pro-inflammatory (IL-8) cytokines and the imperfection of immunoregulation processes. Analyzing the data, it should be emphasized that the localization of IVZ occurs with an adequate immune response of the newborn, which manifests itself in the form of overproduction of IL-6 and a decrease in the level of IL-8. The lack of hyperproduction of pro-inflammatory cytokines IL-8 is most likely due to the immaturity of the immunocompetent cells of the newborn.
Thus, IVIs in newborns occur against the background of changes in the cytokine system indicators, which obviously depend on the health status of the mothers, the nature of the course of pregnancy and childbirth. In this regard, the nursing and treatment of children with infectious and inflammatory risk should be carried out taking into account the latest technologies and modern medications.
Findings
1. The features of the immunological reaction of newborns without clinical manifestations of IVIs born to mothers with infectious risk factors are hyperproduction of IL-6, a decrease in the synthesis of IL-8, which reflect their adaptive capacity in the postnatal period.
2. The use ofindicators ofthe cytokine status of IL-6, IL-8 allows predicting the course of the postnatal period.
References:
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