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26MODERN ASPECTS OF ETIOPATHOGENESIS OF BRONCHIAL
ASTHMA IN CHILDREN Turayeva N.A.1, Melieva G.A.2
1Turayeva Nafisa Omanovna - Assistant;
2Melieva Gulsara Atabaevna - Candidate of Medical Sciences, Senior Lecturer, DEPARTMENT №3 OF PEDIATRICS AND MEDICAL GENETICS, SAMARKAND STATE MEDICAL INSTITUTE, SAMARKAND, REPUBLIC OF UZBEKISTAN
Abstract: bronchial asthma is recognized as one of the most common chronic pathologies among school-age children. The number of patients increases every year, which is associated with the deterioration of the environmental situation. Asthma is a serious and severe pathology, which in the absence of treatment is accompanied by the development of complications. The lack of an adequate correction of the disease significantly worsens the quality of life of the patient, leads to impaired physical and mental development and even life-threatening conditions. The nature of the disease is not fully understood. Pathology is considered multifactorial. The predisposition is determined genetically. In children, bronchial asthma often develops against the background of allergic reactions. Keywords: bronchial asthma in children, food allergies, respiratory infections, obstruction, bronchial mucosa.
UDC: 616-092.11
Bronchial asthma is the most common chronic disease in children with high medical and social significance. Regardless of the severity of bronchial asthma, it is a chronic disease based on allergic inflammation of the bronchi, accompanied by hyperreactivity. This disease is characterized by periodically occurring attacks of shortness of breath or suffocation as a result of diffuse obstruction due to narrowing of the bronchi, hypersecretion of mucus, and swelling of the bronchial mucosa.
In the development of bronchial asthma in children, heredity is important, the implementation of which occurs under the influence of environmental factors. Bronchial asthma is an environmentally caused disease of industrial chemical compounds, as well as exhaust fumes of automobile vehicles. However, the main role in the development of bronchial asthma in children is played by atopy - food allergies, household dust, house dust mites, mold, epidermal (hair of animals - cats, dogs, food of aquarium fish), pollen allergy to flowering plants.
However, it is known that there are cases of asthma with non-allergic inflammation of the airways. These non-allergic mechanisms are currently not well understood. The combination of allergic and non-allergic mechanisms in the development of the disease leads to discussion about whether asthma is a disease with the only underlying causative mechanism, or is it a grouping of different conditions with a result in the form of variable airway obstruction.
In recent years, attention has been paid to various respiratory infections that cause obstructive syndrome, respiratory syncytial virus, rhinovirus, influenza virus, parainfluenza, chlamydophilic, mycoplasma infections [38]. For all forms of bronchial asthma, mast cells and eosinophils are involved in the inflammatory process as key effector cells of the inflammatory reaction, which is associated with their ability to produce a wide range of preformed or newly generated mediators acting in the respiratory tract directly or indirectly through neurogenic mechanisms [6]. In bronchial asthma, eosinophils are often localized in the bronchi under the basement membrane and release cytokines, active oxygen radicals, eicosanides, growth factors, a platelet-activating factor, toxic granuloproteins that can cause bronchoconstriction, and increase vascular permeability, which probably contributes to the formation of hyperresponsiveness 15 ]. In addition, eosinophils, interacting with nerve
endings, lead to an increase in the secretion of acetylcholine by the parasympathetic division of the nervous system. Neutrophils release various enzymes, reactive oxygen, cytokines, chemokines. Mast cells are bronchial asthma in degranulated state, a source autakoidnyh mediators, neutral proteases, in particular tryptase. Macrophages are active in the process of airway remodeling due to secretion of growth factors, such as platelet growth factor, the main fibroblast growth factor [15].
The main three components of the modern definition of asthma are chronic inflammation, bronchial obstruction and increased bronchial reactivity [17, 42]. As a result of these pathophysiological changes, characteristic clinical manifestations of bronchial asthma appear - wheezing (sighing), shortness of breath, chest tightness, cough, sputum production.
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