[The markers of damage of neurons and glia in cerebrospinal liquor under meningitis in children.]

The actuality of analysis of cerebrospinal fluid under meningitis in children is conditioned by severity of course of disease with development of residual aftermaths in part of patients. The appearance of proteins specific for neurons, astro- and oligodendroglia in liquor and blood serum can serve as a marker of severity of damage of cerebral parenchyma and as a predictor of development of neurological deficiency. The analysis was applied to samples of liquor obtained during diagnostic lumbar puncture in 44 children (33 with viral serous meningitis, 11 with bacterial purulent meningitis). The detection of protein S-100, glial fibrillar acid protein and and neuron-specific enolase was implemented using solid-phase immune enzyme technique. The maximal increasing of concentrations of protein S-100 and glial fibrillar acid protein was detected at initial stage of bacterial purulent meningitis with consequent decreasing of at the stage of re-convalescence. Under serous meningitis at acute stage maximal high proved to be average value of concentration of neuron-specific enolase with tendency to its increasing at the stage of re-convalescence. The multi-directional correlation relationships are established concerning levels of of neuron-specific enolase, glial fibrillar acid protein and protein S-100 with standard liquorologic indices and their direct mutual relationships. The variability of levels of neuron-specific proteins in liquor is established associated with clinical characteristics of course of meningitis in children that testifies possibility of their application for specifying involvement into pathological process of different brain structures and necessity of further studying of relationship of infection affection of brain with development of neurological aftermaths at the residual period.

[Pathogenetic mechanisms of demyelinating diseases of the central nervous system in children].

OBJECTIVE: To study cerebrospinal fluid and protein indices characterizing the permeability of the hematoencephalitic barrier and intrathecal immunoglobulin synthesis in children with different course and outcome of demyelinating diseases of the central nervous system. MATERIAL AND METHODS: We examined 72 children with demyelinating diseases of the central nervous system and 16 children of a control group (without neuroinfections). RESULTS: Differences in the concentration of myelin basic protein, immunoglobulin G, albumin and immunoglobulin indices in the cerebrospinal fluid were determined depending on acute, prolonged, chronic course of disseminated encephalitis and multiple sclerosis in children. The maximum value of the immunoglobulin index and the intrathecal immunoglobulin synthesis index was identified in multiple sclerosis. The correlations of cerebrospinal fluid indicators and protein factors in the acute period of demyelinating diseases and the formation of neurologic deficiency in the disease outcome were determined that can be used for prognostic purpose. CONCLUSION: The alterations in the indices obtained in this study can be included in the algorithm of laboratory examination. The results prove the involvement of various mechanisms in the pathogenesis of demyelinating diseases of the central nervous system in children.

[Characteristics of immune response to etiotropic and pathogenetic therapy in children with chronic hepatitis C].

Features of the immune response of children with chronic hepatitis C to the antiviral and pathogenetic therapy have been studied. It is shown that the antiviral therapy is accompanied by stimulation of the immune response as manifested by the synthesis of cytokines (IL-4, IFN-alpha, IFN-gamma) with retention of increased production of IFN-a for more than two years after the end of the course of treatment. In children that previously received interferon inductor (cycloferon) for 12 months, high level of IFN-a production is retained, which ensures antiviral protection. Phytotherapy did not influence the production of cytokines.

Clinical and immunological efficiency of anaferon (pediatric formulation) in calicivirus infection in children.

Therapy with anaferon (pediatric formulation) during the acute period of calicivirus infection shortened the duration of the main symptoms of the disease and period of virus release. Changes in the immunological status included increased production of IgA and IgM and activation of IFN-alpha synthesis.

[Four levels (types) of immune reponse in children with viral parotitis infections]. / Chetyre urovnia (tipa) immunnogo otveta u detei, perenosiashchikh parotitno-virusnuiu infektsiiu.

Four levels (types) of immune response, differing by expression of cytokines (TNF-alpha, IL-1 beta, IL-4, and gamma-IFN) and immunoglobulins IgG2, IgG3, IgG4, and IgE) and by expression and time course of specific cell-mediated and humoral immune response, were detected in children with different clinical forms of mumps. Types 1 and 3 immune response are predominantly cell-mediated, while types 2 and 4 predominantly humoral during the acute phase of the disease. The cytokine and antigen-specific profiles of each type of immune response correlate with the severity of clinical course of mumps.

[The protective role of postvaccinal immunity in mumps in children]. / Protektivnaia rol' postvaktsinal'nogo immuniteta pri parotite u detei.

The immunological study of children with infectious parotitis (IP) without complications and with such complications as pancreatitis, meningitis or orchitis in the glandular form was carried out. In accordance with the previously proposed principle, 4 types of immune response (IR) were established on the basis of differences in initial resistance and the IR profile: cell-mediated immunity (types I and III) and humoral immunity (types II and IV). The patients included nonvaccinated children, as well as children vaccinated on epidemic indications, 3-6, 7-9, 10 and more years before infection. The comparative analysis of the number of IP cases with and without complications in the groups of children, divided according to their immunization history and the type of IR, revealed that postvaccinal immunity in children vaccinated on epidemic indications (less than a month ago) or 3-6 years before infection had protective potential, sufficient for the prevention of complicated forms of IP. Immunity obtained 7-9 years ago was effective for the protection from IP complications only in cell-mediated, but not humoral IR. Postvaccinal immunity obtained more than 10 years ago did not ensure the decrease in the occurrence of complicated forms of IP (in comparison with that in nonvaccinated patients) in children with any type of IR.

[Variants of immune response in children with acute respiratory viral infections]. / Varianty immunnogo otveta pri ostrykh respiratorno-virusnykh infektsiiakh u detei.

Four patterns of changes in the proliferative activity of T-lymphocytes in the lymphocyte blastogenesis test with phytohemagglutinin (PHA) are distinguished in children with acute respiratory viral infections (ARVI). The differences between these patterns are due to aggravated clinical severity of the infection process and enhancement of the cytokine reaction of macrophage monocytes. Comparison of immunological characteristics of response to ARVI in 4 groups of children showed that high reactivity of T-lymphocytes during the acute phase of disease (first and third variants) correlated with a relatively weak production of immunoglobulins and antiviral antibodies, while the suppression of T-lymphocyte response to PHA (second and fourth variants) is associated with expressed humoral profile of immune response by the level of immunoglobulin and antiviral antibody production. These data permit a hypothesis about the predominant generation of T x 1-like clones in children with the first and third variants of immune response and of T x 2-like clones in children with the second and fourth variants.

[Variants of the immune response in the dynamics of the localized form of stomatopharyngeal diphtheria in children]. / Varianty immunnogo otveta v dinamike lokalizovannoi formy difterii rotoglotki u detei.

4 variants of immune response (IR) have been identified according to the dynamics of the development of nonspecific immunosuppression as determined in the reaction of lymphocyte blast transformation to phytohemagglutinin. These variants, characterized by a rise in the production of tumor necrosis factor alpha, interleukin 1 beta, immunoglobulins of 4 classes, are linked with the increased risk of the development of clinically pronounced forms (CPF) of diphtheria. The antigen-specific profile of each of these variants (types) of IR has been studied. Proofs of the fact that each type of IR has definite critical mechanisms of immune protection, contributing to the prevention of CPF of diphtheria, are presented. Treatment with antitoxic antidiphtheria serum produces different effect in 4 types of IR as it acts on different mechanisms of IR.