INFLAMMATORY RESPONSE AND METABOLIC ADAPTATION IN CHILDREN WITH ACUTE RESPIRATORY PATHOLOGY.

OBJECTIVE: The aim: To investigate the parameters change of the general immune responds and endocrine metabolism in the children with Acute Respiratory Pathology and their correlational relationship. PATIENTS AND METHODS: Materials and methods: The study group included: school-age children (10-14 years old) with a diagnosis of acute respiratory disease (ARI) as a general group of respiratory tract inflammatory diseases, of viral and bacterial origin (n=40), which included local inflammatory lesions of the respiratory tract and presented with acute pharyngitis (60.0%), acute bronchitis (20%), acute tonsillitis (22%) and a control group (n=25), identical in age and sex. The research was conducted at the clinical base of the CNE «UCChH¼ of the Uzhhorod City Council. General clinical, immunological studies, inflammatory response of the child's body were conducted. Statistical analysis of the results of the examination of patients was carried out using the Statistics for Windows v.10.0 computer program (StatSoft Inc, USA). The evaluation of the obtained results was carried out using parametric and non-parametric methods. RESULTS: Results: The inflammatory response parameters of the child's organism present indicative increases in the levels of cytokines with a significant predominance in comparison with the data of the children control group: the level of IL-1 increased in 2 times, IL-4 - in10 times, IL-6 - in 1.5 times, γ-IFN - in 3 times, TNFα - in 25 times, Neopterin - in 9 times. The data of the general immune response indicate a 2-times increasing in the level of IgM (3.85 ± 1.89 g/l, p<0.01) and IgG level increased in 10 times (147, 35 ± 56.12 g/l, p< 0.01). The, according to the obtained data but, in comparison with the data of the control group. There are significant differences in the levels of Leptin (р< 0.01), C-peptide (р< 0.01), Thyroid stimulating hormone ( p<0.01), Free thyroxine (p=0.002). The Leptin level, which is at the upper limit of the reference, the level of Thyroid stimulating hormone at the lower limit of the reference, and the slight predomi¬nance of the C-peptide level are noteworthy. Predominance of reliable correlations of pro-inflammatory cytokines IL 1, 4, 6 of varying degrees (r=0.34-0.45) are observed. Only IgG with Free triiodothyronine (r=0.45,p=0.004), IgE with Thyroid peroxidase antibody (r=-0.45,p=0.004) were identified as statistically significant correlations with high reliability. CONCLUSION: Conclusions: The obtained date presents the increasing of the levels Cytocines (Il -1,4,6) in 2-10 times. The IgG level increased in 10 times and IgM - in 2 times. The indicators of endocrine metabolism are within the reference values. Reliable correlations of pro-inflammatory cytokines IL 1, 4, 6 of varying degrees (r=0.34-0.45) are observed. IgG with Free triiodothyronine (r=0.45,p=0.004) have significant reasonableness.

EFFICACY OF COMPREHENSIVE TREATMENT OF NONALCOHOLIC FATTY LIVER DISEASE IN PATIENTS WITH PREDIABETES.

OBJECTIVE: The aim: To evaluate the effectiveness of the proposed treatment recommendations, which included lifestyle changes, as well as the treatment with ursode¬oxycholic acid, rosuvastatin, and omega-3 PUFA, on the severity of cytolytic and cholestatic syndromes in patients with NAFLD and prediabetes. PATIENTS AND METHODS: Materials and methods: Fifty-five patients with confirmed prediabetes and concomitant NAFLD underwent a comprehensive clinical examination and were treated with rosuvastatin 10 mg/d, omega-3 PUFA at a dose of 1000 mg/d and ursodeoxycholic acid at a dose of 10 mg/kg/d. RESULTS: Results: The data obtained after 12 months of proposed treatment revealed a statistically significant improvement of indicators of cytolytic syndrome in patients with prediabetes and NAFLD. There was no significant difference between mean values of ALT and AST of treated patients and the corresponding indicators of apparently healthy persons, which confirms the effectiveness of the recommended treatment. CONCLUSION: Conclusions: Proposed therapy which included recommendations for lifestyle changes and treatment with ursodeoxycholic acid, rosuvastatin and omega-3 PUFA significantly improved hepatic steatosis and cytolytic syndrome in patients with prediabetes and NAFLD.