medecolМедицина и экологияMedicine and ecology2305-60452305-6053Карагандинский медицинский университет10.59598/ME-2305-6045-2023-106-1-5-11medecol-400Research ArticleЭКОЛОГИЯ И ГИГИЕНАECOLOGY AND HYGIENEИммунологические особенности внебольничной пневмонии у детей, вакцинированных пневмококковой вакцинойImmunological features of out-of-hospital pneumonia in children vaccinated with pneumococcal vaccineТукбековаБ. Т.TukbekovaB. T.

г. Караганда

Department of Pediatrics and neonatology

Karaganda

ЖанпейсоваА. А.ZhanpeissovaA. A.

г. Караганда

Department of Pediatrics and neonatology

Karaganda

Zhanpeysova@qmu.kzКизатоваС. Т.KizatovaS. T.

г. Караганда

Department of Pediatrics and neonatology

Karaganda

СабиеваМ. М.SabiyevaM. M.

г. Караганда

Department of Pediatrics and neonatology

Karaganda

МанаповТ. С.ManapovT. S.

г. Караганда

Karaganda

НАО «Медицинский университет Караганды»КазахстанNC JSC «Karaganda Medical University»KazakhstanКГП «Областная детская клиническая больница»КазахстанRSE «Regional Children's Clinical Hospital»Kazakhstan20232307202301511Copyright © Тукбекова Б.Т., Жанпейсова А.А., Кизатова С.Т., Сабиева М.М., Манапов Т.С., 20232023Тукбекова Б.Т., Жанпейсова А.А., Кизатова С.Т., Сабиева М.М., Манапов Т.С.Tukbekova B.T., Zhanpeissova A.A., Kizatova S.T., Sabiyeva M.M., Manapov T.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://medecol.qmu.kz/jour/article/view/400

Цель. Выявить иммунологические особенности внебольничной пневмонии у вакцинированных детей, оценить их влияние на тяжесть заболевания.Материалы и методы. Под наблюдением находились 85 детей в возрасте от 2 месяцев до 3 лет с внебольничной пневмонией различной степени тяжести, госпитализированных в Областную детскую клиническую больницу (г. Караганда). Все дети были разделены на 2 группы: в первую входили вакцинированные дети (n=45), во вторую – дети с нарушениями вакцинации (n=40). Контрольная группа состояла из 20 детей. Расчет и оценка полученных результатов проводились на IBM-совместимом компьютере с операционной системой Windows XP с использованием программного пакета MS Excel 2017 (Microsoft), SPSS 12.0.2 и Statistica 20. Статистический анализ проводился с использованием пакета STATISTICA. Числовые данные представлены такими показателями, как Me (медиана), Q1 (точка L-квартиля или нижнего квартиля) и Q3 (точка U-квартиля или верхнего квартиля). Был рассчитан критерий Краскела – Уоллеса. Различия считались статистически значимыми при p < 0,05.Результаты и обсуждение. Количественный показатель провоспалительных цитокинов MCP-1 у вакцинированных детей с тяжелой внебольничной пневмонией у детей раннего возраста составляет 7,21 [5,25; 9,03] пг/мл Me [Q1; Q3], а у детей с нарушениями иммунизации – 15,18 [6,13; 50,11] пг/мл Me [Q1; Q3] (критерии Крускала-Уоллис р<0,05). У детей в возрасте от 2 месяцев до 3 лет количественный показатель провоспалительных цитокинов MCP-1 у вакцинированных детей с легкой внебольничной пневмонией составляет 2,13 [0,01; 3,02] пг/мл Me [Q1; Q3], а у детей с иммунизацией –3,46 [0,04; 6,74] пг/мл Me [Q1; Q3].

Аim. To identify the immunological features of out-of-hospital pneumonia in vaccinated children, to assess their impact on the severity of the disease.Materials and methods. The study was conducted in 2017-2019. 85 children with various degrees of severity were hospitalized in Karaganda from 2 months to 3 years. They were divided into 2 groups: the first included vaccinated children (n=45), the second included children with impaired vaccination (n=40). The control group consisted of 20 children.The calculation and evaluation of the results obtained was carried out on an IBM compatible computer with the Windows XP operating system using the MS Excel 2017 (Microsoft), SPSS 12.0.2 and Statistica 20 software package. Statistical analysis was carried out using the STATISTICA package. Numerical data is represented by indicators such as Me (median), Q1 (L-quartile or lower quartile point) and Q3 (U-quartile or upper quartile point). Kruskall-Wallace criterion calculated [Kruskall W., Walles W. A.]. The differences were considered statistically significant at p < 0.05.Results and discussion. The quantitative indicator of anti-inflammatory MCP-1 cytokines in vaccinated children with severe nosocomial pneumonia in early childhood is 7.21 [5.25; 9.03] pg/ml Me [Q1; Q3], and in children with immunization disorders-15.18 [6.13; 50.11] pg/ml Me [Q1; Q3] (Kruskal criteria-Wallis p<0.05). In children aged 2 months to 3 years, the quantitative indicator of anti-inflammatory cytokines MCP-1 in vaccinated children with mild nosocomial pneumonia is 2.13 [0.01; 3.02] pg/ml Me [Q1; Q3], and in children with immunization disorders –3.46 [0.04; 6.74] pg/ml Me [Q1; Q3].

Streptococcus pneumoniaeвакцинацияMCP-1детиStreptococcus pneumoniaevaccinationMCP-1childrenReferencesБатюшин М. М. Моноцитарный хемоаттрактантный протеин-1: роль в развитии тубулоинтерстициального фиброза при нефропатиях /М. М. Батюшин, Х. З. Гадаборшева //Медицинский вестник Северного Кавказа. – 2017. – Т. 12, №2. – С. 234-239.Batjushin M. M. Monocitarnyj hemoattraktantnyj protein-1: rol' v razvitii tubulointersticial'nogo fibroza pri nefropatijah /M. M. Batjushin, H. Z. Gadaborsheva //Medicinskij vestnik Severnogo Kavkaza. – 2017. – T. 12, №2. – S. 234-239.Буланов Н. М. Молекулы повреждения почечной ткани (KIM-1, MCP-1) и коллаген IV типа в оценке активности ассоциированного с антинейтрофильными цитоплазматическими антителами гломерулонефрита /Н. М. Буланов, В. Г. Серова, Е. И. Кузнецова //Терапевтический архив. – 2017. – Т. 89, №6. – С. 48-55.Bulanov N. M. Molekuly povrezhdenija pochechnoj tkani (KIM-1, MCP-1) i kollagen IV tipa v ocenke aktivnosti associirovannogo s antinejtrofil'nymi citoplazmaticheskimi antitelami glomerulonefrita /N. M. Bulanov, V. G. Serova, E. I. Kuznecova //Terapevticheskij arhiv. – 2017. – T. 89, №6. – S. 48-55.Добронравов В. А. Острое повреждение почек и тубулярные биомаркеры при трансплантации гемопоэтических стволовых клеток /В. А. Добронравов, К. А. Смирнов, Б. В. Афанасьев //Терапевтический архив. – 2016. – Т. 88, №6. – С. 14-20.Dobronravov V. A. Ostroe povrezhdenie pochek i tubuljarnye biomarkery pri transplantacii gemopojeticheskih stvolovyh kletok /V. A. Dobronravov, K. A. Smirnov, B. V. Afanas'ev //Terapevticheskij arhiv. – 2016. – T. 88, №6. – S. 14-20.Коломеец Н. Ю. Исследование экскреции с мочой моноцитарного хемоаттрактантного протеина-1 как метод мониторинга активности воспалительного процесса в интерстициальной ткани почек у детей с гломерулонефритом /Н. Ю. Коломеец, Н. И. Аверьянова, А. П. Щекотова и др. //Методы диагностики и технологии. – 2012. – Т. 29, №4. – С. 72-77.Kolomeec N. Ju. Issledovanie jekskrecii s mochoj monocitarnogo hemoattraktantnogo proteina-1 kak metod monitoringa aktivnosti vospalitel'nogo processa v intersticial'noj tkani pochek u detej s glomerulonefritom /N. Ju. Kolomeec, N. I. Aver'janova, A. P. Shhekotova i dr. //Metody diagnostiki i tehnologii. – 2012. – T. 29, №4. – S. 72-77.Kapanadze N. Сytokines profile and its connection with disease severity in community-acquired pediatric pneumonia /N. Kapanadze, I. Pantsulaia, I. Chkhaidze //Georgian Med. News. – 2018. – V. 284. – Pp. 103-108.Kapanadze N. Sytokines profile and its connection with disease severity in community-acquired pediatric pneumonia /N. Kapanadze, I. Pantsulaia, I. Chkhaidze //Georgian Med. News. – 2018. – V. 284. – Pp. 103-108.Panee J. Monocyte Chemoattractant Protein 1 (MCP-1) in obesity and diabetes //Cytokine. – 2012. – V. 60, Issue 1. – Рp. 1-12.Panee J. Monocyte Chemoattractant Protein 1 (MCP-1) in obesity and diabetes //Cytokine. – 2012. – V. 60, Issue 1. – Rp. 1-12.Phung TTB, Suzuki T, Phan PH, Kawachi S, Furuya H, Do HT, Kageyama T, Ta TA, Dao NH3, Nunoi H, Tran DM, Le HT, Nakajima N. Pathogen screening and prognostic factors in children with severe ARDS of pulmonary origin //Pediatr Pulmonol. – 2017. – №52 (11). – Рp. 1469-1477.Phung TTB, Suzuki T, Phan PH, Kawachi S, Furuya H, Do HT, Kageyama T, Ta TA, Dao NH3, Nunoi H, Tran DM, Le HT, Nakajima N. Pathogen screening and prognostic factors in children with severe ARDS of pulmonary origin //Pediatr Pulmonol. – 2017. – №52 (11). – Rp. 1469-1477.RCRP (Republican Center for Health Development of the Ministry of Health of the Republic of Kazakhstan) Version: Clinical Protocols of the Ministry of Health of the Republic of Kazakhstan – 2017.RCRP (Republican Center for Health Development of the Ministry of Health of the Republic of Kazakhstan) Version: Clinical Protocols of the Ministry of Health of the Republic of Kazakhstan – 2017.Rita de Cássia Coelho Moraes de Brito,corresponding author Norma Lucena-Silva,Leuridan Cavalcante Torres, Carlos Feitosa Luna, Jaílson de Barros Correia, and Giselia Alves Pontes da Silva. The balance between the serum levels of IL-6 and IL-10 cytokines discriminates mild and severe acute pneumonia. Published online 2016 Dec 1. doi: 10.1186/s12890-016-0324-zRita de Cássia Coelho Moraes de Brito,corresponding author Norma Lucena-Silva,Leuridan Cavalcante Torres, Carlos Feitosa Luna, Jaílson de Barros Correia, and Giselia Alves Pontes da Silva. The balance between the serum levels of IL-6 and IL-10 cytokines discriminates mild and severe acute pneumonia. Published online 2016 Dec 1. doi: 10.1186/s12890-016-0324-zRomanova E. N. Blood levels of cytokines (ifn y, tnf a, il-10) and intercellular adhesion molecules (sicam-1) in pneumonia in patients with influenza a/sh /E. N.Romanova, A. V.Govorin, V. V.Gorbunov //Medical Immunology. – 2012. – V. 14, №1-2. – Pp. 153-156.Romanova E. N. Blood levels of cytokines (ifn y, tnf a, il-10) and intercellular adhesion molecules (sicam-1) in pneumonia in patients with influenza a/sh /E. N.Romanova, A. V.Govorin, V. V.Gorbunov //Medical Immunology. – 2012. – V. 14, №1-2. – Pp. 153-156.Sun L, Cornell T T, LeVine A, Berlin A A, Hinkovska-Galcheva V, Fleszar A J, Lukacs N W, and Shanley T P. Dual role of interleukin-10 in the regulation of respiratory syncitial virus (RSV)-induced lung inflammation. Published online 2013 Apr 10. doi: 10.1111/cei.12059Sun L, Cornell T T, LeVine A, Berlin A A, Hinkovska-Galcheva V, Fleszar A J, Lukacs N W, and Shanley T P. Dual role of interleukin-10 in the regulation of respiratory syncitial virus (RSV)-induced lung inflammation. Published online 2013 Apr 10. doi: 10.1111/cei.12059Susan J. Pizzutto, John W. Upham, Stephanie T. Yerkovich, and Anne B. Chang. High Pulmonary Levels of IL-6 and IL-1β in Children with Chronic Suppurative Lung Disease Are Associated with Low Systemic IFN-γ Production in Response to Non-Typeable Haemophilus influenzae. PLoS One. 2015; 10 (6): e0129517.Susan J. Pizzutto, John W. Upham, Stephanie T. Yerkovich, and Anne B. Chang. High Pulmonary Levels of IL-6 and IL-1β in Children with Chronic Suppurative Lung Disease Are Associated with Low Systemic IFN-γ Production in Response to Non-Typeable Haemophilus influenzae. PLoS One. 2015; 10 (6): e0129517.Vasconcellos ÂG, Clarêncio J2 Andrade D3 Cardoso MA4 Barral A, Nascimento-Carvalho CM. Systemic cytokines and chemokines on admission of children hospitalized with community-acquired pneumonia. Cytokine. 2018 Jul;107:1-8. doi: 10.1016/j.cyto.2017.11.005. Epub 2017 Nov 20.Vasconcellos ÂG, Clarêncio J2 Andrade D3 Cardoso MA4 Barral A, Nascimento-Carvalho CM. Systemic cytokines and chemokines on admission of children hospitalized with community-acquired pneumonia. Cytokine. 2018 Jul;107:1-8. doi: 10.1016/j.cyto.2017.11.005. Epub 2017 Nov 20.Xu XF, Li XJ, Liu JL, Wu L, Chen ZM. Serum cytokine profile contributes to discriminating M. pneumoniae pneumonia in children // Cytokine. – 2016. – №86. –Р.73-78. doi: 10.1016/j.cyto.2016.07.018. Epub 2016 Jul 29.Xu XF, Li XJ, Liu JL, Wu L, Chen ZM. Serum cytokine profile contributes to discriminating M. pneumoniae pneumonia in children // Cytokine. – 2016. – №86. –R.73-78. doi: 10.1016/j.cyto.2016.07.018. Epub 2016 Jul 29.Yan T. Role of anti-inflammatory cytokines in pathogenesis of pediatric mycoplasma pneumoniae pneumonia. J Biol Regul Homeost Agents. 2016 Apr-Jun; 30(2):541-5.Yan T. Role of anti-inflammatory cytokines in pathogenesis of pediatric mycoplasma pneumoniae pneumonia. J Biol Regul Homeost Agents. 2016 Apr-Jun; 30(2):541-5.Yong KK, Chang JH, Chien MH, Tsao SM, Yu MC9, Bai KJ, Tsao TC, Yang SF1. Plasma Monocyte Chemoattractant Protein-1 Level as a Predictor of the Severity of Community-Acquired Pneumonia // Int J Mol Sci. – 2016. –№17(2). – E179. doi: 10.3390/ijms17020179.Yong KK, Chang JH, Chien MH, Tsao SM, Yu MC9, Bai KJ, Tsao TC, Yang SF1. Plasma Monocyte Chemoattractant Protein-1 Level as a Predictor of the Severity of Community-Acquired Pneumonia // Int J Mol Sci. – 2016. –№17(2). – E179. doi: 10.3390/ijms17020179.Yu ZW, Qian J, Gu XH, Zhang XJ, Pan JR, Ju HL. Changes in serum inflammatory factors in wheezing infants with community-acquired pneumonia. Zhongguo Dang Dai Er Ke Za Zhi. 2015 Aug;17(8):815-8.Yu ZW, Qian J, Gu XH, Zhang XJ, Pan JR, Ju HL. Changes in serum inflammatory factors in wheezing infants with community-acquired pneumonia. Zhongguo Dang Dai Er Ke Za Zhi. 2015 Aug;17(8):815-8.Yuanyuan Zhang, Shufen Mei, Yunlian Zhou,Meixia Huang Guijuan Dong and Zhimin Chena. Cytokines as the good predictors of refractory Mycoplasma pneumoniae pneumonia in school-aged children //Sci Rep. – 2016. – Vol. 6. – Р.37037.Yuanyuan Zhang, Shufen Mei, Yunlian Zhou,Meixia Huang Guijuan Dong and Zhimin Chena. Cytokines as the good predictors of refractory Mycoplasma pneumoniae pneumonia in school-aged children //Sci Rep. – 2016. – Vol. 6. – R.37037.

The authors declare that there are no conflicts of interest present.