actabiomedicaActa Biomedica ScientificaActa Biomedica Scientifica2541-94202587-9596Scientific Centre for Family Health and Human Reproduction Problems10.29413/ABS.2022-7.3.11actabiomedica-3555Research ArticleИНФЕКЦИОННЫЕ БОЛЕЗНИINFECTIOUS DISEASESПрогнозирование тяжести вирусного бронхиолита у детейPredicting the severity of viral bronchiolitis in childrenhttps://orcid.org/0000-0002-2493-3740БочкареваЛ. С.BochkarevaL. S.

 ассистент кафедры детских инфекций

672000, г. Чита, ул. Горького, 39а, Россия 

 Teaching Assistant at the Department of Pediatric Infections

Gorkogo str. 39a, Chita 672000, Russian Federation 

larisa.bochkareva.1992@mail.ruhttps://orcid.org/0000-0003-2109-4643МиромановаН. А.MiromanovaN. A.

 доктор медицинских наук, доцент, заведующая кафедрой детских инфекций

672000, г. Чита, ул. Горького, 39а, Россия 

 Dr. Sc. (Med.), Head of the Department of Pediatric Infections

Gorkogo str. 39a, Chita 672000, Russian Federation 

detinf-chita@mail.ruhttps://orcid.org/0000-0003-1432-1844МиромановА. М.MiromanovA. M.

 доктор медицинских наук, профессор, заведующий кафедрой травматологии и ортопедии

672000, г. Чита, ул. Горького, 39а, Россия 

 Dr. Sc. (Med.), Professor, Head of the Department of Traumatology and Orthopedics

 Gorkogo str. 39a, Chita 672000, Russian Federation 

miromanov_a@mail.ruФГБОУ ВО «Читинская государственная медицинская академия» Минздрава РоссииChita State Medical Academy ФГБОУ ВО «Читинская государственная медицинская академия» Минздрава РоссииChita State Medical Academy2022050720227398109Copyright © Бочкарева Л.С., Мироманова Н.А., Мироманов А.М., 20222022Бочкарева Л.С., Мироманова Н.А., Мироманов А.М.Bochkareva L.S., Miromanova N.A., Miromanov A.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.actabiomedica.ru/jour/article/view/3555

Острый вирусный бронхиолит одна из частых причин госпитализации и смертности, особенно среди детей первого года жизни, имеющих факторы риска (недоношенность, врождённые пороки сердца, бронхолёгочная дисплазия, иммуносупрессия). В качестве факторов, ассоциированных с тяжестью бронхиолита, наряду с традиционными, могут рассматриваться однонуклеотидные полиморфизмы генов молекул иммунного ответа.Цель исследования. На основе анализа клинико-лабораторных и молекулярно-генетических параметров выявить прогностические критерии тяжёлого острого вирусного бронхиолита у детей.Материалы и методы. В исследование включено 106 детей с острым вирусным бронхиолитом (тяжёлой степени – 34, нетяжёлой степени – 72), этиологией которого в 67,9 % явился респираторно-синцитиальный вирус. В качестве прогностических критериев оценивалось 47 анамнестических, клинических, традиционных лабораторных и молекулярно-генетических параметров. Определение SNP генов цитокинов IL-4 (С-589Т), IL-10 (G-1082A), IL-10 (C-592A), IL-10 (C-819T), TNF-α (G-308A), IL-17A (G197A), IL-17F (His161Arg), TLR2-753ArgGln, TLR6-Ser249Pro в венозной крови осуществляли методом полимеразной цепной реакции.Результаты. Дополнительным критерием риска развития тяжёлого бронхиолита может служить мутантный генотип (АА) SNP гена IL-10 (C-592A), выявлявшийся исключительно в группе больных тяжёлым бронхиолитом, увеличивая риск развития тяжёлого заболевания в 16,11 раза (ОШ = 16,11; 95% ДИ: 0,81–121,22, р = 0,02) в совокупности с уже установленными модифицирующими факторами: наличием врождённого порока сердца, бронхолёгочной дисплазии, недоношенностью, массой тела при рождении < 1500 г. На основании комплексной оценки установленных факторов риска разработан метод, позволяющий рассчитать вероятность развития тяжёлого острого вирусного бронхиолита.Заключение. Использование разработанного способа прогнозирования позволит не только повысить вероятность развития тяжёлого острого вирусного бронхиолита у детей, но и определить приоритетную группу среди детей с предикторами тяжёлого развития вирусного бронхиолита для первоочередной иммунопрофилактики против РС-вирусной инфекции.

Acute viral bronchiolitis is one of the common causes of hospitalization and mortality, especially among children in the first year of life who have risk factors (prematurity, congenital heart defects, bronchopulmonary dysplasia, immunosuppression). As factors associated with the severe course of bronchiolitis, along with the traditional ones, single nucleotide polymorphisms of the genes of the immune response molecules can be considered.The aim. Based on the analysis of clinical, laboratory and molecular genetic parameters, to identify prognostic criteria for the severe course of acute viral bronchiolitis in children.Materials and methods. The study included 106 children with acute viral bronchiolitis (severe course – 34, mild course – 72), the etiology of which in 67.9 % was respiratory syncytial virus. Forty-seven anamnestic, clinical, traditional laboratory and molecular genetic parameters were assessed as prognostic criteria. Determination of SNP genes of cytokines IL-4 (C-589T), IL-10 (G-1082A), IL-10 (C-592A), IL-10 (C-819T), TNF-α (G-308A), IL-17A (G197A), IL-17F (His161Arg), TLR2-753ArgGln, TLR6-Ser249Pro in venous blood was carried out by the polymerase chain reaction method.Results. An additional criterion for the risk of developing a severe course of bronchiolitis can be the mutant genotype (AA) SNP of the IL-10 gene (C-592A), which was detected exclusively in the group of patients with severe bronchiolitis, increasing the risk of developing a severe disease by 16.11 times (OR = 16.11; 95 % CI: 0.81–121.22, p = 0.02) in conjunction with already established modifying factors: the presence of congenital heart disease, bronchopulmonary dysplasia, prematurity, birth weight < 1500 g. Based on a comprehensive assessment of the established risk factors, a method has been developed that allows calculate the likelihood of developing a severe course of acute viral bronchiolitis. Conclusion. The use of the developed prediction method will not only increase the likelihood of developing severe acute viral bronchiolitis in children, but also determine the priority group among children with predictors of severe viral bronchiolitis for priority immunoprophylaxis against RS-virus infection.

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