Naslov (srp)

Infekcija respiratornim sincicijalnim virusom kao determinanta razvoja hiperreaktivnosti bronhijalnog stabla kod dece uzrasta do 2 godine u odnosu na atopiju

Autor

Relić, Tijana, 1963-

Doprinosi

Kostić, Gordana
Petrović, Marina, 1969-
Čanović, Predrag, 1959-
Lazarević, Ivana, 1974-
Marković, Slavica. 1960-

Opis (eng)

Respiratory syncytial virus (RSV) is the most important causative agent of respiratory diseases in children up to two years of age. RSV bronchiolitis in early childhood is considered to be important risk factor of the recurrent wheezing and asthma development, while RSV infection itself could be determinant of bronchial hyperreactivity (BHR). Also, this age is the risky period for the synergic effect of both infection and atopy in asthma development. The general objectives of this study were to define the characteristics of the RSV infection relative to atopy, bronchial hyperactivity compared to RSV infection and atopy, as well as determining predictive factors for the development of bronchial hyperactivity in children up to two years old. The study presents the epidemiological-clinical observational study section with experimental work on the material of human origin in vitro. It was conducted by examining healthy children aged 5-24 months. Biological samples (children's blood) were taken in the Medical Center under pediatric control and the parents were informed about the purpose, aim and methods of this study. Serum IgA and IgG antibodies were determined by the quantitative ELISA (SERION ELISA classic, Institute Virion/Serion GmbH, Wϋrzburg, Germany). Atopy was established by measuring specific IgE in relation to usual allergens, using Phadiatop Infant Multitest. The results of this study determined the frequency of anti-RSV antibodies in the children aged <2. It is approximately 26% in the region of Sumadija. BHR, that was clinically defined as the presence of chronic bronchial disease and/or 3 or more of any lower respiratory disease, was found in 21.1% of the children up to two years of age. In this study, the groups identified to be at risk for BHR development were the children older than 7 months, male, non-breastfed and positive for RSV infection. Children with atopy were more often infected with RSV than those without atopy (43.3% vs 2.8%). However, the present study defined the unique phenotype of BHR in the age up to two years in which RSV infection and atopy were associated. Namely, every third child with atopy had BHR and 77.8% also had RSV infection. In comparison, in the group of children without atopy, BHR was diagnosed in every fifth child, and association with RSV infection was in only 25%. In the present study, boys with atopy and expressed BHR had RSV infection in more than 80% of cases, but BHR in male children without atopy was not associated with RSV infection. The results of this study suggest that the presence of bronchial hyperreactivity associated with respiratory syncytial virus infection can be early risk marker for asthma development, in all female children and in male children with atopy within the first two years of life. Therefore, early asthma prevention should include routine detection of respiratory syncytial virus infection and atopy in all children in primary health care.

Opis (srp)

Respiratorni sincicijalni virus (RSV) je najznačajniji uzročnik respiratornih bolesti kod dece uzrasta do dve godine. RSV bronhiolitis ranog detinjstva se smatra faktorom rizika za pojavu rekurentnog vizinga i astme, dok RSV infekcija sama po sebi može biti determinanta razvoja hiperreaktivnosti bronhijalnog (BHR) stabla. Ovaj uzrast predstavlja i rizični period za sinergističko delovanje infekcije i atopije kao faktora rizika za pojavu astme. Opšti ciljevi ovog rada su utvrđivanje karakteristika RSV infekcije u odnosu na atopiju, bronhijalne hiprreaktivnosti u odnosu na RSV infekciju i atopiju, kao i utvrđivanje predviđajućih faktora za razvoj bronhijalne hiprreaktivnosti kod dece uzrasta do dve godine. Istraživanje predstavlja epidemiološko-kliničku opservacionu studiju preseka sa eksperimentalnim delom na materijalu humanog porekla in vitro, a sprovedeno je ispitivanjem zdrave dece uzrasta 5-24 meseca. Određivanje serumskih koncentracija anti-RSV IgA i IgG izvršeno je imunoenzimskim ELISA testom, dok je postojanje atopije utvrđeno detekcijom serumskih specifičnih IgE prema uobičajenim alergenima, kvantitativnim Phadiatop infant testom. Rezultatima ovog istraživanja utvrđena je učestalost prisustva anti-RSV antitela kod dece uzrasta do dve godine u Šumadijskom okrugu od približno 26%. BHR, klinički definisan kao prisustvo hronične bolesti bronhija i/ili 3 i više bilo kojih bolesti donjih disajnih puteva, utvrđen je kod 21,1% dece, dok su rizične grupe za pojavu BHR deca sa RSV infekcijom, starija od sedam meseci, muškog pola i deca na veštačkoj ishrani. Takođe, ovo istraživanje je pokazalo da su deca sa atopijom imala imala češće RSV infekciju u odnosu na decu bez atopije (43,3% vs. 22,8%). Utvrđen je jedinstveni fenotip BHR u uzrastu do dve godine, gde je svako treće dete sa atopijom imalo BHR, pri čemu je 77,8% imalo i RSV infekciju. Za razliku od dece sa atopijom, u grupi dece bez atopije BHR je imalo svako peto dete, a učestalost RSV infekcije je iznosila samo 25%. Takođe, dečaci sa atopijom koji su ispoljili BHR imali su RSV infekciju u preko 80% slučajeva, ali BHR kod dece muškog pola bez atopije nije povezan sa RSV infekcijom. Rezultati ove studije ukazuju da rani rizik za razvoj astme može biti determinisan ispoljavanjem BHR nakon RSV infekcije kod sve ženske dece i kod muške dece sa atopijom tokom druge godine života. U vezi sa tim, deca sa atopijom uzrasta do dve godine su prepoznata kao ciljna grupa za pravovremenu primenu mera prevencije od virusnih respiratornih infekcija (primarna prevencija razvoja hroničnih respiratornih bolesti u uzrastu do dve godine) i primenu mera smanjenja izloženosti inhalatornim alergenima (sekundarna prevencija razvoja hroničnih respiratornih bolesti u kasnijem uzrastu).

Jezik

srpski

Datum

2015

Licenca

Ovo delo je licencirano pod uslovima licence
Creative Commons CC BY-NC-ND 2.0 AT - Creative Commons Autorstvo - Nekomercijalno - Bez prerada 2.0 Austria License.

CC BY-NC-ND 2.0 AT

http://creativecommons.org/licenses/by-nc-nd/2.0/at/