支原体肺炎患儿细胞免疫功能及肺功能状态变化的临床研究

目的:研究支原体肺炎患儿细胞免疫及肺功能状态的变化情况。方法:选取2014年10月~2015年10月于本院进行诊治的68例支原体肺炎患儿为观察组,以同期68名体检健康儿童为对照组。观察并比较两组儿童的细胞免疫及肺功能,以及不同程度肺炎患儿的细胞免疫及肺功能指标。结果:观察组患儿细胞免疫指标及肺功能指标均低于对照组,差异具有统计学意义(P0.05);观察组重度肺炎患儿的细胞免疫指标及肺功能指标均低于中度及轻度患儿,差异具有统计学意义(P0.05);观察组中度肺炎患儿的细胞免疫指标及肺功能指标均低于轻度患儿,差异具有统计学意义(P0.05)。结论:支原体肺炎患儿细胞免疫及肺功能呈异常状态,且不同严重程度肺炎患儿的差异明显。     

The results of a serological study of viral hepatitis patients and healthy subjects under the conditions of a high-intensity epidemic process in hepatitis A

The activity of the involvement of preschool children of different ages in organized groups into the epidemic process of hepatitis A and the state of population immunity in elderly persons have been studied. Under the conditions of the intensive development of the epidemic process the active involvement of preschool children into this process as early as at the age of 1-2 years has been noted. At periods between epidemics the active circulation of the infective agent in the presence of decreased manifestations of the disease has been revealed.     

Surveillance of pertussis in the CSSR. IV. Immunological surveys of antibodies to pertussis and parapertussis in the Bohemian regions and in Slovakia in 1958 - 1971.

A comparison of the results of repeated immunological surveys with the notification of morbidity and mortality to pertussis and parapertussis revealed direct dependence and simultaneously confirmed the effectiveness of Czechoslovak vaccine. Immunological surveys should be continued in spite of the fact that morbidity of pertussis is low at present, because immunological surveys may lead to timely detection of shortcomings in the quality of vaccination and vaccine. The results after 14 years of systematic vaccination and revaccination and consequent follow-up to the state of immunity in the population and of other factors in the pertussis surveillance programme rank among the other achievements of epidemiology and hygiene in Czechoslovak health services. Contemporary immunological surveys show that the state of immunity in Czechoslovak child population is such as to exclude the occurrence of pertussis in epidemics in the nearest future. The situation is different in parapertussis where epidemic incidence is still possible and where epidemics regularly occur in children of prae-school age.     

The antidiphtheria and antitetanus immunities of children of the Maritime Territory after the use of adsorbed DTP vaccine and adsorbed DT-m anatoxin]

The state of collective immunity to diphtheria and tetanus in children of preschool age, depending on the kind of vaccine preparation used for immunization, was studied. The immunological potency of adsorbed DPT vaccine (i.e. its capacity of forming prolonged and stable basic immunity) was shown to be higher in comparison with the potency of adsorbed DT toxoid with reduced antigen content (DT-R). The study revealed that in all groups of children the level of antitetanus immunity was higher than the level of antidiphtheria immunity, and 3 years later its decrease was less pronounced. A stricter approach to giving medical grounds for the use of low-reactive adsorbed DT-R in the immunization of children belonging to groups of risk is recommended.     

Characteristics of immune response to diphtheria anatoxin in children with different immune status during the second age-scheduled revaccination

The dynamics of the intensity of specific antidiphtheria immunity after the second age-scheduled revaccination was studied in 129 practically healthy children. The study revealed that the formation of immunity depended on the initial functional state of the immune system before the injection of diphtheria toxoid. Three variants of immune response were determined and the immune status corresponding to each of these variants was characterized. As shown in this study, children with the hyperergic character of immune response were characterized by relatively high initial titers of antitoxin, and the injection of an additional dose of the antigen led to the prolonged state of hyperimmunization with the subsequent decrease of the intensity of immunity by half, registered in the catamnestic observation for 4 years. Children with the hypo- and normoergic variants of immune response were characterized by the most stable immune response to diphtheria toxoid, and during the catamnestic observation they formed the levels of antibody titers 2.5- to 3-fold higher than before immunization. But the protection characteristics in children with the third variant were the lowest among the children under study.     

Whooping cough morbidity and inoculation status

The analysis of pertussis morbidity and the state of immunity to pertussis has made it possible to evaluate the existing epidemiological situation as unfavorable. The restraining influence of specific prophylaxis on the epidemic process of pertussis becomes weaker due to the growing number of nonimmunized children; for this reason, the maximum morbidity rate in pertussis is observed among children under 5 years of age, as it was at the period before the introduction of mass immunization against pertussis. To prevent further possible increase in the intensity of the epidemic process of pertussis and in the severity of the clinical course of the disease, the number of children under 3 years of age, not immunized against pertussis, must be reduced by limiting the number of children exempted from immunization on medical grounds and by increasing the proportion of children immunized from the age of 3 months.     

Effectiveness of measles immunoprophylaxis and the criteria for assessing its possible elimination

The study of measles morbidity in Donetsk Province in 1960-1984 and the study of antimeasles immunity in different groups of the population have shown that the problem of the liquidation of measles cannot be solved by immunizing the population in a single administration of the vaccine. To enhance the effectiveness of the immunoprophylaxis of measles and its influence on the epidemic process, a number of problems must be solved with the aim to improve the quality of the vaccine, especially its thermal stability, to establish the possibility of shifting the beginning of immunization from 15-17 months to 12 months of age, to increase the coverage of children with immunization against measles by decreasing the number of groundless exemptions from immunization and by immunizing children in risk groups according to individual schedules and dosage, to carry out selectively the booster immunization of persons who have lost their postvaccinal immunity, as revealed by laboratory test, or in whom such loss may be supposed, to introduce the objective method (indirect hemagglutination test) for controlling the state of immunity among different groups of the population into laboratory practice at sanitary and epidemiological stations. As to the possibility of the liquidation of measles, the statement of this problem is correct, but for its solution a complex of additional prophylactic and epidemic-control measures should be taken.     

Manifestations of genotypic and phenotypic heterogeneity in populations of Shigella sonnei and of humans at different phases of the development of the epidemic process

The study of the structure and developmental dynamics of S. sonnei populations and the state of local immunity to this infection in children under school age has revealed that the interaction of the heterogeneous populations of the parasite and the host is the internal motive force of the self-regulating phasic development of the epidemic process. In the course of this process complementary changes in the virulence of the infective agent and in the immunoresistance of children are generated on the basis of negative feed-back.     

Effect of low dose irradiation on the reaction of blood lymphocytes of individuals with the somatic diseases

The reaction of blood lymphocytes on adaptive irradiation in vitro (0.05 Gy) and challenge irradiation (1.0 Gy) 5 h after has been studied among 320 children 3-16 years old by micronuclei test with cytochalasin B cytokinetic block. The adaptive response or the hypersensitivity phenomenon (HS) has been determined by the calculation of the number of binucleated cells with micronuclei (MN) in 1000-2000 binucleated cells. For each individual by the chi2 criteria significant differences between the frequencies of damaged cells by irradiation in challenge dose and by combined action of adaptive and challenge doses have been detected. On the base of the results obtained the connection between AR or HS and the somatic diseases of different type and the disturbancies in systems of humoral and cell immunity has been studied. It was shown that in the row of allergic diseases and tuberculous infection among the significant part of the children (approximately 50%) the HS phenomenon was registered. The connection between the HS phenomenon and inflammatory processes (without allergic components), the logopedic disturbancies wasn't observed. It was shown in the group of HS children the deviation in the cell immunity system is registered. Significant deviations in HS group in the system of the humoral immunity is observed. So by the HS phenomenon significant number of the children have the somatic diseases and the deviation in the systems of cell and humoral immunity.     

Effectiveness of the selective revaccination of schoolchildren against measles

The revaccination of 70% of schoolchildren, previously immunized with measles vaccines of 26 different batches with insufficient immunogenic potency, has led to the pronounced and stable increase of immunity in the corresponding groups of children and has decreased measles morbidity among them 20 times.     

Immunoregulation of the population of intestinal gram-negative microflora

The authors present summarized data obtained in their studies on the presence of close feedback relationship between the state of immunity to common antigenic determinants of lipopolysaccharides (LPS), localized on the cell-wall surface of Gram-negative bacteria, and the development of intestinal dysbacteriosis. The problems dealing with the regulation of the amount of intestinal microflora with immunity factors taking part in the mechanism of such regulation are discussed and analyzed. The state of immunity to common antigenic determinants of LPS of Gram-negative bacteria re-flects, seemingly, the total resistance level of the body, i.e. the functional state of the immune system as a whole. The suggestion has been made that the development of intestinal dysbacteriosis may be basically caused by functional disturbances of the immune system, induced by different exogenous and endogenous damaging factors.     

Immunity to diphtheria and tetanus in some of the administrative territories of the RSFSR

The article deals with the state of immunity to diphtheria and tetanus among the adult population in some administrative regions of the RSFSR. Of the children and adults covered by the survey, 91.3-96.7% were found to have protective antibody titers against diphtheria and 98.7-100%, against tetanus. An essential drop in the level of immunity to diphtheria in persons over 18 years of age was revealed: 71.7% of them were nonimmune, which correlated with the high morbidity rate among these persons. At the same time the percentage of adults nonimmune to tetanus was considerably lower than that of adults nonimmune to diphtheria, reaching only 27.1%. The state of immunity to tetanus in adults was found to depend on the seasons.     

Distribution of antibodies to poliovirus in the children of a large industrial city

The results of prolonged dynamic observations on the state of herd immunity against poliomyelitis virus in an industrial city are given. The survey covered 1304 children. The data thus obtained, when synchronized according to years, seasons, the age of the surveyed children and the methods used in the survey, indicated that in every age group 20-30% of children had no antibodies to group I poliomyelitis virus and 30% of children had no antibodies to group III poliomyelitis virus. The geometrical mean of antibody titers to different types of the virus fluctuated from 1.8 to 4.6 log2, the lowest value being obtained for the titer of antibodies to type III poliomyelitis virus. During the whole period of immunological control (1974-1978) no mass circulation of poliomyelitis virus and no outbreaks of poliomyelitis were registered despite the fact that a considerable proportion of children having no antibodies to one or several types of the virus was constantly present among the most susceptible part of children.     

The characteristics of the humoral antibacterial immunity of young children with respiratory organ diseases]

The state of antibacterial humoral immunity in young children with acute bronchitis, acute obstructive bronchitis and bronchial asthma at the period of exacerbation has been shown with the use of the enzyme immunoassay. The concentration of antibodies to endotoxin positively correlates with the severity of clinical manifestations of the endogenic intoxication of the body. As the inflammatory process in the bronchial tree increases, the spectrum bacterial agents to which elevated concentrations of specific antibodies can be detected becomes wider, and this finds its maximum reflection in bronchial asthma.     

The validation of the expediency of a review of the times for revaccinating children against measles

Basing on the results of seroepidemiological study, carried out in two districts of Moscow by different methods, cluster selection method including, the authors have developed the following recommendations aimed at improving the strategy of revaccination against measles: (1) selective revaccination of only seronegative children or those with poor antimeasles immunity should be carried out, thus making it possible to reduce the number of susceptible children and diminish the risk of postimmunization reactions and complications; (2) when determining the groups of children to be revaccinated and the age suitable for revaccination, one should bear in mind the specific local features of the epidemic process in measles and the morbidity values, as well as the data on antimeasles immunity in children of different age groups; (3) serologic monitoring of the quality and immunologic effectiveness of different batches of live measles vaccine permits timely removal of nonstandard batches from practical use, thus improving the efficacy of vaccinal prophylaxis of measles.     

Stocking the Genetic Supermarket: Reproductive Genetic Technologies and Collective Action Problems

Reproductive genetic technologies (RGTs) allow parents to decide whether their future children will have or lack certain genetic predispositions. A popular model that has been proposed for regulating access to RGTs is the ‘genetic supermarket’. In the genetic supermarket, parents are free to make decisions about which genes to select for their children with little state interference. One possible consequence of the genetic supermarket is that collective action problems will arise: if rational individuals use the genetic supermarket in isolation from one another, this may have a negative effect on society as a whole, including future generations. In this article we argue that RGTs targeting height, innate immunity, and certain cognitive traits could lead to collective action problems. We then discuss whether this risk could in principle justify state intervention in the genetic supermarket. We argue that there is a plausible prima facie case for the view that such state intervention would be justified and respond to a number of arguments that might be adduced against that view.     

The use of hypoxic stimulation in chronic and relapsing bronchitis in young children ]

214 children of different age with various forms of bronchitis were subject to immunological and biochemical examination. Against a background of hypoxic state of patients the values of quantitative indices of cellular immunity (E-RFC, blast-transformation reaction with phytohemagglutination) were revealed to decrease and dysimmunoglobulinemia-to form. It is shown that in the period of exacerbation of clinical symptoms of bronchitis the concentration of malonic dialdehyde and resistance of erythrocyte membranes to peroxide hemolysis significantly increase. Analysis of peroxidation level against a background of improvement of clinical indices after the performed treatment indicates that there is no tendency to normalization of metabolic disorders. The above results show that it is necessary to carry out normobaric hypoxic stimulation aimed at treating and preventing bronchitis in children of early age.     

Ways of increasing the efficacy of antibiotic therapy in young children with severe forms of acute pneumonia]

Examination of 136 children with the severe form of acute pneumonia treated in a resuscitation unit revealed a marked suppression of the immunity and lowered antibiotic sensitivity of the bacterial microflora isolated from the respiratory tracts. The patients were previously treated with antibiotics of 2 to 5 families. Auto-blood irradiated with X-rays without the host was transfused to 72 children (group 1) with immunomodulating purposes. 64 children (group 2) were treated with the same purposes with eleuterococcus, pentoxyl and methyluracil. After transfusion of the auto-blood irradiated with x-rays without the host there was an increase in the antibiotic sensitivity of the bacterial flora along with a marked and rapid improvement of the immunity status. The severe state was alleviated earlier in the patients of group 1. The inflammatory lesions in the lungs of the group 1 patients were arrested sooner and the patients were discharged from the hospital 11 days earlier than the children treated with the routine immunomodulators.     

Immunological structure of the population in a system of epidemiological surveillance of diphtheria

The characteristics of antitetanus and antidiphtheria immunity in children, adolescents and adults in Perm have been determined by means of the passive hemagglutination test, and the tendency towards the decrease of their immunity to diphtheria with the increase of their age has been established. The registered and actual coverage of children and adolescents by immunization is characterized on the basis of the presence of antibodies to the tetanus component of combined vaccines. A considerable proportion of persons at boarding schools and vocational technical schools has been found to be seronegative with respect to diphtheria. The seasonal dynamics of antitoxic immunity is presented.     

Annual vaccination against influenza virus hampers development of virus-specific CD8⁺ T cell immunity in children

Infection with seasonal influenza A viruses induces immunity to potentially pandemic influenza A viruses of other subtypes (heterosubtypic immunity). We recently demonstrated that vaccination against seasonal influenza prevented the induction of heterosubtypic immunity against influenza A/H5N1 virus induced by infection with seasonal influenza in animal models, which correlated with the absence of virus-specific CD8(+) T cell responses. Annual vaccination of all healthy children against influenza has been recommended, but the impact of vaccination on the development of the virus-specific CD8(+) T cell immunity in children is currently unknown. Here we compared the virus-specific CD8(+) T cell immunity in children vaccinated annually with that in unvaccinated children. In the present study, we compared influenza A virus-specific cellular and humoral responses of unvaccinated healthy control children with those of children with cystic fibrosis (CF) who were vaccinated annually. Similar virus-specific CD4(+) T cell and antibody responses were observed, while an age-dependent increase of the virus-specific CD8(+) T cell response that was absent in vaccinated CF children was observed in unvaccinated healthy control children. Our results indicate that annual influenza vaccination is effective against seasonal influenza but hampers the development of virus-specific CD8(+) T cell responses. The consequences of these findings are discussed in the light of the development of protective immunity to seasonal and future pandemic influenza viruses.