The nature of the respiratory tract microflora and the immunity indices in a severe form of bronchial asthma in children

65 children with the severe course of bronchial asthma (BA) were examined. The character of respiratory tract microflora, humoral immunity characteristics, mediators, of inflammation and pathomorphological features of the bronchial tree during the severe course of BA in children at the period of remission were studied. The specific features of the colonization of the bronchial tree by microflora in the severe form of BA were established. The severe course of BA in children at the period of remission was characterized by a higher content of tumor necrosis factor and an increase in the lysozyme activity of bronchoalveolar fluid. Disturbances in the proportion of cAMP and cGMP in smooth muscles and an increase in the number of apudocytes containing adrenalin and serotonin may probably be one of the mechanisms of bronchial hyperreactivity.     

Microbiocenosis of the mucous membranes of the upper respiratory tract and its correction with acipol in the treatment of patients with acute respiratory virus infections

Clinical and laboratory evaluation of the preparation Acipol in 45 children greatly susceptible to acute respiratory virus infections (ARVI) was carried out. Simultaneously with the clinical analysis, the study of the microflora of the mucous membranes of the upper respiratory tracts and intestine, as well as the levels of secretory IgA in saliva and coprofiltrates before and after treatment, was made. The inclusion of Acipol into the therapy of ARVI patients facilitated their clinical convalescence, uncomplicated course of the disease, correction of disturbances in the biocenosis of the upper respiratory tracts and increased infectious resistance.     

Nosopharyngeal microflora in ambulatory treated children and adults with upper respiratory tract infections

Upper respiratory tract consists resident and transient bacterial microflora, which in appropriate condition can cause infection. Bacteriological study was performed among 201 patients with upper respiratory tract infections treated in ambulatory. From nasal and pharyngeal swabs Staphylococcus aureus, Haemophilus influenzae, Streptococcus pneumoniae, Moraxella catarrhalis, and Streptococci group A, B, C, G were isolated. Antibiotic susceptibility testing of isolated strains was performed using CLSI criteria. All isolated strains of streptococci were susceptible to penicillin; some of them demonstrated resistance to macrolides and lincosamides. Few isolated strains of H. influenzae demonstrated resistance to penicillin and cotrimoxazole. Azitromycin resistant strains were not detected. All isolated strains of M. catarrhalis were beta-lactamase positive and demonstrated resistance to penicillin. Strains of methicillin sensitive S. aureus (MSSA) were isolated most frequently from pharyngeal swabs (35.4%) and S. pneumoniae (33.3)--from nasal swabs.     

Microflora of the upper respiratory tract of normal young children and in respiratory tract diseases. Normal microflora and dysbiosis at different levels of the upper respiratory tract in healthy children and pneumonia patients

Material obtained from the mucous membranes of the upper respiratory tract (the anterior section of the nasal cavity, the fauces) in young children, both healthy and suffering with different forms of acute pneumonia, has been analyzed with due regard to the structure of the microflora, its specific composition and the size of populations formed by different species constituting the microflora. This analysis has made it possible to determine the species constituting normal microflora, to detect its dysbiotic changes, and to determine their degree (partial or complete dysbacteriosis). The degree of pathologic changes in the microecological balance of the upper respiratory tract has been shown to reflect the severity of acute pneumonia and to be determined by the characteristics of the natural resistance system in young children.     

Regulation of mucous cell metaplasia in bronchial asthma

Mucous cell metaplasia (MCM), defined by the appearance of mucous cells in airways where mucous cells were not present, is a consistent pathologic characteristic in the peripheral airways of bronchial asthma. Under mild inflammatory conditions MCM occurs as a result of pre-existing airway epithelial cells (AECs) starting to express mucin genes and differentiating into mucous cells. Under extensive inflammatory responses, AECs proliferate, and the development of MCM involves the differentiation of pre-existing and proliferating cells into mucous cells. Epithelial cell numbers per mm basal lamina are increased by approximately 30%. IL-13 is the central cytokine that is responsible for MCM in asthma through GABA-R- and STAT6-mediated mechanisms involving the calcium-activated chloride channel CLCA. IL-13 is also responsible for the proliferation of AECs by causing cells to produce TGFalpha that acts on the epidermal growth factor (EGF) receptor. Normally, resolution of MCM involves two distinct mechanisms. 1) Some of the metaplastic mucous cells stop the synthesis of mucus and dedifferentiate into Clara or serous cells to reconstitute the epithelium. 2) When proliferation of epithelial cells had occurred, approximately 30% of metaplastic cells are eliminated during the resolution process. Thus, a safe approach to reducing IL-13-induced MCM would involve blocking mucous synthesis and storage, blocking secretion of stored mucus, and eliminating hyperplastic mucous cells. Understanding the molecular mechanisms of each of these processes is necessary for developing effective therapies for reducing mucous hypersecretion in asthma and leading to a repaired epithelium.     

支气管哮喘患儿上呼吸道菌群和炎症因子水平变化与病情严重程度的关系

探讨支气管哮喘患儿上呼吸道菌群和炎症因子水平变化情况并分析二者与患儿病情严重程度的关系,为临床评估支气管哮喘患儿病情严重程度提供参考指标。

选取肇庆市第一人民医院2018年10月至2022年6月收治的支气管哮喘患儿103例作为研究组,另选同时间段在我院进行健康体检的健康儿童60例作为对照组,并根据病情严重程度将研究组患儿分为轻症、重症两个亚组。检测患儿上呼吸道菌群多样性与血清中C反应蛋白（CRP）、白细胞介素-6（IL-6）、肿瘤坏死因子（TNF）-α水平,分析以上指标与病情严重程度的关系。

与对照组比较,研究组患儿呼吸道菌群Simpson指数,血清CRP、IL-6、TNF-α水平均显著升高,呼吸道菌群Shannon指数显著降低（t=52.413、35.293、36.088、34.930、29.248,均P＜0.001）。重症组患儿呼吸道菌群Simpson指数,血清CRP、IL-6、TNF-α水平均显著高于轻症组,呼吸道菌群Shannon指数显著低于轻症组（t=11.599、11.898、12.699、11.335、12.309,均P＜0.001）。Spearman相关性分析显示,呼吸道菌群Simpson指数、血清CRP、IL-6、TNF-α水平与病情严重程度均呈正相关（r=0.197、0.228、0.264、0.287,P=0.046、0.020、0.007、0.003）,呼吸道菌群Shannon指数与支气管哮喘病情严重程度呈负相关（r=−0.270,P=0.006）。ROC曲线显示,呼吸道菌群Simpson、Shannon指数和血清CRP、IL-6、TNF-α水平以及联合检测对支气管哮喘患儿病情严重程度预测的曲线下面积（AUC）分别为0.615、0.658、0.634、0.654、0.668、0.863,联合检测对支气管哮喘患儿病情严重程度的预测价值更高。

支气管哮喘患儿上呼吸道菌群多样性及炎症因子水平显著升高,且患儿病情程度越严重,其水平变化越显著,二者联合检测对患儿支气管哮喘严重程度具有较高预测价值。

     

Disturbance of immune characteristics of the mucous membranes of the respiratory tract in bronchopulmonary diseases in children

A total of 100 children with bronchopulmonary diseases were examined. Of these, in 80 bronchial asthma and in 20 children acute pneumonia were diagnosed. The deficiency of local cell mediated and humoral factors on the mucous membranes of the upper respiratory tracts was established. In the squamous and columnar epithelium cells an increased destruction and cytolysis was noted leading to disturbances in the integrity of the protective barrier of the epithelial cover. In addition, this study revealed the deficiency of neutrophilic leukocytes, pronounced local eosinophilia and the low level of humoral protective factors. In acute pneumonia an increase in the amount of neutrophilic leukocytes in the secretion of the nasal cavity together with the appearance of destructive processes in epithelial cells took place. Pronounced deficiency in serum IgA and IgG was accompanied by compensatory increase in secretory IgA.     

Fungi allergic pathologies: correlation between allergological tests and presence of fungi in the upper respiratory tract

In order to clarify the aetiological role of fungi in determining allergic diseases, we evaluated the correlation between the positive skin test response to fungal allergens and the presence of the same species in the upper respiratory tract in 193 patients with suspected allergic disease to fungi. The results of our study have shown that the isolation and identification of the fungal flora from the patient’s respiratory tract, in addition to the medical history, the symptomatology, and the diagnostic in vivo and in vitro, can be helpful to identify the species responsible for provoking the allergic manifestations, and can be recommended either as a supplement to the diagnosis or as a guidance in elimination treatment.     

Diagnostic significance of immunoglobulins in infectious allergic bronchial asthma

In 100 patients with infectious allergic bronchial asthma the levels of IgM. IgG and IgA were determined by Mancini's method and the levels of IgE, tissue and microbial antibodies by the Prausnitz - Küstner test before and after combined treatment carried out under conditions of the microclimate of the salt mines in the village of Solotvino. The data on the content of immunoglobulins in the blood serum allowed the authors to establish 3 types of immediate hypersensitivity. THe decreased content of IgM in the blood serum indirectly revealed the role of immune complexes in the pathogenesis of infectious allergic bronchial asthma. The high content of IgE suggested that atopy could take some part in the infectious process.     

Anaerobes in the upper respiratory tract in infancy

Development of the indigenous microbiota begins on the surfaces of the human body after birth when infants are exposed to continuous person-to-person and environmental contacts with microbes. Anaerobes constitute a significant part of indigenous bacterial communities at different body sites. Pioneering anaerobic commensals are able to colonize and survive in the oral cavity during the first months of life. After teeth emerge, more attachment sites and potential niches are available for anaerobic bacterial colonization. Specific partner relationships influence the composition and stability of forming multigeneric communities, biofilms, where Fusobacterium nucleatum is of specific interest. In infancy, the oral colonization seems to be rather stable at species level, though not at clonal level. The colonization pattern in the nasopharynx is different from that in the oral cavity; anaerobes are absent from healthy nasopharynges but transiently colonize this anatomical site during infection. The most plausible origin for nasopharyngeal anaerobes is the oral cavity and, conceivably, saliva is the most likely transmission vehicle. Whether anaerobic bacteria colonize the nasopharynx just because of ecological changes favoring their growth or whether they could play an active role in the pathogenesis of respiratory infections is not known.     

吸烟对人体呼吸道厌氧菌的影响

目的探究吸烟对人体内的呼吸道微生态的影响。方法采用细菌鉴定及药敏分析系统鉴定健康吸烟者与非吸烟者,患下呼吸道感染吸烟与非吸烟者咽后壁分泌物的细菌密度、细菌数量及种类的改变。结果在健康吸烟者与患有下呼吸道感染患者的呼吸道中,厌氧菌明显升高,其中以韦荣菌和消化链球菌为主。结论吸烟可使人体的呼吸道微生态中细菌密度,细菌数量及种类的改变,易患呼吸系统疾病。     

Flow simulation in the human upper respiratory tract

Computer simulations of airflow patterns within the human upper respiratory tract (URT) are presented. The URT model includes airways of the head (nasal and oral), throat (pharyngeal and laryngeal), and lungs (trachea and main bronchi). The head and throat morphology was based on a cast of a medical school teaching model; tracheobronchial airways were defined mathematically. A body-fitted three-dimensional curvilinear grid system and a multiblock method were employed to graphically represent the surface geometries of the respective airways and to generate the corresponding mesh for computational fluid dynamics simulations. Our results suggest that for a prescribed phase of breath (i.e., inspiration or expiration), convective respiratory airflow patterns are highly dependent on flow rate values. Moreover, velocity profiles were quite different during inhalation and exhalation, both in terms of the sizes, strengths, and locations of localized features such as recirculation zones and air jets. Pressure losses during inhalation were 30-35% higher than for exhalation and were proportional to the square of the flow rate. Because particles are entrained and transported within airstreams, these results may have important applications to the targeted delivery of inhaled drugs.     

Comparative proteomics of nasal fluid in seasonal allergic rhinitis

A comparative proteomic approach was applied to examine nasal lavage fluid (NLF) from patients with seasonal allergic rhinitis (SAR, n = 6) and healthy subjects (controls, n = 5). NLF samples were taken both before allergy (pollen) season and during season, and proteins were analyzed by two-dimensional gel electrophoresis (2-DE) and matrix assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) after tryptic cleavage. Twenty proteins were selected and quantified. During allergy season, the levels of six sialylated isoforms of PLUNC (palate lung nasal epithelial clone) were lower in SAR patients than controls, as were the levels of six isoforms of von Ebner's gland protein (VEGP), including a previously undescribed form with N-linked glycosylation, and of cystatin S. PLUNC is a new innate immunity protein and VEGP and cystatin S are two endogenous proteinase inhibitors. By contrast, the levels of an acidic form of alpha-1-antitrypsin were higher in SAR patients than controls. One previously unidentified NLF protein was found in all samples from the SAR patients during allergy season but not in any sample before allergy season: this protein was identified as eosinophil lysophospholipase (Charcot-Leyden crystal protein/galactin 10). MS/MS analysis of the N-terminus of the protein showed removal of Met and acetylation of Ser. Altogether, these findings illustrate the potential use of proteomics for identifying protein changes associated with allergic rhinitis and for revealing post-translational modifications of such new potential markers of allergic inflammation.