Introduction. CC16 protein is secreted by Club epithelial cells of the bronchioles, maintains homeostasis of theairway epithelium and has anti-inflammatory effects in the lungs. It is important to study the level of CC16 proteinin the serum in order to understand the integrity of the bronchial epithelium and the development of bronchialdysfunction in young children with bronchiolitis.Aim of the study. Analysis of blood serum CC16 concentration in younger bronchiolitis patients.Material and methods. We clinically examined 70 young children. The main group consisted of 35 non-allergicbronchiolitis patients. The comparison group included 25 young bronchiolitis patients with a history of allergies.The control group comprised 10 conditionally healthy children. The average age of patients was 8.4 ± 1.6 months,6.2 ± 1.4, and 6.4 ± 1.2 months in the main, comparison, and control group, accordingly. The complex of clinicaland-laboratory examination of children included CC16 serum tests. Serum CC16 content was determined by enzymelinked immunosorbent assay according to the “Human CC16 ELISA Kit”.Results of the study. It should be noted that the most main group patients (22 (62.8 ± 6.4%) of all examined) hadelevated CC16 readings. Whereas in the comparison group we did not find an increase in CC16 protein in any case.In contrast, 13 (51.8 ± 14.4%) children with bronchiolitis with a history of allergy had a decrease in CC16 protein,which may be a sign of endothelial dysfunction (p = 0.01).The study showed that young non-allergic bronchiolitis patients had the mean CC16 (38.9 ± 4.5 ng/ml) significantlyhigher than those with a history of allergies (22.9 ± 3.3 ng/ml), (OR=1,667; 0,854 - 3,250 95% CI; p < 0,05). Thecontrol group patients had the mean CC16 within the reference interval (14.2 ± 2.12 ng/ml).Conclusions. In young children, elevated CC16 may be considered a marker of respiratory failure in bronchiolitispatients. Bronchiolitis patients with a history of allergies had statistically significantly lower serum CC16 levels thanthose in children without a history of allergies.

Introduction. It is quite important to study the markers of allergic inflammation depending on the status of vitamin D in order to understand the pathogenetic links of bronchiolitis in infants.Aim of study. Analysis of the relationship between serum vitamin D levels and indicators of allergic inflammation (eosinophil cationic protein (ECP) and IgE) in infants with bronchiolitis.Materials and methods. A clinical examination of 55 infants was conducted. The main group consisted of 25 children with bronchiolitis who had a history of allergies. The comparison group consisted of 20 children with bronchiolitis without a burdensome allergy history. The control group included 10 relatively healthy children. The mean age of children in the main group was 7.2 ± 1.4 months, 6.4 ± 1.2 months in the comparison group, and 9.2 ± 1.6 months in the control group.Results of the study. It was found that the duration of hospital stay in children of the main group was 8.2 ± 1.32 days, while in children of the comparison group the duration of stay in hospital was significantly shorter (p <0.05). We found a significant difference in the indicators of allergic inflammation that depended on the status of vitamin D in the examined children. Thus, in children with vitamin D deficiency and insufficiency, a marked increase in ECP (56.3 ± 12.8 ng / ml) and total IgE levels to 127.5 ± 3.12 IU / ml was found compared to the same indicators as in children of the main group with the optimal level of 25 (OH) D, and in children of the comparison group, p˂0,001. It should be noted that the rate of allergic inflammation marker ECP in children of the comparison group with deficiency and insufficiency of vitamin D in serum also had a significant difference when compared with infants of the control group, p˂0.05. Conclusions. In children with bronchiolitis, obtained history of allergies and insufficient levels of vitamin D and its insufficiency, the severity of the disease is manifested by a longer duration of clinical symptoms and hospital stay. Eosinophilic cationic protein can be considered as a marker of allergic inflammation in infants with bronchiolitis.

Given the frequency of recurrent wheezing (up to 50 % of cases) in young children during the first year after bronchiolitis, the assessment of the prognostic value of diagnostic biological markers of bronchiolitis requires special attention.According to modern concepts, mast cells, eosinophils, play a significant role in the pathogenesis of bronchiolitis, with degranulation of which the release of cationic proteins (eosinophilic cationic protein (ECP), eosinophil-derived neurotoxin (EDN)) and molecular mediators, namely vascular cell adhesion molecule-1 (VCAM-1), which is a regulator of leukocyte adhesion and transendothelial migration. That is why VCAM-1, ECP and EDN are discussed as important prognostic markers in assessing the risk of recurrent wheezing in children with bronchiolitis.The aim of the study. To analyze the risk factors for recurrent wheezing in children with bronchiolitis, considering allergic history, the influence of external factors (passive smoking, place of residence), levels of VCAM-1, ECP, EDN in the blood serum.Material and Methods. This article is a part of the research work of the Department of Paediatrics No. 1 of Vinnytsia National Medical University named after M.I. Pyrohov on the topic "Optimization of diagnosis and treatment of somatic pathology in children", state registration No. 0115U007075.A clinical examination of 67 infants was carried out. The main group consisted of 34 children with bronchiolitis without a complicated allergic history. The comparison group consisted of 33 children with bronchiolitis who had a burdened allergic history. The average age of the children in the main group was 8.4±1.6 months, and 6.2±1.4 months in the comparison group. The analytical component of the study was based on parametric survival models (Weibull and generalized Gamma models). The analysis of Weibull models was performed in the statistical packages of analytical system R for Mac OS X FAQ, Version 3.1.0 2014-04-10, R. app 1.64 based on the Mac OS X 10.9 platform, 64-bit Intel Core i7 architecture.The study was approved by the Commission on Biomedical Ethics for compliance with the moral and legal rules for conducting medical research at Vinnytsia National Medical University named after M.I. Pyrohov. It was established that the research does not contradict the basic bioethical norms and meets the principles of compliance with the basic provisions of the GCP (1996), the Council of Europe Convention on Human Rights and Biomedicine (04.04.1997), WMA Declaration of Helsinki on Ethical Principles for Medical Research Involving Human Subjects (1964-2008) and Order of the Ministry of Health of Ukraine No. 690 of 23.09.2009 (as amended by Order of the Ministry of Health of Ukraine No. 523 of 12.07.2012). All patients were informed about the purpose and possible consequences of the research procedures. All patients signed an informed written consent to participate in the study prior to the procedure.Results of the study. The risks of recurrent wheezing in children with bronchiolitis according to the Weibull model were allergic history ( β=1,996) mixed feeding, and to an even greater extent artificial feeding ( β=7,832 and β=8,337). High serum levels of ECP β=5,03, EDN β=0,182 and VCAM-1 β=0,0254 are reliable markers of increased risk of recurrent wheezing in children with bronchiolitis. Living in rural areas ( β=-5,8) significantly reduces the risk of recurrent wheezing in children with bronchiolitis compared to children living in urban areas β=0.0162).Conclusions. 1. The levels of VCAM-1, ECP and EDN in the blood serum were recognized as reliable markers for the prognosis of recurrent vesicitis in children with bronchiolitis. The level of EDN ≤ 7 ng/ml in the blood serum is a prognostic marker for the risk of recurrent wheezing in children with bronchiolitis.2. The hypothesis that artificial feeding in children with bronchiolitis with a complicated allergic history confirms and significantly increases the risk of recurrent vesicitis in children with bronchiolitis. The hypothesis about the role of passive smoking exposure in a significant increase in the risk of recurrent wheezing in children with bronchiolitis was confirmed only for patients with EDN levels not exceeding 7 ng/ml in the blood serum.