Summary. The increased proportion of non-rheumatic myocarditis in children has recently determined the urgency of this problem in pediatrics. It is known that non-rheumatic myocarditis in children often occurs against the background of viral or bacterial infection under conditions of altered reactivity of the immune system. There is evidence, mainly in rheumatism, that spontaneous and stimulated lymphocyte blatransformation response in such patients reflects the activity of the process, its tendency to chronicity and may serve as a criterion for the adequacy of therapy. Studies on the functional status of T lymphocytes in patients with non-rheumatic myocarditis are mainly related to experimental models. This determines the relevance of this work. The aim was to compare the functional activity of T-lymphocytes in spontaneous and phytohemagglutenin-stimulated lymphocyte blastranformation reactions in children with non-rheumatic myocarditis in acute and chronic course. Materials and methods. Under observation were 42 children aged 4 to 13 years with non-rheumatic myocarditis. A study was made of the functional activity of T-lymphocytes in the reaction of blast transformation using a radioisotope technique with thymidine-3H. Phytohemagglutenin from Reanal was used as a nonspecific stimulant. The reaction was evaluated on an SBS-2 automatic scintillation counter. The functional activity of T-lymphocytes was studied upon admission of children to the cardiology department and after the treatment. As a result of the study of the functional state of T-lymphocytes in the blast transformation reaction using the thymidine-3H radioisotope label in 52 children with acute and chronic non-rheumatic myocarditis, it was shown that during the period of advanced clinical manifestations, high spontaneous stimulation to the nonspecific phytohemagglutenin stimulator was recorded. The complex of generally accepted therapeutic agents leads to the restoration of the functional state of T-lymphocytes in children with an acute course of non-rheumatic myocarditis, and in chronic, despite the positive clinical dynamics, increased spontaneous stimulation of T-lymphocytes is still recorded, and the response to phytohemagglutenin is not fully restored in them. These data make it possible to recommend indicators of the functional activity of T-lymphocytes as criteria for recovery and determining the timing of treatment. Conclusions. The criterion for recovery and determining the duration of treatment of children with non-rheumatic myocarditis should be not only clinical and electrophysiological indicators, but also indicators of functional activity of T-lymphocytes, reflecting the sensitization of the body

Introduction. At the present stage of development of the problem in the etiopathogenesis of bronchial asthma (BA) in children, regardless of form, one of the leading places belongs to the microbial factor. Aim. The aim of the work was to study the development of autoimmune reactions to the cellular tissue structures of the trachea, bronchi and lung tissue, stimulated by heterophilic antigens of the microbiota of the bronchopulmonary system of children with BA. Materials and methods. A total of 97 children with BA aged 7 to 15 years were examined. The diagnosis of the disease was established according to GINA (2017) and the order of the Ministry of Health of Ukraine dated 08.10.2013 No. 868. Heterophilic antigens of bronchopulmonary structures in microbiota were determined using hyperimmune organ-specific rabbit sera to antigens of the trachea, bronchi and lung tissue. Lipopolysaccharide antigens from homologous cell-tissue structures of the trachea, pulmonary bronchi were determined, water-salt antigens from the structures of the trachea, bronchi, and lung tissue were obtained from accidentally dead children with I (0) blood group. The level of autoantibodies to antigens of the bronchopulmonary system with the quantitative calculation of the indicator Qφ was determined in the nephelometric reaction. Results. In the work it was shown experimentally that microorganisms, isolated from sputum of children, patients with asthma in the period of exacerbation, varying their antigenic potential, are able to include in their structure heterophilic antigens of cell-tissue structures of the bronchopulmonary system. Microorganisms including in their structure heterophilic antigens of the trachea, bronchi and lung tissue not only determine the induction of the pathological process in the bronchopulmonary system, but also translate it into an autoimmune basis, exacerbating the severity of the course of the disease. Conclusions. The study showed that the proposed methods are important for clarifying the etiopathogenesis of BA in children and disclosing the mechanism for switching the pathological process in the bronchopulmonary system to an autoimmune basis and can be used to develop new approaches for the etiopathogenetic treatment of the disease.

Bronchial asthma is one of the common diseases in children of different ages. In recent years, around the world, including in Ukraine, there is a trend towards its sustainable growth. To date, there are no methods of systemic immunodiagnostics that would allow with high diagnostic accuracy to identify clinical forms and severity of asthma, which would allow more fully reveal the pathogenetic mechanisms and individualize approaches to the treatment of asthma in children. The aim of this work was to study the hierarchy of immunological parameters in the pathogenetic matrix, which will determine the features of clinical forms and severity of asthma in children on the basis of systematic analysis. A comprehensive clinical and immunological examination of 176 children with asthma aged 6 to 15 years. To detect the autoimmune component used lipopolysaccharide antigens obtained from homologous cell-tissue structures of the trachea, bronchi and lung tissue from sectional samples of the bronchopulmonary system from accidentally killed children with group I (0) blood 2–4 hours after death. The level of autoantibodies to lipopolysaccharide antigens of the bronchopulmonary system was determined by quantifying the autoantibody index – Qφ. As a result of the study for the first time to improve the diagnosis and differentiation of clinical forms and severity of asthma from the standpoint of system analysis was developed immunodiagnostic complex, which took into account the degree of deviation from the norm values (Student's t-test, t = 1.96) and their distribution in pathogenetic matrix. This approach to ranking the positions of immunological parameters allowed to determine the features of humoral and cellular immunity, the process of apoptosis of cell-tissue structures of the bronchopulmonary system and the autoimmune component in the pathogenesis of asthma in children, which opens approaches to individualization of pathogenetic therapy.

Кафедра педиатрии (зав. -проф. В. Г. Чернуский) медицинского факультета Харьковского национального университета им. В. Н. Каразина Бронхиальная астма (БА) остаётся одной из наиболее актуальных проблем современной педиатрии. Частота этой патологии увеличивается ежегодно и, по данным ВОЗ, около 300 млн в мире болеют БА. Несмотря на современные достижения в диагностике и лечения БА, получить полный контроль за течением БА не удалось. Цель исследования -оценить влияние иммуномодулирующей терапии на неспецифический и гуморальный иммунитет у детей, больных БА, путём включения в стандартную базисную схему терапии индуктора интерферона (циклоферона). Под наблюдением было 120 детей, больных БА, в возрасте от 5 до 14 лет, средний возраст -(11,6 ± 1,5) года. Для установления диагноза и эффективности терапии использовали международную классификацию болезней 10го пересмотра, протокол диагностики и лечения бронхиальной астмы у детей (приказ Минздрава украины № 767 от 27.12.2005 г.), GINA, 2011. В основную группу (n = 60) вошли дети, которые, кроме базисной терапии, получали дополнительно индуктор интерферона (циклоферон) по схеме: 150 мг на 1, 2, 4, 6 и 8й день терапии (№ 5) и далее по 150 мг через 72 ч (№ 5) (всего 1500 мг). В группу сравнения вошли дети (n = 60), которые получали только базисную терапию в зависимости от степени тяжести заболевания. Группу контроля составили 25 здо ровых детей. Методом иммуноферментного анализа определяли уровень сывороточного интерферона, вирусиндуцированную продукцию интерферонаα (ИФНα), митогенстимулированную продукцию интерферонаγ (ИФНγ); уровень общего сывороточного IgE. Оценивали фагоцитарную активность нейтрофильных гранулоцитов (НГ), определяли циркулирующие иммунные комплексы (ЦИК), иммуноглобулины (Ig) А, M и G в сыворотке крови методом ре акции иммунодиффузии. установлено, что дополнительное применение циклоферона оказывало иммунокорригирующее действие на фаго циты, и это приводило к повышению синтеза ИФНα и ИФНγ, снижению выраженности аллергического компонента за счёт снижения уровня IgЕ и циркулирующих иммунных комплексов, к нормализации синтеза IgA, IgМ, IgG, что способствовало в дальнейшем развитию длительной клинической ремиссии заболевания. Ключевые слова: бронхиальная астма; дети; фагоцитарная активность; индукторы интерферона; иммуноглобулины.