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Адрес для корреспонденции: Захарова Ирина Николаевна-д.м.н., проф., зав. кафедрой педиатрии с курсом поликлинической педиатрии имени академика Г.Н. Сперанского Российской медицинской академии непрерывного профессионального образования Касьянова Анна Николаевна-кл. ординатор кафедры педиатрии с курсом поликлинической педиатрии имени академика Г.Н. Сперанского Российской медицинской академии непрерывного профессионального образования Сугян Нарине Григорьевна-к.м.н., доцент кафедры педиатрии с курсом поликлинической педиатрии имени академика Г.Н. Сперанского Российской медицинской академии непрерывного профессионального образования Бережная Ирина Владимировна-к.м.н., доцент кафедры педиатрии с курсом поликлинической педиатрии имени академика Г.Н. Сперанского Российской медицинской академии непрерывного профессионального образования 125993 Москва, ул. Баррикадная, д. 2/1, стр. 1 Боровик Татьяна Эдуардовна-д.м.н., проф., рук. лаборатории питания здорового и больного ребенка ФГАУ «Национальный медицинский исследовательский центр здоровья детей» Минздрава России 119991 Москва, Ломоносовский проспект, д. 2, стр.1

Schoolchildren and their state of health, in particular, deficiencies, deserve no less attention than children of early age, while the recognition of the existence of inadequate vitamin D sufficiency in children of all age groups has not yet led to the introduction of mass prophylaxis for hypovitaminosis D. There are a number of factors determining the concentration of 25(OH)D-calcidiol in the blood. However, it is obvious that among many factors one should focus on several most significant and develop a scheme for correcting deficiency in each region.Purpose: to assess vitamin D sufficiency in adolescents living in Moscow, to correct calcidiol status in adolescents on the basis of baseline concentration of the metabolite transported in the blood. Material and methods: 769 adolescents aged 11-18 years for whom 25(OH)D concentration in the blood was evaluated, then 218 patients were randomized into 2 groups: the study group received tableted dietary supplement Minisun® vitamin D3, the controlgroup received placebo. The dosage of cholecalciferol was defined based on the initial level of calcidiol in patients. The study continued for 6 months, then blood was re-sampled to determine the level of calcidiol.Results: the study found low sufficiency with calcidiol among the schoolchildren: 25(OH)D median was 16.3 [11.4-20.8] ng/ml, only 5.2% of patients had normal concentration of calcidiol in the blood. At the second examination, positively significant differences in the status of vitamin D were observed in the study compared to the control group, while patients in the study group,against a background of cholecalciferol donation, demonstrated 25(OH)D median increase from 16.2 [12.25-19.3] ng/ml to 24.2 [21.05-26.4] ng/ml (p <0.001) .Conclusions: a large proportion of the child population (70.6%) have a concentration of 25(OH)D <20 ng/ml. The doses of cholecalciferol used in the study make it possible to eliminate the deficiency of calcidiol and to overcome the threshold of 20 ng/ml, but in order to normalize vitamin D status in the blood of adolescents living in Moscow, it is necessary to use higher dosages that need to be confirmed by further research.

Acute respiratory viral infections represent a group of clinically, pathomorphologically similar acute inflammatory respiratory diseases that manifest by fever, a runny nose, sneezing, cough, sore throat, a general feeling of ill health of varying severity. Activation of latent, persistent infections of viral and/or bacterial origin may occur in recurrent respiratory infections. Decreased production of local immunity contributes greatly to the development of viral and bacterial infections, persistence of pathogenic micro-organisms. Intestinal microflora can directly or indirectly affect the human respiratory tract through increased production of cytokines, short-chain fatty acids. In recent years, there has been a scientific interest in the therapeutic potential of probiotics for the prevention of acute respiratory viral infections. Earlier studies have shown a positive effect of probiotics on the respiratory tract with a view to prevent and reduce the incidence and severity of respiratory infectious diseases by expending the number of IgA secreting cells in the bronchial mucosa. Studies showed that the use of probiotics can reduce the incidence of acute respiratory infections, duration of fever, cough, and the need for antibacterial agents in children. Peptidoglycans and muramyl peptides that are constituents of the bacterial cell wall have antiviral activity. Probiotics can also inhibit virus attachment through a process of competing for the specific receptors. The regeneration of the mucous membrane is enhanced by the ability of mucin to prevent the virus from attaching to epithelial cells and suppress virus replication. The antiviral effect of probiotics may be caused by the ability to produce antimicrobial peptides, dehydrogenases and NOs. Probiotics can modulate the functions of epithelial and dendritic cells, CD4 +, CD8 + T lymphocytes, NK cells, stimulate the synthesis of secretory immunoglobulins, helping to neutralize the virus.

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