RU2303784C1 - Method for predicting the frequency of acute respiratory-viral infections due to evaluating the state of local immunity in children of primary-school age - Google Patents

Abstract

FIELD: medicine, pediatrics.

SUBSTANCE: one should detect gamma-glutamyl transferase (GGT) in saliva sampled in the morning to an empty stomach. At GGT values being under 0.85 IU/l or above 3.4 IU/l it is possible to diagnose the decrease of local immunity in children and predict the risk for transferring a healthy child into the group of frequently sick patients. Application of the present method enables to predict the frequency of acute respiratory-viral infections (ARVI) before the procedure of prophylactic vaccinations, provides the chance for carrying out corresponding correction measures. The innovation is simple in application being noninvasive and could be applied in any age group.

EFFECT: higher accuracy of prediction.

5 dwg, 1 tbl

Description

The invention relates to medicine, namely to pediatrics. Often ill children make up from 15 to 45% of children, according to different authors, but they account for up to 67.7-75% of all cases of respiratory viral diseases. Frequent and especially severe respiratory diseases can lead to disruption of the physical and neuropsychic development of children, contribute to a decrease in the functional activity of the immune system, and the formation of chronic inflammatory processes. A special role in the formation of frequent diseases is played by a decrease in local immunity in this group of children, therefore, timely diagnosis of immunity disorders by some biochemical parameters in saliva seems relevant to the authors.

The use of publicly available and non-invasive research methods to assess the state of local immunity is especially important. In particular, the material for studying the state of local immunity is saliva collected in the morning on an empty stomach.

The prototype of the claimed method, the authors propose a "Method for predicting frequent respiratory diseases by the coefficient of balance of lysozyme and immunoglobulins in saliva collected in the morning on an empty stomach (Dorofeychuk V.G. et al., AS No. 1332229-1987), the description is presented in the book" Lysozyme : theory and practice ”Baranov AA, Dorofeychuk VG 1999 Moscow - Nizhny Novgorod. In the saliva of the examined child, taken in the morning on an empty stomach, the concentration of immunoglobulins A and G is determined by the method of radial immunodiffusion in a gel, the activity of lysozyme was determined by the nephelometric method, and then the value of the coefficient of balance Ksb was determined:

Ksb = (Ig G × 40) :( IgA × 0.6 LA)

Ig G is the concentration of Ig G;

Ig A is the concentration of Ig A;

LA - lysozyme activity of saliva.

All three are for a particular patient.

40 - lysozyme activity,

0.6 - the ratio of Ig G to IgA - constant values - conditional norm. If the value of Ksb above 2, frequent diseases are predicted.

This method has some disadvantages:

1. Suggested Dorofeychuk V.G. et al. the methods are laborious and require preparatory work, in particular, the daily culture of M. Lysodeikticus is necessary to determine lysozyme.

2. The readings are taken and the calculation of the concentrations of immunoglobulins is carried out 24 hours after the start of the formulation of the method. Calibration is built on each glass separately.

3. And in conclusion, a mathematical calculation is required, which also lengthens the time for obtaining results.

The determination of the enzyme gamma-glutamyltransferase (GGT) in the saliva of an individual patient was carried out by the applicants by the kinetic method. L-gamma-glutamyl-3-carboxy-4-nitroanilide was used as a substrate (the methodology is standardized, Biocon system test).

Gamma-glutamyltransferase is an enzyme that carries out the transport of amino acids through cell membranes by transferring the gamma-glutamyl group from compounds containing this group to the acceptor. In order to penetrate into the cell or leave it, the amino acid must react with the glutathione tripeptide. Glutathione is present in most cells and is used as a reducing agent. The activity of gamma-glutamyltranspeptidase is present in cell membranes with a high secretory or absorption ability.

When conducting a laboratory study of the parameters of the state of local immunity, this method was used, which made it possible to correctly judge the state of the protective properties of the mucous membranes in children of primary school age.

A total of 39 children aged 7–9 years were examined, among which a group of frequently ill patients was identified — 18 people (2nd group), and 21 children made up the control group (rarely ill children without chronic diseases — 1st group) .

Indicators of natural resistance in the saliva of the examined children are presented in table 1.

Table 1.
Indicators of natural resistance in the saliva of rarely ill children (M ± m). Indicators 1 group n = 21 GGT, Me / L 1.36 ± 0.08

An increase in gamma-glutamyl transferase (GGT) indicates an increase in detoxification biochemical reactions, since an increase in GGT is evidence of an increase in the secretory and detoxification functions of cells (in our case, cells of the oral mucosa).

The authors used analytical processing of the obtained data using the decision trees algorithm (Breiman et al. "Classification and Regression Trees". Chapman and Hall, Boca Raton, 1993).

At a GGT level of less than 0.85 Me / L or greater than 3.4 Me / L with a probability of 94.9%, a decrease in children’s natural resistance to SARS is diagnosed, and we can talk about an increased risk of a healthy child moving into a group of often sick.

The advantages of the authors proposed method for predicting the frequency of acute respiratory viral infections by assessing the state of local immunity in primary school children are:

1. Non-invasive nature.

2. The ability to use as a screening diagnosis.

3. The technical simplicity of the collection, storage and processing of material.

4. Use in relation to any age group.

5. The possibility of a specific focus on subsequent corrective actions.

6. Affordable research cost.

The method can be used for screening children when children are admitted to the childcare center, when registering health resort cards, before conducting preventive vaccinations, etc.

Clinical example 1

Erofeev D., 7 years old, formalized card No. 12.

On examination, GGT-4.5 Me / L. It is attributed to the risk group for frequent relapses of ARVI and taken under supervision. One week after the ARVI examination, 5 days, a month later, ARVI relapse, 8 days, 4 months later, follicular tonsillitis, 14 days. The forecast is fully justified.

Clinical example 2

Makarov L. 8 years, formalized card No. 21.

On examination, GGT-1.3 Me / L. It is attributed to the group of rarely ill.

Within 6 months after the examination, the child did not have a single case of SARS. The forecast was confirmed.

Clinical example 3

Samoilov V., 8 years old formalized card No. 34.

Examination of GGT-3.6 Me / L. It is attributed to the group of often sick.

Within 6 months of ARVI observation - 3 times for 8 days.

Clinical example 4

Long S, 7 years old, formalized card number 3.

On examination, GGT-0.12 Me / L. It is attributed to the group of often sick.

For 6 months of observation of acute respiratory viral infections - 2 times, follicular tonsillitis - 1 time, about. otitis bilateral - 1 time, as a complication of acute respiratory viral infections.

Clinical example 5

Mazan E., 8 years old, formalized card No. 7.

Examination of GGT-0, 96 Me / L. It is attributed to the group of rarely ill. For 6 months of ARVI observation - 1 time, 7 days.

Claims (1)

A method for predicting the frequency of acute respiratory viral infections by assessing the state of local immunity in primary school children, including determining the biochemical parameters of saliva taken in the morning on an empty stomach, characterized in that gamma-glutamyl transferase (GGT) is determined in saliva and with GGT values less than 0.85 Me / l or more 3.4 Me / l diagnose a decrease in local immunity in children and predict the risk of a healthy child moving into the group of often sick.