IMMUNOLOGICAL ASSESSMENT IN CHRONIC NASOPHARYNGITIS WITH DIFFERENT VARIANTS OF COMORBIDITY IN THE NASOPHARYNGEAL ZONE
DOI:
https://doi.org/10.37219/9kbzp448Keywords:
chronic nasopharyngitis, adenoiditis, allergic rhinitis, pharyngeal tonsil hypertrophy, rhinosinusitis, immune status, local immunity, cytokines, immunoglobulinsAbstract
Topicality: Understanding the immunological features of chronic nasopharyngitis with or without pharyngeal hypertrophy makes it possible to prescribe treatment based on individualization according to the specific pathophysiological situation and concomitant conditions of the nasopharyngeal area and the child's immune status, which allows for precision pharmacotherapy.
Objective: 1) To study the immunological profile of different variants of chronic nasopharyngitis in children with various associated conditions of the nasopharyngeal zone for further substantiated modulation of the activity of the nasopharyngeal immune system using a mucosal vaccine. 2) The full spectrum of changes in all indicators of local immunity in oropharyngeal secretions in patients with MG III - increased IL-1β, decreased IFN-α, decreased sIgA - most likely ensure the chronicity of infectious inflammation of the nasopharynx in this category of subjects.
Conclusions: The greatest changes in both local and systemic immunity are shown by representatives of MG I (without comorbidity) and MG III (chronic nasopharyngitis on the background of allergic rhinitis). However, such indicators of systemic immunity in patients with MG III as the absence of a decrease in T-lymphocytes CD3+, a decrease in T-lymphocytes CD8+, an increased IPI, a decrease in T-lymphocytes CD16+, an increase in T-lymphocytes CD19+, a decrease in T-lymphocytes CD25+, an increase in Ig M (monomer), an increase in Ig E indicate an immunological profile of an allergic person. Representatives of MG II (chronic nasopharyngitis with hypertrophy of the pharyngeal tonsil) showed a high level of bacterial load in the form of dysbiosis grade 3 with serum leukocytosis and nasal mucus against the background of systemic immunity within normal limits with a noticeable deterioration of local immunity - increased IL-1β, decreased sIgA in oropharyngeal secretion. 3) Differences in indicators of systemic and local, humoral and cellular immunity against the background of quantitative and qualitative changes in the microbiome of the nasopharyngeal zone in representatives of different MG indicate the need for further study of the effectiveness of immunorehabilitation with a differential approach for each variant of chronic nasopharyngitis.
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