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IMMUNOLOGICAL FEATURES OF THE INFLAMMATORY PROCESS
IN CHILDREN WITH HEMOCOLITIS SYNDROME
Khudayberdieva Charos Kurdashevna
PhD Doctoral Candidate, Tashkent Pediatric
Medical Institute. Uzbekiston
https://doi.org/10.5281/zenodo.14748381
Relevance.
Hemocolitis syndrome (HCS) in children represents a
significant clinical challenge, situated at the intersection of gastroenterology,
infectious diseases, and immunology. This syndrome can be triggered by various
etiological factors, including bacterial and viral infections, toxic exposure, and
autoimmune diseases. Children aged 6 months to 7 years are particularly
vulnerable due to the active development of their immune systems and the
dynamic changes occurring in their gut microbiota during this period.
According to recent studies, inflammatory processes in HCS not only
disrupt intestinal function but also lead to systemic changes affecting the entire
div. Notably, the imbalance between pro-inflammatory and anti-inflammatory
mechanisms plays a crucial role in the pathogenesis of the disease. Identifying
specific immunological markers, such as levels of CRP, PCT, IL-4, IL-6, IFN-γ, and
VEGF-A, allows for a deeper understanding of inflammatory mechanisms and the
development of more precise diagnostic and therapeutic approaches.
Research objective.
The aim of this study is to comprehensively
investigate the nonspecific immune response, cytokine profile, and their
relationship with the severity of inflammation in children with acute diarrheal
syndromes of the hemocolitis type.
Specific objectives include:
1.
Determining levels of CRP and PCT as markers of acute
inflammation.
2.
Assessing pro-inflammatory and anti-inflammatory cytokines (IL-4,
IL-6, IFN-γ).
3.
Exploring the role of VEGF-A in the pathogenesis of vascular changes
in HCS.
4.
Analyzing the correlation between disease severity and levels of
these markers.
Materials and methods.
This study involved 120 children aged 6 months
to 7 years who were hospitalized in infectious disease departments with a
diagnosis of acute diarrheal syndrome. The participants were divided into the
following groups:
Group 1:
25 children with mild hemocolitis syndrome.
Group
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2:
95 children with moderate hemocolitis syndrome.
Control group:
25 healthy
children of the same age.
Inclusion criteria:
Age between 6 months and 7 years. Confirmed
diagnosis of acute diarrheal syndrome. Absence of severe comorbidities.
Exclusion criteria:
Chronic gastrointestinal diseases. History of allergic
conditions. Use of immunosuppressants or antibiotics in the past month.
Research methods included:
Clinical assessment:
Evaluation of
symptoms, disease duration, and treatment outcomes.
Laboratory methods:
Measurement of C-reactive protein (CRP). Procalcitonin (PCT). Determination of
cytokines (IL-4, IL-6, IFN-γ) and VEGF-A using enzyme-linked immunosorbent
assay (ELISA).
Statistical analysis:
Data were processed using “BioStat LE
7.6.5” software. Student's t-test was used to assess the significance of
differences.
Results. Levels of Nonspecific Humoral Immune Factors
CRP levels in
children with mild HCS exceeded control group values by 2.8 times, averaging
9.83±1.78 mg/L (p<0.01).
In children with moderate HCS, CRP increased 4.5
times compared to the norm (15.61±3.22 mg/L; p<0.001).
Procalcitonin also
showed an increase, but differences between groups were statistically
insignificant (p>0.05).
Cytokine Profile
IL-6, a key inflammation marker,
increased 2-fold in mild cases (7.03±0.45 pg/mL; p<0.01) and 2.6-fold in
moderate cases (9.28±1.39 pg/mL).
IFN-γ, reflecting the activation of type 1 T-
helper cells, was 1.7 times higher than normal in mild cases and 2 times higher
in moderate cases (p<0.001).
VEGF-A, a marker of angiogenesis, increased 1.9
and 2.3 times, respectively, in the two patient groups.
Balance of Pro- and Anti-
Inflammatory Cytokines
IL-4, which regulates anti-inflammatory processes,
increased by 2.45 times in mild cases but decreased by 31.8% relative to normal
in moderate cases.
Discussion.
The results highlight the role of cytokine imbalance in the
pathogenesis of hemocolitis syndrome. Elevated levels of CRP, IL-6, and IFN-γ
indicate systemic inflammation activation, correlating with the severity of
clinical symptoms. Reduced IL-4 levels in moderate cases point to insufficient
anti-inflammatory responses, contributing to disease progression. Although
VEGF-A performs a protective function by restoring vascular networks, its
excessive production exacerbates inflammatory changes in intestinal tissues.
Conclusions.
Hemocolitis syndrome in children is accompanied by
significant immune system changes, characterized by increased pro-
inflammatory cytokines and diminished anti-inflammatory mechanisms.
CRP, IL-
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6, IFN-γ, and VEGF-A levels can serve as biomarkers for assessing the severity of
inflammatory processes.
Future research should focus on developing targeted
immunocorrection methods for children with hemocolitis syndrome.
References:
1.
Kliegman, R. M., Stanton, B. F., St. Geme, J. W., Schor, N. F. (2020). Nelson
Textbook of Pediatrics, 21st Edition. Elsevier. A comprehensive guide to
pediatric diseases, including gastroenterology and immunology.
2.
Thapar, N., Squires, R. H., Smith, G. (2020). "Pediatric Gastrointestinal
Disorders: A Review of Pathophysiology." Journal of Pediatric Gastroenterology
and Nutrition, 70(5), 545–555. Discusses mechanisms underlying pediatric
gastrointestinal inflammation.
3.
Blaser, M. J. (2018). The Microbiome in Health and Disease. Springer
Nature. Focuses on microbiome-related changes in diseases like hemocolitis.
4.
World Health Organization (WHO). (2022). Guidelines for the Diagnosis
and Management of Acute Diarrheal Diseases in Children.
