Vol. 8 Núm. 22/Septiembre - octubre 2019 649 Artículo de investigación Peripheral blood parameters as a marker of nonspecific adaptive response of the body in acute infectious diseases with tonsillitis syndrome Параметры периферической крови как маркеры неспецифического адаптационного ответа при острых инфекционных заболеваниях с синдромом тонзиллита Recibido: 12 de julio del 2019 Aceptado: 25 de agosto del 2019 Written by: Plakhotnikova S.V.285 Santalova G.V. 286 Gasilina E.S.287 Zhirnov V.A.288 Davydkin I.L.289 Osadchuk A.M.290 Osadchuk M.A.291 Trushin M.V.292 Abstract Абстрак Evaluation of nonspecific adaptive response of Целью настоящего исследования явилась the body in children with acute infectious оценка неспецифической адаптационной diseases associated with tonsillitis syndrome was реакции организма у детей с острыми the aim of this research. This prospective study инфекционными заболеваниями, included clinical, anamnestic and laboratory ассоциированными с синдромом тонзиллита. examination of children with acute infectious Данное проспективное исследование diseases with tonsillitis syndrome. A systemic включало клинико-анамнестическое и multiple factor analysis was conducted лабораторное обследование детей с острыми (significance level р<0.05). The evaluation of инфекционными заболеваниями с синдромом peripheral blood parameters (specific gravity of тонзиллита. Проведен системный lymphocytes and indices of reactive protective многофакторный анализ (уровень значимости potential (RPP) - specific immune lymphocytic- р<0,05). Оценка показателей периферической monocytic parameter (SILMP) and coefficient of крови (удельного веса лимфоцитов и phagocytic defense (CPD)) gives the possibility показателей реактивно-протективный to determine the condition of nonspecific потенциал (РПП) - специфического adaptation in children with acute infectious иммунного лимфоцитарно-моноцитарного diseases associated with tonsillitis syndrome. параметра (ИЛМП) и коэффициента Children with tonsillitis syndrome show фагоцитарной защиты (КФЗ) дает significant increase of integral RPP parameters, возможность определить состояние i.e. decrease of RPP, which is more pronounced неспецифической адаптации у детей с 285 The Federal State Budgetary Education Institution of Higher Education the Samara State Medical University of the Ministry of Healthcare of the Russian 286 The Federal State Budgetary Education Institution of Higher Education the Samara State Medical University of the Ministry of Healthcare of the Russian 287 The Federal State Budgetary Education Institution of Higher Education the Samara State Medical University of the Ministry of Healthcare of the Russian 288 The Federal State Budgetary Education Institution of Higher Education the Samara State Medical University of the Ministry of Healthcare of the Russian 289 The Federal State Budgetary Education Institution of Higher Education the Samara State Medical University of the Ministry of Healthcare of the Russian 290 The Federal State Budgetary Education Institution of Higher Education the Samara State Medical University of the Ministry of Healthcare of the Russian 291 Federation, Samara, Russia.The Federal State Autonomous Education Institution of Higher Training the First Sechenov Moscow State Medical University under Ministry of Health of the Russian Federation (Sechenovskiy University) 292 Kazan Federal University, Kazan, Russia Encuentre este artículo en http://www.udla.edu.co/revistas/index.php/amazonia-investiga o www.amazoniainvestiga.info ISSN 2322- 6307 Plakhotnikova, S.V., Santalova, G.V., Gasilina, E.S., Zhirnov, V.A., Davydkin, I.L., Osadchuk, A.M., Osadchuk, M.A., Trushin, M.V. /Vol. 8 Núm. 22: 649 - 657/ Septiembre - octubre 2019 650 on discharge (on admission - in 57% of children, острыми инфекционными заболеваниями, on discharge - in 87%). The most unfavourable ассоциированными с синдромом тонзиллита. initial nonspecific adaptative body response У детей с синдромом тонзиллита отмечается (NABR) (according to the percentage of достоверное повышение интегральных lymphocytes) is the reaction of increased показателей РПП, т. е. снижение РПП, activation, as it is associated with the transition to которое более выражено при выписке (при the overactivation by the time of discharge (37% поступлении - у 57% детей, при выписке - у of children). Systemic multiple factor analysis 87%). Наиболее неблагоприятной исходной determined which peripheral blood parameters неспецифической адаптационной реакцией have more influence on children’s adaptation организма (по проценту лимфоцитов) during the course of infectious disease: RPP является реакция повышенной активации, так indices showed high influence coefficients in all как она связана с переходом к diseases (CPD was the highest in bacterial гиперактивации к моменту выписки (37% infection - Рi 198.3; SILMP was the highest in детей). Системный многофакторный анализ viral infection - Рi 147.81; in mixed infection определил, какие показатели периферической CPD and SILMP were roughly the same - Рi – крови оказывают большее влияние на 107.25 and Рi - 78.11, respectively), which адаптацию детей в течение инфекционного proves the feasibility of RPP evaluation for заболевания: показатели РПП показали prognostic purposes in the treatment of this высокие коэффициенты влияния при всех category of patients. заболеваниях, что доказывает целесообразность оценки РПП в Key words: Reactive-protective potential, прогностических целях при лечении данной lymphocytes, nonspecific adaptation, acute категории больных. infectious diseases, tonsillitis. Ключевые слова: реактивно-протективный потенциал, лимфоциты, неспецифическая адаптация, острые инфекционные заболевания, тонзиллит. Introduction Stress factors, which include acute infectious (Lebedev et al., 2017). Child’s body has processes, activate compensatory mechanism powerful compensatory mechanisms that are aimed at temporary maintenance of homeostasis responsible for his/her health condition, but their and formation of continuous adaptation [1]. capabilities are limited. If the development of Adaptation is considered as a complex of body adaptation does not begin within a certain period reactions that maintain its functional stability in of time, disadaptation forms, which can trigger case of environmental changes (Jones et al., the development of a disease (Lebedev et al., 2001; Gorban et al., 2016). The essence of 2017). Infectious diseases as a stress factor can adaptation is the ability of the body to change the be the cause of disadaptation (Santalova et al., intensity, rhythm and mode of all its processes 2017). It has been reported that severe cases can the way that all the main parameters of internal lead to immunodepression and even tumor environment are maintained within the development (Santalova et al., 2017). physiological limits despite of the influence of external factors (Procaccini et al., 2014). In this regard, it is important to evaluate both specific and nonspecific adaptative reactions of Reaction to stress has an important influence on the body in children as a response to acute the nature of its outcomes. The body is searching infectious process, including the one with for reaction mechanism that can help reach stable tonsillitis syndrome. Evaluation of the adaptive balance. If it is not possible, the resistance phase body responses can be performed considering the of adaptation syndrome turns into the exhaustion parameters of nonspecific adaptative body phase, which in severe cases can lead to death response (NABR), markers of which are specific (Jones et al., 2001; Gorban et al., 2016). During immune lymphocytic-monocytic potential the adaptation period, the immune system and all (SILMP), which reveals the ability of the body to its protective forces are activated, the immune respond to the nonshared antigens by producing sensitivity threshold lowers, and the child antibodies, and coefficient of cellular phagocytic actively starts to form natural immunity Encuentre este artículo en http://www.udla.edu.co/revistas/index.php/amazonia-investiga o www.amazoniainvestiga.info ISSN 2322- 6307 Vol. 8 Núm. 22/Septiembre - octubre 2019 651 defense (CPD), which shows the possible risk of according to the treatment guidelines for the breaking the resisting barrier by some infection. children’s infectious hospital (Group 2 – on admission, Group 3 - on discharge). Materials and methods Reference values of hemograms of healthy This prospective study included clinical, children from the National Guidelines for anamnestic and laboratory examination of Pediatrics ed. by Baranov A.A., 2015 were taken children with acute infectious diseases associated as control parameters for the evaluation of with tonsillitis syndrome. The research was NABR in children. The percentage of carried out in the 2nd Children’s infectious lymphocytes and reactive-protective potential department of the Samara City Hospital №5. (specific immune lymphocytic-monocytic potential (SILMP) and coefficient of cellular The main group included 100 children aged from phagocytic defense (CPD)) were determined. 3 to 7 years (48 girls and 52 boys) treated for the The types of adaptive responses according to the above-mentioned diseases. The mean age of percentage of lymphocytes were evaluated in children was 58.70±1.61 months. All the children correspondence with the reference values suffered from the moderate form of the disease. (Garkavi et al., 2012) (Table 1). The children of the main group were examined Table 1: Age-specific