Evaluation of indicators of immunity in long and sickly children in primary care

The authors have evaluated the immune status, the level of skin sensitivity to tuberculin in long and sickly children in primary care. It is stated that the main cause of frequent and long illness in children and adolescents are a chronic pathology of the naso - and oropharynx and the allergic diseases (bronchial asthma and atopic dermatitis). Pathogenetic basis of frequent and long respiratory infections are the changes in an immunological reactivity, i.e. reduction of phagocytosis, disorders of functional activity of T-lymphocytes, the ratio changes of helpers/suppressors, reduction of the level of cytotoxic lymphocytes. These changes are non-specific and mixed involve all parts of the immune system. Tuberculin sensitivity in the majority of children has postvaccinal character. There is anergy on the second or third years after vaccination. Apparently, the low sensitivity is an index of immune reactivity in fre-quently and long ill children and it has a low immune response to BCG vaccination. The group of long and sick-ly children can be considered to the risk of developing tuberculosis.

Download Full-text

Indicators of the Immune Status in Children after a New Coronavirus Infection

Acta biomedica scientifica ◽

10.29413/abs.2021-6.2.6 ◽

2021 ◽

Vol 6 (2) ◽

pp. 58-62

Author(s):

E. V. Moskaleva ◽

A. G. Petrova ◽

L. V. Rychkova ◽

E. A. Novikova ◽

A. S. Vanyarkinа

Keyword(s):

Immune Response ◽

Immune Status ◽

Respiratory Infections ◽

Study Groups ◽

Long Term Outcomes ◽

Humoral And Cellular Immunity ◽

Age Related ◽

Coronavirus Infection ◽

Reported Data

Background. The mechanism of the immune response in patients with COVID-19 is still poorly understood and differs from other respiratory infections. Immunodeficiencies and age-related characteristics of immunity can be regarded as factors influencing reinfection and a predisposition to prolonged persistence of SARS-CoV-2. Most of the studies report about post-infection immunity to SARS-CoV-2 for adults and less for children. However, understanding the dynamics of antibody production to SARS-CoV-2 among children as well as other unique features of immune response is extremely important, because this provides to avoid possible complications and long-term outcomes of COVID-19, and predict the epidemic spread of the new coronavirus in the organized groups of children such as kindergartens, schools, study groups and clubs.Aim: to evaluate the humoral and cellular immunity after SARS-CoV-2 infection in children.Materials and methods. We reported data of the first phase prospective cohort study of immunity among 60 children living in Irkutsk, Russia within a month after SARS-CoV-2 infection, which took place in October and November 2020.Results. Immunity of children one month after SARS-Cov-2 infection was characterized by suppressed cell-mediated and humoral immunity, and phagocytosis dysfunction. Reduced phagocytosis by neutrophils was noted for 61.6 % of individuals.Conclusions. Children after COVID-19 had impaired immunity to SARS-CoV-2, which may be a predictor of chronic infection and other long-term outcomes of COVID-19.

Download Full-text

Coronavirus disease 2019, allergic diseases, and allergen immunotherapy: Possible favorable mechanisms of interaction

Allergy and Asthma Proceedings ◽

10.2500/aap.2021.42.210013 ◽

2021 ◽

Vol 42 (3) ◽

pp. 187-197

Author(s):

Désirée E. Larenas-Linnemann ◽

José A. Ortega-Martell ◽

María V. Blandón-Vijil ◽

Noel Rodríguez-Pérez ◽

Jorge A. Luna-Pech ◽

...

Keyword(s):

Immune Response ◽

Allergen Immunotherapy ◽

Respiratory Infections ◽

Clinical Manifestations ◽

Allergic Diseases ◽

Allergic Patient ◽

Human Immune System ◽

Human Immune ◽

The Moment ◽

Immune Changes

Background: Both, allergen immunotherapy (AIT) and SARS-COV-2 infection cause a set of immunologic changes that respectively vary during the course of the treatment or the disease. Objective: To review immune changes brought along by each of these entities and how they might interrelate. Methods: We start presenting a brief review of the structure of the new coronavirus and how it alters the functioning of the human immune system. Subsequently, we describe the immune changes induced by AIT and how these changes could be favorable or unfavorable in the allergic patient infected with SARS-CoV-2 at a particular point of time during the evolving infection. Results: We describe how a healthy immune response against SARS-CoV-2 develops, versus an immune response that is initially suppressed by the virus, but ultimately overactivated, leading to an excessive production of cytokines (cytokine-storm-like). These changes are then linked to the clinical manifestations and outcomes of the patient. Reviewing the immune changes secondary to AIT, it becomes clear how AIT is capable of restoring a healthy innate immunity. Investigators have previously shown that the frequency of respiratory infections is reduced in allergic patients treated with AIT. On the other hand it also increases immunoregulation. Conclusion: As there are many variables involved, it is hard to predict how AIT could influence the allergic patient's reaction to a SARS-CoV-2 infection. In any case, AIT is likely to be beneficial for the patient with allergic rhinitis and/or allergic asthma in the context of the SARS-CoV-2 pandemic as controlling allergic diseases leads to a reduced need for contact with healthcare professionals. The authors remind the reader that everything in this article is still theoretical, since at the moment, there are no published clinical trials on the outcome of COVID-19 in allergic patients under AIT.

Download Full-text

METABOLIC DETERMINANTS OF IMMUNE REACTIVITY

Vestnik of Russian military medical Academy ◽

10.17816/brmma12183 ◽

2017 ◽

Vol 19 (3) ◽

pp. 56-63

Author(s):

Dmitry A Vologzhanin ◽

Yuriy Sh Khalimov

Keyword(s):

Immune Response ◽

Immune System ◽

Immune Status ◽

Severe Trauma ◽

The State ◽

Immune Reactivity ◽

The Moment

As a result of the study of the dynamics of nutritional and immune status in patients with severe trauma in the first 30 days of the posttraumatic period, the interrelations between the parameters of metabolism and the immune system were revealed and the predominant influence of a number of nutrients on the state of the various type of immune response was revealed. Data were obtained indicating the change in the need for immunonutrients at different times from the moment of injury. Prospective approaches to nutritional immunocorrection in patients with trauma, consisting in the differential use of separate nutrients at different period after trauma, have been identified (9 figs, bibliography: 9 refs).

Download Full-text

Assessment of immune status in children with functional respiratory system disorders, living in aerogenic aluminium exposure zone

Perm Medical Journal ◽

10.17816/pmj36544-51 ◽

2019 ◽

Vol 36 (5) ◽

pp. 44-51

Author(s):

Oleg V. Dolgikh ◽

Inga N. Alikina ◽

Maxim A. Guselnikov

Keyword(s):

Respiratory System ◽

Immune Status ◽

Comparison Group ◽

Clinical Signs ◽

Allergic Diseases ◽

Receptor Expression ◽

Immune Reactivity ◽

Functional Reserves ◽

Specific Igg ◽

Differentiation Marker

Aim. To assess the immune status in children of primary school age with functional disorders of the respiratory system, who live in the territory with location of industrial enterprise, producing aluminium. Materials and methods. Fifty-two children aged 711 years with respiratory system disorders, who live in the zone of exposure of aluminium-producing enterprise were examined. Cellular differentiation marker CD127, protein Bcl-2 and TNFR receptor expression levels were identified using the method of flow cytometry. Phagocytic activity of the cells was studied using formalinized sheep erythrocytes; IgG content was determined with radial immunodiffusion method; beta2-microglobulin level with enzyme immunoassay. Functional status of respiratory system was assessed using spirometry, rhinomanometry methods but functional reserves with calculated Skibinskaya index. Results. The prevalence of allergic diseases in the examined children was 2,4 times higher and allergic rhinitis was diagnosed 3,2 times more often than in the group of comparison. The prevalence of bronchial asthma, clinical signs of chronic lympho-proliferative diseases reliably exceeded the level observed in children of comparison group (29.4 %, р = 0.001). There were established the changes in immune reactivity versus the comparison group, manifested by increase in percentage of phagocyting cells, beta2-microglobulin protein, IgG, CD127, TNFR and specific IgG to aluminium by 1.1, 1.2, 1.0, 1.7, 2.5 and 1.2 times, respectively; suppression of protein Bcl-2 expression by 2,6 times (p 0.05) was registered. Conclusions. Among children aged 711 years, who live in the territory with localized aluminium-producing enterprise, the diseases of respiratory organs with allergic component, reliably associated with aluminium compound contamination, were diagnosed more often than in children of comparison group. Immunologic study detected imbalance between humoral and cellular components of immunity: hyperproduction of specific IgG to aluminium, excess expression of proteins and beta2-microglobulin receptors, IgG, CD127, TNFR and deficit of Bcl-2.

Download Full-text

The beneficial helminth parasite?

Parasitology ◽

10.1017/s003118200500884x ◽

2005 ◽

Vol 132 (1) ◽

pp. 1-12 ◽

Cited By ~ 38

Author(s):

D. M. McKAY

Keyword(s):

Immune Response ◽

Immune Status ◽

Allergic Diseases ◽

Careful Analysis ◽

Epidemiological Studies ◽

Concomitant Disease ◽

Helminth Infections ◽

Comprehensive Knowledge ◽

Helminth Therapy ◽

Allergic Disorders

There is unequivocal evidence that parasites influence the immune activity of their hosts, and many of the classical examples of this are drawn from assessment of helminth infections of their mammalian hosts. Thus, helminth infections can impact on the induction or course of other diseases that the host might be subjected to. Epidemiological studies demonstrate that world regions with high rates of helminth infections consistently have reduced incidences of autoimmune and other allergic/inflammatory-type conditions. Here I review and assess the possible ways by which helminth infections can block or modulate concomitant disease processes. There is much to be learned from careful analysis of immuno-regulation in helminth-infected rodents and from an understanding of the immune status of acutely and chronically infected humans. The ultimate reward from this type of investigation will likely be a more comprehensive knowledge of immunity, novel ways to intervene in the immune response to alleviate autoimmune and allergic diseases (growing concerns in economically developed areas), and perhaps the development of helminth therapy for patients suffering from specific inflammatory, autoimmune or allergic disorders.

Download Full-text

145. Monthly Antibiotic Prescribing Peer Comparison Combined with In-person Education Decreases Antibiotic Prescribing for Acute Respiratory Infections

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.190 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S83-S83

Author(s):

Shelby J Kolo ◽

David J Taber ◽

Ronald G Washburn ◽

Katherine A Pleasants

Keyword(s):

Primary Care ◽

Respiratory Infections ◽

Primary Care Providers ◽

The United States ◽

Delivery Mode ◽

Antibiotic Prescribing ◽

Acute Respiratory Infections ◽

Care Providers ◽

Intervention Period ◽

Provider Education

Abstract Background Inappropriate antibiotic prescribing is an important modifiable risk factor for antibiotic resistance. Approximately half of all antibiotics prescribed for acute respiratory infections (ARIs) in the United States may be inappropriate or unnecessary. The purpose of this quality improvement (QI) project was to evaluate the effect of three consecutive interventions on improving antibiotic prescribing for ARIs (i.e., pharyngitis, rhinosinusitis, bronchitis, common cold). Methods This was a pre-post analysis of an antimicrobial stewardship QI initiative to improve antibiotic prescribing for ARIs in six Veterans Affairs (VA) primary care clinics. Three distinct intervention phases occurred. Educational interventions included training on appropriate antibiotic prescribing for ARIs. During the first intervention period (8/2017-1/2019), education was presented virtually to primary care providers on a single occasion. In the second intervention period (2/2019-10/2019), in-person education with peer comparison was presented on a single occasion. In the third intervention period (11/2019-4/2020), education and prescribing feedback with peer comparison was presented once in-person followed by monthly emails of prescribing feedback with peer comparison. January 2016-July 2017 was used as a pre-intervention baseline period. The primary outcome was the antibiotic prescribing rate for all classifications of ARIs. Secondary outcomes included adherence to antibiotic prescribing guidance for pharyngitis and rhinosinusitis. Descriptive statistics and interrupted time series segmented regression were used to analyze the outcomes. Results Monthly antibiotic prescribing peer comparison emails in combination with in-person education was associated with a statistically significant 12.5% reduction in the rate of antibiotic prescribing for ARIs (p=0.0019). When provider education alone was used, the reduction in antibiotic prescribing was nonsignificant. Conclusion Education alone does not significantly reduce antibiotic prescribing for ARIs, regardless of the delivery mode. In contrast, education followed by monthly prescribing feedback with peer comparison was associated with a statistically significant reduction in ARI antibiotic prescribing rates. Disclosures All Authors: No reported disclosures

Download Full-text

143. Initial Impact of COVID-19 on Ambulatory Antibiotic Prescribing for Respiratory Viral Infections

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.188 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S82-S82

Author(s):

Zahra Kassamali Escobar ◽

Todd Bouchard ◽

Jose Mari Lansang ◽

Scott Thomassen ◽

Joanne Huang ◽

...

Keyword(s):

Primary Care ◽

Viral Infections ◽

Respiratory Infections ◽

Urgent Care ◽

Antibiotic Prescribing ◽

Specific Rate ◽

Inclusion Criteria ◽

Diagnosis Codes ◽

Control And Prevention ◽

Viral Respiratory Infections

Abstract Background Between 15–50% of patients seen in ambulatory settings are prescribed an antibiotic. At least one third of this usage is considered unnecessary. In 2019, our institution implemented the MITIGATE Toolkit, endorsed by the Centers for Disease Control and Prevention to reduce inappropriate antibiotic prescribing for viral respiratory infections in emergency and urgent care settings. In February 2020 we identified our first hospitalized patient with SARS-CoV(2). In March, efforts to limit person-to-person contact led to shelter in place orders and substantial reorganization of our healthcare system. During this time we continued to track rates of unnecessary antibiotic prescribing. Methods This was a single center observational study. Electronic medical record data were accessed to determine antibiotic prescribing and diagnosis codes. We provided monthly individual feedback to urgent care prescribers, (Sep 2019-Mar 2020), primary care, and ED providers (Jan 2020 – Mar 2020) notifying them of their specific rate of unnecessary antibiotic prescribing and labeling them as a top performer or not a top performer compared to their peers. The primary outcome was rate of inappropriate antibiotic prescribing. Results Pre toolkit intervention, 14,398 patient visits met MITIGATE inclusion criteria and 12% received an antibiotic unnecessarily in Jan-April 2019. Post-toolkit intervention, 12,328 patient visits met inclusion criteria and 7% received an antibiotic unnecessarily in Jan-April 2020. In April 2020, patient visits dropped to 10–50% of what they were in March 2020 and April 2019. During this time the unnecessary antibiotic prescribing rate doubled in urgent care to 7.8% from 3.6% the previous month and stayed stable in primary care and the ED at 3.2% and 11.8% respectively in April compared to 4.6% and 10.4% in the previous month. Conclusion Rates of inappropriate antibiotic prescribing were reduced nearly in half from 2019 to 2020 across 3 ambulatory care settings. The increase in prescribing in April seen in urgent care and after providers stopped receiving their monthly feedback is concerning. Many factors may have contributed to this increase, but it raises concerns for increased inappropriate antibacterial usage as a side effect of the SARS-CoV(2) pandemic. Disclosures All Authors: No reported disclosures

Download Full-text