Specficics of the pro-antioxidant and antioxidant status in children with acute pneumonia, depending on the severity of the pathological process and the etiological factor

Background: In the recent years, an increasing number of researchers, in addition to the standard causes of a particular pathology’s development, have been paying attention to changes in the immune, pro-antioxidant, psychosomatic and other systemic factors. The processes occurring in the body with the participation of reactive oxygen species are general biological mechanisms of tissue damage and protection. Their role has been described and proven in a variety of nosologies. However, the number of studies evaluating the interaction of prooxidants with antioxidants in children with acute pneumonia is quite few.

Aims: Analysis of the pro-/antioxidant status in children with acute pneumonia, depending on the severity of the pathological process and the etiological factor.

Methods: The main group consisted of 50 patients with acute pneumonia, who were divided into 2 subgroups according to the severity of the disease course. The comparison group consisted of 30 conditionally healthy children. In addition to the list of examinations of children with acute pneumonia, according to the clinical practice guidelines, Imax, S, t values were assessed in the study groups by the method of luminol-dependent chemiluminescence (CL) of the blood plasma, depending on the severity of the pathological process and the etiological factor.

Results: After conducting a ROC analysis in children in the acute period of pneumonia, we established the threshold values of the pro-/antioxidant status parameters: at the Imax level ≤28.1%; S ≤26.2%; t ≤0.34 min. the examined children had a more severe course of pneumonia. When Mycoplasma pneumoniae, Chlamydophila pneumoniae were detected in the sputum, the level of the pro-/antioxidant status parameters was lower (Imax=28.0%, S=36.0%, t=0.37 min) than that in children who had Gram-negative bacteria or Gram-positive bacteria in the sputum (Imax=46.0%, S=45.0; t=0.42 min); p ≤0.05.

Conclusion: Violations of the pro-/antioxidant status were noted in all the children we examined. The most pronounced violations of the pro-/antioxidant status were detected in children with acute community-acquired severe pneumonia caused by atypical pathogens — M. pneumoniae, C. pneumoniae. In addition, the ROC analysis made it possible to determine the threshold values of the pro-/antioxidant status parameters for assessing the severity of pneumonia in children during the acute period of the disease.