rospedРоссийский педиатрический журнал имени М.Я. СтуденикинаM.Ya. Studenikin Russian Pediatric JournalФГАУ «НМИЦ здоровья детей» Минздрава России10.46563/1560-9561-2023-26-2-95-101sylbldrosped-17Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL INVESTIGATIONSИзменения микробиоты верхних дыхательных путей и кишечника при лечении острых респираторных инфекций у детей дошкольного возрастаChanges in the microbiota of the upper airways and intestine in the treatment of acute respiratory infections in preschool childrenhttps://orcid.org/0000-0003-3653-0938КурдюковаТатьяна ИвановнаKurdyukovaTatiana I.

Врач-педиатр, соискатель каф. факультетской и паллиативной педиатрии ВГМУ им. Н.Н. Бурденко

e-mail: tatuzya@yandex.ru 

MD, PhD student of the department of faculty and palliative pediatrics of the Voronezh State Medical University named after N.N. Burdenko of the Ministry of Health of the Russian Federation, Voronezh, 394036, Russian Federation

e-mail: tatuzya@yandex.ru 

tatuzya@yandex.ruhttps://orcid.org/0000-0001-7923-1845КрасноруцкаяОльга НиколаевнаKrasnorutskayaOlga N.

Доктор мед. наук, декан лечебного факультета ФГБОУ ВО ВГМУ им. Н.Н. Бурденко Минздрава России

e-mail: lech@vrngmu.ru

lech@vrngmu.ruhttps://orcid.org/0000-0002-4763-4153БугримовДаниил ЮрьевичBugrimovDaniil Yu.

Канд. мед. наук, доцент каф. патологической анатомии ФГБОУ ВО ВГМУ им. Н.Н. Бурденко Минздрава России

e-mail: danikst@mail.ru

danikst@mail.ruhttps://orcid.org/0000-0001-8641-2847ШевцовАртем НиколаевичShevtsovArtem N.

Канд. мед. наук, доцент каф. оперативной хирургии и топографической анатомии ФГБОУ ВО ВГМУ им. Н.Н. Бурденко Минздрава России

e-mail: shan-87@ya.ru

shan-87@ya.ruФГБОУ ВО «Воронежский государственный медицинский университет им. Н.Н. Бурденко» Минздрава РоссииVoronezh State Medical University named after N.N. Burdenko of the Ministry of Health of the Russian Federation20230908202323295101Copyright © Курдюкова Т.И., Красноруцкая О.Н., Бугримов Д.Ю., Шевцов А.Н., 20232023Курдюкова Т.И., Красноруцкая О.Н., Бугримов Д.Ю., Шевцов А.Н.Kurdyukova T.I., Krasnorutskaya O.N., Bugrimov D.Y., Shevtsov A.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rosped.ru/jour/article/view/17Введение

Введение. Микробиота верхних дыхательных путей и кишечника у детей дошкольного возраста непосредственно участвует в обеспечении защиты растущего организма от острых респираторных инфекций (ОРИ), которые являются самыми частыми инфекциями у детей, около 65% из них переходят в рекуррентные респираторные инфекции.

Цель

Цель: установить изменения микробиоты верхних дыхательных путей и кишечника при лечении ОРИ у детей дошкольного возраста.

Материалы и методы

Материалы и методы. В работе приняли участие 60 детей в возрасте 1–6 лет (медиана 3,38 года), относящихся к часто болеющим детям и распределённых на 3 группы в зависимости от выбранного лечения длительностью 90 сут: 30 детям проводилась коррекция питания; 20 детей получали дополнительно пробиотики; 20 детей получали как коррекцию питания, так и пробиотики. До начала лечения и после его завершения определяли состав микробиоты орофарингеальной зоны и кишечника методом генетического секвенирования региона V3–V4 гена 16S рибосомальной РНК с последующим биоинформатическим анализом.

Результаты

Результаты. Значимые различия выявлены преимущественно в относительном содержании Firmicutes в микробиоте больных, получавших лечение. Содержание Firmicutes в микробиоте детей, получавших пробиотики на фоне коррекции питания (30%), было значительно бóльшим, чем у больных с коррекцией питания (26,91%) и у детей, получавших только пробиотики (25,95%). У пациентов разных групп после лечения выявлено снижение содержания Proteobacteria в микробиоте орофарингеальной зоны. В микробиоте кишечника у 95% пациентов, получавших коррекцию питания и пробиотики, также установлено существенное уменьшение относительного содержания Bacteroidota (более чем в 3 раза), у 100% пациентов — также снижение Proteobacteria (более чем в 4,5 раза). У 85% пациентов выявлено значимое увеличение в микробиоте Firmicutes (с 21,97% до 30,07%), у 95% — повышение содержания Actinobacteriota (с 1,9% до 5,7%). Относительное содержание недифференцированной микробиоты после терапии также было значительно большим (70,08%), чем до лечения (58,40%) у 85% пациентов.

Участие авторов

Участие авторов:Красноруцкая О.Н., Курдюкова Т.И. — концепция и дизайн исследования; Курдюкова Т.И., Бугримов Д.Ю., Шевцов А.Н. — сбор и обработка материала; Курдюкова Т.И. — статистическая обработка; Курдюкова Т.И., Красноруцкая О.Н. — написание текста; Красноруцкая О.Н., Бугримов Д.Ю., Шевцов А.Н. — редактирование.Все соавторы — утверждение окончательного варианта статьи, ответственность за целостность всех частей статьи.

Финансирование

Финансирование. Исследование не имело финансовой поддержки.

Конфликт интересов

Конфликт интересов. Авторы заявляют об отсутствии конфликта интересов.

Поступила 17

Поступила 17.02.2023Принята к печати 21.03.2023Опубликована 28.04.2023

Introduction

Introduction. The microbiota of the upper airways and intestine in preschool children is directly involved in protecting the growing body from acute respiratory infections (ARI), which are the most common infections in children, about 65% of them turn into recurrent respiratory infections (RRI). Aim. To establish changes in the microbiota of the upper airways and intestine in the treatment of ARI in preschool children.

Materials and methods

Materials and methods. The study involved sixty 1–6 year (Me = 3.38 years) frequently ill children. They were divided into 3 groups depending on the chosen treatment lasting 90 days. Children of group 1 (n = 20) underwent nutrition correction. Children of group 2 (n = 20) received additional probiotics. Children of group 3 (n = 20) received both nutritional correction and probiotics at the prescribed doses. Before and after treatment, the composition of the microbiota of the oropharyngeal zone and intestine was determined by genetic sequencing of the V3–V4 region of the 16S ribosomal RNA gene, followed by bioinformatic analysis.

Results

Results. Significant differences were found mainly in the relative content of Firmicutes in the microbiota of patients treated. The content of Firmicutes in the microbiota of children receiving probiotics against the background of nutrition correction (30%) was significantly higher than in patients with nutrition correction (26.91%) and in children receiving only probiotics (25.95%). In patients of different groups, after treatment, a decrease in the content of Proteobacteria in the microbiota of the oropharyngeal zone was revealed. A significant decrease in the relative content of Bacteroidota (by more than 3 times) in 95% of patients, and a decrease in Proteobacteria (by more than 4.5 times) in 100% of patients was also found in the intestinal microbiota of group 3 patients treated with probiotics. In addition, there was a significant increase in the Firmicutes microbiota from 21.97% to 30.07% in 85% of patients, and an increase in the content of Actinobacteriota from 1.9% to 5.7% in 95% of patients. The relative content of undifferentiated microbiota after therapy was also significantly higher (70.08%) than before treatment (58.40%) in 85% of patients.

Contribution

Contribution:Krasnorutskaya O.N., Kurdyukova T.I. — research concept and design of the study;Kurdyukova T.I., Bugrimov D.Yu., Shevtsov A.N. — collection and processing of material;Kurdyukova T.I. — statistical processing;Kurdyukova T.I., Krasnorutskaya O.N. — text writing;Krasnorutskaya O.N., Bugrimov D.Yu., Shevtsov A.N. — editing.All co-­authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Acknowledgment

Acknowledgment. The study had no sponsorship.

Conflict of interest

Conflict of interest. The authors declare no conflict of interest.

Received

Received: February 17, 2023Accepted: March 21, 2023Published: April 28, 2023

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The authors declare that there are no conflicts of interest present.