Background Community-acquired pneumonia is one of the most studied pathologies of childhood, while the problem of diagnostics the disease severity still remains.
Aim To increase the effectiveness of diagnostics the severity of community-acquired pneumonia in infants by studying the processes of neutrophils’ apoptotic activity and oxidative stress.
Methods The study involved 73 infants with community-acquired pneumonia (moderate severity of disease was diagnosed in 44 children (I group); severe pneumonia – in 29 (II group)) and 23 healthy children of the control group. The intensity of neutrophils’ apoptosis and necrosis was determined by flow cytometry, the generation of superoxide anion (O2 -) – by spectrophotometric method, reactive oxygen species (ROS) – by fluorometric method.
Results The intensive growth of neutrophils’ apoptosis was revealed in infants with community-acquired pneumonia of moderate severity (pc-1 <0.001), while necrosis prevailed in severe pneumonia (pc-2 <0.001).
The oxidative stress indicators correlated with disease severity. ROS generation indices in infants of I group – 17.23 (16.29; 18.73) RFU·ml-1, II group – 24.11 (21.23; 25.75) RFU·ml-1, pc-1 <0.001, pc-2 <0.001; O2 - – 1.13 (1.06; 1.14) nmol·(min·mL)-1 and 1.41 (1.33; 1.49) nmol·(min·mL)-1 accordingly, pc-1 <0.001, pc-2 <0.001.
The method of multiple regression analysis showed, that lowering of saturation in infants with severe pneumonia for 33.8% is interrelated with the changes of neutrophils’ apoptosis and necrosis, determined by the determination index, and confirm the diagnostic value of apoptotic activity.
Conclusion The oxidative stress indicators allow to determine the community-acquired pneumonia severity in infants, and intensification of neutrophils’ necrosis with simultaneous inhibition of apoptotic activity is an accurate criterion of severe pneumonia.