CYTOKINE PROFILE IN CHILDREN WITH ULCERATIVE COLITIS

KOZHONAZAROVA G.K.

Key words:

CHILDREN, ULCERATIVE COLITIS, INTERLEUKINS, CYTOKINE PROFILE, PATIENTS

Abstract:

Introduction. Despite significant progress in the study of nonspecific ulcerative colitis in children, the current stage is characterized by the presence of a number of unresolved issues, including the ambiguity of etiology and pathogenesis. The problems of nonspecific ulcerative colitis in pediatric practice remain the difficulties of diagnosis, the severity of the course and features, difficulties in choosing a drug effect. The aim of the study was to investigate the cytokine profile in children with ulcerative colitis and, based on this, to develop a medical monitoring program. The study was conducted at the Gastroenterology department of the National Center for Maternal and Child Health. 30 children diagnosed with ulcerative colitis and 30 children with functional disorders of the digestive tract, serving as the control group, were examined. The levels of the following cytokines were determined: interleukins 1 (IL-1), 6 (IL-6), and tumor necrosis factor (TNFα), which belong to the proinflammatory group, and interleukin 4 (IL-4) from the group of anti-inflammatory cytokines The results obtained. Depending on the localization of inflammation, several subclasses of the disease are distinguished. Lesions of the lower parts of the large intestine were most often recorded, with 40.0% diagnosed as ulcerative proctitis and 46.7% as ulcerative proctosigmoiditis. At the initial stage of the disease, children who did not undergo treatment exhibited a pronounced inflammatory reaction, which, in addition to clinical symptoms, manifested as a change in the cytokine profile. In contrast, the control group of children with functional gastrointestinal disorders showed no changes in interleukins, both pro- and anti-inflammatory. After treatment, cytokine levels in some children remained above normal. Notably, IL-6 levels were elevated in the largest number of children (36.7%), followed by TNFα in 33.3% of patients, and IL-1 in 23.3% (P > 0.05). Additionally, IL-4 was elevated in 43.3% of children during treatment, indicating a favorable immune response to the disease (P > 0.05).

Conclusions. The cytokine profile data should be utilized to guide treatment adjustments, especially in the fundamental therapy of ulcerative colitis, aiming to prevent the earlier development of complicated forms of the disease