Recurrent respiratory tract infections in children are the most common cause of outpatient visits. Due to the necessity of treatment of chronic, frequent use of antibiotics and the dangers of complications are a major clinical problem. Big hopes are now with the possibility of the use of immunostimulation as prevention of these infections. The paper discusses the most important methods of stimulation of the immune system in children. In the light of previous reports were evaluated effects of this type of therapy.
Recurrent respiratory tract infections in children are the most common cause of outpatient visits. Due to the necessity of treatment of chronic, frequent use of antibiotics and the dangers of complications are a major clinical problem. Big hopes are now with the possibility of the use of immunostimulation as prevention of these infections. The paper discusses the most important methods of stimulation of the immune system in children. In the light of previous reports were evaluated effects of this type of therapy.
Natural killer (NK) cells provide the first line of defence against pathogens and tumors. Their activation status is regulated by pro-inflammatory cytokines and by ligands that either target inhibitory or activating cell surface receptors belonging to the immunoglobulin-like, C-type lectin or natural cytotoxicity receptor families. Apart from non-classical HLA-E, membrane-bound heat shock protein 70 (Hsp70) has been identified as a tumor-specific recognition structure for NK cells expressing high amounts of the C-type lectin receptor CD94, acting as one component of an activating heterodimeric receptor complex. Full-length Hsp70 protein (Hsp70) or the 14-mer Hsp70 peptide T-K-D-N-N-L-L-G-R-F-E-L-S-G (TKD) in combination with pro-inflammatory cytokines enhances the cytolytic activity of NK cells towards Hsp70 membrane-positive tumors. Based on these findings cytokine/TKD-activated NK cells were adoptively transferred in tumor patients. These findings were compared to results of clinical trials using cytokine-activated NK cells.
Recurring respiratory tract infections are typical of childhood. This results from the fact that children are exposed to pathogens, usually in groups of people, and from the immaturity of the immune system. Most upper and lower respiratory tract infections are caused by viruses. Nevertheless, antibiotics, which target bacteria, are often prescribed. Antibiotic overuse leads to increased microbial resistance to these drugs, resulting in their inefficacy. Improper treatment of respiratory infections with antibiotics ultimately leads to treatment failure. An increase in antibiotic resistance of many bacterial strains is becoming a serious global problem and makes treatment much more difficult. It is a responsibility of each physician to use antibiotics properly and implement adequate prevention of recurring respiratory tract infections. For many years, it has been attempted to find effective agents that improve immunity in children. The pharmaceutical market offers various preparations advertised as immunostimulants, such as bacterial lysates, vitamins, dietary supplements, probiotics or herbal, animal and homeopathic products. The role of immunomodulatory substances is to promote the immune system to fight pathogens, reduce the frequency of infections and decrease the demand for antibiotics. Unfortunately, most immunomodulators do not have sufficiently reliable clinical trials that would confirm their efficacy.
PL
Nawracające infekcje dróg oddechowych są typowe dla wieku dziecięcego. Wynika to z faktu narażenia dzieci na patogeny, szczególnie w zbiorowiskach, oraz z niedojrzałości systemu odpornościowego. Większość infekcji górnych i dolnych dróg oddechowych wywołana jest przez patogeny wirusowe. Pomimo to bardzo często w leczeniu zakażeń układu oddechowego stosowane są antybiotyki, zwalczające bakterie. Nadmierne stosowanie antybiotyków powoduje narastanie oporności drobnoustrojów na te leki, czego konsekwencją jest brak ich skuteczności. Niewłaściwe leczenie infekcji dróg oddechowych antybiotykami ostatecznie prowadzi do niepowodzenia leczenia. Wzrost antybiotykooporności wielu szczepów bakterii staje się dużym problemem w skali ogólnoświatowej i zdecydowanie utrudnia proces leczniczy. Zadaniem każdego lekarza jest rozsądne stosowanie antybiotyków i właściwa profilaktyka nawracających infekcji dróg oddechowych. Od lat trwają poszukiwania skutecznych środków poprawiających odporność u dzieci. Na rynku farmaceutycznym dostępne są liczne preparaty reklamowane jako immunostymulatory, takie jak lizaty bakteryjne, witaminy, suplementy diety, probiotyki czy też preparaty roślinne, odzwierzęce i homeopatyczne. Substancje immunomodulujące mają pobudzać układ odpornościowy do walki z patogenami, a także zredukować częstość infekcji oraz zmniejszyć zapotrzebowanie na antybiotyki. Niestety, większość preparatów immunomodulujących nie posiada dostatecznie wiarygodnych badań klinicznych potwierdzających ich skuteczność.
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