Age-related characteristics of proteolytic enzymes in acute bronchial obstructions in children

Abstract

Introduction. Acute bronchial obstructions (ABO) in children remain one of the most frequent reasons for hospitalization in pediatric practice. The high prevalence, severity of clinical manifestations, and risk of developing chronic bronchopulmonary pathology make the problem extremely significant for modern medicine. Purpose of the study. To determine the role of proteolytic enzymes in the pathogenesis of acute bronchial obstructions in preschool and primary school children, as well as to evaluate the balance between neutrophilic elastase and α1 antitrypsin. Materials and methods. The study included 47 children with acute obstructive bronchitis. The patients were divided into two age groups: preschoolers (3-6 years, n=28) and schoolchildren (7-10 years, n=19). Clinical examination, laboratory determination of neutrophilic elastase (NE) and α1 antitripsin (α1 AT), as well as instrumental methods (spirometry, pulse oximetry, radiography) were performed. Results and Discussion. During the analysis conducted in children with acute bronchial obstructions, significant differences were identified in the activity of proteolytic enzymes and their inhibitor levels depending on age. In preschool children, the concentration of neutrophilic elastase (NE) was 188.6±5.77 ng/ml. In schoolchildren, NE levels were significantly lower at 159.4±8.79 ng/ml (15.5% lower, p≤0.05). α1-antitrypsin (α1AT) levels were elevated in both age groups. In preschool children, it was -3.72±0.275 g/l; while in school-age children, it was -3.29±0.119 g/l (p≤0.05). Conclusion. The obtained data demonstrate that the imbalance between proteolytic enzymes and their inhibitors is a universal mechanism for respiratory tract damage in childhood. Its severity determines the clinical features of the disease's course and can serve as a basis for developing new diagnostic markers and targeted therapeutic strategies.