Virus-induced asthma exacerbations in children: efficiency and tolerability of the «Esberitox» medication

Authors

  • T. R. Umanets SI «Institute of Pediatrics, Obstetrics and Gynecology named of academician O.M. Lukyanova NAMS of Ukraine», Kyiv, Ukraine https://orcid.org/0000-0001-9058-7383
  • V. F. Lapshyn SI «Institute of Pediatrics, Obstetrics and Gynecology named of academician O.M. Lukyanova NAMS of Ukraine», Kyiv, Ukraine https://orcid.org/0000-0003-1896-1865
  • L. S. Stepanova SI «Institute of Pediatrics, Obstetrics and Gynecology named of academician O.M. Lukyanova NAMS of Ukraine», Kyiv, Ukraine https://orcid.org/0000-0001-7296-849X
  • A. A. Rudnev SI «Institute of Pediatrics, Obstetrics and Gynecology named of academician O.M. Lukyanova NAMS of Ukraine», Kyiv, Ukraine
  • A. A. Buratynska SI «Institute of Pediatrics, Obstetrics and Gynecology named of academician O.M. Lukyanova NAMS of Ukraine», Kyiv, Ukraine https://orcid.org/0000-0003-3790-0419
  • O. I. Pustovalova SI «Institute of Pediatrics, Obstetrics and Gynecology named of academician O.M. Lukyanova NAMS of Ukraine», Kyiv, Ukraine https://orcid.org/0000-0002-6908-6688

DOI:

https://doi.org/10.15574/PP.2020.81.64

Keywords:

bronchial asthma, viral infection, children, «Esberitox»

Abstract

Purpose — to assess the effectiveness and tolerability of «Esberitox» in children with asthma and acute respiratory viral infections.
Patients and methods. 34 children aged 6–14 years with asthma of varying severity and acute respiratory viral infection were examined, which were divided into two groups by simple randomization. Children of the main group (n=20) received treatment in accordance with GINA (2019) and additionally «Esberitox» at an age dosage for 10 days. The children of the comparison group (n=14) were given symptomatic treatment (antipyretic, nasal and local antiseptic drugs) and basic therapy. The criteria for the effectiveness of the treatment were: regression of the symptoms of catarrh of the upper respiratory tract, dynamics of local immunity (immunoglobulins and saliva lysozyme, expression of CD56+ cells in a smear from the nasal mucosa and tonsils, number of macrophages in induced sputum), number of children with exacerbation of asthma.
Results. The use of «Esberitox» in the complex treatment of the examined children contributed to: regression of the symptoms of catarrh of the upper respiratory tract by 3–5 days compared with the persistence of symptoms in children of the comparison group); increase in the number of expressing CD 56+ cells in the nasal mucosa and tonsils, sIgA and lysozyme in saliva, macrophages in induced sputum; reducing the risk of exacerbation of bronchial asthma (no exacerbations in 65.0% of children in the main group and 35.7% of the comparison group). When prescribing «Esberitox» no adverse reactions.
Conclusions. The clinical efficacy and high safety profile of «Esberitox» in children with asthma and acute respiratory infections allows it to be recommended for the treatment and prevention of virus-induced exacerbations of bronchial obstructive diseases in children.
The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of this Institute. The informed consent of the patient was obtained for conducting the studies.
No conflict of interest were declared by the authors.

References

Antypkin YuH ta in. (2011). Pat No. 67055. MPK (2011.01) A61V10/00 Sposib diahnostyky zapalnykh zmin dykhalnykh shliakhiv u ditei z zakhvoriuvanniamy orhaniv dykhannia. No. 2011 09545 vid 29.07.2011, zaiavl. 29.07.11; opubl. 25.01.12, Biul. No. 2.

Antypkin YuG, Chumachenko NG, Umanets TR, Lapshyn VF. (2016). Analysis of morbidity and prevalence of bronchial asthma among children from different age groups and regions in Ukraine. Perinatologiya i pediatriya. 1(65): 95-99.  doi 10.15574/PP.2016.65.95

Kurchenko AI, Svidro OV, Savchenko VS. (2018). Vplyv esberitoksu in vitro na tsytokinoprodukuiuchu zdatnist mononukleariv peryferychnoi krovi pry herpesvirusnii infektsii. Imunolohiia ta alerholohiia: nauka i praktyka. 1-2: 55-62.

Maydannik VG, Emchinskaya EA, Troitskaya IV. (2015). Effektivnost primeneniya rastitelnyih immunomodulyatorov pri zabolevaniyah respiratornogo trakta. Mizhnarodnyi zhurnal pediatrii, akusherstva i hinekolohii. 8; 1: 124-132.

Maidannyk VH. (2017). Zastosuvannia ta efektyvnist preparatu roslynnoho pokhodzhennia pry respiratornii patolohii u ditei. Mizhnarodnyi zhurnal pediatrii, akusherstva i hinekolohii. 11; 3: 85-91.

Gavala M, Bashir Y, Gern J. (2013). Virus-allergen interaction in asthma. Curr Allergy Asthma Rep. 13: 298-307. https://doi.org/10.1007/s11882-013-0344-1; PMid:23475539 PMCid:PMC3662249

Gorska MM. (2017, Feb). Natural killer cells in asthma Curr Opin Allergy Clin Immunol. 17 (1): 50-54. https://doi.org/10.1097/ACI.0000000000000327; PMid:27841766 PMCid:PMC5495007.

Green RJ. (2015). The interaction between respiratory allergies and infection. Current Allergy and Clinical Immunology. 28 (3): 154-158.

Hentschel C, Schnitker J, Kohnen R, Kohler G, Lindhauer I, Henneicke von Zepelin HH. (2000, Mar 2). Phytotherapeutic drugs for the common cold. Results of a randomized controlled double-blind study MMW Fortschr Med. 142 (9): 46.

Hewitt R, Farne H, Richie A et al. (2016). The role of viral infections in exacerbations of chronic obstructive pulmonary disease and asthma. Therapeutic Advances in Respiratory Disease. 10 (2): 158. https://doi.org/10.1177/1753465815618113; PMid:26611907 PMCid:PMC5933560

Jartti T, Gern JE. (2017, Oct). Role of viral infections in the development and exacerbation of asthma in children. J Allergy Clin Immunol. 140 (4): 895-906. https://doi.org/10.1016/j.jaci.2017.08.003; PMid:28987219 PMCid:PMC7172811.

Kaiko GE, Phipps S, Angkasekwinai P, Dong C, Foster PS. (2010, Oct). NK cell deficiency predisposes to viral-induced Th2-type allergic inflammation via epithelial-derived IL-25. J Immunol. 185 (8): 4681-4690. https://doi.org/10.4049/jimmunol.1001758; PMid:20855881. Epub 2010 Sep 20.

Kurai D, Saraya T, Ishil H, Takixawa H. (2013). Virus-induced exacerbations in asthma and COPD. Fronters in Microbiology. 4: 1-9. https://doi.org/10.3389/fmicb.2013.00293; PMid:24098299 PMCid:PMC3787546

Lunding L, Wegmann M. (2015, Aug 21). NK cells in asthma exacerbation Oncotarget. 6 (24): 19932-19933. https://doi.org/10.18632/oncotarget.4841; PMid:26296976 PMCid:PMC4652962

Mathias CB. (2015, Feb). Natural killer cells in the development of asthma Curr Allergy Asthma Rep. 15 (2): 500. https://doi.org/10.1007/s11882-014-0500-2; PMid:25504264.

Mikhail I, Grayson MH. (2019, Oct). Asthma and viral infections: An intricate relationship. Ann Allergy Asthma Immunol. 123 (4): 352-358. https://doi.org/10.1016/j.anai.2019.06.020; PMid:31276807 PMCid:PMC7111180. Epub 2019 Jul 2.

Naser B, Lund B, Henneicke von Zepelin HH, Kohler G, Lehmacher W, Scaglione F. (2005, Nov). A randomized, double-blind, placebo-controlled, clinical dose-response trial of an extract of Baptisia, Echinacea and Thuja for the treatment of patients with common cold. Phytomedicine. 12 (10): 715-722. https://doi.org/10.1016/j.phymed.2005.03.002; PMid:16323289

National institutes of health. National Heart, lung and Blood Institute. (2019). Global strategy for asthma management and prevention. URL: http://www.ginasthma.org.

Okayama Y. (2013, Aug 27). Cellular and humoral immunity of virus-induced asthma. Front Microbiol. 4: 252. https://doi.org/10.3389/fmicb.2013.00252; PMid:23986756 PMCid:PMC3753555. eCollection 2013.

Oliver BG, Robinson P, Peters M, Black J. (2014, Dec). Viral infections and asthma: an inflammatory interface? Eur Respir J. 44 (6): 1666-1681. https://doi.org/10.1183/09031936.00047714; PMid:25234802. Epub 2014 Sep 18.

Papadopoulos NG, Christodoulou I, Rohde G et al. (2011). Viruses and bacteria in acute asthma exacerbations – A GA2LEN-DARE systematic review. Allergy. 66: 458-468. https://doi.org/10.1111/j.1398-9995.2010.02505.x; PMid:21087215 PMCid:PMC7159474

Papadopoulos NG, Xepapadaki P, Mallia P et al. (2007). Mechanism of virus-inducedd asthma exacerbation: state-of-the art. A GA2LEN and Inter Airways document. Allergy. 62: 457-470. https://doi.org/10.1111/j.1398-9995.2007.01341.x; PMid:17324199 PMCid:PMC7159480

Ramsahai JM, Hansbro PM, Wark PAB. (2019, Feb 15). Mechanisms and Management of Asthma Exacerbations. Am J Respir Crit Care Med. 199(4): 423-432. https://doi.org/10.1164/rccm.201810-1931CI; PMid:30562041.

Xepapadaki P, Papadopoulos NG. (2010, Aug). Childhood asthma and infection: virus-induced exacerbations as determinants and modifiers. Eur Respir J. 36 (2): 438-445. https://doi.org/10.1183/09031936.00149009; PMid:20675781.

Young J. (2014). Juhn Risks for Infection in Patients With Asthma (or Other Atopic Conditions): Is Asthma More Than a Chronic Airway Disease? J Allergy Clin Immunol. 134 (2): 247-257. https://doi.org/10.1016/j.jaci.2014.04.024; PMid:25087224 PMCid:PMC4122981