Clinical significance of immunoprophylaxis of respiratory syncytial viral infection in premature children at early age

Objective. To estimate the clinical significance of immunoprophylaxis of RSV infection in premature infants of high-risk groups at an early age. Materials and methods. A prospective cohort study was conducted in young children depending on the presence of RSVI immunoprophylaxis (total n = 216). 2 main and 1 control group were formed: group 1 (n = 104) consisted of children who underwent courses of RSVI immunoprophylaxis (immunization "+"), group 2 (n = 97) included children without immunization (immunization "-"), control group (healthy children, n = 15). Clinical and anamnestic methods included: perinatal history, incidence of acute respiratory diseases (ARD), incidence of cases of bronchial obstruction; laboratory methods were used to identify biomarkers of lung tissue remodeling (total n = 77, group 1/n = 44 and group 2/n = 33): matrix metalloproteinases-2 and 9 (MMP-2, MMP-9), tissue inhibitor of matrix metalloproteinase-2 (TIMMP-2); vascular endothelial growth factor (VEGF) (total n = 92, group 1/n = 44, group 2/n = 33, control/n = 15); echocardiography (Echo-CG) was used as an instrumental non-invasive method to exclude the diagnosis of pulmonary hypertension. Results. RSV immunoprophylaxis in the 1st year of life has demonstrated a decrease in the incidence of acute respiratory diseases (p 0.024) and a reduced risk for bronchial obstruction (p 0.033) and pneumonia (p 0.079) at the age of 1–3 years. The lack of RSVI immunoprophylaxis contributes significantly to the development of cases of bronchial obstruction (AP = 46 %) in the early age period. The association between the levels of biomarkers of pulmonary tissue remodeling in the blood serum with the frequency of episodes of bronchial obstruction at the age of 1–3 has been proved. Conclusions. The use of monoclonal antibodies in children at risk for developing RSV bronchiolitis reduces the incidence of ARD, episodes of bronchial obstruction in the early age period. There was a direct association between the incidence of bronchial obstruction and levels of MMR-9, TIMMP-2 and VEGF-D in the blood serum of children aged 1–3 years depending on immunoprophylaxis.