ПАТЕРН ІМУНОЛОГІЧНОГО ЗАХИСТУ У ДІТЕЙ ІЗ ГОСТРИМ СЕРЕДНІМ ОТИТОМ З УРАХУВАННЯМ АЛЕЛЬНОГО СТАНУ ГЕНА HSP70-2 (rs1061581)

Objective – to assess immune-haematological indices as integrative markers of cellular immune reactivity and nonspecific anti-infective defence in children with acute otitis media (AOM), taking into account the heat-shock protein gene polymorphism 70-2 (HSP70-2, rs1061581).Material and methods. This prospective cross-sectional "case-control" study included 95 children aged 7-18 years with diagnosed AOM (34.74% girls, 65.26% boys). The study adhered to Good Clinical Practice, Good Laboratory Practice, and international ethical standards. The control group comprised 50 healthy children (40% girls, 60% boys). Cellular and general immunological reactivity, resistance, and neutrophil responses were evaluated using complete blood counts and calculated integral indices. The HSP70-2 (rs1061581) gene polymorphism was studied by polymerase chain reaction method.Results. In children with AOM, the immunological defense pattern varies according to the allelic state of the HSP70-2 gene (rs1061581): GG-genotype carriers demonstrate higher levels of cellular and immunological reactivity and resistance, as well as more efficient activation of nonspecific cellular effector immunity (particularly lymphocytic responses), compared with mutant A-allele carriers. This enhanced cellular response is associated with a substantial reduction in the intoxication index by 32.82% (p=0.005), indicating more effective physiological apoptosis, compensatory cellular protection, the humoral immune response development, and increased immunological sensitization. Most indices of neutrophil reactive response did not show genotype-dependent HSP70-2 (rs1061581) differences.Conclusion. Immune protection in children with AOM and the mutant A-allele of HSP70-2 gene is predominantly mediated by monocyte-driven effector pathways, accompanied by a more pronounced inflammatory response, and lower cellular and overall immunological reactivity and resistance. These features contribute to a higher level of exogenous intoxication.