Influence of inhaled bacteriophage therapy on oral mucosal immunity in children with acute tonsillitis

Abstract

The study aimed to assess the effect of inhaled bacteriophage therapy on oral mucosal immunity in children with acute tonsillitis. Materials and methods.We examined 212 patients aged 4 to 15 years old with acute tonsillitis and 110 age-matched apparently healthy children. Research methods: calculating the Neutrophil to lymphocyte ratio (NLR), saliva diagnostics — secretory immunoglobulin A (sIgA) and the pro-inflammatory cytokine (TNFα). Taking into account the scheme of the treatment, the patients were divided into mutually comparable groups: the first group included patients with acute tonsillitis who received the standard generally accepted treatment depending on the clinical form of the pathology, without using bacteriophage therapy — n = 107 (50.5%), the second group — patients receiving a course of bacteriophage therapy — n = 105 (49.95%), nebulizer bacteriophage therapy using liquid complex pyobacteriophage (PCL) (Microgen, Russia) from the first days of the disease along with standard treatment.Results.During bacteriophage therapy, on the 6th day of treatment, an increased sIgA level up to 97.2% was observed particularly in younger and adolescent patients up to 97.2% (p ≤ 0.05). At the same time, this parameter reached 75.8% and 81.6%, respectively (p ≤ 0.05), in patients who received only standard treatment. The following difference between the two study groups was observed: between patients in the younger age subgroup — 21.4%, in the older age subgroup -16.1% (p ≤ 0.05 relative to control group), which indicates a more effective drug-related effect in patients from the younger age group groups. Similar changes are observed while analyzing level of the pro-inflammatory cytokine (TNFα). Conclusion.The use of inhaled bacteriophage therapy in the combination treatment of children with acute tonsillitis helps to shorten the period of general and local clinical manifestations of the disease by 1.4-fold and improve mean local immunity from 5.7% up to 16.1% (p ≤ 0.05).