Carbocysteine Influence on Cough Severity and Local Mucosal Immunity in Acute Respiratory Viral Infections in Children

Aim: To evaluate the effect of carbocysteine on cough and the level of secretory immunoglobulin A (sIgA) in saliva in children with acute respiratory viral infections (ARVI) and the presence of a correlation between the level of sIgA in saliva and the total cough index. Design: Multicentre observational study. Materials and methods. 156 children older than 2 years (4.4 ± 1.2 years) with ARVI were included in the study. All patients received carbocysteine at the age dosage. The total cough index and the concentration of sIgA in saliva were measured on days 1–2 and on days 7–10 from the onset of ARVI. Results. The total cough index significantly decreased in 98.7% of patients by the 7–10th day of illness. The level of sIgA in saliva was initially 26.49 (8.94; 56.51) μg/ml, in dynamics — 30.07 (8.52; 60.40) μg/ml (no significant differences were found). An increase in the level of sIgA in dynamics was noted in 43.6% of patients, and in the vast majority of them the increase was significant — 20% or more. A decrease in the concentration of sIgA in dynamics was noted in 55.8% of patients. A significant correlation was found between sIgA concentrations in saliva at the first and second visits (p < 0,001). There was no significant correlation between the total cough index and sIgA levels. Conclusion. A significant positive dynamic of cough was noted in patients with ARVI during treatment with carbocysteine. The concentration of sIgA in saliva varies within a wide range. A multidirectional change in the level of sIgA in saliva over time was noted in children with ARVI. Further study of the mechanisms of local mucosal immunity can help in the development of new approaches to the treatment and prevention of ARVI. Keywords: carbocysteine, secretory immunoglobulin A in saliva, acute respiratory viral infections in children, cough, mucosal immunity.