IMMUNOMODULATORY THERAPY USING SODIUM DEOXYRIBONUCLEATE AND THE OROPHARYNGEAL MICROBIOTA IN CHILDREN AGED 1 TO 6 YEARS OLD WITH RECURRENT RESPIRATORY INFECTIONS

Respiratory infections are one of the leading diseases currently and almost 2/3 of these infectious processes occur in childhood. The pathogenesis of recurrent respiratory infections is based on the failure of the links of the immune system, mainly caused by a violation of the immune homeostasis of the mucous membranes of the nasopharynx and oropharynx. The purpose of this research was to determine the effect of the immunomodulatory therapy using sodium deoxyribonucleate on the microbiota of the oropharynx in children with recurrent respiratory infections. A single-center randomized placebo-controlled closed experimental study was performed in 90 pediatric patients with recurrent respiratory infections aged 1 to 6 y/o in May 2021-Nov. 2021 on the basis of the private medical center “Center for Modern Pediatrics” located in Voronezh, Russia. The main group consisted of 46 (23 boys and 23 girls aged 4 [3; 5] y/o) who had been given the sodium deoxyribonucleate drug nasally for 30 days. The control group of 44 (22 boys and 22 girls aged 4 [3; 5] y/o) had been given a placebo (a sterile 0.1% sodium chloride fluid) according to the same prescription scheme. The concentration of secretory immunoglobulin was determined by the enzyme immunoassay; the composition of the microbiota was studied by the genetic sequencing of the 16S ribosomal RNA gene. All of the participants in both groups were examined twice: at the start of the study and 90 days after. A statistically significant decrease in the relative amount of Proteobacteria and an increase in the relative amount of Firmicutes and Actinobacteriota, an increase in the concentration of sIgA was found against the background of the use of the drug, which in tis turn indicates an increase in the activity of mucosal immunity (p<0.001). Conclusion: thus, the use of sodium deoxyribonucleate in children aged 1 to 6 years old with recurrent respiratory infections leads to a statistically significant decrease in the relative amount of Proteobacteria and an increase in the relative amount of Firmicutes and Actinobacteriota in the oropharynx; increased activity of mucosal immunity, as evidenced by an increase in the concentration of sIgA.