тел. +38 (044) 483-12-82

№4-6(7) 2024

Eng

DOI 10.37219/2528-8253-2024-4-6-7

Пухлік СМ, Запорожченко ПО

Сучасні аспекти лікування різних етіопатогенетичних варіантів хронічного назофарингіту 

Пухлік Сергій Михайлович
Одеський національний медичний університет
Зав. кафедрою оториноларингології, доктор медичних наук, професор.
E-mail: lor@te.net.ua
Orchid ID: http://orcid.org/0000-0001-7196-9642
https://www.scopus.com/authid/detail.uri?authorId=6506298353
Запорожченко Павло Олександрович
Одеський національний медичний університет
Аспірант кафедри оториноларингології
E-mail: 7770105@ukr.net
ORCID ID: http://orcid.org/0009-0009-4961-6571

СУЧАСНІ АСПЕКТИ ЛІКУВАННЯ РІЗНИХ ЕТІОПАТОГЕНЕТИЧНИХ ВАРІАНТІВ ХРОНІЧНОГО НАЗОФАРИНГІТУ

Пухлік СМ, Запорожченко ПО

Каф. оториноларингології Одеського національного медичного університету

E-mail: lor@te.net.ua

Анотація

Актуальність: Хронічне запалення глоткового мигдалика (ГМ) – поширене захворювання у дитячій популяції, що в тій чи іншій мірі визначається схильністю до збільшення у розмірі лімфоїдної тканини в анатомічно вузьких місцях, присутністю фонових станів і захворювань (персистуючої інфекції або осередків хронічного запалення), відхиленням в алергостатусі. Серед найбільш вагомих причин розвитку рекурентних респіраторних інфекцій (РРІ) та їх впливу на хронізацію запалення у педіатричних пацієнтів виділяють значну кількість респіраторних патогенів та легкість їх передачі, відсутність набутого імунного досвіду у дітей, які не відвідували закладів дошкільної освіти, формування лише типоспецифічного постінфекційного імунітету, наявність соматичної патології, функціональну незрілість імунної системи у дітей. Негативний вплив антибіотикотерапії загострень хронічного назофарингіту та його ускладнень на мікробіоту дитини, високий рівень коморбідності і запуск порочного кола у назофарингеальній зоні прискорює рішучість дій у напрямку профілактичного підходу до контролю частоти та тяжкості плину рецидивуючих та хронічних захворювань верхніх дихальних шляхів та вуха, зокрема хронічного назофарингіту (ХНФ), особливо в умовах високої алергізації сучасного дитячого організму.

Мета дослідження: На основі огляду сучасної літератури висвітлити етіопатогенетичну роль факторів імунного захисту носоглотки при ХНФ та деяких його ускладненнях у дітей в умовах коморбідності для поліпшення лікувально-профілактичних можливостей.

Висновки: Аналіз літературних джерел свідчить про актуальність на теперішній час проблеми корекції імунологічного статусу дитини як профілактичного засобу контролю захворюваності на РРІ та хронізації запалення елементів лімфоепітеліального кільця, яка визначається як переважна проблема дитячого віку зі сталими показниками захворюваності і можливістю розвитку ускладнень. При тому, що вроджений імунітет теоретично забезпечує захист верхніх дихальних шляхів та вуха від патогенів практично на всіх рівнях, включаючи молекулярний, мультифакторний характер етіопатогенезу і коморбідність сприяють формуванню безлічі клінічних варіантів перебігу ХНФ, що знижує ефективність застосування уніфікованих підходів. Недоліком досліджень по проблемі слід визнати недостатню увагу визначенню особливостей перебігу ХНФ у дітей без гіпертрофії ГМ і вплив супутньої патології назофарингеальної зони. Крім того, як свідчать літературні дані, успішний імунний захист, в свою чергу, залежить від вчасного і достатньо сильного включення певного механізму або фактору. Це тим більш важливо, що створення штучного імунного захисту у дитини-атопіка і неадекватна за силою імунна ланка здатна викликати або підтримувати протилежний прозапальний ефект. Тому, за відсутності «золотого стандарту» лікування ХНФ і ризику розробки алгоритмів з присутністю хірургічного фактору, дослідження профілактичного напрямку консервативного лікування ХНФ і його ускладнень у дітей є актуальним.

Ключові слова: хронічний назофарингіт, аденоїдит, алергічний риніт, гіпертрофія глоткового мигдалика, імунокорекція, консервативне лікування, рецидивуючі респіраторні інфекції, риносинусит.

Завантажити .PDF

Література

  1. Bowers I, Shermetaro C. Adenoiditis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan. https://pubmed. ncbi.nlm.nih.gov/30725616/.
  2. Mandapathil M, Beier UH, Graefe H, Kröger B, Hedderich J, Maune S, Meyer JE. Differential chemokine expression patterns in tonsillar disease. Acta Otorhinolaryngol Ital. 2018 Aug;38(4):316-322. doi: 10.14639/0392-100X-1743.
  3. Zhou CJ, Mo LH, Luo XQ, Yang G, Diao WL, Hu SP, Yang PC. Identification of antigen-specific neutrophils in the tonsils with recurrent acute inflammation. 2020 Aug;53(5):237-244. doi: 10.1080/08916934.2020.1777284.
  4. Laiko AA, Zabolotnyi DI, Kosakovskyi AL, Tkalina AV, Laiko VA, Shukh LA. [Adenoid vegetations and adenoids]. Kyiv: Logos; 2006. 171 p. [In Ukrainian].
  5. Kosakivska IA. [Difficulties in diagnosing adenoid vegetation in children]. Suchasna pediatrii︠a︡. 2018;(5):11-13. [Article in Ukrainian].
  6. Kosakovskyi AL, Havrylenko YuV. [Modern approach to the treatment of acute and chronic adenoiditis in children]. Ukraïnskyĭ medychnyĭ chasopys. 2014;(2):71-5. [Article in Ukrainian].
  7. Ikramova FS. Treatment of Chronic Adenoiditis in Children. International Journal of Integrative and Modern Medicine. 2023;1(2):61-65.
  8. Bezchaposhny SB, Gasyuk YA, Smeyanov EV. [Hyperplasia and inflammation of the pharyngeal tonsil]. Kyiv: Logos; 2017. 123 p. [In Russian].
  9. Leta OI, Koshel IV. [The state of the nasopharyngeal microbiome in healthy individuals and patients with chronic nasopharyngitis]. 2022;5(6):57-65. doi: 10.37219/2528-8253-2022-6-57. [Article in Ukrainian].
  10. Bogomilsky MR, Harashchenko TI, Shishmareva EV. [Elimination therapy in the treatment of adenoids in children with acute sinusitis]. Clinical immunology, allergology, infectology. 2010;(1): 55-58. [Article in Russian].
  11. Bogomilsky MR. [Adenoids]. Bulletin of Otorhinolaryngology. 2013;(3):61-64. [Article in Russian].
  12. Neyvirt EG. [Therapy of chronic adenoiditis in children with allergic rhinitis] [dissertation]. Kiev, Ukraine: State Institution «O.S. Kolomiychenko Institute of otolaryngology of National academy of medical sciences of Ukraine»; 2004. [In Ukrainian].
  13. Golubovska OA, editor. [Infectious diseases: textbook]. Kyiv: Medicine; 2014. 784 p. [In Russian].
  14. Zabolotny DI, Melnikov OF, Tymchenko SV, Zabolotna DD, Faraon IV, Vakhnina HP, Pain BN. [Pathophysiological basis of increasing the anti-infective resistance of the mucous membrane of the respiratory tract]. Zhurnal ushnyh, nosovyh i gorlovyh boleznej. 2018;(5-с):34. [Article in Ukrainian].
  15. Abaturov OE, Tokareva NM. [Effectiveness of treatment of respiratory viral diseases in children using bacterial lysates]. Child’s health. 2015;60(1):21-24. [Article in Ukrainian].
  16. Yurochko F, ​​Kopanska D. [Modern diagnosis and treatment of adenoid diseases]. Zdorov’ya Ukrayini. 2021;60(4). https://health-ua.com/diagnostics/xvorobi-organiv-dixannia/67281-suchasna-dagnostika-talkuvannya-hvorob-adenodv. [Article in Ukrainian].
  17. Lezhenko GA, Abaturov AE, Pashkova OE. [The role of endogenous antimicrobial peptides in bacterial colonization of the nasopharynx in children with retronasal tonsil hyperplasia]. Child’s health. 2016;(6):74-81 [Article in Ukrainian].
  18. Pasteur EU, editor. Immunology (selected sections). Educational and scientific center “Institute of biology and medicine” [Internet]. Available from: https://biomed.knu.ua/institute-activity/educational/kafedry/kafedra-microbiology-and-immunology/biblioteka/2300-imunologiya-vibrani-rozdili-avtori-vershigora-a-yu-paster-e-u-kolibo-d-v-ta-in.html.
  19. Weinstock J, Chen XX, Nino G, Koumbourlis A, Rastogi D. The interplay between airway epithelium and the immune system – A primer for the respiratory clinician. Paediatr Respir Rev. 2021 Jun;38:2-8. doi: 10.1016/j.prrv.2021.03.002.
  20. Thompson MR, Kaminski JJ, Kurt-Jones EA, Fitzgerald KA. Pattern recognition receptors and the innate immune response to viral infection. Viruses. 2011 Jun;3(6):920-40. doi: 10.3390/ v3060920.
  21. Ressing ME, van Gent M, Gram AM, Hooykaas MJG, Piersma SJ, EJHJ Wiertz. Immune Evasion by Epstein-Barr Virus. Curr Top Microbiol Immunol. 2015:391:355-81. doi: 10.1007/978-3-319-22834-1_12.
  22. Parker D, Prince A. Innate immunity in the respiratory epithelium. Am J Respir Cell Mol Biol. 2011 Aug;45(2):189-201. doi: 10.1165/rcmb.2011-0011RT.
  23. Luke NR, Jurcisek JA, Bakaletz LO, Campagnari AA. Contribution of Moraxella catarrhalis type IV pili to nasopharyngeal colonization and biofilm formation. Infect Immun. 2007 Dec;75(12):5559-64. doi: 10.1128/IAI.00946-07.
  24. Cao C, Xu Y. [The correlation between adenoid hypertrophy and allergic rhinitis]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2019 Apr;33(4):381-384. doi: 10.13201/j.issn.1001-1781.2019.04.023. [Article in Chinese].
  25. Byars SG, Steams SC, Boomsma JJ. Association of Long-Term Risk of Respiratory, Allergic, and Infectious Diseases with Removal of Adenoids and Tonsils in Childhood. JAMA Otolaryngol Head Neck Surg. 2018 Jul;144(7):594-603. doi: 10.1001/jamaoto.2018.0614.
  26. Ressing ME, van Gent M, Gram AM, Hooykaas MJG, Piersma SJ, Wiertz EJHJ. Immune Evasion by Epstein-Barr Virus. Curr Top Microbiol Immunol. 2015:391:355-81. doi: 10.1007/978-3-319-22834-1_12.
  27. Rajeshwary A, Rai S, Somayaji G, Pai V. Bacteriology of symptomatic adenoids in children. N Am J Med Sci. 2013 Feb;5(2):113-8. doi: 10.4103/ 1947-2714.107529.
  28. Melnikov O.F, Zabolotny D.I, Zabolotnaya D.D, Bredun A.Y, Rylskaya J.G, Peleshenko N.A, Timchenko M.D, Pharaon I.V [Immunodiagnosis, immunotherapy and immunoprophylaxis in the otolaryngology clinic. Indicators of local immunity in assessing the clinical and laboratory status of patients with inflammatory ENT diseases]. Otorhinolaryngology. 2021;4(1):4-13. doi: 10.37219/2528-8253-2021-1-04. [Article in Russian].
  29. Bredun OYu, Melnikov OF. [Immunomorphological correlations in the pathology of the tonsils in children]. Zhurnal ushnyh, nosovyh i gorlovyh boleznej. 2017;(5-s):13. [Article in Ukrainian].
  30. Starnbach MN. The well-evolved pathogen. Curr Opin Microbiol. 2020 Apr:54:33-36. doi: 10.1016/j.mib.2020.01.004.
  31. Schilcher K, Horswill AR. Staphylococcal Biofilm Development: Structure, Regulation, and Treatment Strategies. Microbiol Mol Biol Rev. 2020 Aug 12;84(3):e00026-19. doi: 10.1128/MMBR. 00026-19.
  32. de Jong NWM, van Kessel KPM, van Strijp JAG. Immune Evasion by Staphylococcus aureus. Microbiol Spectr. 2019 Mar;7(2). doi: 10.1128/ microbiolspec.GPP3-0061-2019.
  33. Melnikov OF, Zabolotnaya DD. [Modern approaches to conservative therapy of chronic tonsillitis (clinical and immunological aspects)]. Kiev; 2012. 80 p. [In Russian].
  34. Melnikov OF, Timchenko MD, Zabolotna DD, Bredun AYu, Rylskaya OG. [Comparative study of the content of secretory immunoglobulin A in the oropharyngeal secretion and blood serum of people, carried out by various methods and reagents]. Immunology and allergology: science and practice. 2013;(2):88-91. [Article in Russian].
  35. Melnikov OF, Bredun AYu, Lyubarets SF, Zayats TA, Vakhnina AP, Rylskaya OG, et al. [Determination of immune complexes and immunoglobulins in oropharyngeal secretion in norm and in inflammatory pathologies in the nasopharynx and oropharynx as criteria for the state of local immunity]. Immunology and allergology: science and practice. 2015;(2):87-90. [Article in Russian].
  36. Melnikov OF, Zabolotnyi DI, Kishchuk VV, Bredun AYu, Rylskaya OG. [Immunology of chronic tonsillitis]. Kiev: Logos; 2017. 192 p. [In Russian].
  37. Zabolotny DI, Меlnikov OF, Timchenko SV, Zabolotna DD. [Study of oropharyngeal secretion in patients with chronic inflammatory and allergic diseases of the upper respiratory tract]: Methodical recommendations. Kyiv; 2008. 34 p. [In Ukrainian].
  38. Suvorovtsev VI, Fedorov TV, Gusev VV. [Bacterial IgA1 proteases: obtaining, properties of application prospects]. Bulletin of the Russian Academy of Medical Sciences. 2001;(12);39-42. [Article in Russian].
  39. Khaitov RM, Ataullakhanov RI, ed. [Immunotherapy: a guide for doctors]. Moscow: GEOTAR-Media; 2012. 672 p. [In Russian].
  40. Golubovska, OA. Mucosal vaccines for the prevention and prevention of complications of acute respiratory infections. Zdorov’ya Ukrayini. 2023;(1-2):537-538. https://health-ua.com/multimedia/userfiles/files/2023/ZU_1_2_2023/ZU_1_2_2023_Latingen.pdf. [Article in Ukrainian].
  41. Zabolotny DI, Melnirov OF. [Modern ideas about the role of mucosal vaccines in the diagnosis, treatment and prevention of infectious and inflammatory diseases of the ENT organs]. Zhurnal ushnyh, nosovyh i gorlovyh boleznej. 2018; (5-с):35-36. [Article in Russian].
  42. Torretta S,  Rosazza C,  Elisabetta Pace M,  Iofrida E, Marchisio Impact of adenotonsillectomy on pediatric quality of life: review of the literature Ital J Pediatr 2017 Nov 25;43(1):107 doi: 10.1186/s13052-017-0424-2.
  43. Schupper AJ, Nation J, Pransky S. Adenoidectomy in Children: What Is the Evidence and What Is its Role? Curr Otorhinolaryngol Rep. 2018;6(1):64-73. doi: 10.1007/s40136-018-0190-8.
  44. Laiko AA, Gavrylenko YuV, Bereznyuk VV, Osadcha TM. [Diagnosis and treatment of chronic pharyngeal diseases in children with type 1 diabetes]. Kyiv: Logos; 2020. 142 p. [In Ukrainian].
  45. Koshel IV, Leta OV, Bahrii MM. [Morphological justification of immunorehabilitation therapy of chronic nasopharyngitis associated with WEB]. Art of medicine. 2022;23(3):58-63. doi: 10. 21802/artm.2022.3.23.58. [Article in Ukrainian].
  46. ICD-11 for Mortality and Morbidity Statistics [Internet]. WHO. 2022 Feb [cited 2021 Nov 5]. Available from: https://icd.who.int/browse11/ lm/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f512796448.
  47. Braido F, Melioli G, Candoli P, Cavalot A, Di Gioacchino M, Ferrero V, et al.The bacterial lysate Lantigen B reduces the number of acute episodes in patients with recurrent infections of the respiratory tract: The results of a double blind, placebo controlled, multicenter clinical trial. Immunol Lett. 2014 Dec;162(2 Pt B):185-93. doi: 10.1016/ j.imlet.2014.10.026.
  48. Tozzi AE, Del Chierico F, Pandolfi E, Reddel S, Gesualdo F, Gardini S. et al. Nasopharyngeal microbiota in hospitalized children with Bordetella pertussis and Rhinovirus infection. Sci Rep. 2021 Nov 24;11(1):22858. doi: 10.1038/s41598-021-02322-y.
  49. Feleszko W, Marengo R, Vieira AS, Ratajczak K, Mayorga Butron JL. Immunity‐targeted approaches to the management of chronic and recurrent upper respiratory tract disorders in children. Clin Otolaryngol. 2019 Jul;44(4):502-510. doi: 10. 1111/coa.13335.
  50. Shadrin OG. [The problem of growing contacts and recurrent respiratory diseases in children: solutions]. Zdorov’ya Ukrayini. 2021;51(1):21-22. [Article in Ukrainian].
  51. Dubourg G, Edouard S, Raoult D. Relationship between nasopharyngeal microbiota and patient’s susceptibility to viral infection. Expert Rev Anti Infect Ther. 2019 Jun;17(6):437-447. doi: 10. 1080/14787210.2019.1621168.
  52. Herbeuval JP. Editorial: Type 1 interferon in pathologies, autoimmune diseases, and chronic viral infections: understanding the fascinating biologic role of type 1 interferons. Front Immunol. 2023 Jul 14:14:1239086. doi: 10.3389/fimmu.2023.1239086.
  53. Rojas JM, Alejo A, Martín V, Sevilla N. Viral pathogen-induced mechanisms to antagonize mammalian interferon (IFN) signaling pathway. Cell Mol Life Sci. 2021 Feb;78(4):1423-1444. doi: 10.1007/s00018-020-03671-z.
  54. Walter MR. The Role of Structure in the Biology of Interferon Signaling. Front Immunol. 2020 Nov 12:11:606489. doi: 10.3389/fimmu.2020.606489.
  55. Pronin AV, Narovlyansky AN, Sanin AV. New Approaches to the Prevention and Treatment of Viral Diseases. Arch Immunol Ther Exp (Warsz). 2021 Apr 3;69(1):10. doi: 10.1007/s00005-021-00613-w.
  56. Ressing ME, van Gent M, Gram AM, Hooykaas MJ, Piersma SJ, Wiertz EJ. Immune Evasion by Epstein-Barr Virus. Curr Top Microbiol Immunol. 2015:391:355-81. doi: 10.1007/978-3-319-22834-1_12.
  57. Brezgin S, Kostyusheva A, Bayurova E, Volchkova E, Gegechkori V, Gordeychuk I, Glebe D, Kostyushev D, Chulanov V. Immunity and Viral Infections: Modulating Antiviral Response via CRISPR-Cas Systems. 2021 Jul 15;13(7):1373. doi: 10.3390/v13071373.
  58. Laiko AA, Kosakovsky AL, Zabolotna DD. [Pediatric otolaryngology]. Kyiv: Logos; 2013. 576 p. [In Ukrainian].
  59. Masters KG, Zezoff D, Lasrado S. Anatomy, Head and Neck, Tonsils. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan. Available from: https://www.ncbi.nlm. nih.gov/books/NBK539792/.
  60. Anderson J, Paterek E. Tonsillitis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan. Available from: https://www. ncbi.nlm.nih.gov/books/NBK544342/.
  61. Hellings P, Jorissen M, Ceuppens JL. The Waldeyer’s ring. Acta Otorhinolaryngol Belg. 2000; 54(3):237-41.
  62. Arambula A, Brown JR, Neff L. Anatomy and physiology of the palatine tonsils, adenoids, and lingual tonsils. World J Otorhinolaryngol Head Neck Surg. 2021 Jun 27;7(3):155-160. doi: 10. 1016/j.wjorl.2021.04.003.
  63. Ovcharenko LS, Tkachenko VYu, Vertehel AO, Andriienko TH, Samokhin IV, Kriazhev OV, et al. [The Impact of Adenoid Hyperplasia and Adenotomy on the Immunity and Health of Children]. Child’s health. 2017;4(5):14- [Article in Ukrainian].
  64. Bulfamante AM, Saibene AM, Felisati G, Rosso C, Pipolo C. Adenoidal Disease and Chronic Rhinosinusitis in Children-Is there a Link? J Clin Med. 2019 Sep 23;8(10):1528. doi: 10.3390/ jcm8101528.
  65. Fesenko ME, Zyuzina LS, Fastovets MM, Kalyuzhka OO, Melashchenko OI. [Acute respiratory recurrent infections in children]. Bulletin of the Ukrainian Medical Stomatological Academy. 2019;19(4):34-37. doi: 10.31718/2077-1096.19.4. 34. [Article in Ukrainian].
  66. Kupko N. [Adenoids in a child: how to optimize treatment?]. Children’s doctor. 2018;(3-4):39-44. [Article in Ukrainian].
  67. Kupko N. [Modern treatment options for adenoiditis in children] Children’s doctor. 2019;(1):49-55. [Article in Ukrainian].
  68. Khits A. [Modern views on rhinitis and new possibilities of therapy]. Ukraïnskyĭ medychnyĭ chasopys [Internet]. 2021 Sept.
  69. Melnikov OF, Zabolotnyi DI, Sambur MB, Zabolotna DD, Tymchenko MD, Faraon IV, Zayets TA. [The role of the palatine tonsils in the regulation of the state of humoral local immunity in patients with chronic inflammatory diseases of the nasal cavity and paranasal sinuses when infected with viruses of the respiratory group]. Otorhinolaryngology. 2022;5(5):36-45. doi: 10.37219/2528-8253-2022-5-36.
  70. Cantarutti A, Rea F, Donà D, Cantarutti L, Passarella A, Scamarcia A, et al. Preventing recurrent acute otitis media with Streptococcus salivarius 24SMB and Streptococcus oralis 89a five months intermittent treatment: An observational prospective cohort study. Int J Pediatr Otorhinolaryngol. 2020 May:132:109921. doi: 10.1016/ j.ijporl.2020.109921.
  71. Wang H. Chronic adenoiditis. J Int Med Res. 2020 Nov; 48(11):300060520971458. doi: 10.1177/ 0300060520971458.
  72. Deeva YuV, Naumenko OM, Tarasenko MV [Modern aspects of immune protection of the middle ear in the pathogenesis of acute otitis media and some of its complications]. Otorhinolaryngology. 2022;6(5):23-38. doi: 37219/2528-8253-2022-6-66. [Article in Ukrainian].
  73. Cleary DW, Clarke SC. The nasopharyngeal microbiome. Emerg Top Life Sci. 2017 Nov 30;1(4):297-312. doi: 10.1042/ETLS20170041.
  74. Chapman TJ, Morris MC, Xu L, Pichichero ME. Nasopharyngeal colonization with pathobionts is associated with susceptibility to respiratory illnesses in young children. PLoS One. 2020 Dec 11;15(12):e0243942. doi: 10.1371/journal.pone. 0243942.
  75. Huang CC, Chang TH, Lee CY, Wu PW, Chen CL, Lee TJ. et al. Tissue microbiota in nasopharyngeal adenoid and its association with pneumococcal carriage. Microb Pathog. 2021 Aug;157: 104999. doi: 10.1016/j.micpath.2021.104999.
  76. McCauley KE, DeMuri G, Lynch K, Fadrosh DW, Santee C, Nagalingam NN. et al. Moraxella-dominated pediatric nasopharyngeal microbiota associate with upper respiratory infection and sinusitis. PLoS One. 2021 Dec 28;16(12):e0261179. doi: 10.1371/journal.pone.0261179.
  77. Kim SK, Hong SJ, Pak KH, Hong SM. Analysis of the Microbiome in the Adenoids of Korean Children with Otitis Media with Effusion. J Int Adv Otol. 2019 Dec;15(3):379-385. doi: 10.5152/iao. 6650.
  78. Johnston JJ, Douglas R. Adenotonsillar microbiome: an update. Postgrad Med J. 2018 Jul;94 (1113):398-403. doi: 10.1136/postgradmedj-2018-135602.
  79. Flyman S, Hermansson A, Gisselsson-Solén M. Nasopharyngeal cultures in children; when, what and why? Int J Pediatr Otorhinolaryngol. 2020 Mar:130:109832. doi: 10.1016/j.ijporl.2019.
  80. Deeva YuV, Dovhych SV. [Competitive action of commensal and pathogenic microflora of the mucous membrane of the nasal cavity in patients with rhinosinusitis]. Clinical immunology. Allergology. Infectology. 2021;(7-8):5-9. [Article in Ukrainian].
  81. Ren T, Glatt DU, Nguyen TN, Allen EK, Early SV, Sale M, Winther B, Wu M. 16S rRNA survey revealed complex bacterial communities and evidence of bacterial interference on human adenoids. Environ Microbiol. 2013 Feb;15(2):535-47. doi: 10.1111/1462-2920.12000.
  82. Van Hoecke H, De Paepe AS, Lambert E, Van Belleghem JD, Cools P, Van Simaey L, Deschaght P, Vaneechoutte M, Dhooge I. Haemophilus influenzae biofilm formation in chronic otitis media with effusion. Eur Arch Otorhinolaryngol. 2016 Nov;273(11):3553-3560. doi: 10.1007/s00405-016-3958-9.
  83. Kania R, Vironneau P, Dang H, Bercot B, Cambau E, Verillaud B, Camous D, Lamers G, Herman P, Vicaut E, Tessier N, Van Den Abbeele T. Bacterial biofilm in adenoids of children with chronic otitis media. Part I: a case control study of prevalence of biofilms in adenoids, risk factors and middle ear biofilms. Acta Otolaryngol. 2019 Apr;139(4):345-350. doi: 10.1080/00016489.2019.1571282.
  84. Zhu Y, Wang S, Yang Y, Shen B, Wang A, Zhang X, et al. Adenoid lymphocyte heterogeneity in pediatric adenoid hypertrophy and obstructive sleep apnea. Front Immunol. 2023 May 22:14:1186258. doi: 10.3389/fimmu.2023.1186258.
  85. Henares D, Brotons P, de Sevilla MF, Fernandez-Lopez A, Hernandez-Bou S, Perez-Argüello A, et al. Differential nasopharyngeal microbiota composition in children according to respiratory health status. Microb Genom. 2021 Oct;7(10):000661. doi: 10.1099/mgen.0.000661.
  86. de Steenhuijsen Piters WAA, Binkowska J, Bogaert D. Early Life Microbiota and Respiratory Tract Infections. Cell Host Microbe. 2020 Aug 12; 28(2):223-232. doi: 10.1016/j.chom.2020.07.004.
  87. Brook I. The clinical microbiology of Waldeyer’s ring. Otolaryngol Clin North Am. 1987 May; 20(2):259-72.
  88. Popovych VY, Beketova GV. [Mythical diagnoses in pediatrics: adenoiditis or nasopharyngitis? Which diagnosis is correct? Questions and answers]. Pediatrics. Eastern Europe. 2021;2:294-303. [Article in Russian].
  89. Teijaro J. R. Type I interferons in viral control and immune regulation. Curr Opin Virol. 2016 Feb:16:31-40. doi: 10.1016/j.coviro.2016.01.001.
  90. Zhang SY, Boisson-Dupuis S, Chapgier A, Yang K, Bustamante J, Puel A, et al. Inborn errors of interferon (IFN)-mediated immunity in humans: insights into the respective roles of IFN-alpha/beta, IFN-gamma, and IFN-lambda in host defense. Immunol Rev. 2008 Dec:226:29-40. doi: 10. 1111/j.1600-065X.2008.00698.x.
  91. Negishi H, Taniguchi T, Yanai H. The Interferon (IFN) Class of Cytokines and the IFN Regulatory Factor (IRF) Transcription Factor Family. Cold Spring Harb Perspect Biol. 2018 Nov 1;10 (11):a028423. doi: 10.1101/cshperspect.a028423.
  92. Volosevych LI, Tymchenko SV, Polyakovska OO, Smagina TV, Melnikov OF. [Study of microflora and cytological indicators of oropharyngeal secretions in patients with allergic rhinitis with different conditions of palatine tonsils]. Zhurnal ushnyh, nosovyh i gorlovyh boleznej. 2018;(5-с):14-15. [Article in Ukrainian].
  93. Cho KS, Kim SH, Hong SL, Lee J, Mun SJ, Roh YE, et al. Local Atopy in Childhood Adenotonsillar Hypertrophy. Am J Rhinol Allergy. 2018 May; 32(3):160-166. doi: 10.1177/1945892418765003.
  94. Cao C, Xu Y. [The correlation between adenoid hypertrophy and allergic rhinitis]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2019 Apr;33(4):381-384. doi: 10.13201/j.issn.1001-1781.2019.04.023. [Article in Chinese].
  95. Byars SG, Steams SC, Boomsma JJ. Association of Long-Term Risk of Respiratory, Allergic, and Infectious Diseases with Removal of Adenoids and Tonsils in Childhood JAMA Otolaryngol Head Neck Surg. 2018 Jul;144(7):594-603. doi: 10. 1001/jamaoto.2018.0614.
  96. Bohdanov VK, Pukhlyk S, Makarova M, Poliakova S, Bohdanov K. Assessing serum cytokine and immunoglobulin levels in patients with allergic rhinitis and allergic rhinoconjunctivitis before and after treatment supplemented with macromycetes. J. ophthalmol. (Ukraine) [Internet]. 2023 Nov. 1 [cited 2024 Jan. 7];(5):226. Available from: https://ua.ozhurnal.com/index.php/files/article/view/86.
  97. Pukhlik SM, Bogdanov VK, Dedykova IV. Immune mechanisms of implementation of allergic rhinitis and the way of its correction. Odesʹkij medičnij žurnal. 2023;(2):94-97. doi: https://doi. org/10.32782/2226-2008-2023-2-17. [Article in Ukrainian].
  98. Umanets TA. [Modern view of the management of children with allergies]. Zdorov’ya Ukrayini. 2022;3(64)-4(65):20-21. [Article in Ukrainian].
  99. Alimov DQ, Norboyev KP. Diagnosis and Treatment of Adenoiditis in Children. 2023;6(2):453-455. DOI: 10.15680/IJMRSET.2023.0602026.
  100. Mariño-Sánchez F, Valls-Mateus M, de Los Santos G, Plaza AM, Cobeta I, Mullol J. Multimorbidities of Pediatric Allergic Rhinitis. Curr Allergy Asthma Rep. 2019 Feb 22;19(2):13. doi: 10.1007/s11882-019-0843-9.
  101. Jahonov OO. Immunological aspects of transmitted adenoiditis in children with allergic rhinitis. Scientific progress. 2022;3(4):48-51.
  102. Popovych VY, Koshel IV. [Infection and allergy: how to break the vicious cycle]. Zdorov’ya Ukrayini. 2023;68(2):12-13. [Article in Ukrainian].
  103. Evcimik MF, Dogru M, Cirik AA, Nepesov MI. Adenoid hypertrophy in children with allergic disease and influential factors. Int J Pediatr Otorhinolaryngol. 2015;79(5):694-7. doi: 10. 1016/j.ijporl.2015.02.017.
  104. Pagella F, De Amici M, Pusateri A, Tinelli G, Matti E, Benazzo M,et al. Adenoids and clinical symptoms: Epidemiology of a cohort of 795 pediatric patients. Int J Pediatr Otorhinolaryngol. 2015;79(12):2137-41. doi: 10.1016/j.ijporl. 09.035.
  105. Eren E, Arslanoğlu S, Erdem SB, Nacaroğlu T, Karkıner CŞ, Can D,et al. Chicken or the egg: the dilemma of allergic rhinitis versus adenoid hypertrophy. Rhinology. 2015;53(2):154-159. doi: 10.4193/Rhino14.013.
  106. Terskova NV, Nikolaeva AI, Vakhrushev SG, Smbatyan AS. Air pollution as a risk factor in pharyngeal tonsil hypertrophy. Sibirskoe medicinskoe obozrenie. 2013;5:12-7. [Article in Russian].
  107. Ikramova FS, Alimova ShA. Complex Treatment of Chronic Adenoiditis Using Phototherapy. European Journal of Medical Genetics and Clinical Biology. 2024;1(1):36-38. doi: https://org/10.61796/jmgcb.v1i1.65.
  108. Morais-Almeida M, Wandalsen GF, Solé D. Growth and mouth breathers. J Pediatr (Rio J). 2019 Mar-Apr:95 Suppl 1:66-71. doi: 10.1016/j.jped.2018.11.005.
  109. Chen S, Wang WW, Wang Y, Li Y, Zhu LX. Cellular senescence in recurrent tonsillitis and tonsillar hypertrophy in children. Int J Pediatr Otorhinolaryngol. 2020 Jun:133:110004. doi: 10.1016/j.ijporl.2020.110004.
  110. Pribuišienė R, Kuzminienė A, Sarauskas V, Saferis V, Pribuišis K, Rastenienė I. The most important throat-related symptoms suggestive of chronic tonsillitis as the main indication for adult tonsillectomy. Medicina (Kaunas). 2013;49(5): 219-22.
  111. [Acute otitis media. Evidence-based clinical guidelines]. Kyiv; 2021. 93 p. Available from: https://www.dec.gov.ua/wp-content/uploads/2021/04/2021_688_kn_gso.pdf. [In Ukrainian].
  112. Schilder AG, Chonmaitree T, Cripps AW, Rosenfeld RM, Casselbrant ML, Haggard MP, Venekamp RP. Otitis media. Nat Rev Dis Primers. 2016 Sep 8;2(1):16063. doi: 10.1038/ 2016.63.
  113. Tysome JR, Sudhoff H. The Role of the Eustachian Tube in Middle Ear Disease. Adv Otorhinolaryngol. 2018;81:146-152. doi: 10. 1159/000485581.
  114. Karpova EP, Burlakova KY. [Possibilities of treatment of inflammatory pathology of the nasopharynx in children with chronic adenoiditis and otitis media with effusion]. Vestn Otorinolaringol. 2018;83(6):40-43. doi: https:// doi.org/10.17116/otorino20188306140. [Article in Russian].
  115. Yoon A, Abdelwahab M, Bockow R, Vakili A, Lovell K, Chang I, et al. Impact of rapid palatal expansion on the size of adenoids and tonsils in children. Sleep Med. 2022 Apr:92:96-102. doi: 10.1016/j.sleep.2022.02.011.
  116. Durgut O, Dikici O. The effect of adenoid hypertrophy on hearing thresholds in children with otitis media with effusion. Int J Pediatr Otorhinolaryngol. 2019 Sep:124:116-119. doi: 10.1016/j.ijporl.2019.05.046.
  117. Galić MZ, Klančnik M. Adenoid size in children with otitis media with effusion. Acta Clin Croat. 2022 Feb;60(3):532-539. doi: 10.20471/ 2021.60.03.25.
  118. Chen WX, Fu Y. Lin chuang er bi yan hou tou jing wai ke za zhi. Journal of clinical otorhinolaryngology, head, and neck surgery. 2018;32(17):1359-1362. https://doi.org/10. 13201/j.issn.1001-1781.2018.17.017. [Article in Chinese].
  119. Tao J, Luo R, Chen Y, Hou C, Qin H. [Myringotomy or tympanostomy tube insertion, comparison of surgical treatment of adenoid hypertrophy and otitis media with effusion in children]. Journal of clinical otorhinolaryngology, head, and neck surgery. 2020;34(3):207-210. https://doi.org/10.13201/j.issn.2096-7993.2020. 005. [Article in Chinese].
  120. Markkanen S, Rautiainen M, Himanen SL, Satomaa AL, Katila M, Peltomäki T, Saarenpää-Heikkilä O. Snoring toddlers with and without obstructive sleep apnoea differed with regard to snoring time, adenoid size and mouth breathing. Acta Paediatr. 2021 Mar;110(3):977-984. doi: 10.1111/apa.15496.
  121. Zhu Y, Wang S, Yang Y, Shen B, Wang A, Zhang X, et al. Adenoid lymphocyte heterogeneity in pediatric adenoid hypertrophy and obstructive sleep apnea. Front Immunol. 2023 May 22:14:1186258. doi: 10.3389/ 2023.1186258.
  122. Poddębniak J, Zielnik-Jurkiewicz B. Impact of adenoid hypertrophy on the open bite in children. Otolaryngol Pol. 2019 Apr 5;73(4):8-13. doi: 10.5604/01.3001.0013.1536. PMID: 31474619.
  123. Pukhlik SM, Diedykova IV, Kibalchich DO. [Study of the impact of variants of persistent nasopharyngeal obstruction in children and adolescents with maxillofacial anomalies on the choice of effective treatment tactics] Herald of dentistry. 2023;2(123):128-133. http://www.visnyk.od.ua/ php/mainjournal/article/view/376/336. [Article in Ukrainian].
  124. Diedykova IV, Schneider SA, Andreev OV, Kibalchich DO. [Optimizing the treatment of patients with dento-jaw anomalies depending on the clinical and functional features of the nasopharyngeal zone] World of Medicine and Biology. 2023; (86):44-48. https://repo.odmu.edu.ua/xmlui/ handle/123456789/14494. [Article in Ukrainian].
  125. Purnell PR, Ramadan JH, Ramadan HH. Can Symptoms Differentiate Between Chronic Adenoiditis and Chronic Rhinosinusitis in Pediatric Patients. Ear Nose Throat J. 2019 Jun; 98(5): 279-282. doi: 10.1177/
  126. Rimmer J, Hellings P, Lund VJ, Alobid I, Beale T, Dassi C, et al. European position paper on diagnostic tools in rhinology. Rhinology. 2019 Jul 25;57(Suppl S28):1-41. doi: 10.4193/Rhin19.410.
  127. Abylova FA. [Determination of the quality of life of a child diagnosed with adenoids on a Likert scale]. Actual Problems of the Modern Medicine: Bulletin of Ukrainian Medical Stomatological Academy. 2015;15(3):67-70. [Article in Russian].
  128. Pathak K, Ankale NR, Harugop Comparison Between Radiological Versus Endoscopic Assessment of Adenoid Tissue in Patients of Chronic Adenoiditis. Indian J Otolaryngol Head Neck Surg. 2019 Oct;71(Suppl 1):981-985. doi: 10.1007/s12070-019-01669-z.
  129. Lou Z. “Commentary to: ‘Endoscopic and clinical benefits of hyaluronic acid in children with chronic adenoiditis and middle ear disease'”? Eur Arch Otorhinolaryngol. 2018 Mar;275(3):827-828. doi: 10.1007/s00405-017-4568-x.
  130. Pukhlyk BM. [To general practitioners: diagnosis of allergic diseases]. Klinichna immunolohiia. Alerholohiia. Infektolohiia. 2006;1(2). https://kiai.com.ua/ua/archive/2006/1%282%29/article-30/likaryam-zagalnoyi-praktiki-diagnostika-alergichnih-zahvoryuvan. [Article in Ukrainian].
  131. Fofanova OV, Yurtseva AP, Bodnar OP. [Molecular diagnostics as a perspective of effectiveness of treatment and control of bronchial asthma in children]. Klinichna immunolohiia. Alerholohiia. Infektolohiia. 2018;1:67-70 https://kiai.com.ua/ua/
    archive/2018/1-ZDP/pages-67-70/molekulyarna-alergodiagnostika-yak-perspektiva-pidvishchennya-efektivnosti-likuvannya-ta-kontrolyu-bronhialnoyi-astmi-u-ditey-. [Article in Ukrainian].
  132. Besh LV, Matsyura OI, Slyuzar ZL. [Molecular diagnosis of allergies through the eyes of a doctor of first contact: when and how to use it?]. Allergy in a child. 2021 July;27-28:2-5юhttp://adau.allergo-ua.info/wp-content/uploads/2021/09/Stranytsy-yz-Alerhiia-u-dytyny27_28-1_6.pdf. [Article in Ukrainian].
  133. Melnykov O, Zabolotny D. The concept of diagnosing secondary immunodeficiency states based on determination of immunoglobulins in the secretions. Intern. Journal on Immunorehabilitation. 2004;6(2):235.
  134. Simbirtsev AS. [Cytokines in the pathogenesis and treatment of human diseases]. St. Petersburg: Foliant; 2018. 512 p. [In Russian].
  135. Drannik GN. [Clinical immunology and allergology]. Kiev: Polygraph plus; 2010. 552 p. [In Russian].
  136. Abaturov AE, Gerasimenko ON, Vysochina IL, Zavorodnyaya NU. [Defensins and definzin-dependent diseases]. Odessa: VМV; 2011. 264 p. [In Russian].
  137. Kishchuk VV. [Clinical and immunological approaches to assessing the functional state of the tonsils for the diagnosis and treatment of patients with chronic tonsillitis] [dissertation]. Kiev; 2001. 254 p. [In Russian].
  138. Laiko AA, Zabolotny DI. [Hypertrophy of the lymphadenoid tissue of the pharynx]. Kiev: Logos; 2009. 175 p. [In Ukrainian].
  139. Zabolotny DI, Melnikov OF. [Theoretical aspects of the genesis and therapy of chronic tonsillitis]. Kiev: Zdorov’ya; 1999. 145 p. [In Russian].
  140. Marushko Yu, Melnikov O, Movchan О, Lysovets O. Content of antimicrobial peptides in oropharyngeal secretions of children suffering from acute respiratory diseases. Fiziol. Zh. 2013; 59(4):22.
  141. Sakarya EU, Bayar Muluk N, Sakalar EG, Senturk M, Aricigil M, Bafaqeeh SA, Cingi C. Use of intranasal corticosteroids in adenotonsillar hypertrophy. J Laryngol Otol. 2017 May;131(5): 384-390. doi: 10.1017/S0022215117000408.
  142. Passali D, Spinosi MC, Crisanti A, Bellussi LM. Mometasone furoate nasal spray: a systematic review. Multidiscip Respir Med. 2016 May 2;11-18. doi: 10.1186/s40248-016-0054-3.
  143. Lou Z. “Commentary to: ‘Endoscopic and clinical benefits of hyaluronic acid in children with chronic adenoiditis and middle ear disease'”? Eur Arch Otorhinolaryngol. 2018 Mar;275(3):827-828. doi: 10.1007/s00405-017-4568-x.
  144. Brandtzaeg P. Immunology of tonsils and adenoids: everything the ENT surgeon needs to know. Int J Pediatr Otorhinolaryngol. 2003 Dec; 67 Suppl 1:S69-76. doi: 10.1016/j.ijporl. 08.018.
  145. Brandtzaeg P. Function of mucosa-associated lymphoid tissue in antibody formation. Immunol Invest. 2010;39(4-5):303-55. doi: 10.3109/
  146. Brandtzaeg P. Immunocompetent cells of the upper airway: functions in normal and diseased mucosa. Eur Arch Otorhinolaryngol. 1995;252 Suppl 1:S821. doi: 10.1007/BF02484429.
  147. Deitmer T, Beck CE, Becke-Jakob K, Eich C, Hackenberg S, Hoffmann TK, et al. [Statement on the lower age limit for outpatient adenotomies and tonsillotomies]. 2024 Jan;103(1):17-24. doi: 10.1055/a-2216-8474. [Article in German].
  148. Paramaesvaran S, Ahmadzada S, Eslick GD. Incidence and potential risk factors for adenoid regrowth and revision adenoidectomy: A meta-analysis. Int J Pediatr Otorhinolaryngol. 2020 Oct;137:110220. doi: 10.1016/j.ijporl.2020. 110220.
  149. Francis DO, Chinnadurai S, Sathe NA, Morad A, Jordan AK, Krishnaswami S, Fonnesbeck C, McPheeters ML. Tonsillectomy for Obstructive Sleep-Disordered Breathing or Recurrent Throat Infection in Children [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2017 Jan. Report No.: 16(17)-EHC042-EF.
  150. Ploner S, Gruber E, Mantovan F. [The effect of corticosteroids in children and adolescents after tonsillectomy in the prevention of postoperative nausea and vomiting, pain and bleeding]. 2014 May;33(5):169-74. [Article in German].
  151. Erratum: Comparison of the Effects of Sufentanil and Fentanyl on Postoperative Sleep Quality of Children Undergoing Tonsillectomy and Adenotomy: A Randomized Controlled Trial [Corrigendum]. Nat Sci Sleep. 2021 Nov 22:13:2085-2086. doi: 10.2147/NSS.S348090.
  152. Esposito S, Rosazza C, Sciarrabba CS, Principi N. Inhaled antibiotic therapy for the treatment of upper respiratory tract infections. J Aerosol Med Pulm Drug Deliv. 2017 Feb;30(1):14-19. doi: 10.1089/jamp.2016.1300.
  153. Geiger Z, Gupta N. Adenoid Hypertrophy. [Updated 2022 May 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022. Available from: https://www.ncbi.nih.gov/books/NBK536984/.
  154. Smiianov YV, Smiianov VA, Sniehirova IA, Smiianova OI. Algorithm of adenoiditis treatment in adults, depending on the pharyngeal tonsil hypertrophy stage. Wiad Lek. 2018;71(3 pt 1):564-568.
  155. Badran H, Salah M, Fawzy M, Sayed A, Ghaith D. Detection of Bacterial Biofilms in Chronic Pharyngitis Resistant to Medical Treatment. Ann Otol Rhinol Laryngol. 2015 Jul;124(7):567-71. doi: 10.1177/0003489415570934.
  156. Chao Y, Bergenfelz C, Håkansson AP. In Vitro and In Vivo Biofilm Formation by Pathogenic Streptococci. Methods Mol Biol. 2017;1535:285-299. doi: 10.1007/978-1-4939-6673-8_19.
  157. Bair KL, Campagnari AA. Moraxella catarrhalis Promotes Stable Polymicrobial Biofilms with the Major Otopathogens. Front Microbiol. 2020 Jan 15;10:3006. doi: 10.3389/fmicb.2019.03006.
  158. Luke NR, Jurcisek JA, Bakaletz LO, Campagnari AA. Contribution of Moraxella catarrhalis type IV pili to nasopharyngeal colonization and biofilm formation. Infect Immun. 2007 Dec;75(12):5559-64. doi: 10.1128/IAI.00946-07.
  159. Jacquier H, Vironneau P, Dang H, Verillaud B, Lamers G, Herman P, et al. Bacterial biofilm in adenoids of children with chronic otitis media. Part II: a case-control study of nasopharyngeal microbiota, virulence, and resistance of biofilms in adenoids. Acta Otolaryngol. 2020 Mar; 140 (3):220-224. doi: 10.1080/00016489.2020.1718749.
  160. Balwant Singh Gendeh, Editor. Tonsils and Adenoids. London: IntechOpen; 2023. Chapter 1. Giourgos G, Luchena A, Bovi C. Therapeutic Approaches in Chronic Adenoiditis; p. 1-22. DOI:5772/intechopen.1001165.
  161. Abaturov AE. [Molecular mechanisms of nonspecific protection of the respiratory tract: recognition of pathogen-associated molecular structures]. Child’s health. 2006;2(2):87-92.
  162. Torretta S, Marchisio P, Colombo MR, Rosazza C, Pignataro L. Paediatric nasopharyngeal cytology: a new diagnostic opportunity? Eur J Clin Microbiol Infect Dis. 2016 Jul;35(7):1097-9. doi: 10.1007/s10096-016-2637-5.
  163. Anderson LS, Reynolds MB, Rivara KR, Miller LS, Simon SI. A Mouse Model to Assess Innate Immune Response to Staphylococcus aureus Infection. J Vis Exp. 2019 Feb 28:(144):10. 3791/59015. doi: 10.3791/59015.
  164. Goddard FGB, Knee J, Sumner T, Nalá R, Clasen T, Brown J. Child Salivary SIgA and Its Relationship to Enteric Infections and EED Biomarkers in Maputo, Mozambique. Int J Environ Res Public Health. 2020 Apr 27;17(9):3035. doi: 10.3390/ijerph17093035.
  165. Parker D, Prince A. Innate immunity in the respiratory epithelium. Am J Respir Cell Mol Biol. 2011 Aug;45(2):189-201. doi: 10.1165/rcmb. 2011-0011RT.
  166. Razi CH, Harmancı K, Abacı A, Özdemir O, Hızlı S, Renda R, Keskin F. The immunostimulant OM-85 BV prevents wheezing attacks in preschool children. J Allergy Clin Immunol. 2010 Oct;126(4):763-9. doi: 10.1016/j.jaci. 07.038.
  167. Rozy A, Chorostowska-Wynimko J. Bacterial immunostimulants – mechanism of action and clinical application in respiratory diseases. Pneumonol Alergol Pol. 2008;76(5):353-9.
  168. Schaad UB. OM-85 BV, an immunostimulant in pediatric recurrent respiratory tract infections: a systematic review. World J Pediatr. 2010 Feb;6(1):5-12. doi: 10.1007/s12519-010-0001-x.
  169. Suárez N, Ferrara F, Rial A, Dee V, Chabalgoity JA. Bacterial Lysates as Immunotherapies for Respiratory Infections: Methods of Preparation. Front Bioeng Biotechnol. 2020 Jun 5:8:545. doi: 10.3389/fbioe.2020.00545.
  170. Berber A, Del-Río-Navarro BE, Reyes-Noriega N, Sienra-Monge JJL. Immunostimulants for preventing respiratory tract infection in children: A systematic review and meta-analysis. World Allergy Organ J. 2022 Sep 14;15(9):100684. doi: 10.1016/j.waojou.2022.100684.
  171. Mora R, Salzano FA, Mora E, Guastini L. Efficacy of a topical suspension of bacterial antigens for the management of chronic suppurative otitis media. Eur Arch Otorhinolaryngol. 2012; 269(6):1593-7. Doi: 10.1007/s00405-011-1816-3.
  172. Braido F, Melioli G, Nicolini G, Canonica GW. Prevention of recurrent respiratory tract infections: a literature review of the activity of the bacterial lysate Lantigen B. Eur Rev Med Pharmacol Sci. 2023 Aug;27(16):7756-7767. Doi: 10.26355/eurrev_202308_33430.
  173. Braido F, Melioli G, Candoli P, Cavalot A, Di Gioacchino M, Ferrero V, Lantigen Study Group. The bacterial lysate Lantigen B reduces the number of acute episodes in patients with recurrent infections of the respiratory tract: the results of a double blind, placebo controlled, multicenter clinical trial. Immunol Lett. 2014 Dec;162(2 Pt B):185-93. Doi: 10.1016/j.imlet.2014.10.026.
  174. Pizzimenti C, D’Agostino A, Pirrello P, Ruiba A, Melioli G. The SARS-CoV-2 cellular receptor ACE2 is expressed in oropharyngeal cells and is modulated in vitro by the bacterial lysate Lantigen B. Arch Clin Biomed Res. 2023;7(1):13-18. Doi: 10.26502/acbr.50170315.
  175. Bykova VP. [Structural foundations of mucosal immunity of the upper respiratory tract]. Russian Rhinology. 1999;(1):5-11. [Article in Russian].
  176. Gavrylenko YuV. [Peculiarities of the choice of local therapy for acute and chronic adenoiditis in children]. Sovremennaya pediatriya. 2015;6:30-34. [Article in Ukrainian].