medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2021-1-50-58medsovet-6027Research ArticleЗДОРОВЫЙ РЕБЕНОКHEALTHY CHILDЭлиминационно-ирригационная терапия для поддержания гомеостаза носовой полости у детей раннего возрастаElimination and irrigation therapy to optimize the state of the nasal microbiome in childrenhttps://orcid.org/0000-0002-6719-5805ЧелпаченкоО. Е.ChelpachenkoOlga E.

Челпченко Ольга Ефимовна, д.м.н., профессор, ведущий научный сотрудник лаборатории биомониторинга и молекулярно-генетических исследований

460000, Оренбург, ул. Пионерская, д. 11

Olga E. Chelpachenko, Dr. of Sci. (Med.), Leading Researcher, Laboratory of Biomonitoring and Molecular Genetic Research

11, Pionerskaya St., Orenburg, 460000

oech57@gmail.comhttps://orcid.org/0000-0003-0910-6525ДаниловаЕ. И.DanilovaElena I.

Данилова Елена Ивановна, к.м.н., доцент кафедры педиатрии  

460000, Оренбург, ул. Советская, д. 6 

Elena I. Danilova, Cand. Of Sci. (Med.), Associate Professor of the Department of Pediatrics, Institute of Post-Graduate Training

6, Sovietskaya St., Orenburg, 460000

danilowa@list.ruhttps://orcid.org/0000-0002-8923-8829ЧайниковаИ. Н.ChainikovaIrina N.

Чайникова Ирина Николаевна, д.м.н., профессор, ведущий научный сотрудник лаборатории биомониторинга и молекулярно-генетических исследований 

460000, Оренбург, ул. Пионерская, д. 11

460000, Оренбург, ул. Советская, д. 6 

Irina N. Chainikova, Dr. of Sci. (Med.), Professor, Leading Research Associate, Laboratory for Biological Monitoring and Molecular-Genetic Research

11, Pionerskaya St., Orenburg, 460000

6, Sovietskaya St., Orenburg, 460000

inchainicova@yandex.ruИнститут клеточного и внутриклеточного симбиоза Уральского отделения Российской академии наукРоссияInstitute of Cellular and Intracellular Symbiosis, Ural Branch of RASRussian FederationОренбургский государственный медицинский университетРоссияOrenburg State Medical UniversityRussian FederationИнститут клеточного и внутриклеточного симбиоза Уральского отделения Российской академии наук; Оренбургский государственный медицинский университетРоссияInstitute of Cellular and Intracellular Symbiosis, Ural Branch of RAS; Orenburg State Medical UniversityRussian Federation202116032021015058Copyright © Челпаченко О.Е., Данилова Е.И., Чайникова И.Н., 20212021Челпаченко О.Е., Данилова Е.И., Чайникова И.Н.Chelpachenko O.E., Danilova E.I., Chainikova I.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/6027

В статье обобщены результаты работ отечественных и зарубежных исследователей по изучению гомеостаза полости носа, включая состояние микробиоты слизистой оболочки носа у здоровых детей и при воспалительных заболеваниях верхних дыхательных путей. Нормальная микробиота полости носа представлена коринебактериями (дифтероидами), нейс-сериями, коагулазоотрицательными стафилококками, альфа-гемолитическими стрептококками. Из транзиторных видов в указанном биотопе встречаются такие виды, как Staphylococcus aureus, Escherihia coli, бета-гемолитические стрептококки. Основное внимание уделено особенностям назальной микробиоты у новорожденных и детей раннего возраста (зависимость назальной микробиоты от вида вскармливания, возраста и времени года). Отмечена роль гиперколонизации услов-но-патогенной микрофлорой и ее персистентного потенциала (способность к биопленкообразованию, деградации лизоцима, интерферона) в патогенезе воспалительных заболеваний верхних отделов респираторного тракта. Рассмотрены патогенетические механизмы, обеспечивающие многоуровневую защиту организма от патогенов. Определена целесо-образность использования элиминационно-ирригационной терапии в качестве гигиенического средства санации носовой полости у детей раннего возраста. Обсуждаются вопросы о преимуществах применения изотонических растворов, их эффективность для обеспечения нормальной колонизационной резистентности слизистой оболочки носовой полости.В заключение пришли к выводу, что у новорожденных и детей раннего возраста для гигиенического ухода и санации слизистой оболочки полости носа рекомендуется только промывание с использованием капель солевого изотонического раствора и аспиратора во избежание аспирации и попадания жидкости в полость слуховой трубы и среднего уха, а также с профилактической целью, позволяя поддерживать гомеостаз слизистой носа и предупреждать развитие острых респираторных заболеваний.

The article summarizes the results of the work of domestic and foreign researchers on the study of homeostasis of the nasal cavity, including the state of the microbiota of the nasal mucosa in healthy children and in inflammatory diseases of the upper respiratory tract. The normal microbiota of the nasal cavity is represented by corynebacteria (diphtheroids), neisseria, coagulasenegative staphylococci, alpha-hemolytic streptococci. From among the transient species, such species as Staphylococcus aureus, Escherihia coli, beta-hemolytic streptococci would be found in the specified biotope. The main attention is paid to the features of the nasal microbiota in newborns and young children (dependence of the nasal microbiota on the type of feeding, age and season). The role of hypercolonization by opportunistic microflora and its persistent potential (ability to biofilm formation, degradation of lysozyme, interferon) in the pathogenesis of inflammatory diseases of the upper respiratory tract is noted. The pathogenetic mechanisms providing multilevel protection of the organism from pathogens are considered. The expediency of using elimination-irrigation therapy as a hygienic means of sanitizing the nasal cavity in young children has been determined. The questions about the advantages of the use of isotonic solutions, their effectiveness for ensuring normal colonization resistance of the nasal mucosa are discussed. In conclusion, we must say that for hygienic care and sanitation purposes it is recommended only to rinse the nasal mucosa in newborns and infants using drops of isotonic saline solution and an aspirator to avoid aspiration and inflow of liquid into the cavity of Eustachian tube and middle ear, and also for the preventive purposes, as it allows to maintain homeostasis of the nasal mucosa and prevent the development of acute respiratory diseases.

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The authors declare that there are no conflicts of interest present.