Pediatric Clinic 1, Department of Pathophysiology and Transplantation, University of Milan, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
J Biol Regul Homeost Agents. 2013 Jul-Sep;27(3):627-36.
Recurrent respiratory tract infections (RRTIs) are very common in children and a major challenge for pediatricians. They affect the children's quality of life, cause absences from school and lost parental working days, and repeated medical examinations, hospital admissions as well as antibiotic therapies lead to high costs for society. Given their prevalence and clinical importance, various prevention strategies have been developed. One of the most widely used is the administration of immunostimulants: i.e. molecules of bacterial or synthetic origin that interact with immunological mechanisms in vitro and in vivo. A number of studies have investigated their effects on cellular and innate immunity, and their clinical efficacy, but there is no consensus as to their real usefulness. The main aim of this review is to analyse the available data concerning the activity and efficacy of immunostimulants in preventing pediatric RRTIs. The majority of studies have shown that the number of infections decreases after immunostimulant treatment, but they are affected by various methodological weaknesses. Further studies are urgently needed to confirm whether, when and which immunostimulants should be used.
反复呼吸道感染（RRTIs）在儿童中非常常见，是儿科医生面临的主要挑战。它们会影响儿童的生活质量，导致他们缺课、父母误工，而且反复的医学检查、住院治疗和抗生素治疗会给社会带来高昂的成本。鉴于其普遍性和临床重要性，已经开发了各种预防策略。其中最广泛使用的一种是免疫刺激剂的给药：即与体外和体内免疫机制相互作用的细菌或合成来源的分子。许多研究已经调查了它们对细胞和先天免疫的影响及其临床疗效，但对于它们的真正用途尚未达成共识。本篇综述的主要目的是分析有关免疫刺激剂在预防儿童反复呼吸道感染方面的活性和疗效的现有数据。大多数研究表明，免疫刺激剂治疗后感染的次数会减少，但它们受到各种方法学缺陷的影响。迫切需要进一步的研究来证实免疫刺激剂何时、以及应该使用哪种免疫刺激剂。
