[Long-term study of various immunologic functions in children with chronic nonspecific lung diseases].

For 18 years we have analysed several parameters directly or indirectly involved in immunologic functions in 713 children (age: 0-14 years) suffering from CNSRD (frequently relapsing bronchitis, chronic bronchitis, frequently relapsing or chronic obstructive bronchitis, asthma bronchiale, cystic fibrosis). In all 6,067 data were evaluated. The estimation of the immunoglobulins (in serum and secretions) and the serum level of alpha-1-antitrypsin (alpha-1-AT) had the highest relevance for diagnosis and prognosis of CNSRD. Immunodeficiencies were detected in form of humoral antibody deficiency syndromes as well as local secretory IgA deficiency (MALT insufficiency). The results suggest that the MALT-insufficiency during early childhood is a high risk factor for the development of CNSRD, especially of obstructive lung diseases. In chronic bronchitis the mean levels of serum-IgA were significantly increased (p less than 0.001) and reactively increased serum mean levels of IgM and/or IgG were observed in some chronic bronchitis forms but not during the whole childhood. In homocygote and heterocygote defective alpha-1-AT types the prognosis of chronic lung disease (chronic obstructive bronchitis and/or bronchial asthma) was especially poor. Despite BCG vaccination in the neonatal period most children had negative tuberculin skin tests. This suggests that also the cellular immunofunctions may be depressed in children with CNSRD. Blood group, isoagglutinins, Zn and Fe serum levels had only limited importance for diagnosis and prognosis of the CNSRD. We recommend the estimation of these parameters in special cases only.