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The high specific gravity in the structure of morbidity in children of all age groups, complicated course, determines the urgency of studying the clinical and diagnostic aspects of community-acquired pneumonia. In recent years, interest has been growing in the study of the child's cytokine status. A number of studies indicate that cytokines regulate the severity and duration of the inflammatory process. In this regard, the study of the possibility of determining the level of proinflammatory cytokines (IL-6 , TNF-α) is of great practical importance for assessing the prognosis of community-acquired pneumonia in children. In a prospective cohort study, 90 children with community-acquired pneumonia aged between 5 and 14 years were treated under treatment in the department respiratory of the Children›s Hospital in Karaganda, of which 47% were girls (95% CI 31.51% - 56.33%) and boys 53% (CI 95% 34.91% - 59.88%). The control group included 20 healthy children. Analysis of the results of the study revealed an increase in the content of proinflammatory cytokines in the blood serum and urine on children with community-acquired pneumonia depending on the severity of the course. At the same time, the equivalence of the cytokine trends in serum and urine determines the possibility of noninvasive detection of cytokines, both for characterizing the inflammatory response of the organism as such and for predicting the development of community-acquired pneumonia, which is especially valuable in pediatric practice.

Aim: To assess the relation between urinary excretion of profibrotic and antifibrotic growth factors, albuminuria and glomerular fibrosis in type 1 diabetic patients., Materials and Methods: 64 patients with diabetes were examined, including 25 ones with normal albumin excretion rate (AER), 30 microalbuminuric and 9 macroalbuminuric patients. Urinary excretion of type IV collagen, transforming growth factor-beta 1] (TGF-beta 1), tumor necrosis factor-alpha (TNF-alpha), fibroblast growth factor-2 (FGF-2), hepatocyte growth factor (HGF) and bone morphogenetic protein-7 (BMP-7) was determined by ELISA and compared to control (10 healthy subjects). Renal biopsy specimens were assessed in 7 patients with normal AER and in 14 microalbuminuric patients., Results: Type IV collagen, TGF-beta1 and TNF-alpha excretion was increased significantly in patients with micro- and macroalbuminuria as compared to control (all p<0.05). Excretion of FGF-2 was increased in macroalbuminuric patients only (p=0.003). No marked changes in excretion of antifibrotic growth factors (HGF and BMP-7) were observed. TNF-alpha and FGF-2 correlated positively with urinary type IV collagen (r=0.37 and r=0.31, respectively). The presence of glomerular fibrosis in renal biopsy specimens was associated with higher excretion of TGF-beta1, TNF-alpha and FGF-2 (all p<0.05)., Conclusion: The results suggest that unbalance between profibrotic and antifibrotic growth factors in the kidneys plays an important role in pathogenesis of diabetic nephropathy. Urinary TGF-beta1, TNF-alpha and FGF-2 may offer new possibilities for detection of renal fibrosis in diabetic patients.