ABSTRACT. The pathogenetic mechanisms underlying the development of recurrent bronchitis remain a subject of debate. Studying the biological rhythms of macro- and microelements may facilitate the development of personalized approaches to the prevention and treatment of this disease.
Study Objective – to analyze the daily dynamics of macroelement levels in exhaled breath condensate in children with recurrent bronchitis (RB).
Materials and Methods. Fifty-nine children aged 6-10 years with RB were examined. The control group consisted of 30 children with a history of rare respiratory diseases. Elemental status was assessed noninvasively by examining exhaled breath condensate. A portable Peak Flow Meter (Beringer Ingelheim, Germany), measuring this parameter in L/min, was used for 24-hour monitoring of bronchial patency using the MOS exhaled air flow meter.
Results. The study showed that children with RB exhibit a shift in peak calcium and magnesium concentrations in tracheobronchial secretions (TBS) compared to healthy peers. During the acute phase of RB, a statistically significant decrease (p<0.05) in average daily calcium and magnesium concentrations in the TBS was recorded. This phenomenon can be interpreted as the body's response to the inflammatory process, manifested by increased dilution of tracheobronchial secretions and a decrease in the mineral composition of the TBS, as well as the redistribution of electrolytes and their release from tissue depots, including lung tissue, to ensure the functioning of protective and adaptive mechanisms. Additionally, children with RB exhibited an increase in the amplitude of calcium and magnesium fluctuations in the TBS (p<0.05). During the period of clinical recovery from RB, partial restoration of the circadian rhythm of the elemental composition of the TBS indicates incomplete rehabilitation of metabolic disorders in the lungs. An imbalance in the circadian rhythms of calcium and magnesium in the EBC in children with RB who are at risk for bronchial obstruction contributes to the persistence and progression of inflammation, the formation of bronchial hyperreactivity and an increase in the frequency of exacerbations of RB.
Conclusions. Studying the circadian rhythms of macro- and microelements in exhaled air may be key to understanding the causes of recurrent bronchitis in children. The data obtained can be used to develop personalized prevention and treatment methods, including correction of calcium and magnesium deficiency and restoration of natural biological rhythms.
KEYWORDS: calcium and magnesium, exhaled air condensate, circadian rhythm, children, recurrent bronchitis.
For citation: Mandrov S.I., Zhdanova L.A., Shishova A.V., Laryushkina R.M., Glazova T.G., Semenova D.A. Circadian rhythms of calcium and magnesium in exhaled air condensate in recurrent bronchitis in children. Trace elemets in medicine. 2026;27(1):31-39. DOI: 10.19112/2413-6174-2026-27-1-31-39
REFERENCES
Allanazarov A.B. Clinical features of acute obstructive bronchitis in frequently ill children. Journal of Cardiorespiratory Research. 2023; 4: 43–45. (In Russ.).
Vasilenko A.M., Sharipova M.M. Microelement deficiency and the problem of comorbidity. Microelements in medicine. 2019; 1: 4–12. (In Russ.).
Berest I.E., Tananakina T.P. The role of microelement homeostasis in the pathogenesis of upper respiratory tract diseases. RMJ. Medical Review. 2019; 1: 27–29. (In Russ.).
Bolotova N.V., Skalny A.A., Filina N.Yu., Cherednikova K.A. et al. Manifestation of microelementoses in children with different nutritional status. Microelements in Medicine. 2022; 4: 62–69. (In Russ.).
Valeev V.V., Mingazova E.N., Babaev Yu.A., Mingazov R.N., et al. The role of childhood risk factors on the development of chronic obstructive pulmonary disease. Healthcare Manager. 2022; 9: 70–79. (In Russ.).
Geppe N.A., Kolosova N.G., Denisova V.D., Grebeneva I.V. Possibilities of preventing relapses of obstructive bronchitis in children during the season of acute respiratory infections. Issues of Practical Pediatrics. 2024; 2: 115–122. (In Russ.).
Gizinger O.A., Dadali V.A. Magnesium deficiency and its supplementation using mineral complexes. Therapist. 2021; 8: 32–36. (In Russ.).
Gubin D.G., Kolomeichuk S.N. Biological clock accuracy, chronotype, health and longevity. Tyumen Medical Journal. 2019; 2: 14–27. (In Russ.).
Gubin D.G. [Chronodiagnostics and chronotherapy are the basis of personalized medicine]. Tyumen Medical Journal. 2019; 1: 20–40. (In Russ.).
Daminov F.A., Nabieva F.S., Ochilov O.Sh. Biological role of calcium in the human body. Research Focus International Scientific Journal. 2023; 2: 56–58 (in Russ.).
Kaitmazova N.K. Dynamics of immunity parameters in children with obstructive bronchitis. Modern issues of biomedicine. 2022; 1: 19–25. (In Russ.).
Karimova N., Shamsiev F., Abdullaev S. Dysmicroelementoses in children with bronchial asthma and their diagnostic significance. International Journal of Scientific Pediatrics. 2022; 1: 21–24. (in Russ.).
Koroleva A.A. The effect of manganese on the nervous system: a new look. Microelements in Medicine. 2023; 2: 48–52. (In Russ.).
Lagunova N.V., Semenchuk T.V., Kuntsevich E.I., Myagkaya N.O., et al. Broncho-obstructive syndrome in pediatric practice (clinical cases). Russian Pediatric Journal. 2023; 4: 129–136. (In Russ.).
Lokshina E.E., Zaitseva O.V. Recurrent (repeated) episodes of bronchial obstruction in children: the onset of chronic respiratory diseases in adults? Issues of Practical Pediatrics. 2020; 6: 79–89. (In Russ.).
Lebedenko A.A., Semernik O.E., Tyurina E.B., Appoeva A.A., et al. The role of macronutrients in the pathogenesis of bronchial asthma in children. Medical Bulletin of the South of Russia. 2021; 2: 43–47 (in Russ.).
Lapik I.A., Gapparova K.M. Macro- and microelements in the pathogenesis and treatment of bronchial asthma: molecular mechanisms and evidence base. Microelements in Medicine. 2025; 3: 3–10. (In Russ.).
Lim M.V., Razaev Zh.A., Shavazi N.M. Risk factors for the development of recurrent broncho-obstructive syndrome in children. Pediatrics named after G.N. Speransky. 2023; 1: 185–187. [In Russ.).
Markovskaya A.I., Potapova N.L., Gaimolenko I.N. Evolution of the pattern of bronchial obstruction in preschool children. Bulletin of Physiology and Pathology of Respiration. 2021. Issue 80. 57–65. (In Russ.).
Pilkevich N.B., Markovskaya V.A., Yavorskaya O.V., Smirnova A.P. Pathophysiological relationship of copper with neuro-degenerative disorders. Microelements in Medicine. 2023; 3: 22–30. (In Russ.).
Samorodnova E.A. Calcium deficiency in children: causes, consequences, and possibilities of preventive interventions. RMJ. Mother and Child. 2023; 1:60–67. (In Russ.).
Samorodnova E.A., Fayzullina R.A., Pikuza O.I., Zakirova A.M. Pathogenetic significance of membrane and metabolic disorders in bronchitis in children. Doctor.Ru. 2021; 10: 18–24. (In Russ.).
Stepanova S.I. Biorhythmological aspects of the adaptation problem. Moscow: Nauka. 1986: 239 (in Russ.).
Sidorenko G.I., Zborovsky E.I., Levina D.I. Atraumatic method for studying the surface-active properties of the lung. Methodological recommendations. Minsk. 1981: 24. (In Russ.).
Tatevosyan A.S., Bykov I.M., Gubareva D.A. Metabolic influence on circadian oscillations of pH and Eh in urine and saliva. Innovative Medicine of Kuban. 2022; 4: 82–89. (In Russ.).
Tereshchenko S.Yu., Malinchik M.A., Smolnikova M.V. Inflammatory markers in exhaled air condensate in bronchial asthma. Medical Council. 2021; 16: 212–223. (In Russ.).
Chernova L.N., Skalny A.V. Relationship between the level of chemical elements in hair and various pathologies in children with autism spectrum disorders. Doctor. 2021; 11: 61–65. [In Russ.).
Shavazi N., Allanazarov A., Ataeva M., Gaibulaev Zh. Current views on the occurrence of obstructive pulmonary disease in children. Journal of Cardiorespiratory Research. 2021; 2: 40–43. (In Russ.).
Shamsiddinova, M. Features of the course of acute obstructive bronchitis in children from the group of "frequently ill children". Eurasian Journal of Medical and Natural Sciences. 2023; 3: 70–75. (In Russ.).
Ali K.M. Childhood asthma as a risk factor for adult chronic obstructive pulmonary disease: a systematic review and meta-analysis. Expert Review of Respiratory Medicine. 2022; 16(4): 461–467.
Belgrave D.C.M., Granell R., Turner S.W., Curtin J.A., et al. Lung function trajectories from pre-school age to adulthood and their associations with early life factors: a retrospective analysis of three population-based birth cohort studies. Lancet Respir. Med. 2018; 6 (7): 526–534.
Duan P., Wang Y., Lin R., et al. Impact of early life exposures on COPD in adulthood: A systematic review and meta-analysis. Respirology. 2021; 26: 1131–1151.
Fitzpatrick A.M., Bacharier L.B., Guilbert T.W., Jackson D.J., et al. Phenotypes of Recurrent Wheezing in Preschool Children: Identification by Latent Class Analysis and Utility in Prediction of Future Exacerbation. J. Allergy Clin. Immunol.Pract. 2019; 7 (3): 915–924.
Melén E., Guerra S., Hallberg J., Jarvis D., et al. COPD epidemiology with pediatric asthma care: Implications for the patient and the physician. Pediatr Allergy Immunol. 2019; 30: 589–597.
Putker M., Crosby P., Feeney K.A., et al. Mammalian Circadian Period, But Not Phase and Amplitude, Is Robust Against Redox and Metabolic Perturbations. Antioxid. Redox. Signal. 2018; 28 (7): 507–520.
Raaymakers M.J.A., Brand P.L.P., Landstra A.M., Brouwer M.L., et al. Episodic viral wheeze and multiple-trigger wheeze in preschool children are neither distinct nor constant patterns. A prospective multicenter cohort study in secondary care. Pediatr. Pulmonol. 2019; 54 (9): 1439–1446.
Vural H., Uzun К., Uz Е. Concentrations of copper, zinc and various elements in serum of patients with bronchial asthma. J. Trace Elem. Med. Biol. 2020; 14(2): 88–91.
Xu Y., Qu X., Liang M., et al. Focus on the role of calcium signaling in ferroptosis: A potential therapeutic strategy for sepsis-induced acute lung injury. Pulmonary Medicine. 2024; 11: 1457882. DOI: 10.3389/fmed.2024.1457882.
Information about the authors:
S.I. Mandrov – Dr.Sc. (Med.), Professor, Professor of the Department of Outpatient Pediatrics
SPIN: 3463-7352
L.A. Zhdanova – Dr.Sc. (Med.), Professor, Head of the Department of Outpatient Pediatrics
ORCID: 0000-0003-2172-4465; SPIN: 7224-7822
A.V. Shishova – Dr.Sc. (Med.), Professor of the Department of Outpatient Pediatrics
E-mail: shishova@inbox.ru; ORCID: 0000-0003-0471-0790; SPIN: 4416-1125
I.V. Ivanova – Dr.Sc. (Med.), Professor of the Department of Outpatient Pediatrics
ORCID: 0000-0002-3553-4470; SPIN: 2074-6669
R.M. Laryushkina – Dr.Sc. (Med.), Professor of the Department of Pediatrics and Neonatology
ORCID: 0000-0001-6262-9259; SPIN: 1183-3045
T.G. Glazova – Associate Professor of the Department of Pediatrics and Neonatology
D.A. Semenova – Student
Conflict of interest
The authors declare no obvious and potential conflicts of interest related to the publication of this article.
