Vol 16, No 1 (2019)

The results of indirect treatment comparison of the efficacy of anti-Il-5 pathway therapies in severe eosinophilic asthma on the basis of network meta-analysis and Cochrane review are presented in the article.

The review article presents data on the prevalence of respiratory allergy - allergic rhinitis and bronchial asthma in southern Russia, published over the past decades. The dominant role of pollen allergy is shown in almost the entire southern region of Russia. In the Chechen Republic, sensitization to house dust mites and grass pollen was found in patients with respiratory allergy equally (51.1 and 52.5%, respectively), whereas ragweed and mugwort sensitization was 3 times less (26.6 and 20.7%, respectively) compared with the neighboring regions of southern Russia. These data demonstrate climate-geographical, environmental and other regional features in the prevalence of respiratory allergies.

Aim. To determine the regional characteristics of the pollen spectrum of the air environment by the end of the five-year monitoring; to create the pollen calendar of allergenic plants in Samara, Russia. Materials and methods. Pollen was sampled using the volumetric method with a self-engineered pollen impactor into glass slides, covered with a mixture of petrolatum and wax. The pollen grains were counted and classified according to the systematic groups. Results. IIn 2013 the Samara urban air basin contained pollen of 21 taxa (12 woody taxa and 9 herbaceous taxa); in 2014 - 20 taxa (13 woody and 7 herbaceous); in 2015 - 20 taxa (12 woody and 8 herbaceous); in 2016 - 21 taxa (13 woody and 8 herbaceous); in 2017 - 18 taxa (10 woody and 8 herbaceous). During the five-year survey the dominant taxa were ragweed (24.3%), poplar (12,0%), birch (11.5%), pine (7.5%), maple (6.3%), elm (6.3%), nettle (5.8%), willow (4.8%), Gramineae (4.7%), and wormwood (3.7%). 10 dominant taxa were determined, which formed from 90% to 95% of the annual pollen volume. The prevailing taxa varied considerably from year to year by specific weight. Only three pollen species were present in the spectrum annually in the amount of more than 4% of the annual amount: poplar, birch and ambrosia pollen grains. Conclusion. Regional features of aeropalynological situation was revealed and pollen calendar of allergenic plants in Samara was created.

The aim of the study. To study the effect of hypovitaminosis D on the activity of CSU and the clinical efficacy of cholecalciferol in the complex therapy of patients with different baseline level of vitamin D metabolites. Methods. 48 CSU patients were included in the study - 20 patients in the main group, 28 in the comparison group. The control group consisted of 26 healthy donors. Patients with CSU of the main group regardless of the initial level of vitamin D were treated with non sedative antihistamines and an aqueous solution of cholecalciferol (vitamin D3) at the dosage of 10,000 units/day. The course of treatment with cholecalciferol was 4 weeks. The concentration of 25(OH)D and 1,25(OH)2D was determined in the blood serum of patients before and after the treatment and in control group. The diagnosis of hypovitaminosis D was carried out on the basis of 25(OH)D concentrations <30 ng/ml. The activity of CSU was assessed by the indicators of the urticaria activity score UAS-7. Results. Hypovitaminosis D occurs with the same frequency in patients with CSU and in control group. At the same time, the activity of CSU in patients with hypovitaminosis D is significantly higher than in patients with normal vitamin D levels, as evidenced by UAS-7 (respectively 24.3±13.68 and 17.5±8.1; p<0.05). A negative correlation was found between the activity of CSU and the concentration of 25(OH)D in patients with hypovitaminosis D. Correction of hypovitaminosis D with an aqueous solution of cholecalciferol at a dosage of 10,000 units/day during 4 weeks with simultaneous basic therapy with non sedative antihistamines leaded to a reliable decrease of UAS-7, however, complete control of the disease did not occured. In patients with an initially normal level of 25(OH)D, an additional administration of vitamin D therapy does not lead to significant changes of UAS-7. The concentration of 1,25(OH)2D in the blood serum of patients with CSU did not depend on the presence or absence of hypovitaminosis D and did not change on cholecalciferol therapy.

Modern aspects of patogenetic conception of neurogenic inflammation in immune associated dermatoses are presented in the article. On the basis of literature data and own experience important aspects of pimecrolimus application in atopic dermatitis and other dermatoses are reviewed.

Every year the prevalence of allergic diseases is steadily increasing. Histamine is the main mediator of allergic inflammation. Cetirizine is an effective, selective H1-receptor blocker, and drug of choice in complex treatment of various allergies among adults as well as children.