Vol 6, No 1 (2009)

Chitin - the structural component of fungal cell wall, arthropodal exoskeleton, microfilarial sheat and egg of helminths. Allergens of this organisms cause allergic diseases. The potential role of chitin in allergic reactions has been discussed. Other studies have suggested that chitin preparations may skew immunity away from T-helper-2-mediated allergic responses. Chitinases, enzymes that can degrade chitin polymer, and chitinase-like proteins might also play an important role in allergic disease pathogenesis.

In this review basic properties of dendritic cells and their role in immunopathological conditions are considered. Methods of dendritic cells cultivation and their influence on functional activity of dendritic cells are described. Perspectives of dendritic cells clinical application for immunotherapy of cancer, infection diseases, allergy and autoimmune diseases are analyzed.

Background. The research of effective methods of allergen-specific immunotherapy (ASIT) with good tolerability is important in children with allergic disorders. The aim of the study was to investigate effectiveness and safety of ASIT with pollen allergoids for hay fever treatment in children. Methods. 71 patients 5 to 17 years old with diseases caused by tree pollen sensitization: allergic rhinoconjunctivitis in 36 patients, rhinitis combined with pollen asthma in 17, combined with atopic dermatitis in 1, and pollen asthma in 17, were included in the study. 2 courses of subcutaneous ASIT out of flowering season were conducted in every child using commercially available pollen allergoids. ASIT effectiveness was assessed using 4-point scale where 4 points represents complete disease remission, and 1 point represents lack of effectiveness. Local and systemic side effects were registered as parameters of ASIT safety. Results. Total dose of allergen was 13 768 PNU after the 1st course of ASIT, and 12 700 PNU after the 2nd course. Effectiveness of the 1st course of ASIT was 4,0 points out of 4,0 and of the 2nd course - 4,0 points. Local side effects (infiltration larger than 25 mm, itching and oedema in injection site) in 19,7% patients and systemic side effects (allergic rhinitis exacerbation, urticaria) in 11,3% patients were stopped after allergoid dose adjustment. Conclusion. ASIT with pollen allergoids is effective for hay fever treatment in children. Children with bronchi al asthma are at higher risk for adverse events and need individual dose adjustment.

Medical and social importance of allergic rhinitis is due to: high prevalence among the population of adults and children in some countries, reaching 50% among adolescents, as well as its close links with diseases such as bronchial asthma, acute and chronic rhinosinusitis, allergic conjunctivitis. Currently, allergic rhinitis and bronchial asthma consider as one disease of the airways due to the presence of a cross-connection between the upper and lower respiratory airways and systemic response to the allergen. High efficiency of intranasal corticosteroids in treatment of allergic rhinitis determined by their pronounced anti-inflammatory action and effective influence on all phases of the pathogenesis of the disease. In addition, intranasal corticosteroids are effective in improving of ocular symptoms, fn particular, fluticasone propionate (Flixonase) causes a significant decrease in ocular symptoms caused by seasonal rinoconjunctivitis. Flixonase improves sleep and daytime fatigue and somnolence in patients with perennialallergic rhinitis.

К основным медикаментам, воздействующим на симптомы аллергии и контролирующим течение аллергических заболеваний, относятся средства, которые ингибируют секрецию и высвобождение медиаторов аллергии, а также препараты, подавляющие воспалительные реакции. В обзоре представлены основные группы антигистаминных препаратов, используемых в клинической аллергологии и их основные характеристики, позволяющие дифференцированно подходить к назначению в комплексной терапии различных аллергических и псевдоаллергических реакций.