Russian Journal of AllergyRussian Journal of AllergyРоссийский Аллергологический Журнал1810-88302686-682XPublishing House ABV Press48710.36691/RJA487ArticlesСтатьиReview ArticleATOPIC DISEASES WITHOUT SYSTEMIC SENSIBILIZATIONАТОПИЧЕСКИЕ ЗАБОЛЕВАНИЯ БЕЗ СИСТЕМНОЙ СЕНСИБИЛИЗАЦИИKorostovtsevD SКоростовцевД СGalenkoL AГаленкоЛ Аl.galenko@gmail.comTrusovaO VТрусоваО ВKamaevA VКамаевА БMakarovaI VМакароваИ ВSaint-Petersburg State pediatric medical universityСанкт-Петербургский государственный педиатрический медицинский университет15102014115NO5 (2014)№5 (2014)142010032020Copyright ©; 2014, Pharmarus Print MediaCopyright ©; 2014, Фармарус Принт Медиа2014Pharmarus Print MediaФармарус Принт Медиаhttps://rusalljournal.ru/raj/article/view/487

The diagnosis of allergic disease related to the group of immediate hypersensitivity involves confirmation of IgE sensitization: positive skin tests with the suspected allergen and/or detection of allergen-specific IgE. Research over the past decades showed that IgE synthesis may occur exclusively in the tissues of the affected organ and derived allergen-specific antibodies may not enter the systemic circulation. In contrast to «atopy», this concept of local sensitization was termed «entopy». local production of IgE was detected in more then 47% of adults previously diagnosed as having non-allergic rhinitis. besides the nasal mucosa, local sensitization was found in lymphoid tissues of nasopharyngeal ring, bronchial mucosa in some patients with non-atopic asthma, esophageal mucosa in patients with eosinophilic esophagitis. The processes of local immune response is currently studied and probably one day the accumulated data will swing our understanding of atopic sensitization, that will be reflected in classification and therapeutic approaches.

Диагноз аллергического заболевания из группы немедленной гиперчувствительности подразумевает подтверждение реагиновой сенсибилизации: положительные кожные пробы с подозреваемым аллергеном и/или обнаружение аллерген-специфических иммуноглобулинов Е (IgE). Исследования последних десятилетий показали, что синтез IgE может протекать исключительно в тканях пораженного органа и образованные аллерген-специфические антитела могут не обнаруживаться в системном кровотоке. Эта концепция локальной сенсибилизации, в противопоставление атопии, обозначается термином «энтопия». Локальная продукция IgE выявлена у более 47% взрослых пациентов с установленным ранее диагнозом неаллергического ринита. Кроме слизистой оболочки носа, локальная сенсибилизация обнаружена в тканях лимфоидного глоточного кольца, слизистой бронхов у части пациентов с неатопической бронхиальной астмой и в слизистой оболочке пищевода при эозинофильном эзофагите. Процессы локального иммунного ответа продолжают активно изучаться, и, возможно, в скором времени накопленные данные изменят наше представление о процессе атопической сенсибилизации, а также найдут отражение в классификационных и терапевтических подходах.

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