Vol 17, No 2 (2020)

Mast cells (MCs) and eosinophils (EOs) appeared hundreds of millions of years ago during the evolutionary process and continue to be retained by all vertebrate species. There is no convincing evidence of the absence of these cells in vertebrates under normal conditions. These cells are involved in the reactions of innate and adaptive immunity, in the control of tissue growth and tissue remodeling, activation of adipose tissue, affect reproductive functions and have a wide range of mediators involved in homeostasis. It is known that the interaction of these cells is involved in the initiation and maintenance of allergic inflammation. Fc_εRI-mediated MC activation leads to mediators secretion, among which there are many chemotactic agents for EOs. These agents attract the EOs to the site of allergic inflammation. The EOs come into physical contact with the MCs, accompanied by the EO activation. As a result of the action of mediators released from MCs and EO, the active state of the cells is enhanced and maintained, and, accordingly, the process of inflammation is prolonged with the corresponding consequences in the form of triggering tissue remodeling. Eosinophil-derived active substances released during the reaction, having at least anti-mediator properties, contribute to the suppression and resolution of allergic inflammation. Such a look at the nature of the interactions between EOs and MCs justifies the comparative determination of the kinetics of the release of pro-allergic mediators from those cells and the formation of EO-derived compounds with antiallergic activity. It is expected that such studies will be carried out in the nearest future.

Introduction. Nowadays urticaria is one of the most common diseases. According to the International Guidelines for the definition, classification, diagnosis and management of urticaria, 2^nd-generation H₁-antihistamines are recommended to be used as the first-line and second-line therapy. Omalizumab, a humanized monoclonal anti-IgE antibody, is assumed to be the third-line therapy in urticaria treatment.

Summary. In this review we discuss the latest data on pathogenetic mechanisms of urticaria, focusing on the search of the new targets for the therapy. We represent the latest clinical trials of the new biological treatment for urticaria. Safety and efficiency of 4-folds higher therapeutical dose of the 2^nd generation H₁-antihistamines, and criteria for personalized selection of the antihistamines are discussed.

Allergic rhinitis (AR) is a significant social and medical problem of modern healthcare. The treatment of patients with AR is based on a stepwise approach, the purpose of which is to fully control the symptoms. The first stage drugs of choice are oral non-sedative antihistamines of the second generation. A study was conducted to evaluate the effectiveness of Allerway and drugs containing cetirizine to control the symptoms of seasonal AR (SAR) in an outpatient practice. The data obtained in the framework of a multicenter prospective noninterventional study (the short name of the study is LEVADA) were analyzed. Data were collected at 5 centers using scales for assessement of the symptoms of allergic rhinitis: rTNSS, miniRQLQ, visual analog scale and the Epworth sleepiness scale. The dynamics of SAR symptoms was assessed using the rTNSS scale (24 hours) after 7 and 14 days of treatment. A total of 100 patients were included in the study; 97 patients completed the study. Of these, 46 (47.42%) were women and 51 (52.57%) were men aged ≥18 years. The average duration of the diagnosis of SAR in patients before inclusion in the study in the Allerway group was 97.4±85.51 months (about 8 years), in the cetirizine group 107.0±114.62 months (about 8.9 years), p=0.641. The efficacy of regressing the intensity of SAR symptoms on the rTNSS scale was demonstrated to be (average and average error) –2.92±0.11 points in the group of patients taking Allerway and –2.93±0.11 points in the group of patients taking cetirizine. After 7 days, there was an increase in the proportion of patients with a complete absence of the main symptoms of SAR: nasal congestion, rhinorrhea, itching in the nose. In the group of patients taking Allerway in 44 out of 49 patients (89.8%), it was noted that on average, after 39.4±14.35 minutes, symptom relief was observed in 42 of 48 (87.5%) patients, and in patients taking cetirizine, relief of rhinitis symptoms was noted during 44.0±13.76 minutes. An improvement in the quality of life was noted by reducing the severity of symptoms on the miniRQLQ scale by 44.3±15.29 points in the Allerway group and by –45.0±13.03 in the group receiving cetirizine. It was shown that the use of Allerway (at a dose of 5 mg, once a day) and preparations containing cetirizine (at a dose of 10 mg, with a single dose per day), allows to achieve a positive clinical effect in the treatment of patients with SAR (seasonal allergic rhinitis) in outpatient practice within 7 and 14 days with a high level of safety and compliance.

Introduction. The study of genes that control the activity of cytokines is one of the important issues in revealing the pathogenetic mechanisms of allergic diseases.

Aims. Determination of the frequency of occurrence of polymorphic gene markers genotypes and characterization of the interleukins 17A, 17F content in blood serum in children with bronchial asthma and allergic rhinitis.

Materials and methods. A comprehensive survey of 110 children with allergic diseases of 311 years old and 60 healthy peers. The material for genetic analysis was DNA with the study of mutation points of IL-17A at position 197 (G>A) and IL-17F 7488 (T>C). The content of IL-17A, IL-17F interleukins was measured by enzymelinked assay. For the statistical analysis we used the “Statistica 10”, methods for comparing unrelated groups of genotypes distributions to expected values at Hardy–Weinberg equilibrium with χ².

Results. The frequency of occurrence of genotypes in a group of healthy children was as follows: IL-17A (G197A) – heterozygous GA (63,333%), homozygous GG (36,667%); IL-17F (T7488C) TT (36,667%), CT (63,333%), genotypes AA and CC weren’t determined. In children with allergic diseases, all genotypes were determined: IL-17A (G197A), GG (11,818%), AA (19,091%) and GA (69,091%), IL-17F (T7488C), TT (5,454%), CC (35,455%) and CT (59,091%) with the highest specific gravity of the GG genotype and TT. There were no significant differences in IL-17A, IL-17F levels in the blood serum depending on the genotype.

Discussion. There were significant differences in the structure of the polymorphisms of the IL-17A, IL-17F genes, blood levels of IL-17A, IL-17F and the risk of the disease in allergic children and healthy peers. The frequency of allergic diseases in children with genotypes AA and TT is statistically higher, but with genotypes GG, CC is statistically lower than with other genotypes.

Introduction. The atopic march is the natural course of development of atopy symptoms. It is characterized by a typical sequence of development of clinical symptoms of atopic disease, when some symptoms become more significant, others are recede. Timely allergological diagnostics with the identification of causal allergens allows to preventor suspend the atopic march.

Purpose of the study was to demonstrate the stages of the atopic march formation and clinical manifestations of atopy, the importance of on timely detection of causal allergens, the capability of modern diagnostics and treatment of severe resistant forms of allergic diseases.

 Atopic dermatitis is one of the most common allergic diseases with severe course, which affects the skin. This disease is genetically determined and has a chronic course. Atopic dermatitis is also one of the commonest diseases (between 20% and 40% of all skin disorders) and affects patients of both sexes across the globe. Such high rate of morbidity, onset in early childhood, often continuous relapsing course and a trend toward gradual increase of tolerance to traditional therapies makes the issue of detalization of pathogenesis of atopic dermatitis particularly topical. Immune cells play one of the major roles in the pathogenesis of atopic dermatitis. This article will systematically review the main available to date information on participation immune cells in the pathogenesis of atopic dermatitis.

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