Vol 17, No 2 (2020)


Interactions of mast cells and eosinophils in allergic response

Gushchin I.S.


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. FcεRI-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.

Russian Journal of Allergy. 2020;17(2):5-17
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Promising compounds from natural sources against COVID-19

Andreev S.M., Shershakova N.N., Kozhikhova K.V., Shatilov A.A., Timofeeva A.V., Turetskiy E.A., Kudlay D.A., Khaitov M.R.


The epidemic associated with the new Sars-CoV-2 coronavirus has affected almost all countries of the world and no reliable treatment for this infection exists yet. Many laboratories in the world are currently conducting intensive experimental and theoretical/in silico studies to find effective drugs specific for this disease (COVID-19), but unfortunately, it may take a long time before new drugs appear in the clinical practice. One of the currently widely accepted approaches for finding active compounds is based on the possibility of using existing drugs approved by government medical organizations (as the FDA). Their choice is based on screening, based on the use of computer models that evaluate the specific binding (energy minimization) of such drugs to target molecules that are important for the life cycle. Thus, a few well-known antiviral drugs against HIV, hepatitis C and others selected on this basis exerted an antiviral effect in vitro, but their real effectiveness was far from expected. It should be emphasized that the severe clinical manifestation of the disease is an acute respiratory distress syndrome, mediated by oxidative stress and an aggressive immune attack on its own cells. In this regard, the use of compounds with high antioxidant activity could have advantages both prophylactically and medically. There is a huge range of natural compounds, including official and traditional medicine, which represent valuable unlimited potential for COVID-19 therapy, the advantage of such compounds in their low toxicity. In this review, we tried to focus on the clinical and pharmacological properties of natural substances, mainly flavonoids, which can become promising drugs for the treatment and prevention of COVID-19. The review includes information on possible virus targets and antiviral drugs. Much attention is paid to the question of inhibition of viral activity. Based on published data, including structural features of various compounds, a prediction is made about the prospects of using these compounds as inhibitors of viral activity, as well as anti-inflammatory drugs for the treatment of COVID-19. An important step in the analysis of compounds was the study of the possibility of their interaction with cellular targets of the virus, as well as the ability to bind to the proteins of the Sars-CoV-2 virus itself.

Russian Journal of Allergy. 2020;17(2):18-32
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Fresh look on the urticaria problem.

Litovkina A.O., Smolnikov E.V., Elisyutina O.G., Fedenko E.S.


Introduction. Nowadays urticaria is one of the most common diseases. According to the International Guidelines for the definition, classification, diagnosis and management of urticaria, 2nd-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 2nd generation H1-antihistamines, and criteria for personalized selection of the antihistamines are discussed.

Russian Journal of Allergy. 2020;17(2):33-43
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Original studies

Seasonal allergic rhinitis and its control with antihistamines in an outpatient practice.

Nenasheva N.M., Shartanova N.V., Ovchinnikov A.Y., Osipova G.L., Zhestkov A.V., Pavlova N.V.


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.

Russian Journal of Allergy. 2020;17(2):44-52
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Patient dropouts from sublingual allergen specific immunotherapy with house dust mites. Solving a problem.

Trusova O.V., Kamaev A.V., Makarova I.V.


Relevance. The insufficient effect of sublingual allergen-specific immunotherapy (SLIT) is caused, first of all, by non-compliance with the treatment regimen and premature treatment termination.

Purpose of the study. Determining the frequency of patient drop-out rate during SLIT with house dust mites (HDM) allergens in children with allergic rhinitis (AR) or AR in combination with bronchial asthma (BA), with an analysis of the drop-out reasons, and approbation of the developed visit-to-visit patient management plan (Plan).

Materials and methods. We analyzed 274 cases of treatment with HDM SLIT in children. 218 patients: 67.4% (147) boys, median age 11.33 years [7.26; 15.46], the proportion of patients with BA 43.1% (94 children) – received HDM SLIT in 2013–2020. 56 patients: 71.4% (40) boys, median age 9.29 years [6.13; 15.93], the proportion of patients with BA 78.6% (44 children) received treatment in accordance with the Plan.

Results. A relatively low frequency of treatment withdrawal was noted in the first 2 years of therapy (2 years after the start of treatment, 72.47% patients continue it). However, only 52.29% complete 3 years of therapy, and 14.67% complete 4 years of therapy. Implementation of the Plan increased patient retention in treatment at the 3rd year of treatment to 69.64% (p=0.031).

Conclusions. Only half of the patients receive the required three-year minimum of treatment.

The daily plan optimizes the patient management schedule for HDM ASIT; reduces patient dropout from treatment and can be recommended for practical healthcare.

Russian Journal of Allergy. 2020;17(2):53-60
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Analysis of the genotypes and interleukins 17A, 17F blood levels in children with allergic bronchial asthma and allergic rhinitis

Prosekova E.V., Turyanskaya A.I., Dolgopolov M.S., Zhdanova O.L., Sabynych V.A.


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.

Russian Journal of Allergy. 2020;17(2):61-68
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Case reports

A case of atopic dermatitis with a severe resistant course in adult patient with atopic march

Tusupbekova G.M., Syzdykova A.A., Davletova B.M.


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.

Russian Journal of Allergy. 2020;17(2):69-73
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Help to the practitioner

Features of immunopathogenesis of atopic dermatitis

Pobezhimova O.O., Zhestkov A.V., Sidorova O.S., Kulagina V.V.


 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.

Russian Journal of Allergy. 2020;17(2):74-80
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Personalized approach to choice-making of an immunoglobulin for the replacement therapy in patients with primary immunodeficiency - is the way to success.

Latysheva T.V., Latysheva E.A., Manto I.A., Setdikova N.H.


Immunoglobulin replacement therapy is the most important treatment for the majority of Primary immunodeficiency (PID) forms. It is very important not only to prescribe replacement therapy, but also to choose the appropriate one according to individual patient’s needs at the very moment. Furthermore, in reallife clinical practice some comorbid conditions, which can occur in patient, necessitate the choice of a specific drug from a wide range of IVIG preparations presented on the Russian pharmaceutical market.

Russian Journal of Allergy. 2020;17(2):81-101
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Russian Journal of Allergy. 2020;17(2):102-103
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In memory of Gervazieva Vera Borisovna

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In memory of Gervazieva Vera Borisovna

Russian Journal of Allergy. 2020;17(2):104
pages 104 views

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