Vol 15, No 6 (2018)

Pollen allergy (pollinosis) is one of the most common allergic diseases. Majority of pollen allergy patients (47-70%) have a cross-reactive food allergy to fruits, vegetables, nuts and seeds. Oral allergic syndrome is the most common clinical manifestation of cross-reactive food allergy. The article presents the data on cross-reactive food allergy to Pr-10 homologues in birch pollen sensitized patients.

The basis for the development of atopic dermatitis (AD) is genetic predisposition, hypersensitivity to allergens, Th1/Th2 disbalance, increased degranulation of mast cells and antigen-presenting activity of Langerhans cells, as well as epidermal barrier dysfunction. Recently, genotypes, phenotypes and endotypes of AD, and biomarkers, which can be used to assess the effectiveness of therapy and to develop personalized approaches to the diagnosis, treatment and prognosis of the disease, have been actively studied. The aim of this study was to determine the endotypes of atopic dermatitis on the basis of molecular genetic study of cytokine gene expression in the skin of AD patients. Materials and methods. The study was performed as a «case-control», 90 AD patients and 30 healthy individuals without signs of atopy were included. The material for evaluation of cytokine gene expression was skin biopsy samples taken by punch biopsy. The level of gene expression was determined by real-time PCR with preliminary reverse transcription of mRNA of the corresponding genes («DNA-Technology», Moscow). The transcript levels of ILB, IL2, IL2r, IL4, IL5, IL6, IL7, IL8, IL10, IL12A, IL12B, IL15, IL17A, IL18, IL23, IL28, IL29, IFNy, TNF, TGFß, FOXP3 genes were studied. Results. Based on the molecular genetic study of the local immune response the following endotypes of AD were determined: endotype with predominance of Th1-type immune response (3% of patients); endotype with predominance of Th2-type immune response (3% of patients); mixed endotype with increased expression of IL2 (20% of patients); mixed endotype with reduced expression of IL10 (64% of patients); mixed endotype with increased expression of TGFß (9% of patients). Clinically significant biomarkers of inflammation in atopic dermatitis - decreased mRNA level of IL1ß gene expression and increased mRNA level of IL2R, IL4, IL5, IL6, IL8, IL10, IL12ß, IL23, IL29, IFNy and TGFß genes expression were determined in the skin of AD patients compared to healthy individuals. Conclusion. The use of molecular genetic method for evaluation of local immune response on the basis of cytokines gene expression measurement in the skin allows to identify the most significant biomarkers characterizing different endotypes of AD, and to determine the type of immune response in the individual patient.

Relevance. Cats and dogs are the most popular pets in many countries, what leads to a high and widespread prevalence of their allergens and increase of sensitization to animal allergens with tendency of changing the dominant profile of sensitization with the predominance of the major cat allergen. The purpose of this study was to assess the severity of allergic rhinitis and its combination with other forms of allergic diseases in children sensitized to cat allergens. Materials and methods. Under our supervision there were 228 children aged 3-16 years old living in the cities of the Sverdlovsk region. Evaluation of the sensitization spectrum was carried out according to the results of prick tests and the level of sIgE by immunofluorescence method. Results. All children had manifestations of persistent allergic rhinitis. In 42.1% (n=96) of cases the upper and lower respiratory tract comorbidities were detected, in 16.6% (n=38) - manifestations of atopic dermatitis. In 65.4% (n=149) of children the total level of points on the SFAR scale was <9, complete control over the BA according to the results of the ACT questionnaire was established in 60.7% (n=68) of patients, lack of control - in 7.1% (n=8). Most children showed a significant increase of total IgE and eosinophilic cationic protein levels. Findings. High frequency of allergic comorbidities was noted. The mild persistent forms of respiratory allergies prevailed. A high frequency of polyvalent sensitization was identified.

The article deals with bacterial lung microbiota in patients with bronchial asthma (BA) and chronic obstructive pulmonary disease (COPD), bacterial inflammation of the bronchopulmonary system which can be manifested by sensitization and allergy. Also they can be a trigger with the development of bacterial inflammation. Bacteria can colonize the lungs without severe clinical, laboratory and instrumental changes. High levels of IgG to Str. pneumoniae, Neisseria perflava, Haemophilus influenza in ACOS patients can be evidence of their etiological significance. Taking into account the etiological significance of microbiota, methods of treatment of patients with COPD and BA with the use of antibiotics, vaccines and probiotics have been developed.