Vol 15, No 5 (2018)

The problem of exerciseinduced airway hyper responsiveness and bronchial obstruction is discussed in the review. Epidemiological data on the prevalence of bronchial obstruction in elite athletes of various sports are presented. Modern concepts of etiological and trigger factors caused by exercise induced bronchospasm are considered. Pathogenetic aspects of the formation of bronchial obstruction in athletes are presented.

Research objective. This research was conducted to identify and to evaluate clinical and anamnestic features of primary immunodeficiency disorders (PID) as well as quantitive and qualitive microflora composition in PID-patients in Samara region. Methods. We analysed 29 case histories of patients with PID aged from 3 to 55 years old (20 men, 9 women). Clinical and anamnestic features of the diseases were studied. We also examined microflora of 34 loci from upper respiratory tract of 7 patients. Taking into account a small sample we used statistical analysis of variance by criterion F, the normality of the distribution was evaluated by the Shapiro-Wilk criterion (S-U), the distribution was considered normal when S-U value was <0,05. Results. Humoral immune deficiency takes the first place in the structure of PID (62,1%). In 67% the PID started with infections of bronchopulmonary system. Initial manifestations of PID appeared already in childhood (1,65±0,97 y.o.), the average age of establishing the diagnosis was 11,1±9,62 years (the difference was 9,6 years; p<0,001). The infectious syndrome took place further in all cases. The most frequent manifestations were respiratory system diseases (92%). We examined respiratory tract mucose membrane microbiota in 7 patients: all patients, except the woman with common variable immunodeficiency (CVID), had dysbiosis of respiratory tract mucose membrane characterized by clinically relevant microflora in unusual loci and decreased normobiota’s titers. Conclusion. PID are quite rare conditions. Nowadays 29 patients with established diagnosis of PID are registered in Samara region. This reflects the low prevalence of the diagnosed PID; at the same time the detection of the disease in adult age reflects the low level of diagnostics. More severe disorders were revealed in patients with late disease detection. The PID in clinical case 1 was diagnosed at the age of 16 y.o., and in clinical case 2 - only at the age of 40 y.o. The diagnostics of mycoses, virus infections or mycobacteriosis in this group of patients might be very important.

The updated Federal clinical recommendations on urticaria are presented (2018).

Sensitization spectrum in pre-school children with asthma and/or rhinitis remains unclear. Objective. Our aim was to estimate the allergen sensitization in preschool children living in urban environment of the Altai region with asthma and/or rhinitis. Materials and methods. A cross-sectional survey was performed in 182 children aged from 3 to 6 years suffering from asthma and/or rhinitis in 5 cities of Altai region. Asthma was diagnosed according to the Global Initiative for Asthma guidelines, allergic rhinitis was diagnosed according to the ARIA guidelines. ImmunoCAP and skin prick test were used to assess sensitization spectrum. Results. Among the 182 patients 144 (79,1%) had sensitization at least to one allergen. Sensitization to one allergen was detected in 38.5% of children, sensitization to 2 or more allergens - in 40,6%. Sensitization to Dermatophagoides pteronyssinus was detected in 46,7%, to birch pollen - in 37,3%, to cat epithelium - in 27,4% of patients. Sensitization to food allergens was detected only in 10,4%. Conclusion. The study revealed a high frequency of sensitization to 2 or more allergens - in 79,1% of 3-6 years old children with asthma and/or rhinitis . Most often, preschool children with asthma and/or rhinitis are sensitized to 3 inhaled allergens - to Dermatophagoides pteronyssinus (46,7%), to birch pollen (37,3%) and to cat epithelium (27,4%).