Vol 15, No 3 (2018)

Cross-reactivity to proteins is the issue of the day due to the severity of clinical symptoms, high prevalence of this phenomenon and the absence of preventive measures . Cross-reactivity is found in pollen, house dust, insects, food allergy, helminthes etc. Multiple studies have confirmed the important role of the protein tropomyosin in the development of sensitization to house dust mites allergens, food allergens and insects. The presence of tropomyosin is detected in the allergen spectrum of many arthropods, in particular insects and crustaceans. The researchers have noted the possibility of development of various cross-allergic reactions to tropomyosin protein. Arthropods are the main type of the Earth’s fauna. Clinical symptoms of allergic reactions to Arthropods differ in severity; this is the issue of studying of the the cross-reactivity to tropomyosin protein.

Background. Knowledge of the structure and particularity of sensitization in the region allows us to choose the correct tactics of treatment and prevention of atopic reactions. Objective. To study the structure of sensitization to inhalation allergens in Moscow and Moscow region since 2009 to 2017 and to determine significance of sensitization to house dust mites Dermatophagoides pteronyssinus (Der p) and Dermatophagoides farinae (Der f) in it. Methods. Blood serum of Moscow region patients with atopy (n=2546) was examined by RIDA AllergyScreen method in the period from 2009 to 2017. Results. The allergosensitisation structure was determined. It was revealed that there was no decreasing of the frequency of house dust mites (Der р and Der f) sensitization in observation period. The features of monovalent, polyvalent and combined sensitization among patients with IgE reactions to Der р and Der f were analyzed. Conclusions. According to our research 20% of patients with atopy in Moscow region have sensitization to Der р and/or Der f. The percentage of allergosensitisation to Der р is higher than to Der f. Most often house dust mites sensitization combined with pollen sensitization.

Objective of the research. To study predictors of efficacy of AIT in relation to the symptoms of seasonal ARC and PFAS in children with different IgE profiles. Materials and methods. Open prospective observational study of 161 patients aged 5 to 17 years with clinical symptoms of ARC (the annual escalation in April-May, duration of the disease is not less than 2 years, the need for symptomatic therapy in the flowering season of cause-significant plants) and PFAS for products of plant origin. The examination included skin testing, as well as sIgE determination of birch pollen allergen extract, cross-food allergens of plant origin (apple, pear, cherry, peach, carrot) and recombinant birch pollen allergens allergens (rBet v 1, rBet v 2, rBet v 4, rBet v 6) on the automatic analyzer ImmunoCAP250. All patients received two courses of AIT, sublingual administration. Assessment of efficacy was performed using the modified scheme A.D. Ado and diagnostic introduction earlier unbearable product. Conclusion. Monosensitization to rBet v 1 is a clinical and laboratory marker of the high efficacy of AIT in children with seasonal ARC and PFAS. Conclusion. Monosensitization to rBet v 1 is a clinical and laboratory marker of the high efficacy of ACIT in children with pollinosis and cross-PAS. Daily high-dose immunotherapy with standardized extract of birch pollen allergen has a good therapeutic effect, including in relation to the manifestations ofPFAS.

Background. Peculiarities of the disease and effectiveness of therapy depend on changes in availability and functions of effector immunocompetent cells and cytokine profile. Purpose. To study the peculiarities of immune pathogenetic mechanisms of virus-induced and allergen-induced bronchial asthma phenotypes in children in order to justify the use of immune therapy and to analyze it’s effectiveness. Materials and methods. We have performed an integrated assessment of immunological parameters in 120 children at the age of 3-11 y.o. with virus-induced and allergen-induced phenotypes of bronchial asthma (BA) and in 30 healthy children. Withdrawal criteria: severe BA, immune therapy during preceding 6 months. We used flow flow cytometer COULTER EPICS XL (Beckman Coulter Inc.) for identification of venous blood cells, CYTOKINE-STIMUL-BEST sets (Vektor-Best JSC, Novosibirsk) for levels of spontaneous and mitogen-induced production of cytokines identification. The immunological effectiveness of treatment was analyzed in the open parallel prospective study using random sampling technique in subgroups on the basis of treatment regimen. Statistical data processing was performed by «Statistica 10» program with critical significance level p<0,05, correlations were analyzed using Spearman rank correlation coefficient, clustering with nonparametric analysis of variance «Kruskal-Wallis ANOVA». Results. Children with various phenotypes of BA demonstrated discrepancies between impairments of availability, proliferation, differentiation and functional activity of immunocompetent cells and cytokine production. The imbalance of cytokine production and impairments of availability and functioning of immunocompetent cells remained unchanged after treatment by inhaled glucocorticoids. When bacterial lysate was added to therapy the normalization of parameters of cellular immune response was observed in patients with virus-induced BA. When glucosaminylmuramyl dipeptide was administered, the recovery of the cells’ capacity for production of spontaneous and mitogen-induced IFN-y was noted in children with allergen-induced phenotype of the disease. Conclusion. Immune pathogenetic mechanisms of virus-induced and allergen-induced BA in children with different immune mechanisms of the disease phenotype justifies individual immunotropic therapy use.