Vol 15, No 1 (2018)

Asthma in most cases is under control due to the success of modern pharmacotherapy. At the same time questions concerning the treatment of asthma and comorbidities like chronic rhinosinusitis with nasal polyps (CRSwNP) remain unresolved. Among the causes of СRSwNP formation a microbial aggression or an inadequate immune response (allergy) to various types of antigens (allergens) are considered. Congenital, individual characteristics and abnormalities of the corresponding anatomical structures are also cited as factors contributing to the development of CRSwNP. A functional integrated immunity system - the lymphoid tissue associated with the mucous membranes (MALT), infectious and allergic inflammation in the upper respiratory tract can significantly affect the lower respiratory tract and vice versa. Inflammation is the cornerstone of CRSwNP pathogenesis, that’s why understanding of inflammatory response will reveal the mechanisms of asthma severity in combination with CRSwNP.

Background. Information on atopic dermatitis (AD) epidemiology in preschool children is scarce. Objectives. To estimate the prevalence, clinical, allergological characteristics and risk factors of AD in preschool children. Materials and methods. 5156 children aged 3-6 years old living in the Altai Territory participated in the study. The study included a screening and clinical phases. At the screening stage of the study the prevalence of AD was evaluated using the Russian version of the ISAAC questionnaire, risk factors were evaluated using the additional questionnaire. At the clinical stage diagnosis of AD was verified by allergists. Results. The prevalence of atopic dermatitis was 9,9%. 73,8% of children had mild AD; 58,5% of children were sensitized: 25 (15,6%) to food allergens - 12 (7,2%) to egg, 12 (7,2%) to cow’s milk, 6 (3,6%) to wheat flour and 8 (4,9%) to fish. The most important inhaled allergens were house dust mites, the sensitivity to them was diagnosed in 44 (26,8%) children. The family anamnesis of allergic diseases increases risk of development of AD by 5 times (OR=5,7; 95% CI=4,1-7,9; p<0,01), smoking of parents - by 1,7 times (OR=1,7; 95% CI=1,1 to 2,6; p<0,05); impropriate intake of vitamin D3 in the first year of life increases risk of development of AD by 2,8 times (OR=2,8; 95% CI=2-3,9; p<0,01). Conclusion. The prevalence of AD among children aged 3-6 years old is 9,9%, the majority of children have mild disease, and 57,3% of the children sensitized to one or more allergens. Risk factors of AD in preschool age are allergic family history, passive smoking and impropriate intake of vitamin D3 in the first year of life.

A characteristic feature of atopic dermatitis is herpes infection, which necessitates application of antiviral therapy. The analysis of the peptide composition of Laennec drug by de novo mass spectrometric sequencing allowed us to identify over 10 peptides, characterized by potential antiviral effect at all stages of the viral life cycle. Laennec’s peptides can inhibit viral activation (inhibition of protein HCFC1), fusion of the viral envelope with the plasma membrane in the step of the host cell virus infection (inhibition of protein CD4), virus replication (inhibition of protein CTBP1), maturing of virion (inhibition of proteins CRM1, VPS4B, TPR, proline isomerase), budding of the viral particles from the cell membrane (inhibition of the NEDD4 protein). Laennek therapy in complex treatment of patients with atopic dermatitis and herpes virus infection can be substantiated by its pharmacologic activities including antiviral effect.