Vol 14, No 6 (2017)

Mechanisms of delayed druginduced allergies (DDIA), individual features of the immune response to the drug, influence of various cofactors (concomitant pathology, viral infection, insolation, etc.) create difficulties in diagnostics of drug allergy (DA). Identification and elimination of a causative drug allows to prevent the development of severe allergic reactions. Verification of DA diagnosis during the survey allows to avoid the unreasonable lifelong ban on application of certain drug, which often leads to decreasing of treatment efficiency and increasing its cost. In vitro diagnostic tests are safe, but laborious and expensive. This article will provide the review of literature, reflecting a modern view on the diagnosis of DDIA.

The article presents the study of prevalence of allergic diseases among the employees of industrial sites located at former uranium ores mines in Lermontov region. The aim of the research was to study the spectrum of etiologically significant allergens, prevalence and clinical features of allergic diseases among the employees of industrial sites located at former uranium ores mines in Lermontov region. Materials and Methods. Analysis of data of screening questioning, clinical laboratory, functional and allergological methods of examination was performed. Results. The high prevalence of allergic diseases among employees of hydrometallurgical plant (OJSC GMP) and electromechanical plant (LLC EMP): 27,1 and 24,7%, respectively was found. Two employees of OJSC GMP and one of LLC EMPin 2014 had latent sensitization to pollen, but in 2015 demonstrated severe clinical symptoms of allergic rhinitis (AR). Conclusion. Respiratory forms of Ig-Emediated allergy - AR, bronchial asthma (BA) prevailed in the structure of allergic diseases among the employees of industrial sites located at former uranium ores mines in Lermontov region. 19,6% of OJSC GMP and 16,4% of LLC EMP employees showed an increased level of total IgE in the blood serum. No correlation between the increased total IgE and the presence of allergic deseases was established. These results can be explained by the weakening of the T-suppressor inhibitory mechanism that promotes IgE synthesis in response to antigenic stimulation (allergens, chemical factors, etc.).

217 people were examined including BA patients (n=78), patients with COPD (n=38), patients with combined asthma and COPD (n=39), and community-acquired pneumonia patients (n=17). The control group represented patients with essential hypertension and coronary heart disease (n=25) and 20 healthy persons. NE, AAT, phagocytic activity of neutrophils (FGC), oxygen blast, respiratory function and FeNO, serum IgE and IgG antibodies to Strept. pneumoniae, Neisseria perflava, Haemofil. influenzae and Staph. aigai were determined in all patients. The indicators of the functional state of neutrophils reflected the degree and severity of bronchopulmonary inflammation. Patients with bronchial asthma in combination with COPD had bacterial inflammation, manifested by bronchial obstruction with increasing level of AAT. These features were absent in patients with BA and COPD.

Urticaria is a widespread disease with various phenotypes, duration and severity of the course, a pronounced effect on the quality of life. Despite the heterogeneity of the disease, a huge variety of provoking triggers, the activation of mast cells is still considered the key link in pathogenesis, and therefore antihistamines of the 2nd generation remain effective and safe drugs for treatment of urticaria. The process of improving antihistamines actively continues, one of the directions is the search for molecules based on the release of more active and safe enantiomers from already known drugs (example: levocetirizine from cetirizine). Information on levocetirizine, the efficacy and safety of which in the treatment of urticaria in both adults and children, has been demonstrated in a number of well-planned randomized controlled clinical trials, as well as in various preclinical studies, due to the accumulation of new data, the advent of generic drugs, and also a new scale for assessing the quality of clinical data in the GRADE system needs to be updated. The present review is devoted to solving this problem.

Background. Glucosaminylmuramyl dipeptide (likopid) is a selective NOD2 receptor agonist, its ability to activate phagocytes proves its use in infectious manifestations in asthma patients. Its influence on the adaptive immunity, was studied. The aim of the study was to evaluate the effectiveness of likopid in patients with atopic bronchial asthma and recurrent infections of the respiratory tract. Materials and methods. 44 patients with uncontrolled atopic bronchial asthma with recurrent respiratory tract infections were examined. Patients of group I received likopid 10 mg orally once a day during 10 days additionally to the complex therapy. Patients of group II received only complex therapy without likopid. The immune parameters, disease control parameters, frequency of exacerbations and spirography data in patients of two groups before the treatment and after 10 days, 1 and 3 months were assessed. Results. Both I and II group patients (91,6%) showed similar deviations of the immune status parameters in general, a depression of the functional activity of phagocytes was noted in 83,3% of cases. Patients of group I were characterized by the achievement of better asthma control in 1 month of treatment, while the frequency of asthma exacerbations required revision of therapy was lower in patients of group I than in patients of group II (8,3% and 45%, respectively, p<0,001). The patients of group I, receiving likopid, had increased phagocytic activity after 10 days of treatment, while significant changes were recorded after 1 month of treatment; a decrease in these parameters was shown only in 45,8% (p<0,001) of patients in 3 months of treatment. The conclusion. The use of glucosaminylmuramyl dipeptide in atopic bronchial asthma accompanied with clinical manifestations of the secondary immune deficiency leads to correction of phagocytic activity, as well as to significant decreasing of infections incidence and improving of bronchial asthma symptoms control.