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Vol 14, No 4-5 (2017)

Articles
ACTUAL CONCEPTION OF ALLERGEN-SPECIFIC IMMUNOTHERAPY MECHANISMS, POTENTIAL BIOMARKERS OF EFFICACY AND WAYS OF ENHANCEMENT
Pavlova K.S., Kurbacheva O.M., Galitskaya M.A., Smirnov D.S.
Abstract
The article analyzes international position papers on the allergen-specific immunotherapy mechanisms, discusses potential biomarkers for evaluation of ASIT efficacy, as well as the perspectives for ASIT enhancement.
Russian Journal of Allergy. 2017;14(4-5):5-17
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EPIDEMIOLOGY AND PATHOGENESIS OF DELAYED DRUG ALLERGIC REACTIONS
Romanova T.S., Myasnikova T.N., Khludova L.G., Smirnov V.V., Latysheva T.V.
Abstract
The actual frequency of delayed drug hypersensitivity reactions (DDHR) is unknown to date, since most of the epidemiological studies are based on the history and the clinical manifestations of the disease, without confirmation of the diagnosis with in vitro or in vivo tests. Based on the European epidemiological studies of severe skin reactions to medicines, the «RegiSCAR» was created. It is shown that DDHR is the most heterogeneous group of allergic reactions, both in pathogenesis and in the clinical manifestations. They belong to the IV type of allergic reactions, mediated by T-lymphocytes sensitized to medicines. Most of the DDHR proceed with skin involvement in the pathological process. Different forms of inflammation are caused by the kind of activated immune cells. The pathogenesis of DDHR is very complicated, as a rule, due to several subtypes of immune reactions. Mechanisms for the presentation of chemical or drug antigens remain controversial. At present, there are three concepts in this regard: hapten, prohapten and the theory of pharmacological interaction with immune receptors. In this article, a literature review dedicate to the current view of the epidemiology and pathogenesis of DDHR.
Russian Journal of Allergy. 2017;14(4-5):18-29
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CURRENT CONCEPTS OF ATOPIC DERMATITIS IN CHILDREN: PROBLEMS AND PROSPECTS
Smirnova G.I.
Abstract
Modern data describing the current understanding of the pathogenesis of atopic dermatitis (AD): a genetic predisposition to atopy, disturbances of the intestinal microbiome, disruptions of epidermal barrier integrity and a cascade of immune responses, contributing allergic inflammation in the skin are presented. There are both described several mechanisms of acute and chronic phases of AD, the main directions of pathogenetically substantiated treatment of AD in children and indicated the prospects of new preparations specific blockers of proinflammatory cytokines involved in the development of AD - crisaborole, dupilumab, apremilast et al. External therapy of atopic skin lesions in AD children with modern dermatological cosmetics is presented.
Russian Journal of Allergy. 2017;14(4-5):30-39
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THE DIAGNOSTIC SIGNIFICANCE OF IMMUNOLOGICAL PARAMETERS OF THE PATIENTS WITH CHRONIC RHINOSINUSITIS WITH NASAL POLYPS
Savlevich E.L., Kurbacheva O.M., Khaidukov S.V., Gerasimov A.N., Amanturlieva M.E., Simbirtcev A.S.
Abstract
Background. Investigation of changes in immunological parameters is required to detect the degree of adequate immune system reactions to pathology process and to determine the answer to provided treatment. Taking into account high immunogramm cost differentiated approach is necessary in each specific case basing on economic and diagnostic effectiveness. Now chronic rhinosinusitis with nasal polyps (CRSwNP) is still poorly investigated. In the same clinical situation it is difficult to predict the pathology process development and length of remission period after surgical or conservative treatment. The most substantial difficulties in determining tactics of patients’ management in CRSwNP are associated with asthma, atopy or intolerance to nonsteroidal antiinflammatory drugs (NSAIDs). To determine the diagnostic significance of indicators of systemic cellular immunity for pathology process development forecasting in CRSwNP patients. Methods. CD3, CD4, CD8, CD16, CD19, CD25, CD27, CD45, CD45R0, CD45RA, CD56 and CD127 subpopulations of lymphocytes were examined in peripheral blood of 20 patients (age 46,7±16,06) with bilateral CRSwNP in remission using a flow cytometry method. Results. The study revealed rise in absolute or relative quantity of activated T-lymphocytes (CD3+CD25+), NK cell number (CD3 CD16+CD56+) and T-regulatory (T-reg) cells (CD4+CD25brightCD127lowtoneg), rise in absolute count of memory B-cells (CD19+CD5-CD27+) and NKT-cells (CD16+CD56+CD3+) in CRSwNP patients. An effort to make forecast for the development of CRSwNP due to change in NK (CD3-CD16+CD56+), activated NK (CD3-CD8+) and T-reg (CD4+CD25brightCD127lowtoneg) failed. Conclusion. Study of the cellular immune response to determine the tactics of patients’ management in CRSwNP and predict pathology process development is not a sufficiently informative method.
Russian Journal of Allergy. 2017;14(4-5):40-45
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FEATURES OF CLINICAL COURSE AND TREATMENT STRATEGY FOR PATIENTS SUFFERING FROM BRONCHIAL ASTHMA IN COMBINATION WITH OBESITY
Glushkova E.F., Shartanova N.V.
Abstract
Background. Obesity is considered to be one of the risk factors for the development of bronchial asthma (BA) and the reasons for lack of control can probably influence on inflammation of respiratory tract. However, the nature of these relationships needs to be clarified. The aim of the research was to characterise it clinically, functionally, allergologically and endocrinologically, to highlight the features of the course and to define the tactics of treating patients suffering from bronchial asthma in combination with obesity. Methods. The research was made on the basis of the National Research Center - Institute of Immunology of Federal Medical-Biological Agency of Russia: both in outpatient and inpatient conditions. A statistical analysis of 367 patients treated in inpatient conditions due to exacerbation of asthma of various severity and different BMI was performed. 40 patients with BA who satisfied all inclusion criteria and did not have exclusion criteria were treated in outpatient conditions. Patients were divided into two groups. The main group consisted of 20 patients suffering from asthma and having a BMI of more than 30 kg/m2. A control group consisted of 20 patients suffering from asthma and having a normal BMI. Results. When the data of the research was analyzed, it was found that the prevalence of obesity among the 367 patients with asthma and being treated in inpatient conditions in 2013-2015 was 44,9% of patients, which is comparable to the prevalence of obesity among the population in general. Conclusions. The data of the patients suffering from asthma and obesity treated both in inpatient and outpatient conditions, was analyzed and it is set that obesity does not affect the severity of the clinical course of asthma. It is shown that obesity does not affect the control of symptoms of asthma.
Russian Journal of Allergy. 2017;14(4-5):46-52
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ELIMINATION MEASURES AND SKIN CARE AS IMPORTANT STAGES IN PREVENTION OF EXACERBATIONS OF ATOPIC DERMATITIS IN CHILDREN
Gushchin P.I., Chuvirov D.G.
Abstract
According to recent data, the pathogenetically significant condition for the onset of atopic dermatitis is increasing epidermal permeability barrier and, therefore, a primary step in the treatment and prevention of atopic dermatitis should be control over the skin condition. Effective use of modern methods of prevention of exacerbations helps to reduce the frequency of relapses, lengthen the periods of remissions and, in general, improve the quality of life of sick children.
Russian Journal of Allergy. 2017;14(4-5):53-60
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CHARACTERISTICS OF SENSITIZATION IN CHILDREN WITH SEVERE ATOPIC DERMATITIS FOR THE FIRST FOUR YEARS OF LIFE
Kamaltynova E.M., Afanasyeva M.C., Fedorova O.S., Belonogova E.G.
Abstract
Background. To reveal the regularities of sensitization formation in children with atopic dermatitis (AD) in first four years of life. Methods. Continuous crosssectional study of 69 children with an established diagnosis of AD from age 0 to 4 years was conducted. Severity was assessed according to the SCORAD scale. Clinical examination included: general and biochemical blood tests, determination of total IgE and allergenspecific IgE (IgEs) in serum against the most common epidermal and food allergens with ImmunoCAP, Phadia IDM (Sweden) technology. Results. Diagnostically significant levels of IgEs to these allergens had 68,11% of patients. Sensitization to cow’s milk was estimated in 38,98% (n=23), to chicken egg and its components in 67,92% (n=36), to chicken protein in 67,44% (n=29), to yolk in 54,28% (n=19), to cat epithelium in 47,5% (n=19) of children. Conclusion. Sensitization to food allergens marks the early development of sensitization to exogenous allergens, predominantly to the cat epithelium. Sensitization to house dust mites develops less frequently, but can also occur in children under one year of age. Sensitization to cat epithelium can accompany food sensitization as well as to be an independent cause of AD.
Russian Journal of Allergy. 2017;14(4-5):61-65
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THE STUDY OF THE ASSOCIATION OF SINGLE-NUCLEOTIDE POLYMORPHISMS ARG25PRO OF THE TRANSFORMING GROWTH FACTOR Β1 GENE AND C634G OF THE VASCULAR ENDOTHELIAL GROWTH FACTOR GENE WITH THE RISK OF ATOPIC DERMATITIS IN CHILDREN
Lebedenko A.A., Shkurat T.P., Mashkina E.V., Semernik O.E., Dreyzina T.K.
Abstract
The growth factors such as transforming growth factor β (TGF-β) and vascular endothelial growth factor (VEGF) are played a particular role in the pathogenesis of atopic dermatitis. Therefore, the study of the genetic aspects of their association with risk of atopic dermatitis development in children is of great practical and scientific interest. Background. To study the association of the Arg25Pro polymorphisms of the TGF-β gene and the C634G gene of the VEGF gene with the risk of atopic dermatitis in children. Methods. Allelic variants of Arg25Pro gene TGF-β1 and S634G VEGFA gene in children with atopic dermatitis were studied with method of allelespecific polymerase chain reaction. The control group consisted of patients I and Ila of the health groups of the corresponding sex and age. Results. The results of genetic studies have shown that the occurrence frequency of genotype polymorphism Arg25Pro TGF-β1 gene in patients did not have significant differences from control group (p>0,05). Moreover, among patients who are heterozygous for the gene Arg25Pro TGF-β1, significantly more often had moderate (77,78%) and severe (33,33%) of course of the disease. It is established that the relationship between inheritance of C and Gallele polymorphism C634G VEGFA gene and the development of atopic dermatitis is also statistically significant (χ2=0,33, p=0,57). Conclusion. The study of polymorphisms of Arg25Pro gene of TGF-β and C634G gene of VEGF did not reveal a significant relationship between their inheritance and development of atopic dermatitis in children.
Russian Journal of Allergy. 2017;14(4-5):66-70
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THE PLACE OF ANTILEUKOTRIENE MEDICATIONS IN ANTIINFLAMMATORY THERAPY OF BRONCHIAL ASTHMA
Kurbacheva O.M., Galitskaya M.A.
Abstract
Phenotypes and endotypes of bronchial asthma are discussed; place of personalized approach to basic antiasthmatic therapy is established as well as leukotriene receptors antagonists usage in bronchial asthma therapy is described.
Russian Journal of Allergy. 2017;14(4-5):71-79
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THE ROLE OF MODERN ANTIHISTAMINES IN THE TREATMENT OF ALLERGIC DISEASES
Nenasheva N.M.
Abstract
Allergic rhinitis and urticaria - are common diseases which influence on the quality of life of patients reducing day activity and educability. The second generation of antihistamines are the first choice in the treatment of these diseases. At Russian pharmaceutical market a few dozens of different preparations of this group are available. Most of them are generic forms. The purpose of this article is to show the place of modern antihistamines in allergic rhinitis and urticaria therapy and to find out the best equivalent of generic antihistamine drug in comparison with the original one.
Russian Journal of Allergy. 2017;14(4-5):80-88
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EBASTINE. A REASONABLE CHOICE
Gushchin I.S., Danilicheva I.V.
Abstract
Data on pharmacokinetics and pharmacodynamics, efficacy and safety of ebastin, a review of clinical studies of therapy of allergic rhinitis, chronic idiopathic urticaria and other dermatoses are presented.
Russian Journal of Allergy. 2017;14(4-5):89-97
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EMOLLIENTS IN ATOPIC DERMATITIS TREATMENT IN CHILDREN: CLINICAL AND PHARMACO-ECONOMICAL EFFICACY ANALYSIS
Kamaev A.V., Trusova O.V., Lyashenko N.L., Makarova I.V.
Abstract
Background. Even the mild course of atopic dermatitis (AD) requires the complex approach to the exacerbation therapy and prevention. Systematic skin care is the cornerstone of AD antirelapse therapy, but the emollients price might interfere the compliance. The study aim was to evaluate clinical effectiveness and pharmacoeconomics of therapeutic skin care complex Atopic (daily cream, reliver cream and shower gel) in children with AtD. Materials and methods. Open prospective evaluation of 1-month long. There were 50 children (6 month to 18 years old) with AtD included in 2 groups (exacerbation and remission, 25 children each). We have evaluated mean values of SCORAD index, skin itching and dryness (visual analog scales), pharmacotherapy requests and number of AtD exacerbations. Emollients’ consumption was determined by used packs’ weighting. Month total emollients’ outlay and 1 remission day cost with the Atopic therapeutic skin care complex application were calculated. Results. 47 patients (94%) had completed the protocol; 3 children had stopped Atopic applications due to individual intolerance. After 1 month in AtD exacerbation group mean SCORAD-index score had decreased from 41,8±4,6 to 13,4±2,7 (р=0,0001); in remission group initially low SCORAD results (7,2±0,9) hadn’t changed (6,3±1,8). Among outlay subgroups the daily cream cost was predominant. Mean 1 remission day cost was 72.9 and 52.4 rubles/day for groups 1 and 2, respectively. Conclusions. Gathered data allow to characterize Atopic complex as attractive quality/price ratio cosmetics and to recommend their wide usage in long-term anti-relapse AtD therapy in children.
Russian Journal of Allergy. 2017;14(4-5):98-107
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PERSISTENT SUBCLINICAL INFLAMMATION IN THE SKIN AS A RISK FACTOR FOR RELAPSE IN ATOPIC DERMATITIS: FROM PATHOPHYSIOLOGY TO TREATMENT
Kalyuzhin O.V.
Abstract
Lowgrade cutaneous inflammation, which persists after induction of remission of atopic dermatitis (AD), determines the risk of repeated relapses and progression of the disease. It has been well established that subclinical inflammation in the skin of atopic patients may be inhibited by topical corticosteroids (TCS) and topical calcineurin inhibitors (TCI), and proactive courses of these drugs prolong remission of the disease. In terms of prolonged application, TCI have some advantages over TCS in the context of safety. However, the routine use of TCI in AD is constrained by many practitioners who do not accept the concept of subclinical chronic inflammation and the strategy of maintenance antiinflammatory therapy on areas prone to repeated relapses, as well as obsolete myths about the association of TCI application with increased risk of cutaneous lymphoma. The review presents modem data on the pathophysiology of AD with a focus on subclinical skin inflammation, which persists after regression of acute manifestations of the disease, and the possibilities of suppressing this inflammation with TCI. Data on the safety of TCI for longterm use and the absence of prooncogenic potential are given. In addition, the relevance and expediency of pimecrolimus use in children under 2 years of age are emphasized.
Russian Journal of Allergy. 2017;14(4-5):108-119
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Markova T.P. Anniversary
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Russian Journal of Allergy. 2017;14(4-5):120-121
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Congresses, conferences
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Russian Journal of Allergy. 2017;14(4-5):122-122
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Victor Mikchailovich Man’ko 24.12.1931 - 18.08.2017
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Russian Journal of Allergy. 2017;14(4-5):123-124
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VIKTOR MIKhAYLOVICh MAN'KO 24.12.1931 - 18.08.2017
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Russian Journal of Allergy. 2017;14(4-5):125-125
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TREBOVANIYa K OFORMLENIYu RUKOPISEY
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Russian Journal of Allergy. 2017;14(4-5):126-130
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