Vol 14, No 4-5 (2017)

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.

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.

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.

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.

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.

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.