Vol 13, No 2 (2016)

The modern approaches to the understanding of inflammation in the lower airways in asthma are discussed in the article. we present some recent studies that demonstrate the variety of mechanisms of the inflammatory response and the heterogeneity of patients with bronchial asthma. the immunological particularities of asthma endotypes and phenotypes are shown in this article.

Eosinophilic esophagitis (EE) is a chronic disease characterized by antigen-mediated eosinophilic inflammation leading to esophageal dysfunction. Food and pollen allergens are considered to be the main cause of EE. Indoor allergens can offend EE but not so often as food and pollen. Clinical case of EE associated with persistent allergic rhinitis with sensitization to house dust mites and cockroaches is presented in the article. Successful treatment with inhaled topical corticosteroids, taken orally, confirmed by endoscopy and biopsy is demonstrated.

Background. To identify the set of possible predictors of atopic dermatitis forming in children. Methods. There were 440 children aged from 0 to 18 years old (315 patients with atopic dermatitis, 125 - children of the monitoring group) under investigation. Mathematical models used logistic regression method were developed. Results. On the basis of the obtained data the logistic regression equation was selected, including 16 predictors, statistical significance of which was within 5% of the Wald statistics. Conclusion. Practical application of the devised formula will help to identify children with high risk to develop atopic dermatitis.

Rhinitis (allergic, vasomotor and others) is common inflammatory disease of the nasal cavity. Clinical manifestations of chronic rhinitis, such as nasal obstruction, discharge from the nasal cavity, significantly reduce the quality of life of the patients. Efficacy of modern antihistamine - azelastin in the treatment of seasonal and perennial allergic rhinitis is presented in the article.

Background. Intranasal corticosteroids and antihistamines are the basis of pharmacotherapy of allergic rhinitis (AR). The aim of this study was to evaluate the efficacy, safety and tolerability of Momat Rhino Advance (fixed combination of azelastine hydrochloride 140 mcg + mometasone furoate 50 mcg) intranasal spray in seasonal rhinitis patients. Materials and methods. Momat Rhino Advance was administered within 14 days in adults with seasonal AR in comparison with the original azelastine hydrochloride and mometasone furoate, used in combination with each other from separate devices against nasal (TNSS) and non-nasal (TNNSS) rhinitis symptoms. In total, 220 patients 18-65 years old with moderate/severe seasonal AR, were randomized in an open, parallel-group, multicenter clinical trial conducted in 16 centers in the Russian Federation during the period from April to September 2014. Results and conclusion. As a result of the study a marked decreasing of nasal symptoms using scale TNSS (in 89,6% relatively to the initial visit, p<0,05), and non-nasal symptoms using scale TNNSS (in 92,8% relatively to the initial visit, p<0,05) was obtained. Quality of life index using a standardized questionnaire RQLQ, showed a significant positive trend in treated patients with AR (p<0,05). There were no differences between the main group and other groups of patients in relation to nasal and other symptoms of seasonal AR and quality of life index. All studied drugs have shown high level of safety and tolerability. Thus, there was no difference between Momat Rhino Advance (fixed combination of azelastine hydrochloride 140 mcg + mometasone furoate 50 mcg, Glenmark Pharmaceuticals Ltd., India) nasal spray efficacy and safety in comparison with azelastine hydrochloride - nasal spray, and mometasone furoate nasal spray, applied from the individual devices in seasonal allergic rhinitis patients. The optimum regimen of using of Momat Rhino Advance was twice daily.