Vol 12, No 2 (2015)

The article discusses pathogenesis, clinical features and treatment approaches in exerciseinduced asthma and post-exercise bronchoconstriction. Arguments in favor of using antileukotriene medications in complex treatment of patients with exercise-induced bronchoconstriction are presented.

Objective. To identify endothelial dysfunction (ED) in patients with bronchial asthma (BA) in the acute phase, to establish the relationship between levels of homocysteine (HC) and endothelin-1 (ET-1) in the blood, and the causes of the disease. Materials and methods. 32 young patients in acute phases of bronchial asthma divided into three groups depending on the cause of bronchial asthma, and 10 healthy individuals were included in the study. Respiratory function assessed by spirometry with bronchodilatation test, serum endothelin-1 level was determined with immunofermental analysis, homocysteine level was determined with plasma liquid chromatography method. The results. There was a significant statistical difference between groups in terms of homocysteine, endothelin-1 levels in blood. Significant positive correlation between the levels of homocysteine and endothelin-1 in patients with allergic bronchial asthma and a significant negative correlation between the marker levels of endothelial dysfunction and lung function were identified. Conclusion. Acute phase of asthma accompanied by endothelial dysfunction, characterized by different levels of homocysteine and endothelin-1 in blood, depending on the genesis of the disease.

Background. The purpose of this study was to identify IgE-antibodies to the major and minor allergenic components of pets in the blood serum of patients with bronchial asthma and/or allergic rhinitis (BA/AR). Methods. The study included 327 patients from Moscow and St. Petersburg. All of them were detected for specific IgE-antibodies (IgE-AB) to the animal allergens by ImmunoCAP® (ThermoFisherScientific, Sweden). 105 patients wanted to detect IgE-AB to the main animal allergens molecules ImmunoCAP ISAC® (ThermoFisherScientific, Sweden). Results. In the sera of 327 patients IgE-AB to cat’s (62%) allergen dominated. IgE-antibodies to dog’s, house dust mites (D.pteronyssinus, D. farinae), mold fungi, horses and rodents allergens were found in 2,6-31 times less. IgE-AB to uteroglobin (rFel d 1), major cat allergen, was detected in 80% of patients (84/105). The detection rate of IgE-AB to other cat allergens was 4,2-8 times lower (rFel d 2 - 10%, nFel d 4 - 19%). IgE-AB to major dog allergen rCan f 1 was detected in 39% of patients (41/105). Positive level of IgE-AB to other dog allergens was detected in 2,2-4,9 times lower (rCan f 2 - 8%, nCan f 3 - 9%, rCan f 5 - 18%). Positive level of IgE-AB to lipocalin was assayed in 6% of patients, to serum albumin - in 7%. Conclusion. Prevalence of IgE-AB to cat and dog allergens was almost 3 times higher than the frequency of detection of IgE-AB to house dust mite allergens in citizens of Moscow and S. Petersburg. The frequency of IgE-AB to rFel d 1 was dominated and detected 2 and 4-11 times often than to rCan f 1 and other animal allergens consequently.

Allergic bronchopulmonary aspergillosis (ABPA) is a caused by hypersensitivity to Aspergillus spp. antigens, is the lung disease, which occurs in patients with asthma or cystic fibrosis and is characterized by poor control of background disease and development of respiratory failure. According to experts opinion the number of patients with ABPA is about four million people in the world and 175 000 persons in Russian Federation. The clinical course improvement, prevention of progression and prophylaxis of bronchiectasis depend on timely and correct diagnosis of the disease. International Society of Human and Animal Mycology (ISHAM) formed a working group «ABPA in patients with asthma» for worldwide collaboration with physicians and researchers. The working group proposed new diagnostic criteria. This report presents a clinical case of ABPA in asthmatic patient. The diagnosis is established according criteria proposed by R. Agarwal et al., 2013.

There is some evidence to suggest that colostrum/breast milk immunological composition have potential in infant gut immunity modulation early in life. Objective. To assess levels of cytokines in colostrum and breast milk in atopic and non-atopic mothers, and in those, who have self-reported allergy. Patients and methods. 277 Moscow women were recruited as a part of an International (Great Britain, Russia, Italy) study assessing immune composition of colostrum and breast milk. Skin prick-tests were used to assess sensitization in recruited women. Electrochemiluminiscence of colostrum and breast milk samples for HGF, IFN-γ, IL-2, IL-4, IL-5, IL-10, IL-12, IL-13, TGF β1, TGF β2, TGF β3 was performed in a Flow Cytometry Lab, Imperial College London. Results. In 19,4% of Moscow women a sensitization to one or more allergens was revealed. According to univariate analysis colostrum and/or breast milk levels of TGF β1, TGF β3, HGF, IL-5, IL-10 and IFN-γ were higher in sensitized women. No difference in IL-2, IL-4, IL-12, IL-13, TGF β2 levels was revealed in relation to sensitization. Conclusion. Cytokine and growth factors differences of colostrum and breast milk samples from Moscow women allow to assume the lack of IL-4 and IL-13 shift of cytokine and growth factors in relation to sensitization.

The purpose of this study. To investigate clinical characteristics of the allergic rhinitis in children receiving allergen-specific immunotherapy. Methods. The epidemiologic observational multicenter study was conducted with the allergists of Altai region. The participating allergists filled out the specially designed medical record card on children with allergic rhinitis receiving ASIT. The study lasted from October 2013 to March 2014. Results. Allergists have filled out medical record cards of 165 children with allergic rhinitis receiving ASIT. The average age of children was 10,5±2,3 years, with the average of 4,8±2,5 years of allergic rhinitis prior to the start of ASIT. 159 (96,2%) children had moderate/severe allergic rhinitis, and 121 (73,3%) children had persistent allergic rhinitis. In 123 (74,5%) children rhinitis was accompanied by allergic conjunctivitis, and in 70 (42,2%) children - by bronchial asthma. 69 (41,8%) children receiving ASIT were mono-sensitized, 96 (58,2%) children were polysensitized. 48,5% of children were sensitized to house dust mites, 63,6% to tree pollen, 48,5% to meadow grass pollen, 30,9% to weed pollen, and in 21,8% sensitization to epidermal allergens was found. Conclusion. The findings of the study showed that in most cases (96,2%), children with allergic rhinitis receiving ASIT had moderate/severe rhinitis and in 73,3% symptoms were persistent. In 74,5% of cases, allergic rhinitis was accompanied by allergic conjunctivitis. Most part of children receiving ASIT had multiple sensitization (58,2%). Also a delayed beginning of ASIT was observed - 4,8±2,5 year from primary diagnosis to ASIT initiation.