Vol 12, No 1 (2015)

AD is a multifactorial disease, which is based on genetic disorders, immune mechanisms and influence of exogenous and endogenous factors. Study of immunopathogenesis of atopic dermatitis, it’s specific biomarkers, triggers is very important for understanding of causes and mechanisms of the disease as well as for developing of new methods of treatment. The review describes the current views on the immune response in AD.

Background. The study aimed to develop the optimal concentration and doses of drugs for examination of perioperative drug’s hypersensitivity reactions. Methods. The protocol of allergological examination included clinical, laboratory methods and tests in vivo: skin tests (prick-, intradermal, patch- test) with neuromuscular blockers, opioids, radiocontrast medias, colloids, hypnotics; patch-test with povidon-iodine, chlorhexidine; dosing provocative test (including investigation of blood, nasal secretion eosinophilia, serum tryptase measurements) with antibiotics, nonsteroid anti-inflammatory drugs, local anesthetics. 20 healthy volunteers were included in the study during 2 years (2010-2012) for estimating of the doses and concentrations of testing drugs. Results. Non irritating concentrations for skin tests (prick- and intradermal) with perioperative drugs have been estimated on healthy controls. No one of healthy controls had false positive tests and nonspecific histamine-release effects while testing in vivo. Increased tryptase level 1 h after and the level of blood eosinophilia and eosinophiliaof nasal secretion 6 hours after dosing provocation test with each drug were found to be statistically insignificant. Conclusions. Optimal concentrations and doses of drugs for allergological examination of perioperative drug’s hypersensitivity reactions were estimated.

Clinical recommendations (CR) - is a consensus for the diagnosis and treatment of patients with certain nosology, created by experts in various fields of medicine based on the experience of experts, and data from multicenter trails. CR optimize patient management, minimizing the risk of medical error. CR of a particular importance are CR for the rare diseases, because the majority of doctors lack of experience. One of the illustrations of such rare diseases are primary immunodeficiencies (PID). Owing to the development of fundamental immunology, diagnostic and therapeutic options, these patients may survive to adulthood, so this problem has gone beyond the field of pediatricians. Now the probability to meet such patients is much higher for many doctors of different specialities. The paper discusses the problem of PID in Russia, the challenges of creating a CR on this disease and the ways of their solution.

The aim of study. To estimate clinical efficiency of the antagonist of the leukotriiene receptors - montelukast in control of atopic diseases at children of preschool age. Materials and methods. Open randomized comparative study of clinical efficiency of montelukast in parallel groups of children of preschool age having atopic diseases was conducted. Results. Inclusion of montelukast (singular) in basic therapy of children of preschool age, having atopic diseases, allowed to decrease the number of exacerbations of a bronchial asthma and allergic rhinitis and as well as the necessity of «emergency aid», when a dose of topical glucocorticosteroids reduced 1,9 times. Conclusion. Montelukast treatment showed high clinical efficiency and allowed to control symptoms of allergic rhinitis and bronchial asthma, when it was included in the basic therapy of atopic diseases at children of preschool age.

The article presents the results of a prospective noncomparative study of carbamylated monomeric allergoid Lais ® for sublingual immunotherapy (SLIT) in patients with allergic rhinoconjunctivitis caused by pollen grasses. We suggest that SLIT using Lais ® sublingual tablets is an effective and well-tolerated method of treatment.

Immunological estimating of different diet therapy types became currently very important. The aim of this work was to study the changes of immunological biomarkers during usage of formulas based on different sources of protein in children with food allergy and to assess and predict the effectiveness of diet therapy. The study included 66 children with food allergy in age from 1,5 months to 1,5 years. Observed children were divided into three groups depending on the type of formulas used. The dynamics of immunoregulatory substances (IL-5, TGF β 1, IL-10, IL-4, IL-2, IL-13, Eotaxin3), and allergenspecific IgE and IgG antibodies to cow’s milk protein, α-lactoglobulin, β-laktoglobulin, casein, soy and goat’s milk during diet therapy were evaluated. Observation duration was 28-30 days. The differences in the dynamics of the investigated parameters depending on the type of formula were revealed. Thus, the use of formula based on cow’s milk hydrolysates revealed their primarily effect on cytokines IL-2, IL-5 and growth factor TGF β ; the use of formula based on soy protein revealed combined effect on humoral immunity (allergen specific IgE and IgG antibodies) and IL-5; the use of formula based on goat milk characterized decreased levels of allergenspecific IgG antibodies to the cow’s milk protein and its fractions, reduced allergen specific IgE antibody concentrations to cow’s milk protein and α-lactoglobulin, decreased levels of IL-5, and, exclusive for this formula - reduction of IL-4 level. Accordingly, the assessment of immunological biomarkers can be used to personalize diet therapy in children with food allergy.