Vol 11, No 5 (2014)

The diagnosis of allergic disease related to the group of immediate hypersensitivity involves confirmation of IgE sensitization: positive skin tests with the suspected allergen and/or detection of allergen-specific IgE. Research over the past decades showed that IgE synthesis may occur exclusively in the tissues of the affected organ and derived allergen-specific antibodies may not enter the systemic circulation. In contrast to «atopy», this concept of local sensitization was termed «entopy». local production of IgE was detected in more then 47% of adults previously diagnosed as having non-allergic rhinitis. besides the nasal mucosa, local sensitization was found in lymphoid tissues of nasopharyngeal ring, bronchial mucosa in some patients with non-atopic asthma, esophageal mucosa in patients with eosinophilic esophagitis. The processes of local immune response is currently studied and probably one day the accumulated data will swing our understanding of atopic sensitization, that will be reflected in classification and therapeutic approaches.

In this article the problems of improving the control of bronchial asthma through optimization of bronchodilator therapy are discussed. Cholinergic mechanisms in the pathogenesis of asthma and the possibilities of use of long-acting m-anticholinergic - tiotropium (via liquid inhaler R espimat) - in the treatment of this disease are shown. Pharmacological properties of bronchodilators are discussed to identify the main groups of patients who need tiotropium therapy.

Bronchial asthma (BA) - a global public health problem worldwide. All treatments aimed at improving the control of symptoms of the disease, prevention of exacerbations and improving the quality of life for patients. The use of inhalation therapy is the basis for the treatment of all bronchoobstructive diseases. The effectiveness of treatment depends not only on the quality of the inhaled drug, but also by means of delivery of the drug into the bronchi. Easyhaler - a new dry powder inhaler, inhalation activated enables precise dosing of the drug. According to various studies, the method of delivery of drugs has proven high efficiency, ease to use and adherence of patients to the unit.

Bronchial asthma (BA) is one of the most socially significant diseases of the respiratory system. The control over the symptoms of BA is achieved less than in 50% of cases even in highly developed countries. The reasons for the lack of control are heterogeneous. One of the most important reasons for the lack of control over symptoms BA in Russia is the unavailability of highly effective drugs for socially unprotected layers of the population. The solution of this problem could be the creation of Russian analogs for asthma treatment. A new Russian product - a combination of topical corticosteroids and DBA (fluticasone/salmeterol) - Suticase-native is going to appear on the Russian market. A study to assess the efficacy and safety of the new product was carried out on the base of three Russian scientific centers. This trail compared a new drug Suticase-nativ (salmeterol 50 mcg plus fluticasone propionate 250 mcg/dose), powder for inhalation (produced by «Nativ» - company, Russia), with its famous counterpart - a Seretide accuhaler diskus (salmeterol 50 mcg plus fluticasone propionate 250 mcg/ dose), powder for inhalation dosed, production Glaxo Operates UK Ltd, in patients with bronchial asthma. The results of the study showed high efficiency and safety of Suticase-Nativ, comparable to Seretide.

Histamine is the main mediator of both true allergic and pseudoallergic reactions. Acting with histamine receptors it causes the appearance of the main symptoms of allergic diseases in various organs and tissues, so the search for effective and safe antihistamines continues for a long period of time. currently, there are antihistamines of 1 and 2 generation, which differs primarily by the ability of passing through the hemato-encephalitic barrier. despite the fact that for the majority of allergic diseases, the drugs of choice are nonsedating antihistamines 2 nd generation, which have no sedative effect, in some cases, antihistamines of the 1 st generation are not only preferable, but also indispensable. the article provides the analysis of the clinical situations in which antihistamines of the 1st generation are the tools of choice on the example of clemastine (tavegil).

This article represents the results of research of low-frequency ultrasound with levocetirizine in patients with acute infectious rhinitis (AIR). Low-frequency ultrasound therapy with levocetirizin effectively reduces rhinitis symptoms (nasal obstruction, sneezing, rhinorrhea) duration, demonstrates anti-inflammatory activity and reduces of topical decongestants requirement in AIR patients. Effectiveness of this therapy was estimated by objective and subjective methods.