Vol 9, No 1 (2012)

The basic results of clinical researches on efficacy and safety studying sublingual allergenspecific immunotherapy (slASIT) are presented in the review. The results of SUBLINGUAL application of allergens in Russian Federation are presented.

The aim of the study which included 2311 patients (aged 18—80 yrs), examined by 100 physicians (57% allergists, 37% pulmonologists and 7% general practitioner) in 18 Russian cities, was to assess the prevalence of allergic rhinitis in patients with asthma, as well as to evaluate the specifics of the course of these diseases, when concomitant or not. The study design included one outpatient visit, followed by the completion of studyspecific case report forms and Asthma Control Questionnaire (ACQ) validated for use in Russia. The vast majority (88%)of asthma patients had concomitant allergic rhinitis (Group 1). Patients with asthma only (Group 2) were older (50,6±0,78 vs 41,9±0,35 yr, p<0,05, had more severe asthma course (FEV t 70,6±1,1 vs 78,3±0,46% of predicted, p<0,05), lower prevalence of atopy (45% vs 98%, p<0,05) , higher body mass index (BMI) (28,2±0,27 vs 27,3±0,12, p<0,05), and smoked more often compared to Group 1 (30% vs 23%, p<0,05). The treatment of concomitant allergic rhinitis recommended in current clinical guidelines may improve asthma control. Significant proportions of patient with asthma (27%) and allergic rhinitis (41%) were treated not in line with evidence-based International and National Guidelines. The conclusion of this study is that allergic rhinitis is a common comorbidity in patients with asthma. The implementation of the evidence based approach to diagnosis and treatment of both diseases, in accordance with current clinical guidelines, in real clinical practice in Russia is extremely important.

Background. The objective of this study was to estimate a vascular wall status of large arteries and function of endothelium in patients with different clinical forms of bronchial asthma throughout the disease progression. 220 patients with bronchial asthma have been examined, including 106 persons with moderate asthma ( 1 st group), 61 persons with severe asthma (2 nd group), and 53 persons with steroid-dependent asthma. Control group was formed from 40 healthy donors. Methods. We have assessed parameters of external respiration, arterial rigidity, and the levels of TNFα, IL-6, sCD31 (sPECAM-1), CRP in the peripheral blood at the time of exacerbation and 48 weeks later. Results. We found elevation of IL-6 and TNFα levels in all the tested groups in the period of exacerbation comparing to the control group (p<0,05), thus confirming development of SIRS. We have registered increased levels of sCD31 (sPECAM-1) in all the tested groups suggesting development of endothelial dysfunction. Increase in aorta rigidity in patients with asthma has been manifested by elevation of pulse wave velocity and augmentation index. Conclusion. We have demonstrated that the degree of arterial rigidity and endothelial dysfunction could be used as indicators of systemic inflammation being corresponded to the alterations in external respiration in asthma patients.

The Article is devoted to an actual problem of modern public Healthcare — Pneumococcal infections and possibilities of their prophylaxis. Background. To develope the effective and safe specific prevention method of pneumococcal disease in children of risk groups with the use of conjugated and polysaccharide-based vaccines. Materials and methods. 285 children of both genders aged from 6 months to 5 years old with various deviations in health status and risk factors of development of invasive pneumococcal disease were included in the study. Children from the main group (n=218) were immunized by the seven-valent pneumococcal conjugate vaccine (PCV7), part of children (n=31) were primary vaccinated by PCV7 later and received a boost dose of polysaccharide vaccine (PPV-23), children in the control group (n=36) were once immunized by PPV-23. Safety, clinical and immunological effectiveness of various schemes of vaccination were evaluated. Results. Frequency of adverse events to the introduction of PCV7 such as fever were up to 6.4%, local reactions — 4,6%. The majority of children (87—89%), immunized with PCV7 had elevated level of specific antibodies in more than 3 times compairing to the control group. In children vaccinated with PCV7, the number of pneumonia cases decreased to 6.8 times, acute average otitis — to 3,5 times, ARD — to 1,3 times.

In the article data about classification, pathogenesis, clinical manifestations and treatment of different forms of allergic conjunctivitis in children are presented.

Methods: 117 infants with atopic dermatitis and food allergy were enrolled. The analysis of clinical and immunological characteristics of the infants with multiple food intolerance was performed. Results: asthma, high levels of specific IgE to cow milk, egg, beef, pork, sensitization to allergens of cereals, fruits and vegetables were characterized for infants with multiple food intolerance. Conclusion: infants with multiple food intolerance possess defined clinical and immunological characteristics which can form the basis for prescribing of amino acid formula.