Vol 7, No 4 (2010)

Epidemiologic data on atopic diseases with fungal sensitization is summarized in the review. Basic pathogenic aspects of fungal allergen associated disorders are presented. Fungi may adversely affect human health through three processes: allergy, infection and toxicity. Allergic reactions to fungi can be immediate or delayed. The most common form of hypersensitivity to molds is immediate (or IgE-mediated) type hypersensitivity.

Background. To study the clinical effectiveness of topical immune modulator cream thymogen 0,05% and its influence on some immunological parameters in the skin and blood of atopic dermatitis (AD) patients. Materials and methods. 40 people were included in the study, who were divided into main (AD patients, n=20) and a control group (healthy donors, n=20). All AD patients received topical treatment with cream thymogen 0,05% during 14 days. Patients applied cream to affected skin 2 times daily. Clinical efficacy of the treatment was assessed by changes of following parameters: investigated global assessment (IGA), subjective evaluation of the itch intensity and skin dryness . Samples of skin biopsies and peripheral blood of AD patients and healthy donors were tested for gene expression of cytokines by polymerase chain reaction in real time. Results. Topical treatment with cream thymogen 0,05% during 14 days in all AD patients showed positive clinical effect: reduction of dryness and itch. Immunological analysis revealed a significant increasing of cytokine IL-7 gene expression and decreasing of cytokines IL-8, IL-5 genes expression (p<0,05). In the peripheral blood no significant differences of cytokines genes expression before and after the treatment with cream thymogen 0,05% in comparison with healthy donors have been detected. Conclusion. Cream thymogen 0,05% showed a local immunomodulating activity resulted in the decreasing of the intensity of skin inflammation and clinical improvement in AD patients. Changes of cytokines genes expression in skin, but not in blood were identified.

The own data concerning cream pimecrolimus 1% application in atopic dermatitis patients complicated with steroid rosacea are presented.

Background. Allergic rhinitis is a common disease, affecting 25-35% of the population. Birch pollen is a significant cause of immediate hypersensitivity among sensitive subjects, affecting about 80% of the population in the central part of Russian Federation. Specific subcutaneus immunotherapy (SCIT) is the only treatment producing lasting clinical improvement in patients with allergy. The aim, of the study was to investigate the efficacy of one - year SCIT for allergic rhinoconjunctivitis for birch pollen using the Average Rhinoconjunctivitis Total Symptom Score (ARTSS) and Average Rescue Medication Score (ARMS). Materials and methods. 54 subjects with IgE-mediated seasonal allergic rhinoconjunctivitis with/without seasonal asthma were enrolled; 47 patients with pollen allergy were included in a control group. All patients were sensitized to birch pollen-allergens. SCIT was performed during 9 months 2009-2010 years by a birch extract standardized in IR and absorbed onto calcium phosphate (Phostal, France). Patients were asked to complete diary during the birch pollination season (from 1 April to 1 June). Pollen grains were counted daily during the pollen seasons by standardized protocol and the amount of pollen was expressed as the number of pollen grains/m3 air. The ARTSS was derived from individual symptom scores for nasal and eye symptoms during the pollen season. In addition there was a daily score for the use of rescue medication (ARMS). Rescue medication allowed included Hl-antihistamines, nasal steroids, oral steroids; each puff, drop (nostril/eye), tablet counted as one point. Results. The seasonal pollen counts and the duration of the pollen season had differed in 2009 and in 2010. Reduction in ARTSS of 29% and decrease in ARMS of 28,9% were found in the birch pollen season for subjects treated with the SCIT compared with controls after one year of treatment. The immunotherapy after the end of the treatment was not effective in 3 patients (5%). Conclusion. Immunotherapy by Phostal shows clinical effect on development of seasonal rhinoconjunctivitis. The decrease in ARTSS for Phostal-treated patients that occurred in parallel with a marked reduction in their requirement for ARMS provides additional evidence for the efficacy of SCIT over and above usual pharmacotherapy for rhinitis.