DIAGNOSIS OF AN ALLERGIC REACTION TO ANTIBIOTICS IN AN PATIENT WITH ACTIVE HUMAN HERPESVIRUS -4, -6 TYPE INFECTION (CLINICAL CASE).

Beta-lactam antibiotics (BLAs) can provoke drug hypersensitivity reactions, particularly delayed-type reactions. This article presents a case of drug allergy with manifestations of Stevens-Johnson syndrome (SJD) in a 42-year-old man with yersiniosis and active herpesvirus -4, -6 type, who received amoxacillin with clavulanic acid. The patient underwent a basophil activation test (BAT) for BLAs, and a positive result was found for both amoxacillin and 2nd and 3rd generation cephalosporins. On the example of a clinical case, probable pathogenetic mechanisms of the risk of the appearance of immediate-type hypersensitivity reactions in persons with active herpesvirus -4, -6 type infection are shown. The possibility of using the cellular BAT for the diagnosis of delayed-type hypersensitivity reactions and for the diagnosis of cross-reactions to antibiotics has also been demonstrated.

ANALYSIS OF CAUSATIVE FACTORS OF RECURRENT BRONCHIAL OBSTRUCTION SYNDROME IN YOUNG CHILDREN.

Nowadays, newborns that required prolonged respiratory maintenance for different reasons are more often surviving. Increase in the number of complications is observed on the background of positive clinical effects of certain component of intensive therapy. Search for the factors, which provoke appearance of recurrent bronchial obstruction syndrome, is an important component and basis of prophylaxis. The aim of our research was to conduct analysis of factors that provoke the development of recurrent bronchial obstruction syndrome. To build mathematical model of bronchial obstruction development in young children with respiratory disorders in neonatal period, the method of logistic regression was used. The results of conducted analysis enabled to detect that the presence of respiratory therapy significantly determines the risk of appearance of recurrent bronchial obstruction syndrome and suggest mathematical model of individual calculation of risk factors in this pathology. Data of conduction of mathematical analysis can be used for elaboration of a complex of rehabilitation measures concerning the development of recurrent bronchial obstruction syndrome in children, who suffered respiratory disorders in neonatal period. The highest risk of recurrent bronchial obstruction syndrome development in children born before 29 gestational week with simultaneous combination of prolonged (over 700 hours) total period of respiratory therapy. Elaborated method of individual calculation of the risk of recurrent bronchial obstruction syndrome development in young children, who experienced respiratory disorders in neonatal period, has practical significance and can be applied in everyday clinical practice.

COMPARATIVE ANALYSIS OF PREVALENCE OF THE MOST COMMON ALERGY DISEASES IN CHILDREN OF THE KYIV REGION (UKRAINE).

Allergic diseases (AD) have been one of the most urgent problems on nowadays worldwide. In some countries with a high AD prevalence according to ISAAC Phase One, compared to ISAAC Phase Three, especially in English-speaking countries, there is a tendency to reduction of respiratory symptoms prevalence, while in other countries, on the contrary, it continues to grow. The aim of the study is to conduct a comparative analysis of the prevalence of asthma, rhinitis and eczema in the Kyiv region of Ukraine in the dynamics for the period 2017-2018 and 1998-1999, to understand current epidemiological trends. 3186 children of different age groups, living in different regions of the Kyiv region, have been surveyed. For comparative analysis, data from asthma, rhinitis and eczema and two age groups of 6-7 years (n=1647) and 13-14 years old (n=1539) were used as required by the design of ISAAC. The epidemiological study of the prevalence of AD symptoms among children in the Kyiv region in dynamics of the 19-year period showed that there was a slight decrease in the prevalence of asthma in both age groups, although their level remains rather high. But the rate of severe asthma, especially among adolescents, has risen. Thus, the prevalence of asthma symptoms among children aged 6-7 years decreased from 16.8% to 15.4% (-0.07% per year), and among adolescents from 15.2% to 11.2% (-0, 2% per year). The prevalence of rhinitis and eczema symptoms among children in the Kyiv region continues to grow in both age groups over the years, which is consistent with the global world trends. The steady growth of allergic diseases prevalence requires further investigation of causative factors and possible ways of their solution for both Ukraine as a whole and for the Kyiv region in particular. Worrying problems of insufficient asthma control also flow out from the performed analysis, especially in regards the adolescent age category, which determines the future research directions.

PECULIARITIES OF MIR-146A AND MIR-155 EXPRESSION IN PATIENTS WITH ALLERGOPATHY IN COMBINATION WITH CHRONIC EPSTEIN-BARR VIRUS INFECTION IN LATENT AND ACTIVE PHASES.

Epstein-Barr virus (EBV) is referred to the viruses with lifelong persistence in the human body in active and latent phases. EBV initiates impairment of expression of cell microRNA, which participates in the regulation of immune system function and can be related to different pathological conditions, including allergopathy. Aim - to assess the levels of miR-146a and miR-155 expression in patients with allergopathy in combination with active and latent phases of EBV infection. Clinical, general laboratory, cytological, instrumental, specific allergological, molecular-genetic investigations were performed. Based on these investigations, patients were divided into two groups: 1st group (27 individuals) with allergopathy and active phase of chronic EBV-infection, 2nd group (19 individuals) with allergopathy and latent phase of EBV infection. Control group included 20 healthy individuals. Higher (р>0.05) levels of miR-146a expression were detected in patients of both groups compared with control group. Expression of miR-155 was higher (р>0.05) only in patients of the 1st group compared with control. No significant difference was noticed between investigated groups. In latent phase, EBV uses own mechanisms of latency to avoid immune surveillance, which are manifested by increase in miR-155 and miR-146а expression. In active phase, this vector of changes intensified and was associated with acute manifestations of allergopathy.

ANALYSIS OF THE LEVEL OF CYTOKINES WITH ANTIVIRAL ACTIVITY IN PATIENTS WITH ALLERGOPATHOLOGY IN ACTIVE AND LATENT PHASES OF CHRONIC PERSISTENT EPSTEIN-BARR INFECTION.

Epstein-Barr virus (EBV) initiates various immune disorders, including changes in cytokine profile, which result in the development of different pathological conditions, in particular, allergopathology. Aim - to investigate the level of cytokines with antiviral activity in patients with allergopathology in active and latent phases of chronic persistence of Epstein-Barr viral infection. In general, 38 patients with allergopathology in combination with chronic persistence of EBV-infection in active (1st group) and latent (2nd group) phases were examined. A complex clinical and laboratory examination was performed; immunological, molecular and genetic, instrumental investigations, statistical analysis of the results were conducted. Peculiarities of the levels of cytokines with antiviral activity IL12, IL1ß, IL33, TNF-α, IFN-g were investigated in two groups of patients: 1st group - patients with allergy in combination with active phase (PCR "+") of chronic EBV infection, 2nd group - patients with allergy in combination with latent phase (PCR "-") of chronic EBV infection. Control group - 20 healthy individuals of corresponding gender and age. In patients with allergopathology in combination with chronic persistence of EBV, marked deregulation of optimal correlation of cytokine network components was detected, in particular, elevation of IL1ß concentration with simultaneous decrease in IL12, IL33 and normal level of IFN-g and TNF-α (in active phase) and reduction of IL1ß, IFN-g concentration with simultaneous increase in IL12, IL33 and normal level of TNF-α (in latent phase) of infection. Absence of consolidated influence of investigated cytokines with antiviral activity plays a leading role in pathogenesis of pathological process under conditions of continuous persistence of the virus in the body with its further activation. The obtained proofs of cytokine imbalance indicate inadequate cell-mediated and humoral response of the body in chronic EBV-infection with allergopathology formation.

INVESTIGATION OF PROTECTIVE EFFECTS OF SYNBIOTICS ON ALLERGOPATHY FORMATION.

A strategic direction of modern medicine in combating allergy is the search for new methods of primary prophylaxis, among which a key role may belong to normalization of the human body microflora. The aim of the research was to study the influence of synbiotics on bacteriological and immune indices in premature infants evaluating their preventive role in allergopathy formation. During prospective cohort investigation, 88 babies from one to four months of age, born on the 27th to 37th week of gestation to healthy mothers and women with allergopathy, were examined. Routine laboratory, bacteriological and instrumental investigations were performed. Measuring total serum IgE, cytokines IL-5, IL-10 and TNF-alpha in coprofiltrates was performed by means of immunoenzymatic assay. The activity of histaminase was detected by means of "Histamine 50-Skin-Prick Test". All examined patients were divided into four groups, depend on parents's atopic disease and prescribing synbiotics. For month, children from the first and the third groups were administered a commercial synbiotic - nutritional supplement with probiotics and fructooligosaccharides in the dose: one billion viable microencapsulated bacteria Lactobacillus rhamnosus GG in combination with fructooligosaccharides. Children from the second and the fourth groups were not administered synbiotic. Control of indices was conducted after 4 weeks. On bacteriological analysis of feces, the number of lacto- and bifidobacteria increased by 30% in children from the first and the third groups. Indices of total serum IgE were within age norm both before intake of synbiotic (1-2 groups) and after treatment. A reliable (p≤0.01) reduction of TNF-alpha and increase in IL-10 was revealed in coprofiltrates of children, who received synbiotic Preema sachet. Inclusion of synbiotic, which contains one billion viable microencapsulated bacteria Lactobacillus rhamnosus GG in combination with fructooligosaccharides to complex therapy of premature children results in regulation of cytokine balance with the tendency to reduction of an inflammatory process and has a preventive effect concerning allergopathy formation.