[Data from the Russian Severe Asthma Registry (RSAR)].

AIM: Creation of the "Russian register of patients with severe asthma" and obtaining data on the population characteristics of patients with severe asthma (SA), the prevalence of SA phenotypes, treatment outcomes and the degree of disease control. MATERIALS AND METHODS: Observational non-interventional study, which consists in the data analysis obtained on the basis of registration cards of the Russian Register of Patients with Severe Bronchial Asthma, data collection in which was carried out on the Oracle XE platform. Statistical data processing was carried out using Power BI, PSPP and Microsoft Excel spreadsheets. RESULTS: The study included 4376 adult patients (mean age 60.613.5 years, 65% women) diagnosed with SA from 57 regions of Russia for the period from June 2018 to December 2021. T2 inflammation was detected in 94.8% of patients when determining blood eosinophils and IgE of blood serum; 69% of patients with SA corresponded to the allergic phenotype. 83.3% of patients had no control of BA and 53% had 1 or more exacerbations of BA per year. 8% of patients received systemic corticosteroids as a permanent therapy, while biologics 10.6%. CONCLUSION: The vast majority of adult patients with SA correspond to the T2 phenotype, have uncontrolled asthma with a high frequency of exacerbations and reduced lung function. A more favorable course of the disease was noted in patients receiving biological therapy, which requires appropriate measures to increase the possibility of access to this type of therapy.

[Cytologic features of bronchoalveolar lavage in evaluation of course of exogenous allergic alveolitis].

Application of complex of modern cytologic methods of research bronchoalveolar lavage allowed to allocate most characteristics of development of lymphocytic and macrophagic reaction of bronchial tree in different course of exogenous allergic alveolitis. The most indicative in assessment of origin of exogenous allergic alveolitis development is the characteristics of macrophagic population. In acute course of exogenous allergic alveolitis the considerable number of young activated and non-activated macrophages, increased number of mature phagocytes is observed. Even more significant increase of phagocytic macrophages is observed at dissemination which is primarily is connected with participation of these cells in lymphocytic apoptosis which takes place in high percentage of lymphocytes (up to 49%). Increased number of mature phagocytes is observed at chronic course of exogenous allergic alveolitis that is an important diagnostic pattern of this option of development of exogenous allergic alveolitis in association with the lowest T-helpers/T-supressors index.

[New therapy schemes for acute, subacute and chronic variants of extrinsic allergic alveolitis].

In order to improve treatment of patients with exogenous allergic alveolitis morphologically different variants of the disease, i.e. acute, subacute and chronic were identified and confirmed. For each variant of exogenous allergic alveolitis new therapy schemes were proposed. The study included 74 patients who were divided into 5 groups. In the first group with acute exogenous allergic alveolitis inhalation glycocorticosteroids in high doses in combination with plasmapheresis were prescribed, in the second group standard therapy with systemic glycocorticosteroids was prescribed. The third and the fourth group consisted of patients with subacute exogenous allergic alveolitis. The protracted ambroxol inhalation using nebulizers and the reduced dose of systemic glycocorticosteroids were used in the third group; and the standard dose of systemic glycocorticosteroids was used in the fourth. The fifth group consisted of patients with chronic exogenous allergic alveolitis, who received the standard dose of glycocorticosteroids and cytostatic drugs. After one month of therapy, it was ascertained that the use of high doses of inhalation glycocorticosteroids in combination with plasmapheresis in patients with acute exogenous allergic alveolitis led to significant improvements in clinical and CT presentation, physical activity tolerance, as well as the use of systemic glycocorticosteroids. The use of ambroxol inhalation in patients with subacute exogenous allergic alveolitis led to a significant improvement in clinical symptomatology, functional parameters and CT presentation, thus enabling to reduce the dose of glycocorticosteroids used and to avoid unwanted side effects.