Effect of Nasal Obstructive Disorders on Sinonasal Symptoms in Children with Different Levels of Bronchial Asthma Control.

Allergic rhinitis (AR) and allergic rhinosinusitis (ARS) are typical upper airway pathologies (UAP) in children with bronchial asthma (BA) frequently accompanied with nasal obstructive diseases (NOD). In order to establish the effect of NOD on correlations between nasal and synonasal symptoms with clinical assessments of asthma control, 82 children, 9.8 [8.9; 10.7] years old, with atopic BA were assessed using ACQ-5 for the BA control level, TNSS for nasal symptoms, and SNOT-20 for synonasal quality of life in combination with rhinovideoendoscopy for NOD. All patients had AR/ARS; in 76.3% (63/82) of children, UAP had a multimorbid character with the presence of NOD. Significant correlations were found between ACQ-5 and TNSS (R=0.40, p < 0.0001) and ACQ-5 and SNOT-20 (R=0.42, p < 0.0001). Correlations between TNSS/ACQ-5 and SNOT-20/ACQ-5 were higher in patients who do not have a combination of AR/ARS with NOD (R=0.67, p=0.0012; R=0.50, p=0.022, resp.) than in patients who have AR/ARS combined with NOD (R=0.30, p=0.015; R=0.26, p=0.04, resp.). Thus, the association of BA control level with the expression of nasal and synonasal symptoms is higher in children who do not have multimorbid UAP.

[PHARMACOGENETIC MARKERS OF THE EFFECTIVENESS OF TREATMENT OF CHILDREN WITH ATOPIC BRONCHIAL ASTHMA.]

Data on the pharmacogenetic markers of the effectiveness of treatment of children with atopic asthma are presented, which reveal a variability of the response to treatment with glucocorticosteroids, leukotriene receptor antagonists, and b2-adrenoreceptor agonists in children with bronchial asthma. The association of genotype Gly/Glyl6 gene b2-adrenergic receptor with insufficient effect of the therapy with short-acting b2-agonists is demonstrated. The Glyl6 allele, CYP2D6 - 1934GGd contributes to the formation of a phenotype with severe asthma and tolerance to therapy with b2-agonists and inhaled corticosteroids.

[Genetic aspects of atopic diseases in children].

Atopic diseases is a group of pathologic conditions with polygenic inheritance the development of which is governed by familial predetermination to allergy. This review summarizes results of research on pathogenetic mechanisms of atopic diseases and their clinical features. Analysis includes the structure of hereditary predetermination to allergic reactions and diseases, risk of their development in subsequent generations, the role of age, sex, and ethnic background in pathogenesis of atopic diseases and formation of allergic constitution governed by genotype and environment. Polymorphisms of candidate genes responsible for atopic diseases are considered along with their response to basal pharmacotherapy.

[Bronchial asthma in children and adolescents].

Modern concept of the development of bronchial asthma (BA) is discussed based on original and reported findings with reference to specific features of its etiology, pathogenesis, clinical course, and drug therapy. Special emphasis is laid on the methods of allergen-specific immunotherapy of atopic BA. Up-to-date staged treatment of different forms of BA in children by inhalation of glucocorticosteroids is described.

[Polioxidonium in comprehensive therapy of recurrent herpetic stomatitis in children with allergic diseases].

In the study with participation of 96 children of 1-7 years age with recurrent herpetic stomatitis and allergic diseases therapeutic efficacy of Polioxidonium was investigated. Polioxidonium was used in combination with traditional methods and with He-Ne-laser irradiation. Local oral cavity immunity, indexes of cellular immunity (in the reaction of lymphocytes blast-transformation with phytohemagglutinin), indexes of humoral immunity (IgG and IgE) were studied, complement C(3)-component was determined. Polioxidonium in combination with traditional methods and with laser therapy for recurrent herpetic stomatitis treatment in children with allergic diseases influenced favourably upon clinical course of allergic diseases, let achieve stable remission, increased efficacy of their treatment, promoted immunological status and shorten the terms of medical rehabilitation.

[Goiter transformation as a risk factor of the development of bronchial asthma in children under the influence of natural and technogenic factors of the environment].

The paper deals with the comparative characterization of the prevalence of goiter transformation in children with bronchial asthma (BA) in relation to the level of a technogenic load and natural iodine deficiency in case of the Perm Region. There was a wide distribution of goiter transformation in children, which did not correspond to natural iodine supply in the Perm Region, suggesting the contribution of anthropogenic strumogenic factors to the formation of goiter endemia. There was a high prevalence of thyromegaly in children with BA as compared with those with another disease and its high the incidence as man-made pollution increased particularly in the areas exposed to a combination of natural and technogenic factors as compared in relatively pure areas. The findings suggest that goiter transformation is a marker of ecological ill-being and an additional serious risk factor of the development and prolonged course of BA in predisposed children.

[Changes of the immune status of children with relapsing herpetic stomatitis, suffering from allergic diseases, during licopide treatment]. / Izmeneniia na fone lecheniia likopidom immunnogo statusa detei s retsidiviruiushchim gerpeticheskim stomatitom, stradaiushchikh allergicheskimi zabolevaniiami.

The efficiency of licopide in combination with traditional treatment was evaluated in 59 children aged 1-14 years suffering from allergic diseases and relapsing herpetic stomatitis. Immunological studies were carried out before and after a course of therapy: local oral immunity, cellular immunity (in the blast transformation test with phytohemagglutinin), lymphocyte populations and subpopulations, humoral immunity values (IgA, IgM, IgG, and IgE), and C3 complement component were evaluated. The results indicate that licopide in complex with traditional methods normalized the immunological values, had a favorable impact on the course of relapsing herpetic stomatitis, and led to a stable remission of allergic diseases (p<0.001).

[New way in dietotherapy of infants with food allergy]. / Novyi podkhod k dietoterapii detei s pishchevoi alergiei.

The authors followed up (in outpatient conditions) a total of fifty 1-to-9-mounth-old infants with the diagnosis of atopic dermatitis, disseminated form, of subacute course. The infants were followed up for 3-12 months, with 83% of the 113 examined patients 1-3 weeks after the beginning of treatment having shown clinical improvement of cutaneous inflammatory processes. Of the 172 infants subjected to immunological examination, in 100--the level of total IgE in blood serum was significantly elevated. These children also had elevated level of the specific IgE antibodies to cow's milk proteins. The outcomes of the carried out dietotherapy using mixture "Nanny" showed that this therapeutic product resulted in remission in the majority of the followed up infants suffering from allergy to cow's milk proteins.

[Atopic disease in children: present-day concepts of pathogenesis and therapy]. / Atopicheskie zabolevaniia u detei: sovremennaia kontseptsiia patogeneza i terapiia.

A contemporary understanding of evolution mechanisms and of therapy related with allergic diseases in children is defined on the basis of published data and independent research. A concept predetermining the significance of atopy in pathogenesis of allergic pathologies is outlined; an essential role of environmental factors and a genetic contribution to the role promotion are pointed out. Issues pertaining to the onset of both early and late phases of the allergic response and of allergic inflammation are touched upon. Finally, modern approaches towards therapy of allergic diseases in children are described.

[Role of polyunsaturated fatty acids in diet therapy of children with allergic diseases]. / Rol' polinenasyshchennykh zhirnykh kislot v lechebnom pitanii detei s allergicheskimi zabolevaniiami.

135 pediatric patients receiving hypoallergic diet were included into the study group. The control group consisted of 20 children. The impact of PUFA omega-3 biologically active supplements (polyen, prima-Oil) was studied in hypoallergic rations. Biochemical indices were simultaneously investigated. The revealed dynamic changes of fatty acid spectrum in plasma and red cell membranes, cellular and humoral immunity status and eicosanoids synthesis were followed by positive clinical changes. Diets enriched with biologically active supplementation (PUPA omega-3) can be recommended for application in pediatric practice.

[Ebastine in the treatment of seasonal allergic rhinitis]. / Ebastin pri lechenii sezonnogo allergicheskogo rinita.

AIM: To test the efficiency and tolerance of the second generation antihistamine drug ebastin (kestine) in patients with seasonal allergic rhinitis (SAR). MATERIALS AND METHODS: Kestin was given for 3 weeks in doses 10 and 20 mg/day to 226 patients with SAR running for 6.8 +/- 6.1 years. SAR symptoms relief, subjective effects, side effects were studied. RESULTS: The total index of rhinitis symptoms diminished from 11.6 to 1.2 scores. Subjective response was registered in 82% of the patients, objective in 77%. Neither treatment aggravations nor serious side effects occurred. 2 patients had drowsiness, head aches, dizziness and discontinued treatment. CONCLUSION: Kestin is effective in SAR, had no serious side effects, is well tolerated.

[The immunotherapy of bronchial asthma with a multicomponent vaccine administered intranasally and orally]. / Immunoterapiia bronkhial'noi astmy polikomponentnoi vaktsinoi pri intranazal'no-oral'nom vvedenii.

Multicomponent vaccine prepared from opportunistic bacteria, when administered intranasally and orally to patients with bronchial asthma and chronic bronchitis, was well tolerated by the patients. Side effects induced by the vaccine in a few patients lasted for a short time and were mainly local. Immunotherapy with the vaccine led to a decrease in the severity of the course of the disease, as well as in the frequency and severity of exacerbations. In 26 out of 35 adult patients (74.3%) good and excellent effect was noted; during the observation of 20 sick children aged up to 3 years for a period of 1 year similar effect was noted in 60% of cases. Vaccinal therapy, in addition to its main effect, also contributed to a considerable drop in the morbidity rate of acute respiratory diseases among susceptible children.

[The effect of interference currents on bronchial patency and bronchial hyperreactivity in children with bronchial asthma]. / Vliianie interferentsionnykh tokov na bronkhial'nuiu prokhodimost' i giperreaktivnost' bronkhov u detei, bol'nykh bronkhial'noi astmoi.

The results are available on introduction of interference therapy in 30 children with bronchial asthma versus control group of 20 untreated patients. Bronchoprovocative histamine and exercise tolerance tests have specified characteristic features of interference current effects on bronchial permeability and hyperreactivity.

[Use of the fish oil "Polyen" in pediatric practice]. / Opyt primeneniia ryb'ego zhira "polien" v pediatricheskoi praktike.

The effects of supplementation of basic diets with 'Polyen' in daily doses of 2.5-4.0 g during 30-40 days together with antioxidants were studied in patients with kidney diseases (diet No7, n = 14), different allergies (hypoallergenic diet, n = 37) and in control children (n = 12). It was shown positive dynamics in fatty acid contents in plasma and red blood cell membranes, in humoral and cell immunity indicators and in improving of clinical symptoms of diseases. 'Polyen' is recommended for wide use in pediatric practice.

[The adsorbed-DTP-m vaccination of children with allergically altered reactivity]. / AKDS-m vaktsinatsiia detei s allergicheski izmennoi reaktivnost'iu.

Immunization and booster immunization with adsorbed DPT-m vaccine was carried out, respectively, in 45 and 15 children with different severity of the course of an allergic disease, each child receiving simultaneously individually prescribed complex drug therapy. The postvaccinal period took a relatively favorable course. General and allergic reactions and complications observed after the injection of the preparation did not hinder the continuation of the course of immunization, while the appearance of neurological reactions provoked doubts on the expediency of the repeated injection of this preparation. A decrease in the content of diphtheria and tetanus toxoids in one immunization dose did not lead to the decreased synthesis of specific antibodies. The present investigation showed the possibility of using adsorbed DPT-m vaccine with reduced antigen content in cases of both the remission of an allergic disease and the subacute course of such disease.

[The vaccinal prevention of diphtheria and tetanus in children suffering from bronchial asthma and asthmatic bronchitis]. / Vaktsinoprofilaktika difterii i stolbniaka u detei, stradaiushchikh bronkhial'noi astmoi i astmaticheskim bronkhitom.

The course of the vaccinal process was studied in 69 children with bronchial asthma and asthmatic bronchitis after the injection of adsorbed diphtheria-tetanus (DT) toxoid with reduced antigen content. After immunization all these children were found to form protective levels of anti-diphtheritic and antitetanus antibodies irrespective of the severity and duration of the remission of the main disease prior to vaccination; at the same time no obstructive changes in bronchial ventilation were observed after immunization with adsorbed DT toxoid with reduced antigen content. The schemes of the preparatory medicinal treatment of patients at the period of vaccination are given with due regard for the duration of the remissions of bronchial asthma and asthmatic bronchitis.

[Use of vitamins in allergic illnesses in children]. / Primenenie vitaminov pri allergicheskikh zabolevaniiakh u detei.

Therapeutic efficacy of vitamins B6, P and E was studied in children with allergic diseases. Bronchial asthma and atopic dermatitis were treated more effectively if maximal doses of vitamin B6 were used. Quercetin was found to be useful for treatment of children with pollinosis in order to correct impairments in metabolism of lymphocyte membrane lipids. Only slight efficacy of vitamin E was detected in atopic dermatitis of children.

[The intracellular second messenger system and its regulatory effects in children with a bronchial asthma attack complicated by heart failure]. / Sistema vtorichnykh vnutrikletochnykh posrednikov i ee reguliarognye éffekty u detei v pristupnom periode bronkhial'noi astmy, oslozhnennoi serdechnoi nedostatochnost'iu.

Components of the intracellular mediators system: calmodulin in leukocytes, Ca2+ and cyclic nucleotides in leukocytes and blood plasma were studied in children with attack of bronchial asthma and heart failure. Alterations in content of these biologically active substances correlated with clinical manifestations of bronchial asthma: severity of the disease, duration of the attack, contractile activity of myocardium. Calmodulin, Ca2+ and cyclic nucleotides were demonstrated to be involved in development of the asthmatic attack. Alterations in the system calmodulin-Ca2+ were related to adaptation and contributed to realization of regulating effects responsible for a decrease of impairments in tissues.

[Bronchial asthma in children with sensitization to mites]. / Bronkhial'naia astma u detei s kleshchevoi sensibilizatsiei.

Overall 180 children with bronchial asthma induced by sensitization to Dermatophagoides pteronyssinus and Dermatophagoides farinae were examined clinically and immunologically. The patients' age ranged from 1 to 14 years. A relationship was established between bronchial asthma exacerbation and the stay at home. In that disease pattern, asphyxia attacks were noted to occur more frequently in the evening and night hours. Emphasis is laid on the leading part played by the IgE-mediated mechanism in bronchial asthma induced by tick-borne sensitization. In children suffering from that pattern of bronchial asthma, specific hyposensitization with Dermatophagoides pteronyssinus allergens and antiallergic immunoglobulin were found to be highly effective.