卷 17, 编号 1 (2020)
- 年: 2020
- 文章: 12
- URL: https://bakhtiniada.ru/raj/issue/view/6353
Articles
Editorial
Russian Journal of Allergy. 2020;17(1):5-6
5-6
2019 ARIA: care pathways for allergic rhinitis in Russia
摘要
One of the most common chronic upper respiratory diseases worldwide is allergic rhinitis (AR). Despite advances in understanding the mechanisms of allergic inflammation, the symptoms of AR in most cases are not completely controlled by modern treatment methods. Allergic rhinitis is a precursor and predisposing factor for the development of other respiratory diseases, one of which is asthma. Diagnosis of AR is being actively conducted, but there is still a serious problem of uncontrolled and chaotic treatment of patients, so it is necessary to provide comprehensive medical care within the national health system. ARIA aims to develop and apply internationally recommendations for the management of patients with allergic respiratory diseases. In collaboration with other international associations that deal with the treatment and diagnosis of allergies and respiratory diseases, regulations and programs have been developed for the treatment of patients with AR, as well as when it is combined with asthma, which form the basis of ARIA. This document has been adapted for use in the field of healthcare in the Russian Federation and covers key issues related to the management of patients with AR and in combination with AR and asthma.
Russian Journal of Allergy. 2020;17(1):7-22
7-22
Drug-induced anaphylaxis: prevalence, risk factors, triggers
摘要
Currently, there is a tendency to increase the prevalence of drug-induced anaphylaxis. Medicines occupy a leading position among the causes of the development of anaphylactic reactions in the adult group of patients and second place in children, the most significant in this matter are non-steroidal anti-inflammatory drugs, antibacterial drugs and X-ray contrast agents. The risk of developing of drug anaphylaxis in most cases is not predictable, while the frequency of severe and fatal reactions is extremely high. This article presents an analysis of current data regarding the prevalence, possible risk factors, and triggers of drug anaphylaxis.
Russian Journal of Allergy. 2020;17(1):23-31
23-31
Polypous rhinosinusitis in combination with bronchial asthma: clinical features and cellular characteristics of local and systemic inflammation
摘要
Background. The combination of chronic rhinosinusitis with nasal polyps (CRSwNP) and bronchial asthma (BA) is currently considered as a separate phenotype characterized by similar features of inflammatory changes leading to an increase in the clinical course of both CRSwNP and BA. The aim of the study was to investigate the clinical features and characteristics of the local and systemic inflammatory process in patients having a combination of CRSwNP and BA. Materials and methods. The study included 96 volunteers, who were divided into 4 groups: group 1 consisted of healthy volunteers (Normal); group 2 consisted of volunteers with CRSwNP in combination with allergic BA (CRSwNP + aBA); group 3 - volunteers with PRS in combination with non-allergic BA (CRSwNP + nBA); and group 4 - CRSwNP without BA. Clinical, laboratory, instrumental and allergology examination methods were applied for all participants of the study. BA control status was determined using the asthma control questionnaire (ACQ-7), and CRSwNP control status was determined using the nasal and paranasal sinus clinical outcome control questionnaire (SNOT-22). At the same time, the quality of life of the patients was also evaluated using AQLQ (Asthma Quality of Life Questionnaire). Results. The results confirmed the interaction of BA and CRSwNP, where the combination of these diseases led to a more severe and uncontrolled clinical course of BA and CRSwNP based on the assessment using SNOT-22, ACQ-7 and AQLQ questionnaires. These results correlated with an increase in the absolute number of eosinophils in peripheral blood and pronounced eosinophilic cell infiltration of nasal polyp stroma. Data processing demonstrated that the combination of CRSwNP and nBA showed signs of more pronounced eosinophilic inflammation, which is an unfavorable prognostic factor. Conclusions. The comparison of the cellular characteristics of the local and systemic inflammatory process in patients with CRSwNP in combination with BA allowed us to conclude that polyp development follows a local inflammatory process. Further study of the pathogenesis of CRSwNP and BA will help to understand the mechanisms that connect these diseases and consider possible target molecules for biological therapy.
Russian Journal of Allergy. 2020;17(1):32-49
32-49
Randomized controlled trial of impact of early regular emollient using on transepidermal water loss and cumulative incidence of atopic dermatitis in infants at risk
摘要
The solution of the problem of atopic dermatitis (AD) prevention is an important task of modern medicine. Recently the idea of early systematic skin care in infants aimed at improving the epidermal barrier function and reducing the risk of AD development is widespread. The aim of the study was to investigate the effect of early regular emollients application in infants at risk on transepidermal water loss (TEWL) and cumulative incidence of AD. Materials and methods. An open randomized controlled trial included 80 healthy newborns (41 girls and 39 boys) with a family history of allergic diseases has been conducted. All participants were divided into main (n=38) and control (n=42) groups. Infants of the main group received emollients application twice per day for 6 months as well as a symbiotic complex from 3 to 6 months daily compared to the no intervention in control group. All infants were followed-up during the first year of life, besides of clinical examination TEWL was assessed as an objective criterion of epidermal barrier function. The main outcome was the development of AD at the age of 12 months. Results. 72 infants have been included into final analysis (35 - main group, 37 - control group). By the end of follow-up 19 patients (26.4%) had confirmed AD, with significant difference in cumulative incidence of AD between group: 37.8% in the main group and 14.3% in control, р<0.05. A significant decrease in TEWL in infants of the main group was revealed compared to control at all stages of the study (р<0.05). Conclusion. The results of the study confirmed the effectiveness of early regular emollient application in infants at risk as a factor which improves the protective function of epidermal barrier and reduces the risk of AD development.
Russian Journal of Allergy. 2020;17(1):50-57
50-57
Features of diagnostics and clinical approaches to case management of patients with hereditary angioedema without C1 esterase inhibitor deficiency. Analysis of the clinical case
摘要
This article describes the clinical, biochemical and genetic features of hereditary angioedema (HAE) with normal level and functional activity of C1 esterase inhibitor. The discussion includes pathogenesis, diagnostics and case management of patients with hereditary angioedema without C1 esterase inhibitor deficiency. The materials of few scientific sources about patients with HAE without C1 esterase inhibitor deficiency in stages and our own clinical case (the female patient of fertile age with a confirmed mutation associated with factor XII (Hageman) deficiency) was given. The article describes the current state of the issue of the algorithm of primary diagnostics and differential diagnostics of HAE without C1 esterase inhibitor deficiency based on international and Russian data. It has been suggested that the new understanding of pathogenesis and treatment of patients with HAE without C1 esterase inhibitor deficiency is encouraging and becoming accessible to the medical society.
Russian Journal of Allergy. 2020;17(1):58-65
58-65
Comparative study of Allergy Explorer (ALEX) versus ImmunoCAP platforms
摘要
Objective. In this study, technical performance of the new multiplex ALEX test was compared with results from ImmunoCAP single tests (tIgE, sIgE) and the multiplex platform ImmunoCAP ISAC sIgE 112. Materials and methods. Eleven whole allergen extracts and corresponding allergen components from different allergen groups were used for the analysis of 64-66 patients’ sera by all three platforms. Results. For the whole allergens, 55% false negative results were obtained with the ALEX test comparing to the ImmunoCAP sIgE tests while for allergen components the ALEX test gives 33% false negative results when compared to ImmunoCAP sIgE test results. Additionally, the ALEX test is characterized by a low dynamic range - the platform demonstrated no results above 36 kUA/L for samples giving >100 kUA/L using ImmunoCAP Specific IgE tests in the analysis of sIgE response to the whole allergens. For the allergen components, ALEX showed no results above 38 kUA/L for samples of up to 150 kUA/L according to ImmunoCAP Specific IgE test results. Comparing to ImmunoCAP single plex tests, ALEX show low dynamic range and poor agreement in quantitative results for tIgE and sIgE both for whole allergens and allergen components, while in the comparison with ImmunoCAP ISAC sIgE 112 platform, the agreement is better, but the sensitivity and dynamic range are still low._ Conclusions. The ALEX test has some serious limitations in its performance comparing to both types of ImmunoCAP platforms.
Russian Journal of Allergy. 2020;17(1):66-84
66-84
Grass pollen allergy: a disease-modifying sublingual allergen-specific immunotherapy with the SQ timothy grass extract tablet
摘要
Introduction. Nowadays pollen allergy (hay fever) is one of the most common allergic diseases. Due to the ubiquity of grass species and the long pollination season, grass pollen allergy is an important social and economic problem. Summary. In this review we discuss the clinical data on the use of the SQ timothy grass sublingual immunotherapy (SLIT) tablet for the treatment of allergic diseases caused by grass pollen. The data of various studies demonstrate a significant long-term clinical effect after 1 course of SLIT with this allergen. Conclusions. Based on the studies, the SQ grass SLIT-tablet is established to be a disease-modifying therapy.
Russian Journal of Allergy. 2020;17(1):85-92
85-92
Bilastine as a modern antihistamine for the treatment of allergic rhinitis and urticaria
摘要
Antihistamines have long been an integral part of the treatment of allergic rhinitis and urticaria. Treatment of these diseases is usually long-term, so the drugs of choice are H1-antihistamines of the second generation, which have high efficiency and a good safety profile in the absence of clinically significant side effects. The variety of drugs in this group makes it possible to personalize the therapy, using the drug taking into account the individual sensitivity of the patient. One of the antihistamines used in practical allergy at the present time is bilastine. The article presents the data of clinical studies devoted to the research of the effectiveness, safety and tolerability of Hj-antihistamine of the second generation - bilastine. Short-term and long-term use of bilastine in patients with rhinitis (rhinoconjunctivitis) and chronic urticaria has demonstrated it’s good effectiveness and safety, which are due to the pharmacological properties of the medicine and the peculiarities of its metabolism. A number of sources provide data on the high safety profile of bilastine not only in the standard therapeutic dosage, but also with its four-fold increase. The results of these studies are of particular importance, since the clinical recommendations for the management of urticaria in various countries, including Russia, provide for the possibility of increasing the dose of H1 -antihistamines in case of insufficient effectiveness of therapy. Studies have also shown that bilastine has no clinically pronounced side effects that could significantly limit the use of the medicine, including in patients with concomitant diseases, or negatively affect patient’s compliance. According to the results of clinical studies, bilastine is characterized as an effective, safe, well-tolerated medicine for long-term therapy of allergic rhinitis and urticaria.
Russian Journal of Allergy. 2020;17(1):93-100
93-100
Congresses, conferences
Russian Journal of Allergy. 2020;17(1):101-102
101-102
100th Anniversary of birth. Professor Tatiana Sergeevna Sokolova (02.12.1919-13.08.2009)
Russian Journal of Allergy. 2020;17(1):103-107
103-107
In memory of Vitalii Jakovlevich Arion (10.12.1933-09.02.2020)
Russian Journal of Allergy. 2020;17(1):108-108
108-108