Резюме. Цель исследования: оценить динамику иммунологических показателей при проведе-нии сублингвальной аллерген-специфической иммунотерапии смесью из пыльцы деревьев у детей с поллинозом. Материалы и методы: в исследование включено 100 больных в возрасте от 5 до 18 лет, страдающих поллинозом. Аллерген-специфическую иммунотерапию проводили в предсезонный пе-риод в течение 3 лет. Динамику цитокинов в сыворотке крови и в смывах из полости носа изучали до лечения и после 2-го и 3-го курса лечения. Результаты: в процессе лечения выявлено повышение концентрации IL-10, IFNγ и уменьшение содержания IL-4 в сыворотке крови. Значимой динамики содержания цитокинов в смывах из полости носа не выявлено. Выводы: выявленные изменения со-ответствуют изменению профиля Т-клеточного ответа в сторону Th1-пути, что подтверждает эффек-тивность сублингвальной аллерген-специфической иммунотерапии на патогенетическом уровне. Changes of immune indexes during sublingual allergen-speCifiC immunotherapy in Children with hay feverabstract. Aims of study: evaluation of immunological parameters in course of sublingual allergen-specific immunotherapy with tree pollen mixture in children with hay fever. Materials and methods: the study included one-hundred patients 5 to 18 years of age with hay fever (pollen rhinitis, rhinoconjunctivitis and/or asthma). Allergen-specific immunotherapy was administered pre-seasonally for three consecutive years. Cytokine changes were studied in blood serum and in lavages from nasal cavity. Samples assessed before treatment and after 2 nd and 3 rd courses SLIT completion. Results: increased serum concentrations of IL-10, IFNγ, and decreased IL-4 contents were revealed in the course of treatment. No significant changes in cytokine concentrations were detectable in nasal lavages. Conclusions: the changes revealed correspond to a shift of T cell response profile towards Th1 pathway, thus confirming pathogenetic effects of sublingual allergen-specific therapy.
The diagnosis of allergic disease related to the group of immediate hypersensitivity involves confirmation of IgE sensitization: positive skin tests with the suspected allergen and/or detection of allergen-specific IgE. Research over the past decades showed that IgE synthesis may occur exclusively in the tissues of the affected organ and derived allergen-specific antibodies may not enter the systemic circulation. In contrast to «atopy», this concept of local sensitization was termed «entopy». local production of IgE was detected in more then 47% of adults previously diagnosed as having non-allergic rhinitis. besides the nasal mucosa, local sensitization was found in lymphoid tissues of nasopharyngeal ring, bronchial mucosa in some patients with non-atopic asthma, esophageal mucosa in patients with eosinophilic esophagitis. The processes of local immune response is currently studied and probably one day the accumulated data will swing our understanding of atopic sensitization, that will be reflected in classification and therapeutic approaches.
Food allergies (fa), defined as an adverse immune response to food proteins, effect up to 3-5% of the popula- tion in westernized countries, and their prevalence appears to be rising. a variety of mechanisms underlie the allergic reactions, not all of them run through the IgE sensitisation. the absence of sIgE in peripheral circulation characterize a group of non-Ig-Emediated disorders, such as food protein-induced enterocolitis, enteropathy and prococolitis. In case of eosinophilic esophagitis, gastritis and enterocolitis IgE sensitization arises in nearly 50%, therefore these disorders are classified as mixed-type. In some cases of gastrointestinal fa local IgE production, when switching to IgE synthesis occurs only in one organ, have been proved. although systemic investigation of this phenomenon is still lacking. Immune inflammation coursed by food allergens can involve nearly all organs and systems. this review focuses on gastroenterological manifestations of food allergy, except of broad field of gluten intolerance that demands a separate thorough reviewing.
Acute respiratory infections are widespread in the pediatric population and represent a significant burden to the health care system and families of patients. Anatomic ans physiological features of preschool children and individual predisposition, especially atopic phenotype, determine high risk of complicated course of acute respiratory infections with bronchial obstruction syndrome. The etiological factors of recurrent AR are quite diverse from chronic infections to foreign bodies of the bronchi or genetically determined diseases, but the most common cause of recurrent AR in children remains bronchial asthma. Therapy of acute obstructive episode in real clinical practice is most often similar to therapy of bronchial asthma attack and includes effects on the main components of pathogenesis: contraction of smooth muscles, mucus hypersecretion and inflammatory edema of the bronchial wall. There has been accumulated a great practical experience of using combined preparation of fenoterol and ipratropium bromide, which currently exists also in the form of domestic medicinal product Astmasol-SOLOpharm. In addition to standard bronchodilator and mucoconstrictor therapy, hypertonic solutions, in particular Ingasalin 3%, are an important component of therapy of prolonged obstruction and relapse prevention. The possibilities of this remedy in shortening of terms of obstructive disorders and decrease of risk of antibiotic therapy are demonstrated by clinical example.
Activated zinc pyrithione (ZP) has a number of contributory pharmacodynamic effects that provide it's efficacy in psoriasis and atopic dermatitis. Because of ZP impairs the integrity of cell membranes it is active against many bacterial and yeast species. In psoriasis and atopic dermatitis ZP therapy is accompanied by accelerated cells' apoptosis of lower layers of epidermis and atopic inflammatory infiltrate as well as by decrease in skin neutrophils and lymphocytes. The broad spectrum of pharmacological activities together with wide clinical experience worldwide endorse activated ZP as effective and safe nonsteroidal medication for topical therapy of different dermatoses and support it's use in dermatology, paediatrics and allergy.
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