The main focus in the course of COVID-19 goes on assessing the overall immune response. The role of mucosal immunity in this disease has not been studied sufficiently.The study aimed to analyze published data about secretory IgA as a significant indicator of the mucosal immune response of the respiratory tract in the context of the COVID-19 pandemic.Methods. Articles were identified via PubMed bibliographic database. The time-span of research was two years (2020, 2021).Results. The search identified 54 articles. There is evidence that secretory IgA (sIgA) is the main antibody isotype of the mucosal immunity. It is produced in quantities significantly higher than those of all other isotypes of immunoglobulins combined. sIgA antibodies are effective against various pathogens, including the SARS-CoV-2 virus, due to mechanisms such as neutralization, suppression of adhesion to the mucosal surface and invasion of epithelial cells, agglutination and facilitating the removal of pathogenic microorganisms with the mucosal secretions. Virus-specific IgA antibodies in the blood serum are detected in patients with COVID-19 as early as two days after the first symptoms, while IgM or IgG class antibodies appear only after 5 days. We accessed the efficacy of intranasal immunization as to induction of predominant production of sIgA in the upper and lower respiratory tract.Conclusion. The current information on the local immune response of the respiratory mucosa is important for understanding the pathophysiological mechanisms of the disease, diagnosis, and development of new methods of treatment and prevention of COVID-19.

Лечение пациентов с хроническим риносинуситом (ХРС) остается актуальной проблемой современной оториноларингологии. Разнообразие клинических форм ХРС определяется множеством этиологических факторов, включая генетические факторы, окружающую среду, инфекционные агенты, аллергию, иммунные нарушения и системные заболевания. Проявления заболевания в значительной степени снижают качество жизни пациентов. Не редки случаи развития у пациентов ХРС на фоне аллергического ринита (АР). Учитывая полиэтиологичность заболевания, подход к лечению ХРС у пациентов с круглогодичным аллергическим ринитом носит индивидуальный и комплексный характер. Противовоспалительная терапия занимает значимое место в лечении пациентов с ХРС, в особенности при сопутствующем круглогодичном АР. Хирургическое лечение показано таким пациентам в большинстве случаев, однако при наличии сопутствующего круглогодичного аллергического ринита требует дополнительной периоперационной терапии. Ключевые слова: хронический риносинусит, аллергический ринит, интраназальные глюкокортикостероиды. P.A. KOCHETKOV, PhD in medicine, E.B. RAKUNOVA TREATMENT FEATURES OF CHRONIC RHINISINUSITIS IN PATIENTS WITH PERENNIAL ALLERGIC RHINITIS The issue of chronic rhinosinusitis (CRS) treatment is currently important. Wide variety of CRS clinical forms can be defined by multiple etiological factors, comprising genetic, environmental, infectious, allergic, immune contravention and systemic diseases. Cases when CRS occurs in patient with concomitant allergic rhinitis (AR) are not rare. Considering multifactorial etiology of CRS the therapy approach must be individual and complex especially in patients with concomitant AR. Usually surgical treatment is indicated, but in case of concomitant AR it requires additional pred-and postoperative therapy.

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Acute inflammatory diseases of the upper respiratory tract (URTI) accompanied by cough are one of the most common groups of diseases in the world. It includes acute respiratory viral infections, often manifested by rhinosinusitis, tonsillopharyngitis and laryngitis. According to statistics, about 90% of all infectious diseases are acute respiratory infections, with cough accompanying acute respiratory infections in 83% of cases. Cough largely determines the severity of the disease, and its duration over 4 weeks indicates a high probability of process chronicity. Cough with difficult to detach sputum dramatically reduces the patient’s quality of life, bringing discomfort in everyday activities. In addition to the cough, the problem of viral diseases lies in the rather difficult diagnosis at the outpatient stage, due to which excessive prescription of antibiotics occurs. In order to avoid the occurrence of complications, chronicization of the disease and reduce the level of inappropriate prescriptions of antibacterial drugs, it is necessary to apply therapy, aimed both at the etiology, the links of pathogenesis, and the symptoms in order to alleviate the condition of the patient and his speedy recovery. The processes leading to the development of cough in URTI are described in the article; principles of differential diagnostics and peculiarities of therapy of URTI are reviewed. The article presents data on the use of a natural remedy, ivy leaf extract, which helps to get rid of cough in a shorter period of time, thereby improving the well-being of the patient, and is notable for its good tolerability and rare occurrence of side effects, which may surpass synthetic alternatives.

Usually benign laryngeal lesions like cysts, polyps and fibrous masses occurs in result of phonotrauma as reactive changes of the mucous of vocal cords. Presence of organic pathology of larynx is a reason of functional voice disorders. 45 patients in age of 18-70 y.o. with benign laryngeal lesions were investigated. All patients underwent microlaryngoscopy with excision of the lesion in inpatient mode. This article describes complex of pre- and postoperative procedures performed to assess the vocal function in patients. For the surgical excision of lesions «cold-steel» instruments, radiofrequently ablation and laser surgery were used. Authors analysed the correlation between complaints, acoustic voice parameters and the process of mucous recovery. Laser technique is recommended for surgical treatment of benign lesions of larynx. Fibrolaryngoscopy, laryngostroboscopy and computer acoustic assessment of vocal parameters are required before voice normalization. Phonotherapy is indicated n case of persistence of dysphonia.