Current Concepts of Atopic Dermatitis in Children: Problems and Prospects

Смирнова, Г И

doi:10.18821/1560-9561-2017-20-2-99-107

jour

2019

DOI: 10.18821/1560-9561-2017-20-2-99-107

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Current Concepts of Atopic Dermatitis in Children: Problems and Prospects

Г И Смирнова

Abstract: There are presented modern data describing the current understanding of the pathogenesis of atopic dermatitis (AD): a genetic predisposition to atopy, disruptions of epidermal barrier integrity and a cascade of immune responses, contributing allergic inflammation in the skin. There are both described several mechanisms of acute and chronic phases of AD, the main directions of pathogenetically substantiated treatment of AD in children and indicated the prospects of new preparations specific blockers of proinfla… Show more

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Cited by 4 publications

References 22 publications

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Features of the quality of life in children with food allergy

Фуголь

Strozenko

Lobanov

et al. 2021

RPJ

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Introduction. Food allergy (FA) being a clinically heterogeneous condition, the only treatment for which is a strong elimination diet. The need to exclude one or more foods from the diet, constant monitoring of the diet, anxiety and excitement about the exacerbation of allergic symptoms lead to a significant decrease in the quality of life. Materials and methods. The study included thirty eight 2-7 year children patients with various clinical manifestations of FA (atopic dermatitis, allergic and alimentary colitis, food-borne dermatitis). The comparison group consisted of twenty seven healthy children matched by age. The quality of life in all children was assessed using the Pediatric Quality of Life - PedsQLTM4.0 questionnaire. Results. All FA children patients showed a significant decrease in the quality of life in terms of such indicators as emotional functioning (60.2 in the main group and 83.5 in the comparison group), social functioning (77.9 in the main group and 88.1 in the comparison group), role functioning or kindergarten functioning (FDS) (77.5 in the main group and 84.9 in the comparison group) and psycho-social health (69.3 in the main group and 85.5 in the comparison group). The overall score in assessing the quality of life is significantly lower in the group of FA children (71 in the main group and 87 in the comparison group). Conclusion. To improve the quality of life of children with FA, there is needed a comprehensive individual approach including both psychological support for the child and his family members, and the solution of issues with the provision of «safe» food in children’s educational institutions.

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Features of the quality of life in children with food allergy

Фуголь

Strozenko

Lobanov

et al. 2021

RPJ

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The efficacy and safety of immunobiological therapy of atopic dermatitis in children

Larkova

Glukhova

Revyakina

2022

RPJ

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The review shows atopic dermatitis (AD) as a chronic inflammatory skin disease that develops in early childhood in infants with a hereditary predisposition. The inflammatory response type 2, including a complex interaction of type 2 T-helpers (Th2), congenital lymphoid cells, granulocytes (including eosinophils, mast cells and basophils), cytokines (IL-4, IL-5, IL-13 etc.) and immunoglobulin E (IgE) underlie at the base of the AD pathogenesis. IL-4 and IL-13 deserve special attention since they affect several links of pathogenesis at once. Both cytokines interact with receptors. Their critical subunit is the alpha chain of the IL-4 receptor. This molecule is the target for dupilumab, the first genetically engineered biologically active drug that demonstrated the high efficacy in the treatment of AD in 6 to 18-year children patients. At the same time, the data available in the literature indicates the drug to have both nonspecific (soreness at the injection site, allergic response) and specific (conjunctivitis, secondary herpetic infections, eosinophilia) adverse effects, which should be taken into account by practitioners when prescribing immunobiological therapy. Conclusion. In randomised, double-blind, placebo-controlled trials in children of different ages with the moderate to severe course of AD, immunobiological therapy with dupilumab has demonstrated high clinical efficacy in the form of a rapid remission of the disease and exemplary safety.

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Successful use of a janus kinase inhibitor for the treatment of atopic dermatitis

Revyakina

Mukhortykh

Larkova

et al. 2022

RPJ

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The article presents a clinical report of the use of a new drug of the janus kinase inhibitor, upadacitinib, possessing of the effect on the intracellular JAK/STAT system, the role of which in the pathogenesis of atopic dermatitis (AD) is being actively studied. JAK/STAT includes janus kinases JAK1, JAK2, JAK3, tyrosine kinase, protein-transductor and transcription activator (STAT). When the cytokine interacts with the corresponding receptor, janus kinases phosphorylate STAT proteins inducing transcription of genes that mediate the action of key cytokines to trigger the development of an inflammatory response in the shock organ. Upadacitinib is recommended for uncontrolled AD patients older 12 years. The use of upadacitinib in a 17-year-old patient at a dose of 15 mg in tablets, daily, has shown high efficacy in achieving clinical remission of AD and complete relief of the skin itching.

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Current Concepts of Atopic Dermatitis in Children: Problems and Prospects

Cited by 4 publications

References 22 publications

Features of the quality of life in children with food allergy

Features of the quality of life in children with food allergy

The efficacy and safety of immunobiological therapy of atopic dermatitis in children

Successful use of a janus kinase inhibitor for the treatment of atopic dermatitis

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