scholarly journals 2019 ARIA: care pathways for allergic rhinitis in Russia

2020 ◽  
Vol 17 (1) ◽  
pp. 7-22 ◽  
Author(s):  
Musa Rakhimovich Khaitov ◽  
L Seymurovna Namazova-Baranova ◽  
N Ivanovna Ilyina ◽  
O Mikhaylovna Kurbacheva ◽  
Claus Bachert ◽  
...  

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.

2017 ◽  
Vol 3 (1) ◽  
pp. 1-6
Author(s):  
Yousri M Hussein ◽  

To assess the value of serum Interleukin-13 (IL-13) levels as an immunological marker in atopic upper respiratory diseases, to clarify its differences in atopic and non atopic bronchial asthma and to determine the role of an Interleukin -13 receptor alpha 1 (IL-13 Rα1) gene Single Nucleotide Polymorphism (SNP) (A1398G) in the pathogenesis of these diseases.


Background. Significantly less is known about the immunoregulative cytokines, especially in allergic airway disease. This study aims to present the involvement of IL-35 and IL-10 in patients with allergic rhinitis (AR) and allergic bronchial asthma (BA). Methodology. The study comprised 71 patients –AR, patients with concomitant AR and mild atopic BA, and healthy controls (HC). We examined the serum levels of IL-35 and IL-10, along with other instrumental examinations, between March and September 2021. Findings. Levels of the regulatory cytokines IL-35 and IL-10 were significantly lower in patients than in HC (87.19±11.90 vs. 96.12±1.79 pg/ml; and 30.26±17.55 vs. 111.56±65.03 pg/ml, respectively). Furthermore, threefold higher serum IL-10 levels were found in healthy subjects compared to patients (p = 0.006). No difference in the levels of interleukins was found between the studied groups. Conclusions. Our results indicate that elevated IL-35 and IL-10 may play an essential role in reducing the activity of underlying allergic inflammation in allergic respiratory diseases, although no difference in the levels of the studied cytokines was found between the different groups of patients. Therefore, we can speculate that the immunosuppressive cytokines IL-35 and IL-10 were involved in maintaining the healthy state of no inflammation.


Author(s):  
M.A. Zemlianova ◽  
I.V. Tikhonova

Alumina refineries are among the leading sources of atmospheric air pollution with a wide range of pollutants hazardous to human respiratory organs. It is relevant to study and evaluate the occurrence of the risks for development of respiratory diseases in children living in the area affected by the emission components of an alumina refinery. We assessed air quality of the area under observation and comparison according to monitoring observations, risk of non-carcinogenic effects from the respiratory organs. The content of chemicals in the blood and urine adequate to risk factors was quantified. The structure of individual groups of respiratory diseases was analyzed. The causal relationships of violations of laboratory parameters with an increased content of chemicals in biological media were evaluated. It was found that an aerogenic exposure of chemical pollutants is formed on the territory with the production of metallurgical alumina. It determines the risk for development of respiratory diseases, exceeding an acceptable level up to 49.9 times. In the exposed children, the content of manganese, chromium, nickel, copper, xylenes, formaldehyde and aluminum, fluoride ion in the urine was increased to 4.2 times in relation to the indices in the comparison group. A high level of additional respiratory morbidity(1.8 times) was revealed. Chronic lymphoproliferative diseases of the nasopharynx and inflammatory diseases of the upper respiratory tract (up to 6.6 times more often), inflammatory diseases with a predominance of the mechanism of allergic inflammation ( up to 2.1 times more often)are more often detected in the framework of the respiratory diseases. Negative effects on the part of the respiratory system in the form of activation of antioxidant processes, the development of an inflammatory reaction, local, general and specific sensitization of the respiratory tract were established. It confirms the occurrence of the risks for the development of respiratory diseases in children in the exposure area of the chemical factors of alumina refinery-associated economic activity.


Author(s):  
E.V. Prosekova ◽  
A.I. Turyanskaya ◽  
N.G. Plekhova ◽  
M.S. Dolgopolov ◽  
V.A. Sabynych

Расширение спектра изучаемых клонов Тхелперов определило более сложные иммунные механизмы реализации аллергического воспаления. Цель. Характеристика показателей и взаимосвязей цитокинового профиля сыворотки и субпопуляционного состава Тлимфоцитов периферической крови у детей с бронхиальной астмой и аллергическим ринитом. Материалы и методы. Проведено комплексное обследование 150 детей в возрасте 311 лет с верифицированным диагнозом бронхиальной астмы, аллергического ринита и 30 здоровых сверстников. Иммунологические параметры крови оценивали методом проточной цитометрии, концентрации интерлейкинов и IgE в сыворотке крови определяли методом твердофазного иммуноферментного анализа. При статистической обработке использовали программы Statistica 10 с критическим уровнем значимости р0,05. Результаты. У детей с аллергическими заболеваниями в сыворотке крови определены высокие уровни содержания интерлейкинов4, 8, 13, 17А, сопоставимый с показателями группы контроля уровень IL17F и низкое содержание IFNy. При бронхиальной астме и аллергическом рините у детей выявлено увеличение количества CD3CD8CD45RO, CD3CD8CD45RACD45RO Тлимфоцитов и CD3CD4 Тхелперов и повышение количество Th17 при снижении CD3CD4CD45RO клеток памяти. В группе здоровых детей популяция Th17 составляла 9,491,6, у детей с аллергическими заболеваниями количество данных клеток было значимо выше 14,50,77 (р0,001). Анализ сывороточного содержания цитокинов у детей с изолированным течением БА и в сочетании с аллергическим ринитом выявил разнонаправленные корреляции, отличающиеся по силе и направленности от таковых в группе здоровых детей. Заключение. У детей при изолированном течении бронхиальной астмы и в сочетании с аллергическим ринитом выявлены: сопоставимое с показателями здоровых детей количество CD3CD4 Тклеток, дисбаланс в субпопуляционном составе Тхелперов за счет преобладания Th2 и Th17, активация синтеза IL17A, IL4, IL8, IL13, низкий уровень сывороточного IFNy, изменения силы и направленности взаимосвязей цитокинового профиля и спектра субпопуляций Тлимфоцитов.Expansion of the range of examined Thelper clones has determined more complex immune mechanisms for the implementation of allergic inflammation. Objective. To characterize the parameters and relationships between the serum cytokine profile and Tlymphocyte subpopulation in peripheral blood of children with bronchial asthma and allergic rhinitis. Materials and methods. 150 children aged between 311 years old with bronchial asthma, and allergic rhinitis and 30 healthy volunteers were examined. Immunological parameters were assessed by flow cytometry, the concentration of serum interleukins and IgE were determined by means of enzymelinked immunosorbent assay. Statistical analysis was performed with Statistica 10 program with a critical level of significance p0.05. Results. High levels of interleukins 4, 8, 13, 17A were determined, IL7F level was not significantly different from that in control group and low level of IFNy was found in the serum of children with allergic diseases. The number of CD3CD8CD45RO, CD3CD8CD45RACD45RO Tlymphocytes, CD3CD4 Thelper cells and Th17 were increased and at the same time CD3CD4CD45RO memory cells were decreased In bronchial asthma and allergic rhinitis children. Number of Th17 cells in healthy children was 9.491.6, in allergic children it was significantly higher 14.50.77 (p0.001). Analyses of serum cytokine count in children with isolated BA and in association with allergic rhinitis revealed multidirectional correlations differing in strength and direction from those in the group of healthy children. Conclusion. In children with isolated bronchial asthma and associated with allergic rhinitis the following parameters were found: CD3CD4 Tcells count was comparable to that in healthy children, the imbalance of Thelper subpopulation: prevalence of Th2 and Th17, activation of IL17A, IL4, IL8, IL13 synthesis and low level of serum IFNy.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zeina Akiki ◽  
Danielle Saadeh ◽  
Rita Farah ◽  
Souheil Hallit ◽  
Hala Sacre ◽  
...  

Abstract Background No national research has yet explored the prevalence of asthma among adults in Lebanon. This study aims to evaluate the prevalence of physician-diagnosed asthma and current asthma, and their determinants among Lebanese adults 16 years old or above. Methods A cross-sectional study was carried out using a multistage cluster sampling. The questionnaire used collected information on asthma, respiratory symptoms, and risk factors. Results The prevalence of physician-diagnosed asthma was 6.7% (95% CI 5–8.7%), and that of current asthma was 5% (95% CI 3.6–6.9%). Chronic symptoms such as cough, wheezing, and shortness of breath were worst at night. Factors positively associated with physician-diagnosed asthma were a secondary educational level (adjusted OR, aOR = 4.45), a family history of chronic respiratory diseases (aOR = 2.78), lung problems during childhood (15.9), and allergic rhinitis (4.19). Additionally, consuming fruits and vegetables less than once per week (3.36), a family history of chronic respiratory diseases (3.92), lung problems during childhood (9.43), and allergic rhinitis (8.12) were positively associated with current asthma. Conclusions The prevalence of asthma was within the range reported from surrounding countries. However, repeated cross-sectional studies are necessary to evaluate trends in asthma prevalence in the Lebanese population.


2016 ◽  
Vol 71 (4) ◽  
Author(s):  
I. Chkhaidze ◽  
T. Maglakelidze ◽  
N. Khaltaev

Background and aim. Millions of people suffer from chronic respiratory diseases (CRD). To address this serious global health problem WHO formed the Global Alliance against Chronic Respiratory Diseases (GARD). Chronic obstructive pulmonary disease (COPD) is a major priority of GARD due to high chronic morbidity and mortality; however, there is still little prevalence data available. The prevalence of COPD in Georgia, as well as other CRD, is suspected to be high. Methods. GARD Pilot Survey (GAPS) in Georgia had been carried out by the Georgian Respiratory Association. The survey was conducted in the Sagarejo and Mtskheta districts with total population of about 70.000. All subjects provided information on asthma, bronchitis, respiratory symptoms, smoking, allergic conditions, CRD comorbidity and lifestyle via an interviewer-administered questionnaire. A total of 3,646 questionnaires were analysed. Results. It was discovered that official data concerning allergic rhinitis, TB and asthma are almost equal, but readings in relation to CRD are about five times lower according to official data of the Ministry of Health of Georgia. The data results: for allergic rhinitis - 218 in GAPS vs. 177 in the official statistics (for 100.000 population); for TB -105 in GAPS vs. 147 in the official statistics; for asthma -250 in GAPS vs. 374 in the official statistics; the data about CRD according to our survey is almost five times higher - 365 in GAPS vs. 84 in the official statistics (for 100.000 population). Conclusions. It is necessary to expand the survey to the entire country population. Country results are likely to be useful and interesting for local doctors and managers, as well as for officials.


2018 ◽  
Vol 32 (6) ◽  
pp. 502-517 ◽  
Author(s):  
Nuray Bayar Muluk ◽  
Fazilet Altın ◽  
Cemal Cingi

Objectives Our intention was to review all material published to date regarding superantigens (SAgs) and allergy from an otorhinolaryngological viewpoint to understand this association more clearly. Methods We identified all materials published mentioning both SAg and allergic rhinitis (AR), chronic sinusitis, asthma, and atopic dermatitis (AD) that are indexed on PubMed, Google, or the ProQuest Central databases. Results Staphylococcus aureus is a significant bacterial pathogen in humans and has the ability to produce enterotoxins with superantigenic features. The inflammatory response in allergy seen in both B cell and T cell may be attributed to SAgs. Sufferers of both allergic asthma with rhinitis and AR alone produce serological evidence of immunoglobulin E formation to SAgs produced by S. aureus. Perennial AR sufferers carry S. aureus more frequently and the presence of the organism within the nasal cavity may exacerbate perennial AR. SAg produced by S. aureus potentially worsens the asthmatic inflammatory response within the airway and may lead to the airways becoming hyperresponsive, as well as possibly activating T cells if asthmatic control is poor. Staphylococcal SAgs potentially increase the risk of developing chronic rhinosinusitis with nasal polyposis, additionally being a marker for more severe disease. If SAgs bring about chronic inflammatory responses in the nose and sinuses, then T cells excreting interferon-gamma may be a crucial mediator. In allergic dermatitis, S. aureus could be a key player in exacerbation of the condition. Even in younger pediatric patients with allergic dermatitis, allergic hypersensitivity to SAgs is frequent and may be a factor explaining how severe the condition becomes. Conclusion Just as SAgs are known to feature in many allergic conditions, they play their part in AR, chronic rhinosinusitis, asthma, and AD. Further research is required before the relationship between SAgs and allergy can be adequately explained.


2021 ◽  
Vol 23 (4) ◽  
pp. 921-926
Author(s):  
N. N. Zhukova ◽  
M. V. Manzhos ◽  
L. R. Khabibulina ◽  
E. Yu. Syrtsova

Allergic rhinitis and bronchial asthma are widespread respiratory allergic diseases. In some territories of the Russian Federation, the dominant cause of pollinosis is ragweed. The aim of the study was to evaluate the clinical and immunological efficacy of ASIT with the allergen Ambrosia artemisiifolia in patients sensitized to Ambrosia trifida in the Samara region. Patients with proven sensitization to Ambrosia trifida was held immunotherapy with Ambrosia artemisiifolia allergoid preseason. After treatment, patients had a decrease in the severity of symptoms of allergic rhinitis according to VAS (p = 0.00001), a decrease in the need for medications (p = 0.0003), as well as the need for corticosteroids against the background of therapy from 34.6% to 0% (p = 0.00001). In 8% of cases, the result of treatment was good, in 69% satisfactory, in 23% unsatisfactory. In the control group, there were no changes in the severity of symptoms (p = 0.858). Also, in the control group, the need for medications remained unchanged and 14.3% of patients continued to use corticosteroids.After ASIT, there was a decrease in the level of IL-4 (p = 0.002), and a decrease in the ratio of IL-4/ IL-10 (p = 0.0063); at the same time, changes in the level of other cytokines (IL-10; IFNγ) were statistically insignificant (p > 0.05). Before treatment, the levels of IL-4/ IL-10 in both groups were comparable, and after treatment, the differences became statistically significant (p = 0.031). We did not get a statistically significant change in the level of IgG4 Amb a 1 or IgG4 Amb trifida. There was no correlation between the level of individual cytokines and the results of treatment. As a result of the conducted ASIT, positive clinical and immunological results were obtained. In most patients, the disease has acquired a controlled course. At the same time, the lack of excellent and low number of good results of ASIT is probably due to the intraspecific allergenic properties of ragweed. 


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