CLINICAL AND SPIROGRAPHIC FEATURES OF BRONCHIAL ASTHMA IN SCHOOLCHILDREN DEPENDING ON THE DIFFERENT REGIMENS OF BASIC ANTI-INFLAMMATORY THERAPY

2020 ◽  
Vol 73 (1) ◽  
Author(s):  
Olena Koloskova ◽  
Tetiana Bilous ◽  
Galyna Bilyk ◽  
Kristina Buryniuk-Glovyak ◽  
Olena Korotun ◽  
...  
Keyword(s):  
Bronchial Asthma ◽  
Inhaled Corticosteroids ◽  
Persistent Asthma ◽  
High Specificity ◽  
Clinical Feature ◽  
Clinical Group ◽  
Comparison Groups ◽  
Anti Inflammatory ◽  
High Doses ◽  
Persistent Bronchial Asthma

The aim: To study the clinical and spirographic features persistence of the bronchial asthma in schoolchildren against the background of the alternative daily doses of inhaled corticosteroids to increase the effectiveness of anti-inflammatory therapy for this disease. Materials and methods: A complete comprehensive clinical-paraclinical examination of 65 schoolchildren with persistent asthma was conducted. According to the average daily dose of inhaled corticosteroids (ICS) the patients were divided into two clinical groups. The first (I) group consisted of 46 children who received ICS in the regimen of low-to-medium equipotent doses (253.95±9.98 μg per day), and the second (II) comparison group was formed of 19 patients who controlled the pBA using high doses of ICS (494.74±5.56 μg per day). Results: The patients of the І clinical group compared to patients of the ІІ group have a higher risk of the mild bronchial obstructive syndrome during asthma attacks. In assessing the level of control of persistent bronchial asthma using the CIA-scale, it was found that in II group cases of the controlled course of the disease were observed almost two times less than in children of the I group of comparison. In conducting spirography in children of comparison groups, it was shown that the ratio of indices of bronchospasm (FEV1/ FVC) was worse in patients receiving high doses of ICS. Conclusions: So, сharacteristic clinical feature of asthma controlled by high doses of ICS is more severe nature of bronchial obstructive syndrome during the period of exacerbation (OR=1.9-3.0). In the management of persistent bronchial asthma, the Gensler index which has high specificity (94.4%) and accuracy (92.2%) should be used for disease control verification.

scholarly journals Mechanisms of formation of airway hyperreactivity in view of phenotypical heterogeneity and clinical deviation of bronchial asthma in adolescents (literature review)

2021 ◽  
pp. 47-54
Author(s):  
О.К. Koloskova ◽  
◽  
О.О. Shakhova ◽  
S.І. Tarnavska ◽  
O.V. Vlasova ◽  
...  
Keyword(s):  
Bronchial Asthma ◽  
Inhaled Corticosteroids ◽  
Persistent Asthma ◽  
High Body Mass Index ◽  
Airway Hyperreactivity ◽  
Extremely Low Birth Weight ◽  
Chronic Obstructive ◽  
Bronchial Obstruction ◽  
Bronchial Inflammation ◽  
Mechanisms Of Formation

Bronchial asthma is a disease characterized by recurrent episodes of variable bronchial obstruction, chronic bronchial inflammation, bronchial hypersensitivity and remodulation. Modern therapy of the disease was aimed at these links of pathogenesis, and this concept postulated the need for long-term use of anti-inflammatory drugs and, above all, topical inhaled corticosteroids. However, it should be recognized that the coherent inflammatory theory currently requires revision and new understanding, or even replacement with a new theory, which, considering these characteristics of the disease as an epiphenomenon, will serve as a basis for new approaches in treatment and prevention. The aim of our work — to analyze the mechanisms of formation of bronchial hyperreactivity, taking into account the phenotypic heterogeneity and clinical deviation of bronchial asthma in adolescence (based on the analysis of scientific sources). It is extremely important to determine the risk of transition of the adolescents' bronchial asthma into adulthood, when chronic obstructive pulmonary diseases might develop. Among the main predictors of this risk such factors as age, obesity, early puberty, body weight at birth and in the newborn period and sex can be distin guished. Thus, some authors associate the risk of persistence of the disease with its onset in early childhood, and others — at the age of 6 years old. High body mass index and early onset of puberty are considered to be the predictors of persistent bronchial asthma. It is noted that low and extremely low birth weight of premature infants or rapid weight gain in the neonatal period are associated with a decrease in lung ventilation and the risk of persistent asthma in the future. It is believed that bronchial asthma in children is more common in boys than in girls, in contrast, during puberty, allergic diseases and asthma are more common in girls. Conclusions. The above mentioned literature data give reason to believe that, despite advances in the scientific understanding of the pathogenesis of the main characteristics of bronchial asthma, there are great difficulties in using them in practice. Moreover, current inflammatory paradigm of bronchial asthma needs to be revised because it being a dogma becomes unproductive from a clinical point of view. No conflict of interest was declared by the authors. Key words: asthma, adolescents, hyperreactivity, remission.

scholarly journals BIOMARKERS OF INFLAMMATION AT BRONCHIAL ASTHMA IN CHILDREN WITH ALTERNATIVE DEBUT OF THE DISEASE

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
O.K. Koloskova ◽  
Т.М. Bilous ◽  
О.P. Korotun ◽  
F.V. Herman ◽  
V.V. Bilous ◽  
...  
Keyword(s):  
Bronchial Asthma ◽  
Inflammatory Process ◽  
Community Acquired Pneumonia ◽  
Clinical Group ◽  
Group Iii ◽  
The Third ◽  
Group I ◽  
Comparison Groups ◽  
Discrete Nature ◽  
Personalized Approach

Objectives - to analyze the activity of the inflammatory process in the airways of childrenwith bronchial asthma depending on different onset of the disease.Material and methods. Keeping to the principles of bioethics a comprehensiveretrospective examination of 319 children suffering from BA was performed. In 257children (clinical group I) bronchial asthma developed against a background of chronicobstructive bronchitis. The second clinical group included 43 children, in whom asthmadebuted after community-acquired pneumonia. The third (III) clinical group consistedof 19 children in whom asthma was first verified after inpatient treatment for asthmaticstatus.Results. According to the severity of bronchial asthma, it was found that the representativesof the III clinical group, compared with other patients, significantly more often had a severecourse of the disease. For patients of the I clinical group in the debut it is characterizedby increased eosinophils and decreased neutrophil counts in sputum, for patients ofgroup II - increased eosinophils and epitheliocytes, but a decrease in lymphocytes, andfor children of clinical group III - low eosinophils sputum with a simultaneous increasein neutrophils. In particular, a statistically significant increase in the content of VEGF,a decrease in the content of cationic proteins, MMP-9, and interleukins-6, and -13 inthe sputum indicates the predominance of neoangiogenesis in children of clinical groupIII. Instead, in the representatives of the II clinical group the remodeling processes weremainly caused by the inflammatory process with the release of intracellular eosinophiliccationic proteins.Conclusion. These data indicate the discrete nature of the type and severity of theinflammatory process of the respiratory tract in the dynamics of observation in childrenof clinical comparison groups, which suggests the presence of certain phenotypicdifferences due to the alternative onset of the disease, which in its turn was determinedby different triggers. Such deviations of the inflammatory process indicate that patientswith asthma require a personalized approach to differentiated diagnostic monitoring andtargeted anti-inflammatory treatment, taking into account the peculiarities of the onsetof the disease.

scholarly journals Efficiency of bronchial asthma control in children of school age depending on the features of the disease debut

2021 ◽  
Vol 25 (1(97)) ◽  
pp. 54-62
Author(s):  
O. Koloskova ◽  
T. Bilous ◽  
N. Shevchenko ◽  
G. Bilyk
Keyword(s):  
Asthma Control ◽  
Bronchial Asthma ◽  
Status Asthmaticus ◽  
Chronic Obstructive ◽  
Clinical Group ◽  
Chronic Obstructive Bronchitis ◽  
Group I ◽  
Asthma In Children ◽  
Anti Inflammatory ◽  
Basic Treatment

Objective. To assess the effectiveness of achieving and maintaining control of bronchial asthma in children during dynamic observation, depending on the characteristics of the onset of the disease. Material and methods. In order to study the peculiarities of the course and controllability of bronchial asthma in children, depending on the alternative onset of the disease, 319 children were comprehensively examined by the "experience-control" method in parallel groups using a simple random sample on the basis of the Regional Children's Clinical Hospital in Chernivtsi. In 257 patients (I clinical group), bronchial asthma developed on the background of chronic obstructive bronchitis, the II clinical group included 43 children in whom BA debuted after suffering community-acquired pneumonia, and the third (III) clinical group was formed by 19 children in whom BA was verified after inpatient treatment for status asthmaticus. Research results. It was shown that the representatives of the III clinical group, compared with other patients, probably more often had the phenotype of early asthma and severe disease, and the ratio of the chances of severe asthma in the future for these children compared with the cohort of group I was 6.8. According to the results of self-assessment of asthma control on standardized questionnaires GINA and AST, as well as using a clinical-instrumental assessment scale, it was found that the level of disease control in all groups was insufficient, and the distribution of children in clinical groups in group III relative to other patients with partially controlled and uncontrolled asthma predominated. The conducted standard anti-inflammatory basic treatment allowed to achieve certain positive changes in patients of clinical observation groups, and the representatives of the III clinical group required more active basic anti-inflammatory therapy, in particular, the volume of the 1st step in GINA compared to patients of the I group was prescribed twice less often, and the 4th - 6.9 times more often. Conclusion. Patients with the onset of bronchial asthma in the form of status asthmaticus further retain a worse level of control over the disease as compared to patients with chronic obstructive bronchitis or pneumonia in history. This cohort of patients requires a larger volume of basic treatment, as well as a personalized approach to prescribing therapy with the obligatory consideration of the characteristics of asthma onset.

ОСОБЕННОСТИ ЛЕЧЕНИЯ БРОНХИАЛЬНОЙ АСТМЫ В ПЕРИОД БЕРЕМЕННОСТИ

2019 ◽  
Author(s):  
O.V. Lavrova ◽  
M.A. Petrova ◽  
G.B. Fedoseev
Keyword(s):  
Pregnant Women ◽  
Bronchial Asthma ◽  
Pregnancy Complications ◽  
Inhaled Corticosteroids ◽  
Combined Therapy ◽  
Persistent Asthma ◽  
Asthma Therapy ◽  
Complete Control ◽  
Basic Therapy ◽  
Standard Procedures

Цель. Анализ характера терапии бронхиальной астмы, а также течения беременности у пациенток с бронхиальной астмой в период с 2002 по 2017 г. Материалы и методы. С 2002 по 2017 г. обследованы и проходили наблюдение в период беременности 3890 пациенток, страдающих бронхиальной астмой. Проводилось комплексное клинико-функциональное обследование. Пациентки находились под наблюдением акушера-гинеколога весь срок беременности, проходили стандартное обследование, оценивалась частота осложнений беременности. Было проведено сравнение характера базисной терапии бронхиальной астмы в группах пациенток с персистирующим течением заболевания, наблюдавшихся с 2002 по 2009 г. (1-я группа) и с 2010 по 2017 г. (2-я группа) в сопоставлении с частотой встречаемости осложнений беременности в данных группах. Результаты. При сравнении частоты встречаемости угрозы прерывания беременности, гипертензивных расстройств, преэклампсии выявлена достоверно более низкая частота встречаемости этих осложнений беременности во 2-й группе (2010-2017 гг.). При этом частота назначения ингаляционных глюкокортикостероидов (ИГКС) в составе комбинированных препаратов возросла с 21,79 до 63,87, что практически в три раза превышает данный показатель в 1-й группе (2002-2009 гг.). Заключение. При сопоставлении изменений в характере базисной терапии, произошедших с 2002 по 2017 г., с достоверным снижением частоты встречаемости осложнений беременности в группе, наблюдавшейся с 2010 по 2017 г., можно предположить, что именно терапия комбинированными препаратами ИГКС/ агонистов Р2-адренорецпторов длительного действия позволяет наиболее полноценно обеспечивать контроль бронхиальной астмы, приводя к снижению частоты осложнений беременностиStudy goal. To analyse asthma therapy in pregnant women with bronchial asthma at a period since 2002 to 2017. Materials and methods. 3890 pregnant women with asthma were examined and followed up during pregnancy at a period since 2002 to 2017. Comprehensive clinicalfunctional examination was conducted. Patients were under surveillance of the obstetriciangynecologist during the whole pregnancy, standard procedures were carried out, and the frequency of complications of pregnancy was estimated. Basic therapy of asthma was compared in groups with the persistent asthma duration, followed up since 2002 to 2009 (1 group) and since 2010 to 2017 (2 group). Also, frequency of pregnancy complications was estimated in these groups. Results. The second group (2010-2017) demonstrated reliably lower frequency of threatening abortion, hypertension and preeclampsia. At the same time the frequency of inhaled corticosteroids (ICS) administration as a part of the combined therapy increased from 21.79 to 63.87 (almost to three times) in comparison with the first group (2002-2009). Conclusions. Combined therapy with ICS/LABA provides most complete control of bronchial asthma, and decreases frequency of pregnancy complications in pregnant women with BA.

ОСОБЕННОСТИ ЛЕЧЕНИЯ БРОНХИАЛЬНОЙ АСТМЫ В ПЕРИОД БЕРЕМЕННОСТИ

2019 ◽  
pp. 14-19
Author(s):  
O.V. Lavrova ◽  
M.A. Petrova ◽  
G.B. Fedoseev
Keyword(s):  
Pregnant Women ◽  
Bronchial Asthma ◽  
Pregnancy Complications ◽  
Inhaled Corticosteroids ◽  
Combined Therapy ◽  
Persistent Asthma ◽  
Asthma Therapy ◽  
Complete Control ◽  
Basic Therapy ◽  
Standard Procedures

Цель. Анализ характера терапии бронхиальной астмы, а также течения беременности у пациенток с бронхиальной астмой в период с 2002 по 2017 г. Материалы и методы. С 2002 по 2017 г. обследованы и проходили наблюдение в период беременности 3890 пациенток, страдающих бронхиальной астмой. Проводилось комплексное клиникофункциональное обследование. Пациентки находились под наблюдением акушерагинеколога весь срок беременности, проходили стандартное обследование, оценивалась частота осложнений беременности. Было проведено сравнение характера базисной терапии бронхиальной астмы в группах пациенток с персистирующим течением заболевания, наблюдавшихся с 2002 по 2009 г. (1я группа) и с 2010 по 2017 г. (2я группа) в сопоставлении с частотой встречаемости осложнений беременности в данных группах. Результаты. При сравнении частоты встречаемости угрозы прерывания беременности, гипертензивных расстройств, преэклампсии выявлена достоверно более низкая частота встречаемости этих осложнений беременности во 2й группе (20102017 гг.). При этом частота назначения ингаляционных глюкокортикостероидов (ИГКС) в составе комбинированных препаратов возросла с 21,79 до 63,87, что практически в три раза превышает данный показатель в 1й группе (20022009 гг.). Заключение. При сопоставлении изменений в характере базисной терапии, произошедших с 2002 по 2017 г., с достоверным снижением частоты встречаемости осложнений беременности в группе, наблюдавшейся с 2010 по 2017 г., можно предположить, что именно терапия комбинированными препаратами ИГКС/ агонистов Р2адренорецпторов длительного действия позволяет наиболее полноценно обеспечивать контроль бронхиальной астмы, приводя к снижению частоты осложнений беременностиStudy goal. To analyse asthma therapy in pregnant women with bronchial asthma at a period since 2002 to 2017. Materials and methods. 3890 pregnant women with asthma were examined and followed up during pregnancy at a period since 2002 to 2017. Comprehensive clinicalfunctional examination was conducted. Patients were under surveillance of the obstetriciangynecologist during the whole pregnancy, standard procedures were carried out, and the frequency of complications of pregnancy was estimated. Basic therapy of asthma was compared in groups with the persistent asthma duration, followed up since 2002 to 2009 (1 group) and since 2010 to 2017 (2 group). Also, frequency of pregnancy complications was estimated in these groups. Results. The second group (20102017) demonstrated reliably lower frequency of threatening abortion, hypertension and preeclampsia. At the same time the frequency of inhaled corticosteroids (ICS) administration as a part of the combined therapy increased from 21.79 to 63.87 (almost to three times) in comparison with the first group (20022009). Conclusions. Combined therapy with ICS/LABA provides most complete control of bronchial asthma, and decreases frequency of pregnancy complications in pregnant women with BA.

scholarly journals Features of asthma treatment during pregnancy

2019 ◽  
Vol 16 (2) ◽  
pp. 14-19
Author(s):  
O V Lavrova ◽  
M A Petrova ◽  
G B \\Fedoseev
Keyword(s):  
Pregnant Women ◽  
Bronchial Asthma ◽  
Pregnancy Complications ◽  
Inhaled Corticosteroids ◽  
Combined Therapy ◽  
Persistent Asthma ◽  
Asthma Therapy ◽  
Asthma Treatment ◽  
Complete Control ◽  
Standard Procedures

Study goal. To analyse asthma therapy in pregnant women with bronchial asthma at a period since 2002 to 2017. Materials and methods. 3890 pregnant women with asthma were examined and followed up during pregnancy at a period since 2002 to 2017. Comprehensive clinicalfunctional examination was conducted. Patients were under surveillance of the obstetriciangynecologist during the whole pregnancy, standard procedures were carried out, and the frequency of complications of pregnancy was estimated. Basic therapy of asthma was compared in groups with the persistent asthma duration, followed up since 2002 to 2009 (1 group) and since 2010 to 2017 (2 group). Also, frequency of pregnancy complications was estimated in these groups. Results. The second group (2010-2017) demonstrated reliably lower frequency of threatening abortion, hypertension and preeclampsia. At the same time the frequency of inhaled corticosteroids (ICS) administration as a part of the combined therapy increased from 21.79% to 63.87% (almost to three times) in comparison with the first group (2002-2009). Conclusions. Combined therapy with ICS/LABA provides most complete control of bronchial asthma, and decreases frequency of pregnancy complications in pregnant women with BA.

scholarly journals Rational therapy of asthma in children with inhaled corticosteroids

2016 ◽  
Vol 1 (1) ◽  
pp. 63-67
Author(s):  
N. A. Geppe ◽  
N. G. Kolosova ◽  
S. I. Shatalina
Keyword(s):  
Bronchial Asthma ◽  
Inhaled Corticosteroids ◽  
Persistent Asthma ◽  
Initial Therapy ◽  
Rational Therapy ◽  
Asthma In Children ◽  
Effective Drugs

Currently, the most effective drugs for the treatment and management of bronchial asthma (BA) are inhaled corticosteroids (ICS) which, according to global guidelines, are indicated as initial therapy for persistent asthma of any severity.

scholarly journals Effects of high doses of inhaled corticosteroids on adrenal function in children with severe persistent asthma.

Thorax ◽  
1993 ◽  
Vol 48 (6) ◽  
pp. 599-602 ◽  
Author(s):  
T K Ninan ◽  
I W Reid ◽  
P E Carter ◽  
P J Smail ◽  
G Russell
Keyword(s):  
Inhaled Corticosteroids ◽  
Persistent Asthma ◽  
Adrenal Function ◽  
Severe Persistent Asthma ◽  
High Doses
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