Debatable aspects of systemic angiitis and autoinfl ammatory diseases

The new data about immune-infl ammatory rheumatic diseases pathogenesis with the participation of the processes of autoimmunity and autoinfl ammation attract attention to the heterogeneity of systemic angiitis, their nomenclature, classifi cation, pathogenesis and the approaches to the therapy. Recommendations of the second International Chapel Hill Consensus Conference (CHCC2012) and EULAR recommendation (2016, 2018) regarding diagnostics and treatment of SA are discussed. The data of 141 patients with various forms of SA and 18 patients with the diseases, which relate to the group of autoinfl ammatory processes as well as the retrospective analysis of 130 patients with the hyperimmunoglobulinemia E are given.

Contribution of prenatal factors and in formation of asthma phenotypes in children (part I)

Results of the prospective study conducted to assess the perinatal risk factors contribution in the asthma phenotypes formation in childhood are presented. Of 712 children, which have been observed from the first wheezing onset in St Petersburg’s state ambulances, 238 children with bronchial asthma developed in later years of life were included in random sample. Bronchial asthma proceeded in the structure of atopic disease in 128 children (phenotype ABA), and as the part of the limited allergic lesion of respiratory tract - in 110 children (phenotype RBA). It was found that bronchial asthma in mother, especially mother’s asthma with the early age onset, pregnancy pathology and maternal Smoking during pregnancy are the most significant risk factors which contribute in formation of ABA asthma phenotype. Maternal Smoking during pregnancy increased the frequency of severe asthma with ABA phenotype in the offspring during next years of their life. Clinically, the ABA phenotype is characterized by more frequent debut at the age of 1 year and usually diagnosed before 7 years of age, the presence of food sensitization in 70-90 % of cases, and a high level of hyperimmunoglobulinemia E. Such triggers as the Cesarean delivery, absence of the breastfeeding and exposure to tobacco products in the first years of life are the most significant risk factors in formation of the RBA asthma phenotype. The absence of allergic diseases in both parents or allergic ллерголог in mothers, later age debut and diagnosis of asthma, extremely low frequency of food sensibilization (less than 15 %), high frequency of hyperresponsivity, and low frequency of hyperimmunoglobulinemia E, exceeds the norm in 2 times are the typical features of RBA asthma phenotype.