Introduction. Identifying the causes of allergic diseases and allergen sensitization patterns in young children remains a challen ging task of significant interest to the medical community. Objective. This study aimed to determine risk factors, sensitization profiles, and major allergens in children aged 2–4 years with allergic rhinitis (AR) residing in Beloretsk (Republic of Bashkortostan). Materials and methods. In this open-label, single-center, prospective study, 113 children with persistent rhinitis were enrolled and divided into two groups: AR (n = 68, mean age 3.19±0.78 years) and non-AR (n = 45, 3.00±0.80 years). Evaluations included medical history, eosinophilic cationic protein levels, total and specific IgE (ImmunoCAP), and nasal cytology. Polysensitized children (n = 11) underwent further testing using the ISAC-112 molecular panel. Statistical analysis employed median (Me) with 95% confidence intervals (95% CI), Mann — Whitney U-test, Yates-corrected χ ² test, Spearman’s correlation coefficient, and Chaddock’s scale. Results. AR developed by the age of three, with 54.41% of patients exhibiting mild persistent perennial symptoms (p = 0.019), predominantly sneezing (p < 0.001). Significant risk factors included family history of asthma (OR 11.9; 95% CI [2.8; 50.9]), seasonal AR (OR 2.5; 95% CI [1.1; 5.7]), maternal anemia (OR 2.3; 95% CI [1.1; 5.0]), cesarean delivery (OR 2.8; 95% CI [1.2; 6.8]), atopic dermatitis (OR 3.9; 95% CI [1.4; 10.3]), adenoid hypertrophy grade 2—3 (OR 3.2; 95% CI [1.3; 8.1]), animal exposure (OR 3.6; 95% CI [1.8; 7.3]), and passive smoking (OR 2.8; 95% CI [1.4; 5.8]). Sensitization was detected to cat dander (75.00%), dog dander (66.18%), birch (47.06%), timothy grass (20.59%), mugwort (36.76%), and house dust mites (D. p., D. f.) (41.18%). Molecular analysis (ISAC-112) confirmed sensitization to Fel d 1 (90.91%) and Bet v 1 (73.72%). Conclusion. These findings highlight the importance of regional studies in understanding the clinical and risk factors of pediatric allergic diseases, contributing to improved diagnosis and prevention strategies.
Introduction. Bronchial asthma (BA) is the most common chronic respiratory disease in children, exerting a significant impact on the quality of life of both the child and the family. The development of BA is influenced by both internal and external risk factors. Comorbidity remains a pressing issue in BA, frequently contributing to severe and uncontrolled disease courses. Currently, psychosomatic and psychopathological disorders in patients with severe manifestations of BA are being actively studied. Presentation of the clinical case. We present a clinical case of uncontrolled BA in a 17‑year‑old adolescent hospitalized in the pediatric department. A comprehensive clinical and laboratory examination was performed, which confirmed the diagnosis, clarified the sensitization profile, allowed the development of elimination measures, and facilitated the selection of adequate controller therapy. Despite ongoing treatment and adherence on the part of the patient and his family, full control of BA could not be achieved. Given the patient’s complaints of sleep disturbances, difficulty falling asleep, shortness of breath associated with emotional stress, and pronounced vegetative symptoms, a psychiatric and psychotherapeutic consultation was deemed necessary. As a result of additional evaluation, a diagnosis of Generalized Anxiety Disorder was established, and antidepressant therapy was initiated, which led to significant clinical improvement and asthma control. Conclusion. This clinical case illustrates the role of psycho‑emotional disorders as a factor contributing to the uncontrolled course of BA.
Relevance. The prevalence of shellfish allergy is estimated to be approximately 0.5–2.5 % among the population and varies depending on the patient’s age, the degree of seafood consumption in their diet, geographical regions, and the method of diagnosis. In most cases, severe anaphylactic reactions are recorded in clinical settings. Materials and methods. The study is based on an analysis of medical records and personal supervision of a 12-year-old patient with polysensitization and recurrent episodes of anaphylaxis. Results. The article describes a clinical case of cross-sensitization between shellfish and house dust mites in a child with comorbid polyallergy. A 12-year-old boy with a complicated allergic history. The onset of atopic march began with severe atopic dermatitis associated with sensitization to cow’s milk proteins, accompanied by recurrent angioedema and anaphylaxis. From the age of 2, he experienced persistent allergic rhinitis and bronchial obstruction syndrome due to sensitization to house dust mites. The most recent episode of anaphylaxis occurred in response to the consumption of cooked shrimp. The development of clinical symptoms in response to shellfish consumption in patients with primary sensitization to house dust mites is mediated by cross-reactivity of allergens from the tropomyosin family. Conclusion. Assessment of cross-sensitization is crucial to properly inform the patient to avoid new episodes of allergic reactions. For this reason, patients with comorbid allergies should undergo component allergodiagnosis.
Patients with asthma are at increased risk of developing osteopenia due to decreased bone mineral density (BMD). Particular attention is given to the role of vitamin D, whose deficiency is associated with the management of symptoms and bone health. Study Objective. To study BMD and its biochemical markers, with an emphasis on vitamin D status and intake in children with asthma in the Moscow region. Materials and Methods. Anamnestic, questionnaire, and laboratory methods were used, including assessment of nutritional impact, grade D, biochemical markers of bone metabolism, and molecular genetic analysis. Mineral support was obtained using X-ray densitometry. Data were statistically processed using SPSS Statistics 26 (IBM) using parametric and nonparametric methods at a significance level of p <0.05. Results. The included study included 100 children with asthma, 15 % of whom had AD, and showed decreased BMD of varying severity. Most patients had low vitamin D levels, which were gradually adjusted and required oral cholecalciferol. High-dose inhaled glucocorticosteroids were associated with a more frequent decrease in BMD, while higher BMD values were recorded in children with moderate physical activity. The level of 25(OH)D was significantly lower in patients with asthma carrying the GG genotype of the VDR (FokI) gene polymorphism compared to those with the AA and AG genotypes. No relevant medical studies on bone health were identified. Conclusion. This study confirms a significant decrease in BMD in children with asthma compared to those in medical settings and reveals significant changes in biochemical markers of bone metabolism. Low vitamin D levels and limited physical activity in this group of patients necessitate comprehensive treatment and correction of metabolic changes to prevent long-term complications, including osteoporosis. A multidisciplinary approach that combines stress management, nutritional status improvement, and physical activity is essential to BMD and reduce the risk of bone disease in adulthood.
Introduction. Atopic dermatitis (AtD) is one of the most common skin diseases in the world and its frequency is increasing. This is one of the few diseases that debuts in infancy, and can persist throughout life, worsening its quality, and sometimes leading to disability. Therefore, the treatment of atopic dermatitis remains an urgent problem in allergology and pediatrics in general. Traditionally, the treatment of atopic dermatitis is based on elimination measures and local anti-inflammatory therapy for skin exacerbations, but often such a complex is insufficient to relieve the symptoms of the disease, which leads to the need to use targeted therapy with monoclinal antibodies, including in some cases upadacitinib. Description of the clinical case. This publication presents our own successful experience of using upadacitinib in the form of a description of a clinical case in an 8-year-old patient with uncontrolled severe AtD. Before the drug was prescribed, the patient’s disease course was continuous, with severe exacerbations and no remission, as well as resistance to the recommended therapy at this age, including targeted therapy (Dupilumab, Omalizumab).Conclusion. In our opinion, the appointment of upadacitinib outside the age limits of the instructions may be justified in the most severe cases of atopic dermatitis, torpid to traditional therapy and other targeted drugs, since it carries fewer risks of side effects than the use of systemic glucocorticosteroids and cytostatics, but requires a consultation in an appropriate institution.
Introduction. Eosinophilic gastrointestinal diseases are a group of chronic immune-mediated diseases of the gastrointestinal tract characterized by gastrointestinal symptoms and pathological eosinophilic infiltration of certain parts of the gastrointestinal tract in the absence of secondary causes of eosinophilia. Depending on the lesion level, eosinophilic esophagitis, eosinophilic gastritis, eosinophilic enteritis and eosinophilic colitis are distinguished. The absence of specific symptoms of eosinophilic gastrointestinal diseases complicate the diagnostic process, the key element of which is the morphological examination of biopsies of the mucous membrane of the corresponding part of the gastrointestinal tract to determine eosinophilic infiltration. To date, eosinophilic esophagitis in children is a well-defined disease with established recommendations, which facilitates the diagnosis and treatment of this pathology, which cannot be said about eosinophilic gastritis, which remains a clinical mystery with evidence based on limited individual case reports. Presentation of the clinical case. The publication presents a clinical case of a 9-year-old girl with combined eosinophilic lesions of the esophagus and stomach. An endoscopic examination of the upper gastrointestinal tract performed on an outpatient basis, followed by a morphological assessment of biopsies of the esophageal mucosa, made it possible to diagnose eosinophilic esophagitis. A biopsy of the gastric mucosa and small intestine was not performed. The lack of stable positive dynamics against the background of prescribed treatment led to hospitalization and repeated examination, including morphological examination of the mucous membrane of the esophagus, stomach and intestines. The examination revealed eosinophilic infiltration not only of the mucous membrane of the esophagus (>15/1PH*400), but also of the antrum of the stomach (up to 67 eosinophils*5PH*400). As a result, eosinophilic esophagitis was diagnosed in combination with eosinophilic gastritis, for which diet therapy, proton pump inhibitors and glucocorticosteroids were prescribed, which led to an improvement in the child’s condition, relief of pain and symptoms of dyspepsia, and the formation of clinical remission. Conclusion. Despite the increasing number of studies and publications on the problem of eosinophilic gastrointestinal diseases, the criteria for diagnosis and treatment of such patients remain controversial. The presented clinical case demonstrated the difficulties that arise for a practicing physician in managing children with eosinophilic gastrointestinal diseases, in particular combined eosinophilic lesions of the esophagus and stomach, given the low symptoms and atypical clinical manifestations of this pathology, which necessitates further study of the mechanisms of development and improvement of the algorithm for the diagnosis and treatment of these diseases.
Rationale: the problem of the growth of allergic diseases associated with plant pollination is urgent. At present, numerous works discuss the influence of global warming on the onset, intensity and duration of plant pollination. An increase in the total annual pollen concentration in the aeropalynological spectrum is noted. For the Central Federal District (CFD) of Russia, pollination of woody wind-pollinated plants, particularly birch, is of the greatest clinical significance. Objective: to study the clinical characteristics of birch pollinosis in children of the city of Ryazan and Ryazan region in the season of 2023 in conditions of intensive dusting of birch (Betula). Materials and methods. An open single-centre retrospective randomized uncontrolled cohort study was conducted. The study included 211 children who sought emergency medical care from 01.02.2023 to 30.06.2023 in hospital or polyclinic with symptoms of bronchial asthma, allergic rhinitis and atopic dermatitis. The time frame of the study was February to June 2023. In parallel, prospective aerobiological monitoring with the help of Lanzoni volumetric trap ‘VPPS 2000’ and analysis of search queries of residents of Ryazan and Ryazan region in the system ‘Yandex Wordstat’ were conducted. For statistical processing of the obtained results, Past 4.03 software and SPSS V24.0 package were used, including descriptive statistics. Results. According to the data of aerobiological studies in the season 2023 record high concentration of birch pollen for the last 9 years of observations. This resulted in a high incidence of emergency visits to health care facilities with symptoms of pollinosis. The main age group of children who applied was from 7 to 12 years old, but there were also cases of children under 3 years old, which indicates rejuvenation of the pollynosis debut. There was a dependence on sex, as the number of boys who applied was 2.5 times higher than the number of girls who applied. Bronchial asthma predominated in the structure of clinical phenotypes of children urgently hospitalised, and half of all asthma cases were its manifestation. A moderate positive association (r = 0.4; p = 0.002) between airborne pollen concentration and the number of children who sought care was found in hospitalised patients when aeropalynological monitoring and clinic data were compared. Conclusion. The peculiarity of the pollen season in 2023 in the Ryazan region (Central Federal District of the Russian Federation) is the record high concentration of birch pollen for the last 9 years of observations. This led to an increase in the number of children with emergency symptoms of respiratory and cutaneous pollinosis.
Introduction. The clinical features of asthma in individuals with high body weight have led to the identification of a specific phenotype: asthma in obese patients, where the presence and severity of obesity contribute to a more severe course of asthma and make it difficult to treat. Despite the increasing number of studies confirming the significance of the ADRB2 gene in the pathogenesis of asthma and obesity, the available data are rather contradictory and do not provide a definitive answer. Aim. Evaluation of the role of polymorphic variants rs1042713 and rs1042714 of the ADRB2 gene in children with BA and obesity. Materials and methods. A single-center observational cross-sectional pilot study was conducted on 161 children with a diagnosis of BA, with an average age of 12.6±0.2 years. The study participants were divided into two groups: the main group consisted of obese patients (n = 59), and the comparison group consisted of patients with normal body weight (n = 102). Genotyping was performed using the “Metabolism” kits from NPF “Litex” (Moscow) using the PCR-RV method on a CFX-96 Bio-Rad instrument (USA). Results. An increase in the frequency of detection of the 16Gly allele of the rs1042713 polymorphism in patients with asthma and obesity was shown (OR = 1.59; 95 % CI [1.01–2.50]). An association of the Gly16Gly genotype with an increased risk of uncontrolled BA in children with obesity was found (OR = 9,.68 [95 % CI = 1.16 –81.12]). In 59 % of cases, patients with mild asthma had the “wild” genotype Gln27Gln rs1042714 versus 37 % with moderate to severe disease (OR = 2.45, [95 % CI [1.23–4.91]) and the Gln allele (OR = 2.03, [95 % CI = 1.19–3.44]) the ADRB2 gene. The presence of polymorphic variants of the ADRB2 gene had a clinical implementation. Doses of topical glucocorticosteroids (TGCs) in children with obesity-related BA were significantly higher than in patients without obesity (250 [100—500] μg/day and 100 [0—250] μg/day. respectively, p = 0,0017) and were associated with the presence of the 16Gly allele of the rs1042713 polymorphism of the ADRB2 gene (Me 500 [250—750] μg/day, p = 0,0002) and the 27Glu allele of the rs1042714 polymorphism, which may be a potential predictive marker of response to inhaled corticosteroids in carriers of these ADRB2 genotypes in children with bronchial asthma. Conclusions. The presence of Arg16Gly and Gly16Gly genotypes and the Arg16 allele of the ADRB2 gene in patients with BA and obesity increases the risk of uncontrolled disease. The results obtained are important for identifying individuals at risk of uncontrolled BA in obese children, which allows for timely implementation of a set of preventive measures among them.
Introduction. Bronchial asthma in children is an urgent medical problem. Currently, there are separate clusters of BA variants and various phenotypes. ARVI is the most frequent trigger of BA exacerbations, which makes the study of interferon status relevant. Methods. A study of IFN-α and IFN-γ in the blood serum of children with AIBA (n = 60) and VIBA (n = 10). Results. An increase in IFN-γ was found in AIBA by 1.9 times and in VIBA by 1.7 times. An increase in IFN-α was observed in both AIBA (4.7 times, 2.95 ± 0.73 pg/ml) and VIBA (9.9 tim es, 6.24 ± 1.32 pg/ml). A decrease in IFN-γ in the blood serum was observed in moderate AIBA (1.23 ± 1.59 pg/ml) and severe AIBA (0.76 ± 0.64 pg/ml). Conclusion. Decreased IFN-γ content is an important factor in the severe course of AIB. As an additional marker for the diagnosis of BA phenotype, the use of IFN-α / IFN-γ ratio is proposed.
Relevance. The increasing prevalence of hypersensitivity reactions to dental materials among the population of any age entails the need to understand the diversity of the etiology of this problem in order to prevent allergic manifestations in dental practice. Materials and methods. Scientific papers were searched in the search engines PubMed, ScienceDirect, Wiley Online Library, SpringerLink, RusMed, eLibrary.ru by keywords: allergy to dental materials, allergy to metals, hypersensitivity to polymers, allergy to acrylates, allergy to latex. The search depth was 5 years (2020–2025). The source search algorithm followed the principles of PRISMA. 516 foreign and domestic publications were identified. A total of 41 publications from an electronic search in the above databases and 19 articles additionally found using a manual search were included in the analysis. Results. Among dental materials, metals and polymers are the most common chemical components that can cause hypersensitivity reactions. Hypersensitivity reactions can manifest as immediate hypersensitivity reactions (type I) to metals, latex and some polymers with clinical manifestations in the form of urticaria, angioedema, bronchospasm and anaphylaxis, or delayed hypersensitivity reactions, more often to metals with symptoms of contact allergic dermatitis. Dental materials with biocompatibility issues include composites, latex gloves, local anesthetics, endodontic materials, casts, and metals. The most common manifestations of allergies in dental patients are cheilitis and perioral dermatitis (25.6 %), burning mouth syndrome (15.7 %), lichenoid reaction (14 %) and orofacial granulomatosis (10.7 %). Common contact allergens were sodium thio-sulfate (14 %), nickel sulfate (13.2 %), mercury (9.9 %), palladium chloride (7.4 %), and 2-hydroxyethylmethacrylate (5.8 %). While dental clinic staff usually have contact dermatitis of the hands. The most common causes of contact allergic dermatitis in dental workers are metals, latex, antimicrobials, formaldehyde, preservatives, and methacrylates. Conclusion. To clarify the diagnosis, it is important to find out a detailed allergy-related medical history, clinical examination, and confirmatory tests such as patch tests and MELISA. The latest ELISA research method should be widely implemented in real practice.
Introduction. Contact allergic dermatitis (CAD) is known to be one of the most prevalent allergic diseases of skin, so its research is of a high interest. Besides clarification of modern approaches to the treatment of contact allergic dermatitis is undoubtedly of current interest. The increase in the growth of contact allergic dermatitis in children explains the relevance of solving the problem of treating the disease in this age group. Purpose of the lecture. The purpose of this lecture is to review modern approaches to the treatment of contact allergic dermatitis taking into account current clinical guidelines with an emphasis on childhood. Materials and Methods. This lecture presents consideration of modern principles of treatment of contact allergic dermatitis taking into account the specific features of pediatric practice. A non-systematic literature review was conducted. Pharmacological mechanisms of main medications used are discussed. Focus is based on rational skin therapy. Besides information is given about topical glucocorticosteroids and principles in choosing of concrete group and formulation of them. Also characteristics of topical calcineurin inhibitors are given, and their role in treatment of contact allergic dermatitis is explained. In addition, mechanism of the “vicious circle” during secondary infection and treatment tactics are described. Results. Increased prevalence of contact allergic dermatitis in children depends primarily on household contact with chemicals and metals, as well as on the use of topical medications. This should be taken into account in prescription of elimination regime. Choice of the class and the formulation of topical corticosteroids should be made differentially taking into account the age, structural features of the child’s skin, its sensitivity in different areas and the stage of the inflammatory process. Based on indications topical calcineurin inhibitors might be used in treatment of contact allergic dermatitis especially in pediatric practice. They are characterized by the absence of those side effects which are common during use of topical corticosteroids. Secondary infection which is quite often observed in CAD in childhood requires timely administration of antiseptics and combined topical medications containing corticosteroids, antibiotics and antifungal components. Conclusion. Contact allergic dermatitis has good prognosis in case of implementation of elimination measures, adherence to treatment algorithm in accordance with clinical guidelines and age-based characteristics.
Introduction. In the period from October to December 2024, there was an increase in cases of community-acquired pneumonia in children caused by Mycoplasma pneumoniae in the Republic of Bashkortostan, which has important epidemiological and clinical consequences. Mycoplasma infections have a cyclical pattern of epidemics, frequent outbreaks in organized groups, and a significant seasonal pattern, which makes children particularly vulnerable. In children with bronchial asthma, mycoplasma infection can worsen the course of the disease, contributing to bronchial hyperreactivity and complications such as spontaneous mediastinal emphysema. Objective. The aim is to perform a clinical and pathogenetic analysis of the course of community-acquired pneumonia caused by Mycoplasma pneumoniae in a child with bronchial asthma complicated by spontaneous mediastinal emphysema. Presentation of the clinical case. The case of a 15-year-old boy with bronchial asthma and polyvalent sensitization, who developed community-acquired pneumonia of mycoplasmic etiology with a complication in the form of spontaneous mediastinal emphysema, is presented. The clinical picture of the disease included a dry cough, chest pain, difficulty breathing, and fever. The laboratory confirmed the diagnosis of mycoplasma pneumonia with a positive PCR result for Mycoplasma pneumoniae. X-ray examination revealed signs of inflammation and emphysema. Complex therapy included antibiotics, anti-inflammatory drugs and inhalation therapy, which contributed to the positive dynamics and improvement of the patient’s condition. Conclusion. The presented clinical case illustrates the specific course of community-acquired pneumonia of Mycoplasma etiology in a child with bronchial asthma complicated by spontaneous mediastinal emphysema. The combination of chronic airway inflammation and atypical bacterial infection contributed to the development of a severe complication. Timely diagnosis, including pathogen identification, comprehensive antibacterial and anti-inflammatory therapy, as well as maintenance of baseline asthma treatment, ensured a favorable clinical outcome and prevented adverse events.
Relevance. In recent decades, there has been an increase in a number of non-communicable chronic diseases and treated as a global health priority. There is an increase in the prevalence of allergic diseases, including allergic rhinitis (AR), and obesity in the pediatric population. In this regard, the study of AR in children with comorbid obesity is of particular interest. The aim of the review is to summarize current data on the immunological and clinical-epidemiological features of AR in children with comorbid obesity. Content. The review presents current information on the role of individual cytokines and adipokines in the development of chronic systemic inflammation in children with AR and obesity. An analysis of literature data on the significance of obesity as a possible risk factor for the development of AR in childhood is conducted. Clinical and epidemiological features are discussed, and individual studies are presented on some aspects of AR therapy in obese patients. Conclusions. The analysis showed that the currently available data on the relationship between AR and overweight/obesity in children are contradictory and require further research.
Introduction. Sublingual immunotherapy is administered using allergens that contain varying amounts of antigen. Different manufacturers employ distinct application regimens. The study investigates the efficacy of “Antypollin”, a low-dose sublingual tablet containing birch allergen 0.1–1000 PNU combined with ascorbic acid. Materials and Methods. An open-label, comparative non-randomized trial was conducted involving 52 participants. We evaluated the effectiveness of sublingual tablets of birch pollen extract (1000 PNU) in relation to seasonal variations in pollen concentrations when used according to pre-seasonal–seasonal protocols for patients with seasonal allergic rhinitis. Additionally, the allergenic potency of these tablets was assessed by comparing them with solutions having known characteristics. Results. Allergenicity testing was performed on 40 subjects using prick tests with a solution of 1000 PNU/mL, resulting in an average papule diameter of 4 [IQR: 3–5] mm. This corresponded to approximately 50,000 EAA (Russian Unit of allergen activity). Total cumulative dose over the course amounted to 24,667 PNU, with half being administered prior to peak season onset. Specifically, within the first 42 days, 667 PNU were delivered, followed by two phases from day 43 to 66 and again from day 67 to 90, each providing 12,000 PNU. During the birch pollen period between April 28th and May 11th, 2025, annual mean pollen concentrations ranged from 1000 to 2500 grains per cubic meter. In the treatment group receiving Antypollin tablets, the Visual Analog Scale (VAS) score for rhinitis symptoms showed significantly lower values compared to controls (median VAS scores: 2 [IQR: 1–5] versus 7 [IQR: 4–8]; p < 0.001). Similarly, the total symptom-medication score (TCS) demonstrated significant improvement (p = 0.001), with median values of 12.7 [IQR: 8.3–18.1] versus 22.8 [IQR: 17.0–28.3]. At peak pollen period (April 21–27th, 2025), pollen levels reached up to 14,500 grains per cubic meter. During this phase, while VAS symptom scores remained statistically different (5 [IQR: 3–6.5] vs. 7 [IQR: 5–8]; p < 0.01), the TCS did not achieve statistical significance (88%; median difference: 22.3 [IQR: 11.6–22.8] vs. 23.0 [IQR: 17.0–28.4]; p = 0.12). In contrast, during alder flowering periods characterized by lower pollen concentrations, weekly averaged median TCS scores in the Antypollin group were significantly reduced compared to control groups (10.6 [IQR: 5.9–14.1] vs. 14.9 [IQR: 14.7–19.4]; p = 0.01). Nasal and conjunctival symptoms differed markedly (6 vs. 9; p < 0.05), although medication usage only trended toward differences (3.43 vs. 9.71; p = 0.07). Symptom severity, measured via VAS, was halved relative to controls. Nasal complaints exhibited a 30 % reduction in median values (3 vs. 6), whereas ocular symptoms decreased by 33 % (3.5 vs. 5), though these results did not reach statistical significance (p ranging from 0.06 to 0.12). Conclusion. The study demonstrated that birch pollen tablets combined with ascorbic acid exhibit sufficient allergenicity and serve as an effective therapeutic agent under conditions where pollen concentrations approximate annual average levels. Patient complaint rates and medication consumption should be adequate for analysis of efficacy. After completing the first course of therapy, it was observed that high pollen concentrations elicit similar clinical manifestations in both the treatment and control groups. This indicates insufficient therapeutic effect following a single course. It is likely that more prolonged courses of maintenance therapy will be required to achieve sustainable immunotherapeutic outcomes.
Over the past decades, the proportion of obese children has increased 4-fold. At the same time, there is an increase in allergic pathology in the children’s population. The aim is to present modern data on the relationship between childhood obesity and allergic diseases. Materials and methods. A search was conducted for domestic and foreign literature on the relationship between various links in the pathogenesis of allergic pathology and obesity using the databases Scopus, Web of Science, PubMed, Google Scholar, eLibrary, Cyberleninka. The review includes studies published from January 2016 to January 2025. Results. Data on the mechanical and inflammatory effects of obesity in relation to atopy in children are described. In addition, obesity is associated with increased production of inflammatory cytokines and adipokines, which supports low-activity systemic inflammation and increases the risk of exacerbations of allergic diseases. Allergic rhinitis, atopic dermatitis, food allergies, and chronic urticaria also appear to be associated with the chronic systemic low-activity inflammation characteristic of obesity. Vitamin D deficiency, characteristic of obesity, appears to play a role in the development of bronchial asthma and allergic rhinitis, while dyslipidemia and skin barrier defects may explain the link between obesity and atopic dermatitis. Conclusion. Further research on the relationship between obesity and atopy is needed, confirming the role of adipose tissue in the development of allergic diseases, in order to develop new therapeutic strategies.
Relevance. The increasing incidence of eosinophilic gastrointestinal diseases among the pediatric population entails the need to understand the etiology and pathogenesis of this pathology in order to improve the quality of diagnosis and treatment of this group of diseases. Materials and methods. In the search engines PubMed, ScienceDirect, Wiley Online Library, SpringerLink, RusMed, eLibrary.ru A search was conducted for scientific papers by keywords: eosinophilic gastrointestinal diseases, eosinophilic esophagitis, eosinophilic gastritis, eosinophilic enteritis, eosinophilic colitis, eosinophilic infiltration, children, adolescents. The search depth was 12 years (2012–2024). The source search algorithm followed the principles of PRISMA. 515 foreign and domestic publications have been identified. The analysis includes 36 papers. Results. Currently, eosinophilic diseases of the gastrointestinal tract attract the close attention of scientists, which is associated with a significant increase in this pathology. Eosinophilic gastrointestinal diseases are a group of chronic immune-mediated diseases of the gastrointestinal tract characterized by gastrointestinal symptoms and pathological eosinophilic infiltration in the absence of secondary causes of eosinophilia with a depth of organ damage from the mucous membrane to the muscular and serous layer, which leads to severe violations of their structure and function. This group includes eosinophilic esophagitis, eosinophilic gastritis, eosinophilic enteritis and eosinophilic colitis. The presented review analyzes the results of modern scientific research on the epidemiology, pathophysiology and clinical features of eosinophilic gastrointestinal diseases in children. Diagnostic criteria are given. Modern approaches to the treatment of these diseases are considered. Most scientific publications are devoted to eosinophilic esophagitis, in the diagnosis and treatment of which a certain consensus has been reached. The management of children with eosinophilic gastritis, eosinophilic enteritis and eosinophilic colitis is particularly difficult, which determines the need for further study of the pathogenesis of these diseases. Conclusion: the number of scientific papers that have increased in recent years expands knowledge about eosinophilic gastrointestinal diseases in children, but it is worth striving to reach consensus on eosinophilic gastritis, eosinophilic enteritis and eosinophilic colitis.
