Pan-allergens are molecules, mainly proteins of various families, responsible for cross–reactivity to a wide range of related and unrelated allergens. The clinical significance of having sensitization to some pan-allergens, for example, nsLTP, parvalbumins, storage proteins grows from the fact that severe, generalized reactions can develop, for example, nsLTP syndrome. Sensitization to pan-allergens depends on many factors, such as geographical location, age, food preferences, socioeconomic characteristics of the patient. The aim of the study is to identify the pattern of the sensitization to various molecules of pan-allergens in patients with allergic diseases living in the central part of Russia. We analyzed the sera of a total of 556 patients with allergic diseases in a multiplex enzyme immunoassay. Six profilin molecules, 2 polcalcin molecules, 12 – nsLTP, and 7 parvalbumin molecules were used. The frequency of IgE-ab to profilins in patients in central Russia is low (5-7%). At the same time, almost all patients with IgE-ab to profilins have IgE-ab to Bet v 1 (PR-10) and concomitantly to other profilins. In this regard, Bet v 1 can be considered as a primary sensitizer. The peculiarity of sensitization to polcalcins and LTPs was the low frequency of detection of IgE-ab to them (from 0.2% to 3%). At the same time, neither the nsLTP molecules of a peach, nor even apples, which are often consumed in central Russia, provoke the development of nsLTP syndrome. The detection rate of IgE-ab to parvalbumin in the sera of all patients with allergic reactions is also relatively not high and is 7-10%. Whereas the frequency of detection of IgE-ab to parvalbumins in the sera of patients with fish allergy is very high and reaches 63-90%. As a rule, IgE-ab are detected to all molecules, i.e., for parvalbumins of all studied fish species. The sensitization profile to profilins, polcalcins, nsLTP and parvalbumins in patients living in central Russia has its own unique characteristics. One of the primary sensitizers in patients with sensitization to pollen of wind-pollinated trees is Bet v 1 (PR-10 homologue), IgE-ab to which was detected in 42% of patients. The detection rate of IgE-ab for various molecules of pan-allergens in general was low as follows: profilins – 5-7%, polcalcins – 0.5%, nsLTP – 0.2-3%, and parvalbumins – 7-10%.

The article presents the characteristics of the ALEX2 (MacroArrayDX, Wien, Austria). It is designed for simultaneous detection of IgE total and specific IgE-aB to 120 extracts and 180 molecules by solid-phase enzyme immunoassay. Extracts and allergen molecules combined with nano-particles are sorbed on a solid-phase substrate, forming a macroscopic multiplex matrix - the immune allergy chip. The Institute of Clinical and Laboratory Standards (CLSI) conducted research on the verification and validation of the ALEX2 in relation to the ImmunoCAP macroarray test system (ThermoFisher Scientific, Uppsala, Sweden), which is often used in allergodiagnostics. The results obtained on the two test systems were comparable. One of the most important features of the ALEX2 test system is that unique allergen molecules and allergenic extracts are included in its composition, and a method has been found to inhibit cross-reactive hydrocarbon determinants (CCDs), which cause frequent non-specific binding of IgE-aT. The use of this test system makes it possible to carry out component allergy diagnostics with the determine of the dominant sensitizing factor in cases of mono- and polyvalent sensitization. The test results affect the determination of indications and the effectiveness of ASIT, allow assessing the risk of anaphylaxis and predicting further treatment tactics for the patient.

The effect of ectoin on the release of allergens from pollen grain of wind-blown plants was studied. The birch, alder, hazel, timothy, and orchard grass pollen grains were used for this experiment. Enzyme-linked immunosorbent assay (ELISA) and morphological examination of birch pollen grains utilizing the light microscope were used. The findings indicated that ectoin does not promote the allergen release from pollen. Thus, ectoin not only improves the barrier function of the nasal mucosa and washes pollen from the nasal cavity, but also does not disturb their integrity and does not affect the release of allergens.

The effectiveness and safety of drug treatment are the main criteria for its success. Local anesthetics, used in all medical fields, in some cases can cause a wide variety of undesirable side reactions, but in recent years, such manifestations that have arisen in Russian clinical practice tend to qualify as anaphylactic shock. This article presents the types of adverse reactions and global statistics of anaphylaxis to local anesthetics, as well as analyzes the possible reasons for the erroneous diagnosis of fatal outcomes of anaphylaxis. The purpose of the review was to clarify information about reliable markers of clinical and postmortem anaphylaxis, providing unambiguousness and objectivity of forensic medical examination. Attention is focused on the specific postmortem signs of immediate allergic reactions and the sequence of professional interpretation of all the circumstances associated with a fatal adverse reaction against the background of the use of local anesthetics.

Цель исследования: исследовать влияние крема «Перфэктоин», содержащего 7% эктоина, на клинические симптомы атопического дерматита (АтД), а также таксономическое разнообразие и численность микроорганизмов, колонизирующих кожный покров больных АтД.Материал и методы: исследование проводили с августа по ноябрь 2019 г. в Москве.Под наблюдением находились 30 пациентов в возрасте от 16 до 45 лет с диагнозом АтД.Пациенты посещали врача до и после 1 нед.обработки кремом «Перфэктоин».Каждый раз их осматривал врач-аллерголог, брали пробы с кожи на микробиоту.Счет клинических симптомов поражения кожи оценивали в соответствии со шкалой EASI (Eczema Area and Severity Index), оценивающей степень тяжести локального поражения кожи в баллах.Видовую идентификацию и количественную оценку микробиома кожного покрова проводили методом времяпролетной МАСС-спектрометрии (MALDI-TOF).Результаты исследования: микробиом кожи пациентов с АтД имеет богатое таксономическое разнообразие и представлен микроорганизмами с различными экологическими характеристиками.Воздействие «Перфэктоина» на разные микроорганизмы было неодинаковым.В соответствии с оказанным эффектом все микроорганизмы можно разделить на три группы.В первой группе численность микроорганизмов после применения «Перфэктоина» снижалась.Таких видов было большинство -59% (31 из 53 видов).Во второй группе, к которой относятся 30% микроорганизмов (16 из 53 видов), численность после недельной обработки «Перфэктоином» нарастала.В третьей группе, составляющей 11% (6 из 53 видов), численность не изменялась.Применение крема «Перфэктоин» уменьшает гиперемию, интенсивность воспаления кожи (уплотнение, папулы/отек) и расчесывание, что влияет на снижение общей суммы баллов тяжести и интенсивности локального воспаления.Заключение: воздействие «Перфэктоина» на микробиом кожи пациентов с АтД было различным.Около 60% микроорганизмов статистически достоверно снизили численность после контакта в течение недели с

Objective: to assess the climatic and seasonal characteristics of vitamin D status in the population of different cities of the Russian Federation.Material and methods. The study was conducted from September 2014 to June 2018. Surveyed 104321 serum of patients (one hundred four thousand three hundred twenty-one) of the 105 cities of the Russian Federation. Of them women: 80738, which was 77.4% of men 23583 - 22,6%. To determine the concentration of 25(OH)D in serum electrochemiluminescent method was used. The analysis was performed on the automatic analyzer Cobas 8000 (Switzerland).Results. The concentration of calcidiol (25 (OH) D) in patients living in cities located in different climategeographic regions of the Russian Federation varied from 3.0 to 536.10 ng/ml. the Average concentration of 25(OH) D was the lowest in Makhachkala (19.26 ± 0.53 ng/ml), the maximum in Surgut (42.5 ± 0.44 ng/ml). Only 18% of the cities average concentration of 25(OH)D reached the lower limit of positive level of 30 ng/ml. More than half of the patients (60,1-81.7 per cent) of all regions, the concentration of 25(OH)D was below normal - less than 30 ng/ml. Vitamin d deficiency (<20 ng / ml) was found in almost a third of the Russian population (24.1-65.7%). The statistically significant highest level of 25(OH)D was detected in the autumn months (30,30 ± 0,30 ng/ml), and the lowest - in the spring (27,11 ± 0,25 ng/ml). The frequency of serum detection, where calcidiol concentration was lower than normal (<30 ng/ml), even in autumn was observed in more than half (57.5%) of the entire population.Conclusion. Thus, the data indicate a serious deficiency and even deficiency of vitamin D in the population of the Russian Federation. Us there is no correlation between the average level of vitamin D in the blood serum and the geographical latitude of the settlement. However, the dependence of the concentration of 25 (OH) D on the time of year, when the patient's blood is taken for analysis.

Objective: to assess the climatic and seasonal characteristics of vitamin D status in the population of different cities of the Russian Federation. Material and methods . The study was conducted from September 2014 to June 2018. Surveyed 104321 serum of patients (one hundred four thousand three hundred twenty-one) of the 105 cities of the Russian Federation. Of them women: 80738, which was 77.4% of men 23583 - 22,6%. To determine the concentration of 25(OH)D in serum electrochemiluminescent method was used. The analysis was performed on the automatic analyzer Cobas 8000 (Switzerland). Results . The concentration of calcidiol (25 (OH) D) in patients living in cities located in different climategeographic regions of the Russian Federation varied from 3.0 to 536.10 ng/ml. the Average concentration of 25(OH) D was the lowest in Makhachkala (19.26 ± 0.53 ng/ml), the maximum in Surgut (42.5 ± 0.44 ng/ml). Only 18% of the cities average concentration of 25(OH)D reached the lower limit of positive level of 30 ng/ml. More than half of the patients (60,1-81.7 per cent) of all regions, the concentration of 25(OH)D was below normal - less than 30 ng/ml. Vitamin d deficiency (<20 ng / ml) was found in almost a third of the Russian population (24.1-65.7%). The statistically significant highest level of 25(OH)D was detected in the autumn months (30,30 ± 0,30 ng/ml), and the lowest - in the spring (27,11 ± 0,25 ng/ml). The frequency of serum detection, where calcidiol concentration was lower than normal (<30 ng/ml), even in autumn was observed in more than half (57.5%) of the entire population. Conclusion . Thus, the data indicate a serious deficiency and even deficiency of vitamin D in the population of the Russian Federation. Us there is no correlation between the average level of vitamin D in the blood serum and the geographical latitude of the settlement. However, the dependence of the concentration of 25 (OH) D on the time of year, when the patient's blood is taken for analysis.

Aim.To find out microbial landscape characteristics of the palatine tonsils in healthy students, depending on the season. Materials and methods. It were examined 40 students without any oropharyngeal pathology aged 17-30 (23 ± 3.5). There were no signs of chronic tonsillitis at pha-ryngoscopy, no signs of acute respiratory infection; they did not take antibiotics for one last month prior to the study and had no tonsilitis for the last 5 years. Examination was made three times, once in a season: autumn from October 16 till November 2; winter from January 27 till March 6 ; spring from April 2 till April 19. Results. The normal microlandscape in healthy individuals aged 17-30 years permanently had Streptococcus viridans, Streptococcus pyogenes, Staphylococcus aureus, Staphylococcus epidermidis, Candida albicans, Neisseria, Micrococcus, Bacillus, and Pseudomonas aeruginosa. Presence of S. pyogenes andP. aeruginosa in the structure of microlandscape of the palatine tonsils did not cause any clinical symptoms in their carriers. We also revealed a seasonal dynamics expressed by the frequency of the increase of conditionally pathogenic flora on palatine tonsils in spring and the decrease in all microorganisms growth in winter.

Aim.To find out microbial landscape characteristics of the palatine tonsils in healthy students, depending on the season. Materials and methods. It were examined 40 students without any oropharyngeal pathology aged 17-30 (23 ± 3.5). There were no signs of chronic tonsillitis at pha-ryngoscopy, no signs of acute respiratory infection; they did not take antibiotics for one last month prior to the study and had no tonsilitis for the last 5 years. Examination was made three times, once in a season: autumn from October 16 till November 2; winter from January 27 till March 6 ; spring from April 2 till April 19. Results. The normal microlandscape in healthy individuals aged 17-30 years permanently had Streptococcus viridans, Streptococcus pyogenes, Staphylococcus aureus, Staphylococcus epidermidis, Candida albicans, Neisseria, Micrococcus, Bacillus, and Pseudomonas aeruginosa. Presence of S. pyogenes andP. aeruginosa in the structure of microlandscape of the palatine tonsils did not cause any clinical symptoms in their carriers. We also revealed a seasonal dynamics expressed by the frequency of the increase of conditionally pathogenic flora on palatine tonsils in spring and the decrease in all microorganisms growth in winter.

The objective of the work: to assess therapeutic efficacy on the preparation AquaMaris® Ectoin as a “barrier solution” for patients with AIR. Patients and methods. The examination was performed at the period of April, 17 to May 24, 2015 in Moscow region. 36 patients at the age of 20 to 45 years with AIR were observed. According to the general diagnostic standards the examination included: medical history data, survey, skin test with the basic set of inhalation allergens, defining the specific IgE-antibodies to pollen antigens in the serum, cytological analysis of the nasal secretion, otorhinolaryngological examination with the topical syndromes record. The spray AquaMaris® Ectoin used in the work is a natural product that contains a combination of ectoin and isotonic solution of sea salt. The patients were prescribed the preparation Aqua Maris® Ectoin according to the following treatment regimen: 1–2 spray into each nostril 3–4 times per day. When required the preparation was allowed to use as frequently as necessary. Results. All the patients were divided into 3 groups: - Group 1 – the patients in which the application of the preparation Aqua Maris® Ectoin resulted in reduction of the syndromes (20 of 34 patients; 59%); - Group 2 – the patients in which the condition became worse (6 of 34 patients; 18%); - Group 3 – the patients in which the AIR symptoms severity did not change (8 of 34 patients; 23%). Therefore, the number of patients in which the application of the preparation Aqua Maris® Ectoin resulted in reduction of the syndromes exceeded the number of patients where the AIR symptoms severity did not change or the condition became worse, by 2.6 and 3.3 times. The highest number of patients noted the following symptoms of deterioration of the condition: conjunctiva and lids inflammation, tears, nasal itching, post-nasal drip, impaired olfaction against the background of the low concentration of eosinophils in the nasal secretion. Conclusion. Therefore, the application of the monotherapy with the preparation Aqua Maris® Ectoin at the early stage of development of allergic seasonal inflammation of the upper respiratory tract provides significant decrease in the allergic load on the nasal mucosa of the sensitized organism. In view of this fact, the inclusion of the preparation Aqua Maris® Ectoin into the standard of allergic rhinitis treatment as a “barrier solution” is deemed important.

Background. The purpose of this study was to identify IgE-antibodies to the major and minor allergenic components of pets in the blood serum of patients with bronchial asthma and/or allergic rhinitis (BA/AR). Methods. The study included 327 patients from Moscow and St. Petersburg. All of them were detected for specific IgE-antibodies (IgE-AB) to the animal allergens by ImmunoCAP® (ThermoFisherScientific, Sweden). 105 patients wanted to detect IgE-AB to the main animal allergens molecules ImmunoCAP ISAC® (ThermoFisherScientific, Sweden). Results. In the sera of 327 patients IgE-AB to cat’s (62%) allergen dominated. IgE-antibodies to dog’s, house dust mites (D.pteronyssinus, D. farinae), mold fungi, horses and rodents allergens were found in 2,6-31 times less. IgE-AB to uteroglobin (rFel d 1), major cat allergen, was detected in 80% of patients (84/105). The detection rate of IgE-AB to other cat allergens was 4,2-8 times lower (rFel d 2 - 10%, nFel d 4 - 19%). IgE-AB to major dog allergen rCan f 1 was detected in 39% of patients (41/105). Positive level of IgE-AB to other dog allergens was detected in 2,2-4,9 times lower (rCan f 2 - 8%, nCan f 3 - 9%, rCan f 5 - 18%). Positive level of IgE-AB to lipocalin was assayed in 6% of patients, to serum albumin - in 7%. Conclusion. Prevalence of IgE-AB to cat and dog allergens was almost 3 times higher than the frequency of detection of IgE-AB to house dust mite allergens in citizens of Moscow and S. Petersburg. The frequency of IgE-AB to rFel d 1 was dominated and detected 2 and 4-11 times often than to rCan f 1 and other animal allergens consequently.

Background. The objective was to study the species diversity and the proportion of lipophilic yeasts of the genus Malassezia on the skin of children with atopic dermatitis and control groups, to evaluate age-related features and clinical significance of sensitization to Malassezia and IgE-antibodies to Mn-SOD in children with atopic dermatitis. Materials and methods. The study involved 144 children aged between 1 -14 years: 93 patients with atopic dermatitis, a control group of K1 - 24 children with asthma and /or AR without atopic dermatitis and K2 - 27 healthy children without skin diseases. The yeast Malassezia spp. identified by morphological and physiological characteristics and analysis of the nucleotide sequences of the D1/D2 region of 26S (LSU) rDNA. For detection of IgE antibodies to various allergens, including Malassezia, used the device and reagents ImmunoCap (Thermofisher, Sweden); IgE-antibodies to Mn-SOD was detected by the method of ISAC ImmunoCap (Thermofisher, Sweden). Results. Identified 5 species of Malassezia, absolutely dominated M. sympodialis. IgE-antibodies to Malassezia spp. were detected in 45% (42/93) of patients with atopic dermatitis: 11% - children with ADL, 22% from the ADB and 67% from the ADT. Statistically significant correlation between the level of IgE-antibodies to the yeast Malassezia spp. and severity of atopic dermatitis (SCORAD) - r=0,5928, p

UNLABELLED:Aim. Determine the occurrence of S. aureus in microbiocenosis of nasal cavity of children and adults with allergic and infectious rhinitis.MATERIALS AND METHODS:Content of nasal cavity microflora in patients with infectious and allergic rhinitis was studied. 295 patients were observed, among those--179 children aged 3 months to 14 years and 116 adults aged 15 - 71 years.RESULTS:In 60.3% of cases in children and 52.5% of adults S. aureus was revealed to be the dominating microorganism. Additionally, in 26.8% of children and 35.3% of adults epidermal staphylococcus was isolated.CONCLUSION:Antagonistic properties of these 2 species of microorganisms assume their competition on the nasal mucous membrane.

Abstract. Eosinophils are regarded as major cell population directly involved into late phase of allergic inflammation of nasal mucosa. We performed a comparative study, measuring the amounts of eosinophils and eosinophilic cationic protein (ECP) in nasal secretions and serum samples of thirty-three patients with persistent allergic rhinitis (PAR), and twenty-five persons with chronic infectious rhinitis (CIR), to determine diagnostic significance of these parameters. Eosinophil counts in nasal secret were carried out by exfoliative cytology analysis. Sampling of nasal secretions was performed by absorption method. The samples were standardized by concentration of urea in nasal secretions and sera. ЕСР levels in nasal secretions and serum were determined by chemiluminescence assays (UniCAP 100, Phadia, Sweden). Mean scores of eosinophils in nasal secret of PAR patients were 4.6 times higher, than in the patients with CIR. Median ECP values in serum and nasal secretions of PAR patients were, resp., 30.5±28.0 μg/l and 402.7±326.9 μg/l. In patients with CIR, ECP values were 12.4±11.5 μg/l in serum and 86.9±137.4 μg/l in nasal secretions. The appropriate differences have been significant (р < 0.05). No correlations were found between ECP levels in serum and nasal secretions, as well as between ECP levels and eosinophil counts in nasal secretions. The technique of ECP determination in nasal secretions was the most sensitive approach, whereas counting of eosinophils proved to be the most specific method. ECP levels in nasal secretions well characterize an active phase of allergic inflammation and may be used as quantitative parameter for estimation of PAR severity.

Abstract. Oral allergy syndrome (OAS) is defined as a set of clinical manifestations caused by IgE-mediated allergic reactions that occur at oral and pharyngeal mucosae in the patients with pollen sensitization after ingestion of certain fruits, vegetables, nuts and spices. OAS arises from cross-reactivity between specific pollen and food allergens, due to similarity of a configuration and amino acid sequence of allergenic molecules. OAS is considered as class II food allergy, being caused by thermo- and chemolabile allergens, and it is rarely combined with generalized manifestations of food allergy. Prevalence and spectrum of the causal allergens depend on a kind of pollen sensitization. In Moscow region, as well as in Northern Europe, allergic sensitization most commonly occurs to the pollen of leaf trees, whereas OAS is mostly connected with ingestion of fruits from Rosaceae family and nuts. Since last years, a newly developed technique of component-resolved molecular diagnosis (CR diagnostics) allows of more precise detection of OAS-causing allergen molecules. These data are of extreme importance for administration of adequate nutritional therapy and prediction of SIT efficiency. (Med. Immunol., 2011, vol. 13, N 1, pp 17-28)

Abstract. Incidence of allergic diseases is increased over last years. House dust is considered a major risk factor of allergic sensitization which plays an important role in development of allergic rhinitis, bronchial asthma, atopic dermatitis. Dust mites in the home comprise a large part of domestic allergens. Dermatophagoides pteronyssinus, Dermatophagoides farinae, Euroglyphus maynei, Lepidoglyphus destructor, Blomia tropicalis are most important in this respect. Der p 1 and Der p 2 are regarded as major house dust mite allergens. Recent studies concerned induction of IgE responses against mite tropomyosin (Der p 10), an allergen occurring in mites which exhibits high cross-reactivity with tropomyosins from a variety of sea foods (e.g. shrimps), as well as human tropomyosins. Allergen-specific immunotherapy (ASIT) represents the only causative approach to allergy treatment in such cases. From this viewpoint, a quantitation of specific IgЕ against major house dust mite allergens would be necessary to predict ASIT efficiency. Treatment by house dust mites allergen extracts is effective in management of allergic rhinitis and mild asthma. A component-resolved diagnostic (CRD) with purified house-dust mites allergens allows to discriminate patients who were mostly sensitized to the major house dust mites allergens (e.g. Der p 10, tropomyosin). The component-resolved diagnostics could be performed before starting the allergen-specific immunotherapy by mite allergens, in order to avoid unresponsiveness to this mode of therapy.

Abstract. Forty four patients with persistent allergic rhinitis and sensitization to the house dust mites were observed. All the patients have been examined in conformity with international diagnostic standards. The first group of observation included fifteen patients who received intranasal therapy by flutikasone propionate nasal spray at a dose of 200 mkg once a day for two weeks. The second group of observation included fourteen patients who received 10 inhalations of Affinoleukin® (a lyophilized complex of low molecular weight proteins from human leukocyte membranes with glycine), as aerosol, at a single dose of 2 units. Fifteen non-treated patients comprised a group of comparison. Eosinophil counts and concentrations of free hemoglobin (by immunometrical method in co-agglutination reaction) were made in nasal secretions twice (before treatment and two weeks later). It was found that the increase of free hemoglobin levels, as well as increase in eosinophil count in nasal secretions represents a symptom typical of exacerbation in persistent allergic rhinitis and reflects severity of disease. The therapy led to significant clinical improvement, decrease in free hemoglobin levels and eosinophil counts in nasal secretions, corresponding to clinical effect of both therapeutic modes of topical pharmacotherapy, resp., in 73% and 79% of the patients with persisting allergic rhinitis. Decrease in free hemoglobin level has allowed for the first time to reveal the immunotherapeutic efficiency of treatment with Affinoleukin® aerosol during exacerbations of persisting allergic rhinitis.

Abstract. Results of immunological and molecular biology investigations over last decades allowed clear to specify mechanisms of development and clinical features of allergic reactions to food of plant origin, including allergies to fruits Prunus persica - peaches and nectarines. The article contains the analysis of literature data on allergic reactions to peach, as well as clinical observations of the patients with this kind of allergy and of the results of the component component resolved diagnosis, ISAC ImmunoCAP, conducted by these patients. The collected data allow to detect two fundamentally different types of allergic reactions to Prunus persica. This is due to sensitization to allergen Pru p 3 severe systemic reaction, and due to sensitization to Pru p 1 or Pru p 4 – local response, manifesting oral allergy syndrome and associated with sensitization to pollen allergens.