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Type I allergy is mediated by the formation of IgE antibodies to proteins secreted by nonreplicating microorganisms (plant pollen, house dust mites, etc.) that enter the mucous membranes in very low concentrations. The mechanisms and localization of naive B cells’ switching to IgE production have not been fully determined. The aim of this work was to determine the switching site of B cells and the traffic of IgEproducing B cells in mice immunized with a low dose of equimolar mixture of egg proteins Gal d1, Gal d2, and Gal d3. Allergens in saline solution were injected into the withers of mice 9-10 times with an interval of 2-3 days; the total dose was 2.7 µg/mouse. The production of IgE to Gal d proteins in the blood and by B cells isolated from the withers, draining lymph nodes, spleen, and bone marrow of immune mice was analyzed in dynamics after cessation of sensitization. Both in blood and in in vitro cultures, the dominance of IgE changed from the recognition of the LMW Gal d2 during the sensitization of mice to the HMW Gal d3 after sensitization was discontinued. In this model, an IgG memory response appeared only a month after the end of sensitization and recognized only Gal d3. In vitro cultures showed that B cells switched to IgE production locally in the withers with low traffic to the spleen. In the blood serum, IgE titers for all Gal d proteins decreased after the cessation of sensitization and persisted for a long time. A month after the cancellation of the sensitization, a pool of B cells producing IgE in vitro appeared in the spleen. These B-cells died after 20-30 days as no in vitro IgE production was observed later than 85-90 days. The results obtained allowed us to draw several conclusions. B cells switch to IgE synthesis locally at the site of allergen injections. The response was two-phase: LMW Gal d2 was recognized in the early response, while HMW Gal d3 was recognized in the late phase. In this model, the IgG response to HMW Gal d3 was clearly dominant. In conclusion, it has been shown that when the immune system recognizes a mixture of proteins originating from some allergen, the dominance of proteins recognized by both IgE and IgG is observed. Since allergy patients most often do not have IgG antibodies, it can be assumed that in this case an acute phase response, supported by antigen intake, is observed, in which LMW allergens are recognized.

The paper highlights modern views on the metabolism of vitamin D in the human body. The analysis of the literature data on the mechanisms of the effect of vitamin D deficiency on the pathological processes occurring in the skin with psoriasis is carried out. It is known that psoriasis is associated with a high prevalence of metabolic syndrome, diabetes mellitus, and cardiovascular diseases. There is a direct correlation between a decrease in vitamin D levels and an increased risk of developing metabolic syndrome and cardiovascular mortality, including in patients with psoriasis. Data on the possibility of using vitamin D in dermatology are presented. Based on international and Russian clinical recommendations, the place of oral colecalciferol preparations in the prevention and correction of vitamin D deficiency and deficiency has been determined. The use of oral vitamin D for the simultaneous treatment of psoriasis and metabolic syndrome reduces the risk of cardiovascular diseases and type 2 diabetes mellitus. We analysed the international and domestic recommendations for the treatment of vitamin D deficiency and insufficiency, the use of which makes the oral administration of vitamin D3 (cholecalciferol) optimal for the treatment and prevention of vitamin D deficiency, as the results of several studies showed a higher efficacy of vitamin D3 vs vitamin D2. Vitamin D3 is found in vitamin D-fortified foods and is available as dietary supplements and drugs. The bioavailability of vitamin D in dietary supplements may differ depending on the used vehicle substance.

The article presents the data concerning the efficacy and safety of topical corticosteroids (TCS) in psoriasis treatment in the practice of dermatovenerologist. The questions of etiology and pathogenesis of psoriasis are considered; violation of activation of innate and adaptive immunity plays the key role in its development. The basic approaches in psoriasis treatment, based on the international and Russian clinical guidelines, are distinguished. The place of TCS in psoriasis therapy is determined. The authors give the recommendations for the management of patients with psoriasis and the choice of therapy depending on the form and severity of the pathological process with the use of TCS as the first-line therapy of mild and moderate psoriasis on the basis of the modern Russian and foreign recommendations. The article presents the data of own clinical observations of Akriderm SK micronized drug application for treatment of different forms of psoriasis. A detailed description of management tactics and results of therapy in two patients with psoriasis is presented. The high efficacy of topical Akriderm SK drug in mono- and combined therapy in combination with phototherapy in patients with moderate to severe psoriasis has been shown. Based on the analyzed data of foreign and domestic studies, as well as the authors’ own experience, it is shown that the use of Acriderm SK in psoriasis therapy is effective and safe and meets the requirements of modern treatment principles and standards. The experience of its use for treatment of psoriasis patients demonstrated high therapeutic efficacy and low risk of adverse events.

The data of foreign and domestic clinical studies on the efficacy and safety of sertaconazole (SK)is discussed. Broad spectrum of activity of SK and lack of resistance to the drug is established. Several studies opens new opportunities for the SK for the treatment of dermatosis, in the pathogenesis of which play an important role of opportunistic infection. High efficiency and compliance, a significantly greater safety index than that of the other members of the azole group, suggest the SK as a formulation that extends the capabilities of the outer antimycotic therapy of fungal infections of the skin.