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Asthma is a severe and chronic disabling disease affecting more than 300 million people worldwide. Although in the past few drugs for the treatment of asthma were available, new treatment options are currently emerging, which appear to be highly effective in certain subgroups of patients. Accordingly, there is a need for biomarkers that allow selection of patients for refined and personalized treatment strategies. Recently, serological chip tests based on microarrayed allergen molecules and peptides derived from the most common rhinovirus strains have been developed, which may discriminate 2 of the most common forms of asthma, that is, allergen- and virus-triggered asthma. In this perspective, we argue that classification of patients with asthma according to these common trigger factors may open new possibilities for personalized management of asthma., La lista completa de autores que integran el documento puede consultarse en el archivo., Facultad de Ciencias Exactas

BackgroundAcute respiratory viral infections (ARVI) continue to be the main reason for seeking pediatric care in Ukraine. Comparative characteristics of etiological spectrum of ARVI in Ukrainehas not been sufficiently studied.Aim of Study to investigate the etiology of ARVIand compare it between epidemiological seasons 2018-2019 and 2019-2020.MethodsThe study was conducted inthe Eurolab clinic (Kyiv, Ukraine) during the period 2018-2020. Nasopharyngeal swabs, collected from ARVI children aged 2 months to 16 years old, were analyzed by multiplex real time polymerase chain reactionfor 7 viruses – Respiratory Syncytial virus (RSV), Parainfluenza virus (PIV), Adenovirus (AdV), human Metapneumovirus (hMPV), Rhinovirus (RV), human Bocavirus (hBoV) and Coronavirus (CoV). Rapid influenza diagnostic testing was used.Results147 samples were collected during the period from October 2018 until February 2019;125 (85,0%) were positive: hMPV – 33 (26,3%), IVA – 28 (22,4%), RV – 21 (16,8%), RSV – 10 (8,0%), hBoV – 7 (5,6%), AdV – 5 (4,0%), PIV – 4 (3,4%). Diagnosis of pneumonia was established in 18% of children infected by hMPV and 21% of children with IVA infection. Other clinical manifestations of hMPV infection were: tracheobronchitis, obstructive bronchitis, bronchiolitis, rhinopharyngitis, laryngitis.12 of the children with RV infection had symptoms of rhinopharyngitis, wheezing, bronchitis and laryngitis. 203 nasopharyngeal swabs were collected during epidemic season 2019-2020, 180 (88,7%) of them were positive: RV – 56 (31,7%), AdV – 39 (22,2%), CoVNL-63, 229E – 28 (12,7%), hBoV – 19 (10,6%), IVA -15 (8,3%), PIV – 12 (6,6%). Confirmed diagnosis of pneumonia had 6 (10,6%) children with RV. 10 (17,8%) children with AdV infection had pneumonia as a clinical manifestation. CoVNL-63, 229E caused rhinopharyngitis, croup, wheezing, tracheobronchitis. Generally, 103 samples were collected during the period from March 2019 until September 2019. 98 of them were positive: RSV -37 (37,8%), RV -29 (29,6%),CoV – 12 (12,2%), AdV – 10 (10,2%), PIV – 9 (9,2%).ConclusionsThere has been a change in the etiological spectrum of ARVI during the last two years. During epidemic season 2018-2019 in Ukraine, the most prevalent viruses were hMPV -33 (26,3%), IVA -28 (22,4%), RV – 21 (16,8%). During epidemic season 2019-2020 the most commonlydetected pathogens were RV- 56 (31,7%), AdV 39 (22,2%), CoVNL -63, 229E28 (12,7%).Epidemiological studies should be continued in order to forecast the probable clinical course of disease, and for optimization therapy.

Background Acute respiratory tract infections (ARTI) in children are the leading cause of morbidity in Ukraine. The role of respiratory viruses in the clinical manifestations of ARTI in children in Ukraine has not been sufficiently studied. The aim of study To investigate the etiology of ARTI and compare the clinical features of different virus infections in children during the period from September 2018 to January 2019. The methods Nasopharyngeal swabs, collected from ARTI children aged 2 months - 16 years, who received outpatient treatment or were hospitalized to Eurolab clinic (Kyiv, Ukraine) were examined. They were screened for 7 respiratory viruses using Multiplex PCRs - Respiratory Syncytial virus (RSV), Parainfluenza virus (PIV), Adenovirus (AdV), human Metapneumovirus (hMPV), Rhinovirus (RV), human Bocavirus (hBoV)and Coronavirus (CoV). Although rapid influenza diagnostic test was used. Results Respiratory pathogens detected in 125 of the 147 (85,0%) samples. HMPV was detected in 33 children. Clinical manifestation of hMPV infection were: tracheobronchitis - 13, pneumonia - 6, obstructive bronchitis - 7, bronchiolitis - 3, rhinopharyngitis -3, laryngitis -3. Influenza A (IVA) was detected in 28 children with ARTI: tracheobronchitis - 13, pneumonia - 6, obstructive bronchitis - 2. Half of children with IVA also have symptoms of rhinopharyngitis. RV was detected in 21 children, 12 of them have symptoms of rhinopharyngitis, 3 - croup and 3 - wheezing, 2 - bronchitis and 1 - laryngitis. Clinical characteristics of others viruses are following: RSV was detected in 10 children, it caused pneumonia (3 cases), obstructive bronchitis (5 cases). HBoV was detected in 7 children and caused rhinopharyngitis, laryngitis (6 cases), tracheobronchitis (2), two child had viral exanthema. AdV was detected in 5 children and caused rhinopharyngitis with lymphadenopathy in 3 cases, pneumonia in 2 cases. PIV during season caused rhinopharyngitis, laryngitis (2 cases), croup (1 case), obstructive bronchitis (1 case). The coinfection percentage was 13, 5%. Conclusions During epidemic season in Ukraine the most prevalent viruses were hMPV -33 (26,3%), IVA -28 (22,4%), RV - 21 (16,8%). Using Multiplex PCR assay can be helpful in prognosing of probable clinical course of disease, for optimization therapy.

Background Pneumonia is the third most common fatal cause for children under age five in Ukraine. The increase in the incidence of acute respiratory infections requires the determination of the role of pathogens in the etiology of pneumonia. The spectrum of etiological agents of community-acquired pneumonia (CAP) has not been studied in Ukraine. The aim of study To identify and improve the understanding of the causative role of infectious pathogens in etiology childhood CAP during the epidemic season. The methods 49 children from 2 months to 16 years old with pneumonia were examined and treated at the Eurolab clinic (Kyiv) from September to January 2018/2019. The diagnosis was based on clinical examination, chest radiography, blood test, Multiplex PCRs for throat and nasals wabs, rapid influenza diagnostic tests (RIDTs). Results Pneumonia was confirmed with a chest x-ray in 36 patients. The diagnosis was determined without radiographic findings, based on clinical symptoms (cough, localized crackles, or decreased breath sounds, fever, tachypnea) and hypoxemia in 13 children over 5 years old. Viral pneumonia was diagnosed in 31 patients (63%) with normal WBC count. It was characterized by hyperinflation with bilateral interstitial infiltrates and peribronchial cuffing on chest x-ray in 23 children. PCR tests were used in 21 children to determine etiology: Metapneumoviruses (hMPV) - 6; Respiratory syncytial virus (RSV) - 3; Adenoviruses - 2; Mycoplasma pneumoniae - 2 (confirmed by seroconversion in IgG); Chlamydophila pneumonia - 6 (3 - with Ig G seroconversion); Mycoplasma pneumonia and Chlamydophila pneumonia - 1; Adenovirus and Influenza A - 1. In 6 children with viral pneumonia, influenza A was identified by RIDTs. Measles was the cause of pneumonia in 2 patients. Conclusions The study suggests that viruses (primarily, hMPV, influenza and RSV) play a major role in childhood CAP. Future research is required to understand viral and bacterial colonization of the respiratory tract and the relevance of the detection of pathogens in the etiology of community-acquired pneumonia, which will reduce chest X-rays and optimize antibiotic therapy for pneumonia in children.

It is known that among 40–70 % of patients pollinosis can run in conjunction with pollen-food allergy syndrome (PFS), while development of PFS is associated with the consumption of fresh fruits, vegetables, nuts and spices. Clinical course and severity of the disease depend on the sensitization profile, which can be represented by proteins-panallergens (PR-10, profilins, nsLTPs). However, there is little information about the sensitization profiles of patients with pollinosis caused by pollen of spring trees in Ukraine. Aim.To study the profiles of sensitization of children with spring pollinosis. Methods.We examined 61 children (aged 4-17 years) with spring seasonal allergic rhinitis/rhinoconjunctivitis (SAR). To establish the diagnosis, all children were given questionnaires, skin prick tests (SPTs) with commercial pollen extracts, and prick to prick tests with fresh fruits, vegetables and nuts. Component resolved diagnosis (CRD) were detected using an ImmunoCAP system. (Phadia, 100). Results. It has been found that in 43 children (70.5 %) had polinosis in combination with PFS, the main clinical manifestation of which was an oral allergic syndrome in 43 children (100 %). Among the causal food allergens that caused the manifestations of PFS were more apples, peaches, carrots and hazelnuts (consumption of which led to 11.6 % of children before the development of anaphylaxis). All of the examined children (100 %) had a positive IgE response to rBet v 1 at significant concentrations. In 9.3 % of children, panallergens were found at once from several botanical groups. Such panallergens: rBet v 2, rBet v 4, rPhl p 7, rPhl p 12, rArt v 3 are generally not defined in the control group children. Conclusions.Birch related PFS are common in Ukrainian pollen-allergic children with nuts and fruits predominantly implicated. Sensitization profile of children with Birch-pollen syndrome is complex and associated with sensitization to panalergens. Clinicians should be worried of PFS in patients with a high degree of sensitization to birch pollen and even young children if they have birch sensitization.