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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 aim of the work is the development of a method of detection of specific class E immunoglobulins (IgE) to the main Bet v 1 birch allergen based on immuno-PCR (iPCR). The recombinant Bet v 1 allergen was obtained in E. coli cells. Its ability to bind to specific IgE was confirmed by enzyme-linked immunosorbent assay (ELISA) using previously characterized sera of individuals with an allergic reaction to birch pollen and control sera in individuals, in which the reaction to this allergen is absent. Based on the obtained recombinant protein, the method of iPCR analysis of specific IgE to Bet v 1 was developed. It was demonstrated that iPCR sensitivity is comparable to ELISA sensitivity, and the titration curves of specific sera in iPCR (unlike those in ELISA) demonstrate a linear dependence; this makes the developed method preferable for quantitative estimation of specific IgE in sera as compared with ELISA.

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

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.

Rupatadine is a newly synthesized formula combining molecules selectively inhibiting peripheral H 1 receptors and the receptors for the platelet-activating factor. This unique combination allows suppressing the early and late phases of allergic reactions. High efficacy, non-sedating properties, possibility of high doses treatment, absence of side effects of rupatadine has been investigated for treatment of allergic rhinitis and chronic idiopathic urticaria in adults and adolescents in several controlled studies, showing a rapid onset of action and a good safety profile even in prolonged treatment periods.

The paper describes the fundamentals and benefits of a new allergy diagnostic technique based on recent advances in molecular biology and biotechnology. Component-resolved diagnosis allows IgE antibodies against purified molecules (individual allergen components) to be revealed. Microanalysis is made using microarrays with applied molecules (allergen components) obtained in a recombinant fashion or extracted from natural raw materials. The authors present a current classification of animal and plant allergens and show the value of component-resolved diagnosis in clinical practice, by using specific clinical examples.

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. Allergic diagnosis is based on accurate clinical history and conducting of skin prick tests (sPt) and specific IgE determination. the past decade recombinant allergen components from pollen of birch are available for allergen-specific IgE antibody testing. the major allergen of birch tree pollen is Bet v 1; Bet v 2 is a well described minor allergen. Methods. 83 patients with birch pollinosis (55 male/28 female, age 4-35 years, mean 15,5) were observed. specific IgE levels were determined by using the ImmunoCap (Phadia, sweden); skin prick tests with standard aeroallergens panel was used. Results. All 83 patients had positive skin tests to birch pollen. the levels of specific IgE to rBet v1 had 87,9% of patients, sIgE to rBet v 2 (profilin) 14,5% of patients, sIgE to rBet v 1 and rBet v 2 13,3% of patients. Conclusion. the prevalence of the patients with presence of IgE - antibodies to profiling Bet v2 among citizens of moscow region, sensitized to birch, accounts 14,5%.

The prevalence of the allergy to birch pollen is high in the middle part of russian Federation. the symptoms of allergic intermittent rhinitis appears in the first decade and lasted during all life. the severity of the disease is aggravated annually. the economic burden of allergic rhinitis includes direct, indirect and hidden costs. the indirect cost (disability and loss of productivity, hypoallergenic life arrangements) exceeds direct costs many times. allergen specific immunotherapy by pollen allergovaccines is unique kind of pathogenic management. asIt demonstrates significant improvement of the symptoms of rhinitis and asthma, quality of life. one of the main problems is high costs of asIt. economical models used in investigations on asIt cost effectiveness demonstrated lucre in the following 10 years of life after 3 year's course of asIt. In order to achieve high clinical result it is necessary to follow european standard's guidance on specific immunotherapy strictly.

Background. Allergic rhinitis is a common disease, affecting 25-35% of the population. Birch pollen is a significant cause of immediate hypersensitivity among sensitive subjects, affecting about 80% of the population in the central part of Russian Federation. Specific subcutaneus immunotherapy (SCIT) is the only treatment producing lasting clinical improvement in patients with allergy. The aim, of the study was to investigate the efficacy of one - year SCIT for allergic rhinoconjunctivitis for birch pollen using the Average Rhinoconjunctivitis Total Symptom Score (ARTSS) and Average Rescue Medication Score (ARMS). Materials and methods. 54 subjects with IgE-mediated seasonal allergic rhinoconjunctivitis with/without seasonal asthma were enrolled; 47 patients with pollen allergy were included in a control group. All patients were sensitized to birch pollen-allergens. SCIT was performed during 9 months 2009-2010 years by a birch extract standardized in IR and absorbed onto calcium phosphate (Phostal, France). Patients were asked to complete diary during the birch pollination season (from 1 April to 1 June). Pollen grains were counted daily during the pollen seasons by standardized protocol and the amount of pollen was expressed as the number of pollen grains/m3 air. The ARTSS was derived from individual symptom scores for nasal and eye symptoms during the pollen season. In addition there was a daily score for the use of rescue medication (ARMS). Rescue medication allowed included Hl-antihistamines, nasal steroids, oral steroids; each puff, drop (nostril/eye), tablet counted as one point. Results. The seasonal pollen counts and the duration of the pollen season had differed in 2009 and in 2010. Reduction in ARTSS of 29% and decrease in ARMS of 28,9% were found in the birch pollen season for subjects treated with the SCIT compared with controls after one year of treatment. The immunotherapy after the end of the treatment was not effective in 3 patients (5%). Conclusion. Immunotherapy by Phostal shows clinical effect on development of seasonal rhinoconjunctivitis. The decrease in ARTSS for Phostal-treated patients that occurred in parallel with a marked reduction in their requirement for ARMS provides additional evidence for the efficacy of SCIT over and above usual pharmacotherapy for rhinitis.

The pathogenesis of chronic rhinosinusitis with nasal polyposis is still unknown. The aim. To estimate IgE-antibodies to staphylococcal enterotoxines and fungal allergens mix in nasal polyps'supernatant and sera of three phenotypes of chronic rhinosinusitis. Patients and methods. Chronic rhinosinusitis with nasal polyposis with aspirin intolerance - 12 patients, chronic rhinosinusitis with nasal polyposis with atopy - 15 patients, chronic rhinosinusitis with nasal polyposis without atopy and aspirin intolerance - 10 patients, and 6 healthy persons were observed. The levels of ECP, tryptase, total IgE, IgE-antibodies to staphylococcal enterotoxines, fungal mix in sera and supernatant of polyp's tissue were detected by ImmunoCaplOO (Phadia AB). Results. The incidence of IgE-antibodies to staphylococcal enterotoxines makes up 12,6% in the sera of all patients, and 30% in polyp's tissue in nonatopic patients and in none of atopics. The local production of IgE-antibodies to fungi in polyp's tissue was high and revealed in 30-73% of all patients (more often in patients with aspirin intolerance - in 73% of cases). There was no dependence between the incidence of IgE-antibodies to staphylococcal enterotoxines, fungal allergens mix in the sera and polyps and the chronic rhinosinusitis with nasal polyposis. Conclusion. The incidence of IgE-antibodies to staphylococcal enterotoxines, fungal allergens mix in polyp's tissue is higher than in sera as in atopic as in nonatopic pts. There were IgE-antibodies to fungi in polyp's tissue in 73% of patients with aspirin intolerance. The presence of IgE-antibodies did not influence on the level of ECP and severity of chronic rhinosinusitis with nasal polyposis .

The questions of local nasal inflammation typical for allergic and infectious rhinitis are discussed. These proteins appear in nasal cavity in the beginning of the disease earlier than in the blood. That's why it is necessary to collaborate new non - invasive methods of new markers diagnostics of local inflammation.

Background. Allergic rhinitis manifestates as the local inflammation with minimum pathophysiological disorders. Revealing of local inflammatory markers in nasal secret is actual problem. The aim: to detect the levels of free hemoglobin, eosinophilic cationic protein and eosinophils in nasal secret in patients with allergic rhinitis and infectious rhinitis. Materials and methods. 60 patients with allergic rhinitis and 30 patients with infectious rhinitis were observed. The diagnosis and severity of disease were rated in conformity with international standards. Results. Mean level of free hemoglobin in patients with allergic rhinitis was significantly higher in comparison with the group of infectious rhinitis and had compiled 55,9 mkg/ml and 6,1 mkg/ml. The quantity of eosinophils more than 10% was observed in 43,9% of cases in patients with allergic rhinitis and in 11,1% in patients with infectious rhinitis. Frequency of elevated level of eosinophilic cationic protein in patients with allergic rhinitis has made 87,9%, in comparison with infectious rhinitis where it corresponded to 28%. The highest sensitivity (87,9%) was found in method of definition of eosinophilic cationic protein. Method of free hemoglobin's definition was characterized by high parameter of correct diagnosis's probability - 97,3%. Conclusion. Methods of definition of eosinophilic cationic protein and free hemoglobin in nasal secret had possessed with the highest diagnostic efficiency.

Aim. Determine the occurrence of S. aureus in microbiocenosis of nasal cavity of children and adults with allergic and infectious rhinitis.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.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.Antagonistic properties of these 2 species of microorganisms assume their competition on the nasal mucous membrane.

The paper describes the fundamentals and benefits of a new allergy diagnostic technique based on recent advances in molecular biology and biotechnology. Component-resolved diagnosis allows IgE antibodies against purified molecules (individual allergen components) to be revealed. Microanalysis is made using microarrays with applied molecules (allergen components) obtained in a recombinant fashion or extracted from natural raw materials. The authors present a current classification of animal and plant allergens and show the value of component-resolved diagnosis in clinical practice, by using specific clinical examples.

Article is dedicated to therapeutic effect of long-term therapy clarithromycin in patients with varying severity of chronic polypous rhinosinusitis. The effectiveness of therapy based on monitoring of symptoms and quality of life on a scale of SNOT-20 in an open clinical trial in the treatment in patients with varying degrees of severity of chronic polypous rhino sinusitis with the macrolide Klaсid 500 SR was assessed in three months. As a result of investigations, good and excellent effect was observed mainly in patients with mild to moderate disease. Obviously, the duration of therapy should be in cases with severe forms of chronic polypous rhino sinusitismore than 3 months.

Microflora of nasopharynx in 117 patients with urticaria was studied. 589 cultures of gram-negative and Gram-positive bacteria were isolated. Gram-positive bacteria represented the overwhelming majority of isolates from which streptococci dominated with high level of constancy (C=91.4%) and prevalence on mucosa. Several patients had signs of chronic streptococcal infection that support the possible role of streptococci in development of urticaria.

32 patients with atopic dermatitis (AD), complicated by pyoderma, were treated with purified staphylococcal toxoid (PST). Changes in clinical and laboratory characteristics in the course of treatment were evaluated. PST was shown to produce a satisfactory therapeutic effect, arresting the symptoms of local staphylococcal infection. An increase in the levels of alpha- and gamma-interferons and decreased content of CD25+ lymphocytes were found. Thus prospects appear for using this preparation as an interferon inductor, as well a for the immunotherapy of AD patients sensitized to Staphylococcus aureus.

The microbiological study of 69 patients with allergic annual rhinitis (AAR) and infectious rhinitis (IR) was carried out. In AAR the isolated representatives of 15 genera and 40 species were distributed in 2 to 7 component; in IR the isolated representatives of 16 genera and 25 species were grouped in 2 to 4-component associations. In AAR Staphylococcus aureus was found to belong to the main species and in IR, S. aureus and S. epidermidis, while the number of species regarded as occasional in AAR was 7 (S. auricularis, S. cohnii, S. hominis, S. haemolyticus, S. warneri, S. apitis, S. schleiferi). Differences in the distribution of Neisseria, nonfermenting Gram negative bacteria, Streptococcus in associations in cases of AAR and IR were established. In AAR Corynebacterium pseudodiphthericum and in IR C. pseudotuberculosis were the dominant species.

Changes of cytological parameters in the course of the nasal provocative test (NPT) we studied in 30 patients aged 14-43 years with chronic rhinitis of unknown etiology. Solutions of allergens in various concentrations were used for NPT and skin testing. NPT results were estimated clinically according to four-point scale and rhinocytogram 20 minutes after injection of different concentrations of allergens to nasal cavity. The results of the provocative tests coincide with case history data more frequently than skin test results. The discrepancy between anamnesis and results of skin tests in the group of patients reached 30.7%. A mean 8-fold increase in eosinophil count in nasal secretion was observed in patients with clinically confirmed NPT (76% cases) 20 minutes after injection of a minimal concentration of allergen extract to the nasal cavity. This eosinophil infiltration of nasal secretion preceded the occurrence of clinical symptoms. An unusual cytological picture of nasal secretion was observed in three patients with positive anamnestic data, results of skin testing and NPT. Eosinophil infiltration of nasal recreation was absent but neutrophil number increased. Increased eosinophil count on rhinocytogram after injection of allergen extract to nasal cavity can serve as an objective criterion of NPT. The described cases of neutrophil infiltration of nasal secretion testify to possible participation of these cells in acute allergic inflammation in patients with clinically positive NPT.

The impact of purified staphylococcal toxoid (PST) on the in vitro production of interferon (IFN) by blood leukocytes was evaluated. PST was found to produce a stimulating effect on the production of alpha-IFN in patients with atopic dermatitis (AD): in 88% of cases a two-fivefold increase in IFN production was observed in AD patients in comparison with healthy donors. In addition, the incubation of leukocytes obtained from atopic and nonatopic patients with PST was shown to stimulate the production of gamma-IFN by these leukocytes fivefold, on the average. These results give theoretical basis for use of PST (as an inducer of endogenic IFN) for AD patients treatment.

The content of IgA, IgM, IgG and the level of specific antibodies in the blood serum of patients with bronchopulmonary diseases after a course of immunotherapy with polycomponent vaccine B[symbol: see text]-4 was studied. A rise in the concentration of IgM due to the synthesis of specific antibodies to Proteus vulgaris, Escherichia coli and Klebsiella pneumoniae was found to occur. The examination of sick children revealed that a high proportion of them (54%) showed a pronounced decrease in the level of IgA. The use of the preparation made it possible to enhance the level of IgA.

To study of therapeutic activity of local (natamycine) and systemic (fluconasol) antifungal drugs in patients with atopic dermatitis (AD) with mycogenic sensitization and candida carriage.29 patients with severe AD and diagnosed contamination of the skin lesions with yeast fungi have received antifungal treatment with fungicidal drugs in low-dose long-term course.The drugs were effective in 83% of patients: poor effect was in 28%, moderate--in 21% and good--in 34% of cases. 5 (17%) patients did not respond. Mild, moderate and severe AD responded in 87, 36 and 60% of patients, respectively. The highest response was registered in patients without sensitization to yeast fungi (78%) or low sensitization (83%). In high sensitization the effect occurred in 57% of the cases.The authors have developed indications for treatment with antifungal drugs in AD patients with mycogenic sensitization.

Colonization by yeast-like flora and its composition on the skin of patients with atopic dermatitis (AD) in comparison with those on the skin of patients with skin diseases of nonatopic etiology and healthy subjects were studied. Inoculations from affected and unaffected sites of the skin were made by the contact method with the use of bacteriological plates with antibiotic-containing solid agar medium. The study revealed that 39% of AD patients, 45% of patients with other skin diseases and 3% of healthy subjects had yeast-like fungi of their skin, Candida spp. (53%) and Rhodotorula spp. (21%) occurring most frequently. In patients with a severe course of AD the tendency towards the preferable colonization of affected sites of the skin was observed: in these cases yeasts occurred 2.5-5 times more frequently than in patients with the mild and moderate course of AD.

Storage mites of the families Acaridae and Glycyphagidae attracted attention as the source of household allergens. Storage mites occurring in house dust were studied. The fauna of storage mites in house dust was represented by two families. The dominating species, both in the relative amount and occurrence, were Tyrophagus putrescentiae and Chortoglyphus arcuatus. In addition, Caloglyphus rodionovi and Carpoglyphus lactis occur regularly. The specific activity of allergenic extracts obtained from storage mites was studied in ELISA. They were shown to have sensitizing and immunogenic properties. The study revealed that storage mites possessed specific determinants and those common with pyroglyphid, not linked with allergens of groups 1 and 2.

Candida albicans, a component of normal human microflora, can induce synthesis of specific IgE-antibodies in patients with atopic bronchial asthma and atopic dermatitis. The study included 25 patients with atopic dermatitis sensitized to C.albicans and 23 patients with atopic dermatitis non-sensitized to C.albicans. The sensitization was determined by the skin test and enzyme immunoassay. The patients had the history of atopic dermatitis exacerbation after taking food containing baking yeasts. Atopic dermatitis with sensitization to C.albicans is characterized by severe course correlating with the following indices: high total IgE (r = 0.6), level of IgE antibodies to C.albicans (r = 0.6), level of serum IgG (r = 0.46) and IgA (r = 0.33). Contrary to adults, children with sensitization to C.albicans had decreased relative number of CD4+, CD8+ and CD72+ of lymphocyte subpopulations. Thus, sensitization to C.albicans manifests in severe atopic dermatitis which in children is often associated with immune deficiency.

The method for obtaining allergenic extracts from T. putrescentiae bodies has been developed. As nutrient medium for the cultivation of these mites oat flour has been selected: it has no allergenic cross-reactive properties with T. putrescentiae. Some physico-chemical properties and specific activity of allergenic extracts obtained from these mites were studied. Protein content in these extracts has been found to vary from 0.93 to 0.26 mg/ml, depending on extraction conditions. Protein constitutes 1.5-30.0% of the dry substance of the allergen. After lyophilization the allergen becomes grayish-white powder, readily soluble in water and aqueous saline solutions. In addition, allergenic extracts from T. putrescentiae have pronounced capacity for binding specific IgE antibodies in the sera of patients sensitized to storage mites of this species, which has been confirmed by RAST inhibition and ELISA. Lyophilization produces no changes in the properties and activity of T. putrescentiae allergenic extracts.

House dust mites and storage mites proved to be one of the main allergens causing hypersensitivity in atopic dermatitis in allergic patients. The authors reproduced experimental allergic dermatosis on the model of delayed type hypersensitivity in guinea pigs, caused by sensitization to the allergen from the mite's bodies Tyrophagus putrescentiae--species having wide distribution in the country. The results characteristic for T-cell type hypersensitivity have been obtained: delayed positive skin tests after 24 hours, typical histomorphological picture (strong allergic alteration, epidermis desquamation, vasculitis, dermis T-cell infiltration and spongiosis--Waksman's syndrome). It is concluded that side by side with humoral IgE-mediated reaction there is strong delayed T-cell hypersensitivity to the storage mites Tyrophagus putrescentiae.