Allergy: XX century disease

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Past XX century was called an “age of allergy” by right. Frequency of allergic diseases increases headily - every 10 years after 1950, increasing on 10%, and today, according to some data, up to 50% of population in the world suffer from various allergic diseases


Past
XX century was called an “age of allergy” by right. Frequency of
allergic diseases increases headily - every 10 years after 1950,
increasing on 10%, and today, according to some data, up to 50% of
population in the world suffer from various allergic diseases.
Prevalence of bronchial asthma is 10-20%, atopic dermatitis - 5-15%.
Allergic diseases, appeared in childhood, stay in adults, often causing
lowering of life quality and loss of ability to work.

Bronchial asthma is a chronic obstructive respiratory disease,
caused by allergic inflammation, accopmanied by hyperresponsiveness
(heightened sensibility) of bronchi to allergens and non-specific
irritants, displaying in the form of choking fits, short wind,
breathing troubles, cough, caused by spasm of bronchi unstriated
muscles, mucous membrane edema, hypersecretion of mucus, remodeling of
bronchi wall. Bronchial asthma appears in children after they suffered
from obstructive bronchitis on the background of acute respiratory
viral infections. Asthma, accompanied only with cough is also possible.

Atopic dermatitis - is a chronic allergic skin disease with
genetic predisposition, various changes on skin with binding presence
of itch, passing consistent stages in its development (infantile
eczema; children; adult or neurodermatitis).

Atopic dermatitis in a child with cytomegalovirus infection

Genetic predisposition to anomalously heightened immunity to a
wide spectrum of popular factors of environment - allergens, underlies
in allergic diseases.

Home dust, animal hair, food products, herbal and tree pollen,
opportunistic pathogenic bacteria, microfungi - are most popular
allergens. However, not only allergens can cause exacerbations of
allergic diseases, but also a number of non-specific factors - climatic
changes, negative ecological influences, tobacco smoke,
psycho-emotional stress.

A common constituent of all these factors` action - is a chronic
allergic inflammation, which is localized in a certain “target organ”.
This way skin is a “target organ” while atopic dermatitis, bronchi
mucous membrane - while bronchial asthma, bowels mucous membrane - food
allergy.

Modern concept of allergy treatment is based on three foundations:

- elimination of allergens (avoiding contact with allergen);

- basic antiphlogistic therapy with hormonal (steroid) or nonsteroid, antihistaminic
resolvents;

- treatment of exacerbation.

Unfortunately, such traditional tactics achieves wishful effect not always.

One of reasons of inefficiency of standard antiallergic therapy is
underestimation of infectional factor`s contribution to development of
these diseases. Various infectional agents (viruses, bacteria,
mycoplasms, clamydias, helmints, Lamblia) can be connected with allergy
development. Last years` researches showed earnestly that:

- people, suffering from allergic diseases, are
infected with certain microorganisms more often, than healthy ones,
what is connected with peculiarities of immune status while allergy;

- these pathogens make a significant
contribution to mechanisms of development of a diseases, contributing
to formation of infectional inflammation;

- allergic diseases accompanied by infection
have certain clinical and immunologic peculiarites, in general passing
with complications;

- treatment, directed against these infectional
agents, improves passing and prognosis of allergic diseases, reducing
weight of passing, frequency and weight of complications.

Atopic dermatitis

Bronchial asthma

Pathogens (ranking)

Staphylococcus
aureus

Pytyrosporum
ovale

Candida

Helmints

Cytomegalovirus

Herpes simplex virus
I, II

Respiratory
viruses (flu, RS-virus, adenovirus)

Mycolasma
pneumoniae

Mycoplasma
hominis

Clamydias

Cytomegalovirus

Pathogenetic mechanisms

Superantigens

Skin colonization

Bacterial allergy

Hyperproduction
of common and specific IgE

Hyperproduction
of common and specific IgE

Delayed-type reaction

Non-specific
hyperactivity of bronchi

Clinical
peculiarities

Exacerbation
of candidal vulvovaginitis in a mother
during pregnancy

Attendant
dysbacteriosis

Large diffusion,
serious skin affection

Signs of superinfection (seborrheic eczema,
staphyloderma, microbial eczema, skin moniliasis)

Beginning
of asthma after pneumonia, long cough, anticipate obstructive bronchitis, visiting
of children collectives (kindergarten,
school)

Serious
passing of disease, hormonal dependence

Serious,
long fits with hospitalizations

Signs of
attendant infectional lesion of respiratory tract, ENT-organs.



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