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Pediatry
~
Педиатрия
UDC 61
ASPECTS OF FOOD ALLERGY IN CHILDREN OF EARLY
AGE DEPENDING ON THE TYPE OF TREATMENT
M.B. Devorova,
Candidate of Medical Sciences, Associate Professor,
The Department of Ambulatory Medicine and Physical Education
Tashkent Medical Pediatric Institute
(100140, Uzbekistan, Tashkent, Yunusabad district, str. Bagishamal, 223)
E-mail: cool.lolo@mail.ru
E.A. Shomansurova,
Doctor of Medical Sciences, Professor
The Department of Ambulatory Medicine and Physical Education
Tashkent Medical Pediatric Institute
(100140, Uzbekistan, Tashkent, Yunusabad district, str. Bagishamal, 223)
E-mail: cool.lolo@mail.ru
Abstract.
The article includes data from a literature analysis on aspects of food allergy in young
children, which are important for physicians, especially pediatricians, and the study of this problem
remains an open question.
Keywords:
child, process, early age, nutrition.
In recent years, there has been a steady increase in chronic somatic pathology in children,
among which one of the first places is occupied by diseases of the digestive system.
An unfavorable trend is associated not only with an increase in the number of gastroentero-
logical diseases, but also with rejuvenation, an earlier debut, and an aggravation of the course of
diseases in children. At the present stage, the morphogenesis and nature of the pathological process in
the gastroduodenal region in young patients is manifested by the absence of a typical clinical picture,
often the erased, low-symptomatic course of the disease, an increase in the frequency of detection of
common and pronounced morphological changes in the mucous membrane.
The nature of the pathology of the gastrointestinal tract formed at a young age largely reflects
the age-related characteristics of the digestive and immunity organs in children. Their mor-
phofunctional immaturity, the imperfection of local specific and nonspecific protection, the incomplete
development of cellular, humoral immunity and their regulatory mechanisms contribute to the entry of
foreign proteins into the div with the subsequent formation of sensitization. Discussion of the
mechanisms of the development of the pathology of the gastrointestinal tract in patients of the first
seven years of life is rare, and the functional capabilities of the immune system at the stages of its
formation are not taken into account. The presence of “critical” periods of development, when the
range of adaptive capabilities is limited, increases the div's sensitivity to exogenous influences, and
aggravates the course of gastroenterological pathology in children of the first seven years of life.
Currently, it has been proven that in children of the first seven years of life, the allergic factor
occupies the main place in the genesis of digestive diseases. In recent decades, there has been an
© Devorova MB., Shomansurova E.A.
I
Деворова М.Б.. Шомансурова Э.А., 2019
increase in the
prevalence of allergic diseases in childhood - up to 15-20 % in the world, and up to 34 % in Russia.
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The frequency of food allergies among children in the first years of life reaches 6-8 %. Today, food
allergy is considered as a multifactorial pathology, in the emergence and development of which a
number of both genetic and environmental factors play a role, which is the reason for the variety of
clinical forms of food allergy. However, in general, the immediate causes of the increasing
prevalence of food allergies are not clear enough.
Since the development of gastroenterological diseases in food allergies is due to the influence
of the immune system, it is relevant to study the relationships between immunological disorders and
the characteristics of the pathology of the gastrointestinal tract in food allergies in children, taking into
account the functional capabilities of the immunity of a growing organism, at the stages of its
formation. It is known that in the immunopathogenesis of both gastroenterological and allergic
diseases, an important role is played by cytokines involved in the initiation and regulation of
inflammatory and immune reactions. However, there are no published data on the significance of YO
and Tb2 cytokines in children at different ages with gastroenterological diseases with food allergies.
Therefore, it is relevant to study the clinical and immunological features of the pathology of the
gastrointestinal tract in food allergies in children, with the aim of developing an individual program
for the prevention and optimization of therapy in this category of patients.
Currently, it is necessary to face difficulties in the early diagnosis of diseases of the gastro-
intestinal tract in children with PA, since there are no unified methodological approaches to identify
the whole variety of mechanisms involved in the implementation of hypersensitivity reactions to food
products. The presence of multidirectional immune disorders in young children with gastroen-
terological pathology in case of food allergy causes objective difficulties not only in diagnosis, but
also in therapy, which is the reason for the constant search for drugs that have a multimodal effect.
The foregoing determined the purpose of this study: Improving the diagnosis and treatment of
pathology of the gastrointestinal tract in food allergies in children based on the identified age- related
clinical and immunological features.
Throughout the existence of mankind, the process of breastfeeding of newborns is common to
all peoples and cultures and is the "gold standard" for the ideal nutrition of young children, necessary
for normal growth and development. Female milk, along with its nutritional value, contains antibodies
that contribute to the formation of the protective forces of the baby's div, increasing its resistance to
pathogenic bacteria and viruses. It is known that children breast-fed with milk are much less likely to
suffer from diseases of the gastrointestinal tract, musculoskeletal system, various allergies, and viral
and bacterial infections. Children who were breastfed for up to a year have a higher intellectual
development compared to children in whom breast milk was stopped before 2 months.
The development of the doctrine of natural feeding in pediatrics proceeded in parallel with an
intensive search for ways to abandon it. According to Lee Forrest Hill (1968), breastfeeding became
so simple, safe, and uniquely successful that the j problem of breastfeeding ceased to exist, and this
was one of the reasons for the catastrophic decrease in the duration and prevalence of breastfeeding in
most developed countries and in Of Russia.
So, for example, in the USA, 24.7 % of children are breast-fed for up to 3 months, in Russia -
31 %.
The works of a number of authors are devoted to the study of the reasons for the early transfer
of children to artificial feeding, which include: separate maintenance of the mother and the child, later
breastfeeding, feeding the children by the hour, night breaks in feeding, feeding from the bottle.
However, these works reflect individual causes of early refusal of breastfeeding, while the significance
of risk factors, such as: social (socio-hygienic, medico-demographic, socio- psychological, medico-
organizational), behavioral (smoking, poor nutrition, excessive alcohol consumption, low physical
activity), biological (genetic, the presence of chronic somatic and gynecological diseases in the mother,
the unfavorable course of pregnancy and childbirth), contributing to reduced th breastfeeding, little
studied.
The aim of the study was to determine the characteristics of the clinical course, etiology of
food allergies in young children, depending on the type of feeding.
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We observed 118 children (53 boys; 65 girls) of young age, of which 29 (23.7 %) under 1 year
old; 50 (in 42.8 %) from 1 year to 2 years; 39 (33.5 %) - from 2 to 3 years. As an analysis of the
manifestations of the clinical symptoms of food allergy shows, in young children it depends on the
type of feeding. The following clinical forms of food allergy were established: gastrointestinal allergy
- in 58 (49.7 %) children; atopic dermatitis - in 25 (22.3 %); respiratory allergoses - in 18 (14.8 %);
acute urticaria and Quincke's edema - in 17 (13.2 %). The duration of the disease is from several
months to 3 years. Early symptoms of gastrointestinal damage were observed within 1 year of life in
80 (89.7 %) sick children. Gastrointestinal allergy was manifested by abdominal pain (pain) in 66 (75
%); intestinal dysfunction in 62 (70.4 %); violation of the stool in 44 (50 %); flatulence - in 26 (29.5
%); spitting up and vomiting in 52 (59 %). Abdominal pain was often persistent, but was also episodic
up to 3-4 times a week. Respiratory allergies (allergic rhinitis, sinusitis, bronchitis, bronchial asthma)
often manifested in children aged 2-3 years. Often, a combination of symptoms of gastrointestinal
allergy, allergic dermatitis, and respiratory allergy was noted.
According to our data, the age at which the first symptoms of the disease began to appear
depends on the form of food allergy. So, in 68.7 % of cases of manifestation of gastrointestinal allergy
they debuted within 3 months of life, in 3.3 % by the end of the first year of life (P <0.05). The
manifestation of allergic dermatitis in 80.2 % of patients occurred within 6 months after birth, in 6.5
% - by the end of the first year of life (P <0.05). The first symptoms of respiratory allergies in 47 % of
children appeared at the end of the year of life. Among exogenous allergens, the first place was
occupied by the protein of cow's milk (70.6 % of cases), chicken eggs (58.1 %) and fish (52 %), the
second - cereals (wheat, corn, rice). In children of 3 years of age, in addition to food allergens,
inhalation allergens (pollen, dust, epidermal) were also important in the etiology of concomitant
allergy, and for allergic dermatoses, infectious (some viruses, fungi). In the development and formation
of food allergies, besides the cause, risk factors are of great importance. Among them, hereditary
burden prevail (70 %), and on the maternal side it occurs 2 times more often than on the paternal side,
allergic diathesis (33.7 %), focal infections (32.3 %), pregnancy toxicosis in mothers of sick children
(34, 2 %).
Conclusion: Therefore, in pediatrics, the search for the most sparing and informative screening
methods of research is relevant, especially in children of the first years of life.
In the etiology of food allergy, food allergens are essential, and in the etiology of concomitant
allergy, pollen, dust and epidermal. In the development of the disease, the absence of natural (breast)
feeding and early mixed or artificial feeding, as well as risk factors: hereditary burden, allergic
diathesis, focal are of great importance. In this regard, the scientific substantiation of new approaches
to supporting breastfeeding is of particular importance, an important place among which is occupied
by programs aimed at eliminating the risk factors for early transfer of children to artificial feeding.
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REFERENCES
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Akdis, C. Diagnosis and treatment of atopic dennatitis in children and adults: European Academy of
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REFERENCES
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Akdis C., Akdis M., Bieber T., et al. Diagnosis and treatment of atopic dermatitis in children and
adults: European Academy of Allergology and Clinical Immunology. American Academy of Allergy, Asthma
and Immunology. PRACTALL Consensus Report.
J Allergy Clin Immunol,
2006, no. 118, pp. 152-169. (In
English).
2.
Alexandrova H.H., Pirogova Z.I., Egorova J.A. Features of the manifestations of diseases of the
gastrointestinal tract in children of early and preschool age.
Russian Medical Journal. Pediatric
gastroenterology! and nutrition,
2003, vol. 11, no. 3, pp. 24-25. (In English).
3.
Aluvihare V., Kallikourdis M., Betz Regulatory A. T-cells mediate maternal tolerance to the fetus.
Nat. Immunol,
2004, vol. 5, pp. 266-271. (hi English).
4.
Balabolkin LI. Age features of allergic pathology in children.
Allergology! and Immunology! in
Pediatrics,
2012, no. 2, pp. 8-16. (In English).
5.
Bener A., Ehlayel M.S., Alsowaidi S., et al. Role of breast feeding in primary prevention of asthma
and allergic diseases in a traditional society.
Eur. Ann. Allergy! Clin Immunol.,
2007, vol. 39 (10), pp. 337-343.
(In English).
6.
Bock S.A., Munoz-Furlong A., Sampson H.A. Further fatalities caused by anaphylactic reactions to
food, 2001-2006.
J Allergy Clin Immunol.,
2007, vol. 119 (4), pp. 1016-1018. (In English).
7.
Kon I.Ya., Fateeva E.M., Sorvacheva T.N. To the discussion on the problems of feeding children in
their first year of life.
Pediatrics,
2003, pp. 69-74. (In English).
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Kondratyev E.I. Natural feeding of children of the first year of life.
Bulletin of Siberian medicine,
2005, Appendix 2, pp. 42-50. (hi English).
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Kryavtsev V.T. Research on child development at the turn of the century.
Questions of psychology),
2001, no. 2, pp. 5-21. (In English).
Материал поступил в редакцию 01.09.19
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АСПЕКТЫ ПИЩЕВОЙ АЛЛЕРГИИ У ДЕТЕЙ РАННЕГО
ВОЗРАСТА В ЗАВИСИМОСТИ ОТ ТИПА ЛЕЧЕНИЯ
М.Б. Деворова,
кандидат медицинских наук, доцент,
Кафедра амбулаторной медицины и физического воспитания
Ташкентский медицинский педиатрический институт
(100140, Узбекистан, г. Ташкент, Юнусабадский район, ул. Богишамол, д. 223)
E-mail: cool.lolo@mail.ru
Э.А. Шомансурова,
доктор медицинских наук, профессор
Кафедра амбулаторной медицины и физического воспитания
Ташкентский медицинский педиатрический институт
(100140, Узбекистан, г. Ташкент, Юнусабадский район, ул. Богишамол, д. 223)
E-mail: cool.lolo@mail.ru
Аннотация.
В статье приводятся данные анализа литературы по аспектам пищевой
аллергии у детей раннего возраста, которые важны для врачей, особенно педиатров, и
изучение этой проблемы остаётся открытым вопросом.
Ключевые слова:
ребенок, процесс, ранний возраст, питание.
