Allergy

Topicality and demand of the subject of dissertation Topicality and demand of the subject of dissertation. According to the world statistics data each year there is an increase the rates among of the blood diseases exactly of allergic vasculitis. According to data of many authors the incidence of allergic vasculitis per 100,000 capita is 13-20 people suffer more children between 4 to 7 years, the ratio of the disease among men and women equal to 2:1.
In the Republic of Uzbekistan the incidence rate of allergic vasculitis has increased. According to the data of National Scientific and Practical Center of Dermatology and Venereology in the past 10 years the incidence of disease per 100 000 population representing 18.3%. Increasing the number of of disease is due to climate change, ecological degradation and higher insolation.
Today, diagnostics based on the pathogenetic mechanisms the development of allergic vasculitis, improvement of existing treatment approaches as well as the elaboration of effective methods is an actual scientific problem.
It is therefore necessary to develop proposals based on scientific investigation the status of hemostasis according to the type and severity of the of allergic vasculitis, depending on the type as well as the characteristics of the clinical manifestations of the disease.
It should be noted that the diagnosis of these diseases and the development of effective treatments severity of the condition in patients with allergic vasculitis and accordingly the form composition of peripheral blood, hemostasis, changes in vascular endothelium, NO-system and assessment of endogenous intoxication, as well as the identification in patients with allergic vasculitis degree of violation of the immune system, the role of immunoglobulins in violation of microcirculation, the role of cytokines in the pathogenesis of inflammatory vasculitis is one of the important tasks.
In the complex treatment of allergic vasculitis of skin scientific developed proposals based on the degree of violation of of the immune system as well as the evaluation of the effectiveness of complex treatment of superficial and deep forms and development of conclusions based on morphological changes in the forms of erythrocytes in the peripheral blood of patients with vasculitis is of particular importance.
According to OP №1652 of President of the Republic of Uzbekistan for November 28, 2011 "Measures to deepening the reform of the health system" provide the same goals. This research work, allowing to identify patients with allergic vasculitis in the early stages, treat and conduct prevention and as a result, reduce the mortality rate, disability, as well as improve the quality of life and the prognosis and all this ultimately determines the significance and necessity of the thesis.
Purpose of research: study of pathogenic mechanisms of allergic vasculitis and development of the modem approach to their diagnosis and treatment based on immunological, biochemical and morphological studies of the results.
Scientific novelty of dissertational research. For the first time found an association degrees of severity of allergic vasculitis with changes of the hemostatic system, the state of lipid peroxidation - antioxidant protection, lipid peroxidation and antioxidant protection, endogenous intoxication based on a comprehensive study of its pathogenesis;
revealed violations of the balance of T-hclpcr and T-supprcssor, which was accompanied by a sharp stimulation of helper subpopulations in both forms of dermatosis and against this background there was a significant increase in T-suppressor for superficial vasculitis and decrease for deep vasculitis;
in patients with superficial form of allergic vasculitis was defined formula disorders of the immune system which allows to identify key indicators of hypoand hyperfunction of the immune system components of immunity: CD43 +, CD33 +, IgA3 + V13 +, CD83 +, Limf3 +, IgM 1 +, IgG 1 +;
formula disorders of the immune system in patients with profound form of allergic vasculitis has the form: CD43 +, B-lim.3 +, IgA3 +, IgM3 +, CD83 +, CD33 +, Limf.3 +, IgGl +;
for the first time revealed that violations of structural and metabolic status of peripheral blood erythrocytes in the acute phase of allergic vasculitis caused by intensification of lipid peroxidation, antioxidant defense systems failure of red blood cells and arc characterized by a modification of the lipid bi layer of erythrocyte membranes with changes in their surface architectonics and rheological characteristics. In turn, the destructive-modified red blood cells circulating in the blood stream in large amounts, increase the degree of thrombophilia and exacerbate the severity of intravascular microcirculatory disorders in allergic vasculitis;
Have been developed algorithms of an estimation the general condition and the extent of disease activity and complex treatment of patients with allergic vasculitis.
Conclusion
1. Injury of the capillaries arc noted at allergic vasculitis of surface skin, arterioles and venules of the skin, while deep skin allergic vasculitis affects medium and large caliber vessels, located on the border of the dermis and hypodermis, and in hypodermis only. Local skin manifestations arc primarily arising from common vascular disorders.
2. Activation of vascular-platelet hemostasis is expressed in allergic vasculitis, which is manifested in the increase of spontaneous and induced platelet aggregation and enhanced activity of von Willebrand factor by 2.5 times compared to the control. This testifies on connection of endothelial dysfunction and disorders of hemostasis (strong correlation r = -0,73), and is one of the major factors of occurrence and pathogenesis of allergic vasculitis.
3. Increased MDA and decreased SOD activity in the scrum of patients with deep skin vasculitis, was in direct proportion of the allergic vasculitis lesion depth. The level of NO in the scrum of patients with superficial form of allergic vasculitis, increased by 43.2% and in patients with deep form - by 50.4% relative to the control group data.
4. In patients with superficial and deep skin vasculitis arc formed the same type of immune responses in the form of activation of cellular and humoral units of immunity under leukopenia and lymphocytosis and was revealed impaired balance of T-helper and T-suppressor accompanied by sharp stimulation of helper subpopulations in both forms of dermatosis and in this background there was a significant increase in T-suppressor for superficial vasculitis and decrease at deep forms of vasculitis.
5. In patients with superficial form of allergic vasculitis defined formula of disorders of the immune system allows to identify key indicators of hypo- and hyperfunction of the immune system along the links Immunities: CD43 + CD33 + IgA3 + V13 + CD83 + Limf3 + IgMl + IgGl +, and in patients with profound form of allergic vasculitis has the form: CD43 + В -lim.3 + IgA3 + IgM3 + CD83 + CD33 + Limf.3 + IgGl+.
6. The destructive-modified erythrocytes before treatment, circulating in the blood flow in large amounts, increase the degree of thrombophilia and exacerbate the severity of intravascular microcirculatory disorders in allergic vasculitis. Under the action the complex treatment in preclinical was observed increasing share of discocytes in the affected area by 50.9%, and the finger - by 23.7%, which leads to normalization of the microvasculaturc, which in turn provides a more pronounced recovery and physiological parameters of blood .
7. Combined therapy has a positive effect on the immune reactivity of patients with allergic vasculitis, improvement of peripheral blood indexes, normalize hemostasis, POL-AOP, adequate nitric oxide (NO) production with vascular endothelium, thereby increasing of therapeutic effect.
8. In 92,2% of patients with superficial and deep vasculitis treated with combined therapy, was received a positive therapeutic effect, allowing for 3-4 days to reduce the length of stay in a hospital bed. The monitoring of patients for three years showed that the method of treatment would prevent relapses of the disease and lengthen the remission.

Applying antihistamine in complex therapy exudative otitis media with an allergic rhinitis antilecotreins and topic intranasalglucocorticosteroids has show them to b reliable clinic effect which degenerated in the de-velopment of hearing decreasing symptoms and improving life style. Under our supervision there were 67 chil-dren with exudative otitis media by age from 3 to 18 year , 39 from them wereboys, and 28 were girl. Using in complex therapy with exudative otitis media with an allergic rhinitis intranasal glucocorticosteroid showing highly clinic effect, which shows reliable mucociliar transport function mucous membrane

The health of the child population depends on physical development and is one of the main indices. It may be taken the objective and reliable information about the health of children by the results of researches and growth indices.

Annotation. Despite the fact that bronchial asthma has been studied, there is currently a trend towards an increase in the incidence in the children's population, therefore, in our work, aspects of this pathology are reflected on the basis of the literary analysis.

Childhood pathology always remains an urgent problem in medicine, and therefore, our work reflects aspects of allergy in children with aggravated heredity, based on literature data.

The article notes the problem of food allergy, which always remains an urgent problem in medicine, especially when it comes to children.

 

20 patients a ged 15-50 years with allergic rhinitis have been studied. A complex study included collektion of
allergological anamnesis, objective data, endoscopik examination of the nasal cavity, cytological examination of
smears-imprints from its surface and nasopharynx. A complex treatment of allergik rhinitis wiith employment of
eliminative, hyposensibilizing, immune, antimycotic, local therapy and performing operation for submucous
resection of nasal septum with incision of vessels of inferior nasal conchae has been carried out. Marked
favourable effect has been received in 72,6 %, insignificant effect in 23,7 % and 3,7 % of patients have not received any effect from treatment.

Exogenous alveolitis (EA) refers to interstitial lung disease (ILD) with the development of widespread interstitial and granulomatous changes in the respiratory system, ultimately leading to diffuse pneumosclerosis, development of cor pulmonale, pulmonary heart failure [11]. One of the first to describe the unusual symptomatology of a pulmonary disease in a farmer working with moldy hay was J.M. Cambell in 1932. Active study of this pathology began in the 60s of the 20th century. As a result of microbiological and immunological studies of moldy hay extracts, it was found that the disease "farmer's lung" is caused by thermophilic actinomycetes [17, 19]. Later a similar clinic of pulmonary disease was observed in individuals who constantly work with poultry [17, 19, 22]. The term "exogenous allergic alveolitis" was first used by physician J. Pepis (1969) and became widespread in Europe [1, 9].

One of the many problems of modern allergology, pulmonology and occupational pathology is alveolitis of various origins, often leading to diagnostic errors (they are mistaken for asthma or COPD) and, as a result, to incorrect treatment [2, 8,14,18,20]. To date, the number of patients with exogenous allergic alveolitis (EAA) is increasing significantly and is about 3% of all pulmonological patients, which requires a special study and selection of the most informative methods for verifying various variants of this disease [1, 3,5,6,24]. Allergic pneumopathies under the general name - EAA arise as a result of an allergic reaction of the lung tissue to intense and prolonged inhalations of a certain kind of antigens (AH) [2,4,6,9,11]. EAA is a diffuse granulomatous inflammatory process of the alveoli and interstitial tissue of the lungs, developing under the influence of intense and prolonged inhalation of predominantly organic water-insoluble antigens.

The condition of endogen intoxication during the treatment with topical steroids for allergic rhinitis has been studied insufficiently. Nasonex (mometasone furoate) was used during the study which is able to inhibit release of mediators of allergic reactions. Under the influence of Nasonex content of MDA decreased to 42.6%, the activity of catalyses plasma increased to 60.0%, a decline of ratio MDA/CА 80.4%, decreased concentration MSM254 and MSM280 45, 0 and 35.5%, respectively, significantly moved them closer to the healthy group

This article presents materials about the preparation of allergens from local strains for allergic diagnosis, as well as the serological methods used in the diagnosis of brucellosis, which is extremely dangerous for humans and animals, among animals in Uzbekistan.

Relevance and necessity of the subject of the dissertation. Today parenteral viral hepatitis is steel one of biggest problems because of its abundance among population, high risk of liver cirrhosis and hepatocellular carcinoma. As well as development of extrahepatic manifestations, which is causing diagnostic and treatment problems in patients with chronicle viral hepatitis (CVH). According WHO approximately 1/3 of worldwide population is infected by hepatitis В virus (HBV). Annually about 2 mln. people dies from HBV complications 700 000 from liver cirrhosis and 300 000 from hepatocellular carcinoma. In addition, more than 500 mln. people are infected by hepatitis C virus (HCV) infection and in fact there is pandemia which is 5 times more than AIDS. 60% of HCV infected patients after acuity developing chronicle disease. Near 20% of HCV infected patients develop progressing fibrosis and cirrhosis. Approximately 20-90% of these patients (with cirrhosis) pass away (dying) from hepatocellular carcinoma in 5 years. WHO is prognosis further grows of global HBV and HCV infection incidence1.
The existence of a broad spectrum of antibodies against the hosts body's own tissues for various non-infective and infective diseases have already installed a number of studies. The cause of autoantibodies is considered to be the loss of the body tolerance to "their" own antigens, and the presence of these autoantibodies can largely determine the outcome of the pathological process. It is known that different antibodies against its own tissues in low titers present in 10% of the normal human population and are transient, as markers of tissue damage resulting from the most varied effects. As trigger autoimmune disorders can act genetic, viral, drug and hormonal factors, acting both alone and in combination with each other. After termination of such exposure and removal from the body of destroyed tissue formation of autoantibodies may stop, but can be saved by specifying an adverse outcome of the pathological process.
Thus, the high incidence of CVH in the country, the systemic nature of lesions, late diagnostics of autoimmune disorders in such cases, resulting in a reduction of quality of life of patients with CVH, an increase in direct costs of treatment, determine a serious economic and social importance of the problem for the health of each state that substantiates the relevance of studying the theoretical and practical issues of CVH, in general, and autoimmune disorders in them, in particular.
The aim of the research: is to study of immunopathogenic mechanisms of formation and development of autoimmune disorders through complex study of factors of the virus and the host, various links of immunity, interferon and cytokine status in patients with chronic viral hepatitis В and C
The scientific novelty of the dissertational research:
For the first time conducted a screening study of patients with chronic viral hepatitis В and C in order to identify systemic and tissue autoantibodies;
First defined the characteristics of particular factors of the virus and the body at chronicle hepatitis В and C, with and without systemic and tissue autoantibodies, their influence on the development of autoimmune disorders;
Identified pathogenetic significance of the relationship processes between autoimmunity and phenotypic features of immune cells in the course of a comprehensive study of the immune system with the analysis of humoral, cellular and non-specific immunity in patients with chronic viral hepatitis based on clinical and laboratory, virological and biochemical parameters;
Revealed a correlation with a number of key cytokines of clinical and laboratory syndrome and immune system performance, depending on the detection system and tissue autoantibodies;
First presented a comprehensive assessment of the cytokine and interferon profile of blood serum in HVG with and without systemic and tissue autoantibodies set features production of pro- and anti-inflammatory cytokines, interferons and their pathogenetic role in chronic viral hepatitis with autoimmune disorders;
The informative and diagnostic significance of clinical, laboratory and immunological parameters and their integral characteristics at CVH different etiology;
Algorithm of immunoassay for the detection of patients with chronic viral hepatitis autoimmune disorders and systemic nature of the tissue and identified additional immunological criteria for diagnosis and prognosis of the disease course in the development of autoimmune disorders.
CONCLUSION
1. Conduct a screening study in patients with chronic viral hepatitis В and C, identified system (organonespetsificheskie) autoantibodies in 43.8% and 30.2%, respectively, and tissue (organ-specific) autoantibodies in 61.4% and 73.5% of cases respectively.
2. It is established that the HBV more frequently than in HCV detected narrow (single) range of SAT (in 87.2% and 62.3%, respectively) And a (complex) spectrum CAT 3 times more often detected by HCV than with HBV (in 3737% and 12.8%, respectively). In the presence of TAT, high levels of autoantibodies against endocrine organs identified and HBV and HCV. Higher rates of TAT to the liver, kidney, small intestine and skin marked with the HBV and to the synovium of joints in the HCV.
3. The relationships detect SAT and TAT on the factors of the virus: the HCV non-replicative form (identification CAT 2 times more often) with genotype 2 HCV-infection (CAT 1.4 times TAT 2.4 times more likely) and mutant (HBeAg-negative) strains of HBV-infection (CAT 2.4 times, 1.6 times TAT often) and at high rates of viral load detection SAT and TAT significantly higher.
4. Determine the relationship identifying SAT and TAT on the factors of the body when HBV Mostly young age 18-35 years (72.5% of all cases with the SAT, 70% of all cases with TAT), female sex (62.5% vs. 44, 4% in the group without SAT, 53.3% versus 26.3% in the group without TAT), low to moderate biochemical activity often accompany the SAT detection by biochemical indicators are prevalence of cytolytic syndrome with symptoms of fibrosis.
5. Determine the relationship identifying SAT and TAT on the factors in the organism HCV: predominant age of 36-50 years (46.3% of all cases with TAT), the normal biochemical parameters revealed in the group with SAT 1.64 times times more likely (27 3%) than in the group without SAT, biochemical indicators are prevalence of mesenchymal-inflammatory and cholestatic syndromes with symptoms of fibrosis.
6. Established that the HBV pathogenetic basis of autoimmune disorders systemic nature is to stimulate the production of antibodies by B-lymphocytes, and decreased elimination of the pathogen, with mild antiviral response. When HCV autoimmune disorders systemic nature developed on the background of profound T-cell immunodeficiency and pronounced anti-viral response with sufficient elimination of the pathogen.
7. It is shown that the immune status of patients with chronic hepatitis C is characterized by a decrease in the absolute number of basic lymphocyte subpopulations (especially constant and deep - CD8 + - and CD 16 + -cells). The observed lymphocytosis (relative) was due to the high content of CD20 + -lymphocytes. The contents of all studied cell immunoreactivity and IgA, IgG, IgM, CEC, with reduced - leukocytes, CD3 + CD4 + CD8 + -, CD 16 + - cells, CIC, raised - Lymphocytes (%) IgM, IgG; other indicators vary in different directions. These changes characterize the adaptive orientation of structural and functional disorders and, in this case reflect the predominance of Th2 response of Thl.
8. The changes at the level of intermolecular regulation of HVG with an autoimmune component characterized by severe symptoms doimmunnogo inflammation due to lower activity of regulatory T cells, which correlate with the degree of activity and clinical manifestations of chronic viral hepatitis and indicate possible pathogenetic and clinical role of autoimmune disorders systemic nature of viral diseases liver.
9. Develop integrated indicators counting severity of autoimmunity to every single organ or tissue, as well as to the general tissue autoimmune status.
10. An increase the number of links between the various indicators while reducing their total information content, the weak integration of many individual immunological parameters among themselves and with other system parameters, indicating discoordination immunoregulatory mechanisms in chronic hepatitis, more pronounced in the presence of autoimmune disorders.

Currently, the structure of morbidity in children is characterized by the predominance of chronic non-epidemic diseases, among which one of the first places is occupied by chronic diseases of the gastrointestinal tract. Gastrointestinal niche allergy is an important medical and social problem. According to scientific sources, the prevalence of this pathology is very contradictory. Thus, according to a number of researchers, at least 20-30% of the population are convinced that they have certain manifestations of food allergies.

Purpose of the study. To study the features of the physical development of preschoolers with allergic respiratory diseases

Physical development is one of the main indicators of the health of the child population. Based on the results of studies of indicators of physical development, it is possible to obtain objective and reliable information about the state of health of children. If these studies are carried out in dynamics, then it is possible to make a scientifically grounded forecast regarding the state of health of children in the future.This information is of great scientific and practical importance for theoretical and practical medicine. The scientific significance of research devoted to the problem of physical development has especially increased in recent years. The fact is that the acceleration process, according to the literature of recent years, has significantly slowed down or even stopped. In this regard, it is necessary in new studies to clarify other aspects of this problem: Comprehensive study of the epidemiology of allergy in children. Clarification of the degree of influence of environmental factors on thephysical development and health of children.Social and hygienic living conditions have a significant impact on the indicators of physical development and health status of children.Determination of the relationship between the interdependence of physical development and functional reserves of the body. Elucidation of the nature of the influence of various diseases on the physical development and health of children.

The frequency of treatment of acute allergic conditions in an ambulance, children living in an ecological-
ly unfavorable region of the city of Bukhara during the periods of 2001-2005, had a tendency to increase by 1.2
times (2.9-3.4%), and boys with the indicated states suffered almost 1.3 times more often than girls. Acute al-
lergic conditions clinically manifested in the form of severe and moderate severity of the course of food allergy
- 39.3%, allergic dermatitis - 18.1%, drug allergy - 12.5%, bronchial asthma - 10.2%, pollen and dust allergy -
10.1% and insect allergy - 9.8%. In the formation and development of acute allergic conditions, in addition to
causative factors, such risk factors as hereditary burden - 70.3%, allergic diathesis - 60.5%, artificial feeding -
55.3% were of significant importance.

Were studied the state of the initial autonomic tone in children perennial allergic rhinitis. Among 42 patients (68,9 per cent) were persistent, and 19 (31,1 per cent) – intermittent form CT. According to the analysis of clinical signs IWT in 28 (54.9 per cent) of children identified CT status, the prevalence of parasympathicotonia (vagotonia), 28(54,9per cent) - eatonii (balanced state of the ANS alone) – 9 (17,6%) of sympathicotonia. In General, CT is not dependent on clinical course, characterized by increased tension of the parasympathetic mechanisms of the ANS. the results indicate about the relationship between IWT and clinical course CT. You can assume the existence of a similar connection with the treatment CT

Important candidate for the major gene predisposition to asthma is completely gene FcεRIβ. The distribution of alleles and genotypes 109T/C polymorphism in allergic asthma FcεRIβ. The results show that markers of increased risk of allergic asthma are genotype FcεRIβ-109T/T allele and FcεRIβ-109T.

To investigate predisposing factors in children with allergic rhinitis

Development of a method for local determination of an allergic reaction to the materials of future dentures in patients with bronchial asthma.

The COVID-19 pandemic, which today is of great concern to the whole world, is one of the most pressing public health problems. This article discusses the course of the disease in children and the consequences of covid 19 in children with an allergic disease.

/\ccording to WHO experts; allergic rhinitis (/\R) affects 10-20% of the population; during epidemiological surveys, his symptoms were observed: currently there is an increase in allergic diseases children; AR prevails among them. According to a number of epidemiological studies conducted in different regions of the world, the prevalence of AR in the pediatric population reaches 22%.

The urgency and relevance of the dissertation topic. In the past decades, according to WHO, the number of people with pancreatitis has doubled, and the average age of patients has decreased from 50 to 38 years. Throughout the world there has been a steady trend towards an increase in the number of diseases of the gastrointestinal tract.
The aim of the research work is to study the immunogcnctic mechanisms of the formation of various clinical forms of HP and to justify their role in optimizing early diagnosis and treatment.
Scientific novelty of the research work is as follows: for the first time, a comprehensive study of patients with CP in Uzbekistan was conducted and marked dysfunction of immunogenctic mechanisms for the formation and development of disorders leading to or contributing to the risk of the disease; correlations of key cytokines with a number of clinical laboratory syndromes and indices of the immune system in alcoholic and biliary CP; the use of cytokine profile indices for differential diagnosis of severity and clinical forms of CP has been proposed; established dysfunction of the cytokine cascade gene, which causes the expression of various key mediators of inflammation and contributes to destructive inflammatory changes in the pancreas; pathogenetically significant interrelationships of genetic variants of polymorphism with clinical laboratory indicators in CP and their role in the development of complications arc determined; the use of cytokine status indicators as a prognostication of the severe course of chronic pancreatitis and its complications is pathogenetically substantiated; a new direction in the treatment of pancreatitis has been developed - a combined approach to the complex of therapeutic measures in CP.

Treatment and prevention of pollinosis is one of the most important and complex problems. Their relevance is characterized by a high frequency of occurrence of a close dependence on natural and climatic conditions. Currently, the importance of early diagnosis and treatment of allergic diseases is emphasized to promote active and healthy aging.

Subjects of research: 40 patients with acute viral hepatitis В (AVHB) and 120 patients with chronic viral hepatitis В (CVHB)
Purpose of work: Study clinical and pathogenic significance of allergic reactions of various types in transition of VHB in lingering andchronic course
Methods of research: Clinical, laboratory, allcrgologic, immunologic, statistical. The results obtained and their novelty: Allergic hereditary family diseases. Allergy to antibiotics and insects bites occur more frequently in patients with A VHB. Unlike patients with AVHB and other forms of CVHB patients with high activity of CVHB more frequently suffer from food allergy and infectious and allergic diseases. Clinical manifestations of allergy dominated among patients with high activity of CVHB. Allergic reactions of the 1st type (anaphylactic type) developed chiefly in patients with AVHB, reactions of the Ilnd (cytotoxic reactions), Hird (Artus phenomenon) and IVth (reaction of delayed type) types were typical for patients with CVHB. Pathogenic importance of the allergic reactions of the Ilnd, Illrd and IVth types in forming of lingering course of the disease. Kctotifcn was effective in complex treatment of patients with AVHB and CVHB with high activity of pathological process in liver.
Practical value: Detection of markers of the Ilnd (index of neutrophils damage), Illrd (circulating immune complexes) and IVth (reaction of inhibition of leukocytes migration) can be considered as prognostic criterion for transition of VHB into lingering course. It is expedient to include ketotifen, preparation exerting a direct antiallergic and mediated hcpatoprotective effects, in the treatment of patients with AVHB and high activity of CVHB.
Degree of embed and economic effectivity: Obtained results were introduced in the clinic of Research Institute of epidemiology, microbiology and infectious diseases, Republican children hospital for infectious diseases of Karakalpakstan and in the course of studies of Tashkent Medical Academy and Nucus branch of Tashkent pediatric medical institute. . Methodical appliance on the thesis data "Viral hepatitis B, D, C and E" and information letter were published (Nucus, 2005) and sent to the corresponding institutions. Economical efficiency for 1 patient amounts to 5000 sum. Sphere of usage? medicine
Fied of application: Infectious hospitals, medical departments in villages, family polyclinics.