Morozova A. The explanation of the use of membrane-stabilizing medications and alpha-adrenoblockers in treatment of children with atopic bronchial asthma.

Object of the study: ABA (atopic bronchial asthma) in children aged 6-13. Purpose of the study: To improve the efficacy of pathogenetic therapy in children with BA during exacerbations based on the data of complex study of the state of oxidant, adrenoreactive systems and glucocorticoid adrenal function. Methods of the study: Analysis of clinical, laboratory, in-strumental investigations, clinical observation of the children, general clinical laboratory and instrumental studies, allergologic tests/ determining alpha-adrenergic reactivity of the bronchi, biochemical, biophysical, radioimmune methods, statistical analysis. Practical significance: Differential indications for administration of antioxidants, antioxidants and alpha-adrenoblockers, antioxidants and stimulators of steroidogenesis stimulators in children with ABA were worked out. The above therapeutic complexes were tested in the clinical setting; their high efficacy was established. The algorithm of differentiated administration of the above complexes in ABA treatment will allow to accelerate the process of choice of therapeutic complexes and to optimize the treatment. Complex study of free-radical lipid oxidation changes, the state of beta-two-, alpha-AR and cortisol level in children with ABA allows to expand the capabilities of the objective study of the severity and prognosis of the disease. The use of hydrogen peroxide induced BCL of the urine allows timely administration of the differentiated therapy based on the period of the disease. Novelty of the obtained results: It was established that pathologic activation of FRLO plays the main role in the impairment of adrenoreceptor function in children with ABA. Based on the investigation of the state of cellular and neurohumoral links of bronchial tone regulation three stages of ABA were distinguished: a) stage of stable compensation characterized by active neuroendocrine and adrenoreactive systems of stressor type, b) stage of unstable compensation suggesting increased strain of beta-two-adrenoreactive system activity and glucocorticoid function of the adrenal cortex, c) decompensation stage manifesting by adrenergic dysbalance and reduction in glucocorticoid function of the adrenal glands. It was proven that cAMP metabolism is attrib-uted to quick and cGMP - to slow reaction which perform com-pensation function: cAMP - in acute and cGMP in chronic hy-poxia. It was determined that in the phase of disease exacerbation with severity increase, main role in CN dysbalance is played by disturbances in cAMP concentration when compared with cGMP. In ABA with severe and moderate course, CN dysbalance was re-vealed which is associated with increased alpha- and decreased beta-two-AR activity in the bronchi. Correlation homeostatic pat-terns of various types of asthma pathogenesis were distinguished for the first time, which allowed to validate the differentiated pathogenetic therapy. High efficacy of administration of antioxi-dants and alpha-adrenoblockers for correction of adrenergic dys-balance in ABA was proved. Antioxidant activity of etimisole and its normalizing influence on cellular adrenoreactively was estab-lished. Clinical features of ABA in children with adrenergic dys-balance, glucocorticoid insufficiency as well as risk factors of their formation were determined. The necessity to use BCL of the cir-cadian urine induced with hydrogen peroxide for prognosis of ABA exacerbation was proved. Introduction: The findings of the research were introduced into the work of joint Pediatric Railroad Clinical Hospital of Kharkiv, Pediatric Department of general clinical hospital