Umanets T. Phenotypes of the course of bronchial asthma in children : pathogenetic mechanisms of development, diagnostics, treatment and secondary preventive methods.

The Dissertation focuses on improving diagnostics as well as effectiveness of treatment and prevention of the desease in children with bronchial asthma based on better understanding of the specifics of formation and progression of different phenotypes of the desease, patogenetic mechanisms of their development, treatment and secondary prevention. Based on the results of clinical studies and collected anamnestic, spyrometrical, cytological, immunocytochemical, immunological data, the specifics of different phenotypes of bronchial asthma in children were studied using separate criteria and complex characteristics determining different asthma phenotypes according to onset of desease. The risk factors of developing and persisting of the bronchial asthma based on clinical phenotypes were determined. The algorithm for diagnostics of clinical phenotypes determining the optimal drug regimens and immunotherapy (allergen-specific and non-specific) was proposed. The equivalence of clinical effectiveness of initial and subsequent courses of parenteral and oral allergen-specific immunоtherapy was proven. With the objective of non-specific immunotherapy in children with bronchial asthma the effectiveness of use of transfer factor was studied and validated. With consideration of phenotype specifics of bronchial asthma course in children, algorithms of the effectiveness of differential schemes of treatment and secondary prevention was developed for this category of sufferers.