Ivanova L. Genotypic-clinical prediction of asthmatic phenotypes in children

The paper discusses the development of the essential medical and social problem - increase of effectiveness in treatment of bronchial asthma in children through the determination of the peculiarities of prominent phenotypes of the disease, formulation of their diagnostic and prognostic criteria, specifying and evaluation of the efficiency of the individualized treatment. The complex examination of 420 school-age children suffering bronchial asthma was held, the defining characteristics of the five phenotypes of the disease, singled out according to the cluster analysis were studied. The diagnostic value and risk indices of those examinations were defined to verify the singled out phenotypes of bronchial asthma. By reference to the results of multifactor correlation analysis the mathematical representation and constellational diagnostic tables were set up to verify the above mentioned phenotypes of the disease. The efficiency of the scheduled facilitary and controlling treatment of bronchial asthma in case of the basic phenotypes of the disease was defined. It was showed that in order to build up the individualized treatment it was reasonable to use the indices of bronchial inflammation activity and phenotypic and genotypic (deletions in genes of glutathione-S-transferase T1 and M1) peculiarities of the patient. The scheme of initial facilitary and controlling treatment of the patients with different phenotypes of bronchial asthma was suggested, step-wise solution of which could provide its optimization.