Sharikadze O. Allergic asthma and comorbid conditions in children: diagnosis, treatment and prevention

The dissertation is devoted to improving the efficacy of medical care for children of early and preschool age with bronchial asthma in combination with comorbid conditions, based on identifying risk factors for disease, scientific justification of new approaches to treatment and prevention of asthma progression, development of algorithms for early diagnosis and treatment and adaptation of existing methods in 1575 children. Established the development of asthma was observed in 40.8% of patients diagnosed with recurrent Broncho obstruction syndrome in the first year of life, and the critical period in the formation of asthma was age - 3-5 years. Based on the results of the research, a model of asthma formation in children of early and preschool age depending on the allergic pathology diagnosed in the first year of life is proposed. - Based on logistic regression analysis using the method of multicomponent diagnostics in children of early and preschool age, changes in the sensitization profile during the first six years were revealed - a significant decrease in sensitization to food allergens (χ2 = 11.6) at the same time with a significant increase in respiratory allergens. χ2 = 4.6) and the formation of tolerance to pet allergens (χ2 = 0.48). The method of conducting skin prick test in children, starting from 6 months as a highly sensitive, safe and economical way to determine sensitization, has been improved and adapted to practice in Ukraine. It has been proven that the determination of major components of inhaled allergens of different groups is a reliable laboratory marker sublingual allergen-specific immunotherapy’s efficacy in preschool children. It has been proven that sublingual immunotherapy (SLIT) performed for 3 years in children with comorbid allergic diseases (allergic rhinitis and / or asthma) had a high therapeutic effect, "good" and "very good" assessment of tolerability and safety, as well as preventive effect regarding acute respiratory viral infections. It was determined that the dynamics of levels of major components of pollen allergens of different groups correlated with the data of a positive assessment of clinical symptoms on a visual analog scale (VAS) and may be an additional marker of the effectiveness of SLIT in preschool children. The clinical and prophylactic efficacy of Lactobacillus rhamnosus GG (LGG) in combination with fructooligosaccharides in 78 children aged 1 to 4 months, born between 28 and 37 weeks of gestation from healthy mothers and from women with allergic pathology, the appointment of which affected significant positive dynamics of general clinical symptoms and specific immunological parameters (r = 0.797- TNF-a; r = 0.39– IL-5; r = 0.478- IL-13; r = -0.218- IL-10) The algorithm of medical and diagnostic measures among preschool children with asthma in combination with allergic comorbid conditions (AR and BP) has been improved to ensure control over the course of the disease.