Specific diagnostics of bacterial allergies. Allergens of bacteria Infectious allergy and immunity

Viral allergy is a disease that occurs during various infectious infections. The reaction can occur in people of any age. Its manifestation depends on the type of allergen and the individual characteristics of the organism.

A viral or bacterial allergy is the body's response to the development of an incompletely cured infectious disease.

Allergy occurs when a person is infected with these microorganisms. Particles of infected cells can also cause the reaction. Most often, chronic diseases contribute to the development of infectious allergies.

People with the following diseases are at greatest risk:

• dysentery;
• syphilis and gonorrhea;
• tuberculosis;
• plague and anthrax;
• mycosis;
• brucellosis.

An infectious allergy can develop in both an adult and a child. Sometimes it appears as a result of taking samples for the presence of an infection in the body.

Symptoms in children and adults

The main signs of allergy caused by infections practically do not differ from the general symptoms of various allergic reactions:

• rash, redness and itching of the skin;
• sneezing, swelling and nasal congestion;
• cough, respiratory disorders;
• tearing, redness and swelling of the mucous membrane of the eyes;
• disruption of work digestive system, diarrhea, nausea.

Redness and tearing of the eyes - a symptom of a viral allergy

Allergy to infection in children often occurs after respiratory illness. The course of the disease is accompanied by:

• runny nose;
• high body temperature;
• difficulty breathing;
• cough;
• lack of appetite.

Pain in the arms, legs, and abdomen may also appear. Sometimes an allergic reaction during an acute respiratory viral infection leads to the development of asthma.

Sneezing, swelling and nasal congestion are common manifestations of viral allergies.

It is very important to identify allergies in time and start treatment, since an exacerbation of the disease can lead to complications. In some cases, it is possible anaphylactic shock.

The reaction that occurs when taking samples for the presence of an infection in the body can manifest itself immediately. At the injection site, itching is felt, redness and swelling of the skin are visible.

Diagnostics

In order to prescribe the correct treatment, it is necessary to establish the type of allergen that causes the reaction. Initially, a complete history is taken, according to which a possible allergen is previously determined. All transferred infectious diseases.

The identification of the exact pathogen is carried out according to the performed skin tests with possible allergen... If there is an increased sensitivity to a certain microorganism, then a characteristic redness appears at the site of its introduction.

An accurate diagnosis is made after full examination.

Treatment

An infectious allergy is dangerous disease, the development of which can lead to the death of the patient. Therefore, when the first signs appear, it is necessary to consult a doctor.

The main principle of treatment is to identify and destroy the allergen, which can be bacteria, microscopic fungi or viruses. Each type of pathogen is treated with certain drugs.

Treatment of allergy caused by viruses

If, after the diagnosis, it is confirmed that the reaction in the body is causing viral infections, then the treatment is carried out with such drugs:

• "Remantadin" is a drug with a pronounced antiviral activity;
• Zanamivir is an antiviral agent that neutralizes viruses of groups A and B.

Remantadine is a drug with a pronounced antiviral activity;

The therapy also includes drugs that include a human immune protein - interferon:

• "Grippferon";
• "Viferon".

Sometimes drugs are used that promote the production of their own interferon in the patient's body. These include:

• "Amiksin";
• "Cycloferon"
• Derinat;
• "Neovir".

To relieve the symptoms of respiratory diseases, various cough medicines, inhalers to eliminate inflammation in the throat, and nasal drops are used.

Bacterial allergy treatment

To destroy bacteria that caused allergic reaction use bactericidal antibiotics:

• "Amoxicillin";
• Ceftriaxone;
• "Aztrionam";
• "Ampicillin";
• Loracarbef;
• "Nafcillin".

To interrupt the development of bacteria and stop their reproduction, bacteriostatic antibiotics are used:

• Erythromycin;
• "Minocycline";
• "Azithromycin";
• "Tetracycline";
• Dirithromycin;
• "Doxycycline";
• Clarithromycin.

These antibacterial drugs are not used for prolonged and acute forms infections, since they can only stop the development of microorganisms. Severe bacterial allergies can only be treated with bactericidal antibiotics.

Fungal allergy treatment

If a fungus became the culprit of the disease, which in turn caused an allergic reaction, then the treatment is carried out with antifungal drugs:

• "Nystatin";
• Fluconazole;
• "Bifonazole";
• "Candicidin";
• "Hamitsin";
• Oxyconazole;
• "Rimocidin";
• Amorolfin.

Therapeutic actions should be aimed at the complete elimination of the allergen. An incompletely cured disease can lead to a second allergic reaction, which can lead to serious complications.

Elimination of symptoms caused by an allergic reaction

Allergies caused by various types of infections have similar symptoms. To eliminate the accompanying symptoms, antihistamines are used:

• Suprastin;
• Claritin;
• "Diphenhydramine";
• "Zirtek";
• Telfast.

If necessary, use anti-inflammatory, healing, antihistamine ointments and creams that relieve irritation on the skin, eliminate itching and swelling.

Zyrtec - second generation antihistamine

Prevention of viral and bacterial allergies

To prevent the occurrence of an infectious allergic reaction, you must adhere to some rules:

• in case of infection with an infectious disease, do not self-medicate;
• at the first signs of infection entering the body, consult a doctor and begin treatment;
• take preventive measures during epidemics of viral diseases;
• stick to healthy way life - goes in for sports, walks in the fresh air, eat right.

Prevention of allergies is aimed at increasing immunity and protecting the body from infection with any infections.

A viral or bacterial allergy that occurs when the body is infected with an infection of a different nature is a serious but curable disease. The main thing is to identify the problem in time and seek help from a doctor who will prescribe the correct treatment.

Sick atopic dermatitis have an increased risk of developing infectious skin complications. It has been established that various pathogens (bacteria, fungi, viruses) can act both as a cause of body sensitization and as a trigger that causes an exacerbation of already existing atopic dermatitis.

Staphylococcus aureus (S. aureus) is found in 90% of patients with atopic dermatitis, while in healthy individuals it is sown only in 5% of cases. Colonization and infection of the skin with S. aureus is one of the common causes of exacerbation of atopic dermatitis. At the same time, acute exudative skin lesions can contain more than 10 million S. aureus per sq. cm, its level is also increased in areas of normal skin in the nasal region.

aureus secretes superantigens on the skin surface - enterotoxin A and B, or toxic shock syndrome toxin. Perhaps this is due to the increased production of their adhesins and a decrease in the expression of antimicrobial peptides. Staphylococcus aureus was isolated in 64.2% of children with moderate and heavy course atopic dermatitis. The highest level of bacterial colonization was observed in the group of children with proven allergic sensitization (71% versus 49% in the group of children with non-allergic form of atopic dermatitis).

The appearance of clinical signs of atopic dermatitis after the application of staphylococcal exotoxin to the intact skin of a healthy person was confirmed. Specific IgE antibodies to staphylococcal toxins were found in the skin of 75% of patients with atopic dermatitis; also revealed a relationship between the level of IgE to superantigens and the severity of atopic dermatitis. Superantigens activate a large number of T cells and thus promote the massive secretion of cytokines, in particular IL-1, TNFa and IL-12 in epidermal macrophages or Langerhans cells. In addition, local production of these cytokines contributes to an increase in CLA expression on T cells and activation of T cell homing in inflamed skin. In other words, bacterial exotoxins (which by their nature are proteins and therefore themselves can act as allergens), in combination with common allergens, worsen the eczematous process in the skin, inducing a T-cell response, strengthening and maintaining chronic inflammation skin with atopic dermatitis.

It is also suggested that bacterial superantigens play a role in the development of resistance and impairment of the response to treatment of atopic dermatitis. Glucocorticoid resistance develops as a result of increased expression of the type b glucocorticoid receptor, which acts as a potent inhibitor of corticosteroids.

Another explanation for the ineffectiveness of even highly active topical steroids is the effect of staphylococcal antigens on skin inflammation without the participation of superantigens. So, in a recently published study, it was shown that in 30-50% of patients with atopic dermatitis, two cationic staphylococcal proteins - NP- and p70, released from peripheral mononuclear blood cells of patients, activate Th2 cells and increase the secretion of cytokines.

V Lately great attention pay to the deficiency in the skin of patients with atopic dermatitis of antimicrobial peptides - one of the components of the innate immunity that protects the skin from bacteria, viruses and fungi. In general, the mechanism of skin colonization by staphylococcus is not clear. Recently, it has been shown that staphylococci express receptors on their surface that recognize various extracellular proteins. Fibronectin and fibrinogen are considered as potential ligands that bind to these receptors, the production of which may be facilitated by IL-4. It has been shown that intradermal testing for allergens from S. aureus and Candida albicans has no prognostic value in children with atopic dermatitis under the age of 9 years.

Since S. aureus is the dominant microorganism found in atopic dermatitis, it would be logical to expect therapeutic effect from antibacterial therapy... Since some researchers find a correlation between the level of skin colonization by staphylococcus and the severity of the disease, this explains the improvement in skin manifestations in patients with poorly controlled course of atopic dermatitis after antistaphylococcal therapy.

However, the effect of antibacterial drugs in atopic dermatitis has not been proven, although a number of studies have noted a positive effect of the use of combined antistaphylococcal agents and topical corticosteroids even in patients without bacterial superinfection. Topical calcineurin inhibitors are also able to reduce the number of S. aureus on the skin of patients with atopic dermatitis.

From the standpoint evidence-based medicine combination efficiency antibacterial agents and local corticosteroids in patients with atopic dermatitis has not been proven.

There is also such a type of allergen as bacterial in nature. These are bacteria, viruses, microbes known to all of us. All our life we ​​have been fighting with them, boiling them, irradiating them, sending them eaters of microbes and all kinds of antibiotics. All is in vain: they mutate, acquire stability and continue to tyrannize us. Something, however, we have managed to achieve. We got rid of, for example, smallpox and do not die from pneumonia and tonsillitis. However, allergies to viruses and bacteria still exist.

It usually begins with a simple ARI or some other typically infectious disease. The temperature rises, bronchitis, shortness of breath, and a cough that does not go away for months appear. Then asthmatic bronchitis occurs, when wheezing, wheezing in the lungs, shortness of breath practically do not disappear. Naturally, a person begins to take medications vigorously, including antibiotics. Such treatment, instead of the expected benefits, brings colossal harm to the body: there is an increased sensitivity to the antibiotic. And when both the microbe and the antibiotic begin to act in the body at the same time, the increased sensitivity to them is formed even faster.

So what causes allergies? Maybe Staphylococcus aureus? Or pneumococcus? Or E. coli living peacefully in the intestines? Imagine yes. It is these harmless microbes, along with streptococcus, neys series, proteus, hemophilus. But of the viruses itself common reason microbial allergies are, for example, influenza and parainfluenza viruses.

What contributes to the development of diseases caused by microbes? First of all, a focus of chronic infection, for example, a purulent inflammation of the middle ear or an abscess (abscess) of a tooth. The microbes that caused this process secrete special substances to which an increased sensitivity is formed in the body. Thus, a person with an ordinary carious tooth may also develop bronchial asthma. Carious teeth, inflammation of the paranasal sinuses (for example, with sinusitis), gallbladder with cholecystitis and other foci of infection can cause bacterial allergies.
Diseases caused by microbes, fungi or viruses, in the development of which allergies play an important role, are called infectious allergic diseases. These are, for example, tuberculosis, brucellosis and others.

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The role of allergy in the pathogenesis of infectious diseases

There are four degrees of participation of allergy in the mechanisms of development of infectious diseases.

I. Allergic mechanism is the leading one in the pathogenesis of the disease. It is this group of infectious diseases that is called infectious-allergic. These include a few acute infectious diseases, which are based on hyperergic inflammation, and all hron infections: tuberculosis, brucellosis, tuberculoid leprosy, actinomycosis, coccidioidosis, hron, candidiasis, syphilis, yaws, rheumatism, etc. but also conditionally pathogenic microbes. Among them, the most common cause of sensitization are staphylococci, streptococci, neisseria, E. coli and other widespread microbes and fungi (candida). As a rule, the disease develops on the basis of sensitization by microbes in hron, inflammatory foci. The microbial etiology in these cases is confirmed not only by positive skin tests, but also by the exacerbation of the disease after setting such tests.

Some acute infectious diseases, especially whooping cough, influenza, mycoplasma pneumonia, can activate the microflora in the foci of hron, infections and cause an exacerbation or even the emergence of infectious and allergic diseases - bronchial asthma, microbial rhinitis. The same complications are sometimes observed as a result preventive vaccinations live vaccines. The mechanism of their development can be different: adjuvant activity (see Adjuvants, adjuvant disease), increasing the body's sensitivity to histamine, creating conditions for the reproduction of banal microflora.

Pathogens of infections can also cause the development of autoallergic or autoimmune diseases (see. Autoallergic diseases).

II. The allergic component is not decisive in the pathogenesis acute infectious diseases, but it is easily detected clinically using laboratory data and the results of histols, studies. This includes almost all acute infectious diseases with a few exceptions of those morfol, which are based on pronounced hyperergic inflammation (scarlet fever, erysipelas, erysipeloid, tularemia). Allergic tests with them usually become positive at a time when the diagnosis is no longer in doubt.

III. Allergy does not play a significant role in pathogenesis infectious diseases, because it does not have time to develop, for example, with botulism, cholera.

IV. Allergic reactions (drug allergy, serum sickness) are superimposed on the course of an infectious disease. These reactions are not directly related to the pathogenesis of the underlying disease, but can cause severe complications... For example, the frequency and severity of allergic reactions to antibiotics used to treat infectious diseases is increasing; application to lay down. serum is associated with the introduction of the strongest allergens (animal protein), the incidence of serum sickness in this case reaches 20-30%.

Some features are infectious allergic diseases.

Infectious and allergic diseases are characterized by a number of common features:

1. At the heart of morfol, changes is the formation of cellular infiltrates (granulomas).

2. Neither past illnesses nor prophylactic vaccination with live vaccines provide reliable lifelong immunity.

3. The causative agent has a tendency to intracellular location, which determines the development of delayed-type PS (eg, with toxoplasmosis, visceral leishmaniasis, histoplasmosis, leprosy, brucellosis, etc.). Perhaps, in this case, the formation of L-forms of bacteria (see) plays a primary role, which has already been proven in relation to brucellosis, tuberculosis.

4. Most infectious and allergic diseases have hron, course (years, decades, and sometimes for life): tuberculosis, tuberculoid leprosy, actinomycosis, syphilis, yaws, etc.

5. Chron, infectious and allergic diseases are characterized by clinical polymorphism. Often they begin with a limited focus (tuberculosis, histoplasmosis, syphilis, tularemia, etc.), and sometimes this "primary affect" is not observed, generalization (brucellosis) quickly sets in. In any case, in the future, a wide variety of lesions in terms of prevalence and localization is possible: septic and disseminated forms are possible, isolated or multiple, acute or hron, lesions of the musculoskeletal system, internal organs, nervous system.

6. The majority of diseases are characterized by alternation of periods of relative wedge, well-being and exacerbations; often undulating course, relapses after an imaginary cure.

7. The emergence of latent forms is characteristic, for example, tuberculosis, brucellosis, histoplasmosis, when the disease is absent in the presence of the pathogen in the body.

8. The state of unstable balance between the human body and the microbe leads to the fact that for hron, infections big influence have nutritional conditions, vitamin deficiencies, the effects of cooling, overheating, trauma, pregnancy, etc.

The course of infectious and allergic diseases depends on the reactivity of the organism.

The following reactivity options are possible, determined using skin tests and other research methods:

a) unresponsiveness and hyporeactivity: skin tests are negative or poorly expressed, intravenous administration the vaccine causes a mild general reaction; unresponsiveness most often occurs in the terminal stage of the disease; with hyporeactivity, the course of the disease is sluggish, without pronounced allergic lesions, but persistent, protracted, with prolonged subfebrile condition, pronounced functional changes in the nervous system;

b) "normoreactivity": skin tests are clearly expressed, in vitro tests well reveal the state of the delayed-type PC; a wedge, the course is relatively favorable with various manifestations of allergic inflammatory lesions; vaccine therapy has a positive effect;

c) hyperreactivity: when making skin tests, a severe general reaction with lymphangitis, a rise in temperature, focal reactions; locally, severe inflammatory, sometimes necrotic changes predominate; specific immunotherapy for hyperresponsiveness causes severe responses and is not indicated.

It is necessary to distinguish allergic diseases from infectious-allergic diseases, which are caused by non-pathogenic microbes and their metabolic products and which do not cause an infectious process in humans. They proceed as usual allergic diseases caused by allergens of non-microbial origin. An example is an allergy to antibiotics of microbial origin, which is referred to as drug allergy... In a number of countries, detergents with the addition of proteolytic enzymes obtained from Bacillus subtilis are widely used; the development of bronchial asthma and other allergic diseases has been described in workers producing detergents with these highly allergenic additives and in persons using powders.

Molds and their spores can cause asthma attacks as inhalation allergens. Yeast fungi in some cases play the role of a food allergen.

In the case of a "farmer's lung" (see. Pneumonia, exogenous allergic alveolitis), the cause of the disease is inhalation of thermophilic actinomycetes contained in broken hay. At the same time, sensitization is observed according to the type of Arthus phenomenon with a high level of precipitins in the blood.

Infectious allergy and immunity

Opinions on the relationship between delayed-type HR and immunity in infectious diseases are very controversial. In an experiment, it is difficult to separate immunity from delayed-type PChs, since. different ways immunizations that do not lead to the formation of delayed-type HP do not give a sufficiently pronounced immunity. With experimental parenteral administration of microbes labeled with radioactive isotopes, it was found that delayed-type IF significantly slows down the spread of the pathogen. In acute infections, this fact is not of great importance, since dissemination occurs faster than delayed-type PS develops. However, when infected with minimal doses of the pathogen, which lingers for a long time in the limf, nodes, the delayed-type PCh can slow down its further spread. With hron. infections with a long-term existence of the pathogen in separate foci (tuberculosis, brucellosis), delayed-type HP can prevent the secondary generalization of the infection. In addition, with the suppression of delayed-type HP by anti-lymphocytic serum, the digestive ability of macrophages in relation to the pathogen is inhibited, that is, the main mechanism of immunity suffers (see).

At the same time, the wedge, manifestations hron, infections are based on allergic inflammation.

and more severe forms of pulmonary tuberculosis, brucellosis lesions of c. n. N of page, joints, liver, heart, toxoplasmotic lesions of the eye, manifestations of tuberculoid leprosy and others develop as a response inflammatory reaction of the sensitized organism to the presence of the pathogen. The transition from generalized forms of infection to its localization coincides with an increase in sensitization. Hyporeactive forms, proceeding with insufficient sensitization, are extremely persistent and difficult to treat. In latent forms, quite clinically compensated, sensitization is sharply expressed.

Thus, delayed-type PS is useful as one of the mechanisms of immunity that helps to limit and localize the infection, preventing its re-generalization. At the same time, it largely determines the entire wedge, hron picture, infectious diseases. For each individual patient, it is necessary to establish whether the state of the delayed-type HP is beneficial or harmful, is an indicator of immunity, or causes severe wedges, phenomena, i.e., whether it is necessary to strive for desensitization.

In a different way it is necessary to assess the role of I. and. with local infectious processes. The threat of generalization of staphylococcus, Neisseria and other microbes from the foci of hron, infection is small, therefore, the protective role of delayed-type HP is secondary, and its pathogenetic significance is undoubted.

etc., with ankylostomiasis, the primary penetration of larvae through the skin does not cause a local reaction, invasion develops. With repeated infection, there is local inflammation and the hookworm larvae die. However, it is not known whether the death of the larvae is due to allergic inflammation or other immune mechanisms. At the same time, the most severe manifestations of inflammation around helminths localized in the tissues, urticaria, Quincke's edema, attacks of bronchial asthma are certainly harmful for them.

With toxoplasmosis, leishmaniasis, a pronounced delayed-type PC develops, leading to the appearance of hron, an inflammatory process around the foci of localization of the pathogen; skin tests with the corresponding allergens are positive.

For helminthiasis, an immediate-type PC is characteristic, but with some of them, delayed-type PC can also be observed (schistosomiasis, Echinococcosis, trichinosis). The severity of sensitization and the role of allergic reactions in their pathogenesis are different.

In acute opisthorchiasis, eosinophilia in the blood reaches very high numbers, however, the general wedge, manifestations of allergy are rare.

Methods for determining infectious allergies

Diagnostics I. and. possible with the help of various allergens (see Allergens, drugs). Viral allergens are prepared from the virus-containing allantoic fluid of chicken embryos (tick-borne encephalitis, influenza, epid, mumps), from the tissue of the affected organs (veins, lymphogranuloma) with maximum purification of substrate antigens. Various bacterial allergens are used: suspensions of microbial cells (tularin, brucellosis corpuscular antigen), broth culture filtrates (altuberculin, histoplasmin, actinomycin), thermostable fractions according to Ando-Verzhikovsky, allergens obtained by destruction of cells by ultrasound, purified protein fractions(tuberculin-PPD), polysaccharide-polypeptide complexes (pestin), alkaline protein extracts, etc. In all preparations, the main active principle is the proteins of the microbial cell.

Skin tests are most often used to identify PN (see). With their help, it is possible to simultaneously detect the inverter of the immediate type (after 20-30 minutes) and the inverter of the delayed type (after 24-48 hours). The specificity of skin tests is relative, since different types of microbes within the same genus have a pronounced commonality of allergens, therefore, cross reactions, for example, with different types mycobacterium tuberculosis, with different kinds brucella, etc. There are common allergens in different genera of microbes, for example, in mycobacteria of tuberculosis and non-pathogenic mycobacteria, in different genera of fungi, in the entire group of enterobacteria. At the same time, skin tests are specific for detecting sensitization to a given species or genus of microbes or fungi; they are not positive in healthy people and in infectious diseases caused by other pathogens.

A positive result of a skin test does not exclude any other etiology of lesions, since skin tests reveal only the state of sensitization to the microbe from which this allergen was obtained. For example, a positive test with toxoplasmin does not exclude tuberculous, brucellosis and other etiology of the lesion. The most convincing is the development of a focal reaction after a skin test or after an additional subcutaneous injection of an allergen in doubtful cases in a higher dose.

When diagnosing allergic diseases, positive results of skin tests with allergens of widespread microbes are not always indicative enough. In healthy people, tests with allergens of staphylococcus, candida and other allergens are positive in a significant percentage of cases. In this regard, with etiol, the diagnosis of allergic diseases is necessary along with skin provocative tests (see). In bronchial asthma, a provocative test is considered positive and confirms the role of the microbe in the development of the disease if inhalation of the corresponding allergen causes bronchospasm; in case of infectious-allergic rhinitis, application of an allergen to the nasal mucosa causes an exacerbation; with allergic dermatoses, the setting of a skin test leads to increased inflammation in the foci. One of the varieties of provocative tests is the intravenous administration of allergens. In the practice of diagnosing and treating infectious diseases, it is used only for brucellosis and reveals sensitized patients more than a skin test. In the experiment, with the help of intravenous administration of lysed microbial allergens, an immediate-type PS to microbial allergens (anaphylactic shock) is detected, and with the introduction of corpuscular allergens, a delayed-type PS is detected.

To identify And. And. for various diseases, a complex of in vitro tests has been developed: to determine the delayed-type PS, the blast-transformation reaction of lymphocytes is used (see), the migration inhibition reaction, to determine the immediate-type PS, the passive degranulation reaction of mast cells is used. For each reaction, it is necessary to select an allergen, to work out its optimal doses.

A positive result of skin tests convincingly proves the presence of I. and., But says nothing about the activity of the disease. Sharply positive tests are characteristic of completely compensated and latent cases of the disease and can persist for years after bacteriol, recovery. In addition, sensitization can be the result of a latent form of infection, prophylactic vaccinations.

Requires caution and evaluation of the results of in vitro samples. They are less reliable than skin and provocative tests, and have a certain diagnostic value only when comprehensive examination sick. A positive reaction of blastotransformation of lymphocytes speaks more about the activity of the infectious process than about the degree of I. and .; the neutrophil damage reaction reflects the level of antibodies in the blood serum.

Treatment

Treatment of manifestations And. And. is aimed at eliminating the pathogen, since after the elimination of the infection, while maintaining the state of sensitization, antigens are not formed in the body, allergic reactions do not occur. Antibiotics used for this purpose prevent the development of sensitization only when prescribed at a very early stage of the disease, by reducing the number of microbes. Antibiotics do not affect the already developed delayed-type HP.

The state of delayed-type PS can be maintained for decades after bacteriol, recovery, possibly due to the transition of microbes to L-form sludge and due to the fact that the life of T-lymphocytes reaches 20 years. In the absence of a pathogen in the body, this has no pathogenetic significance, and attempts at hyposensitization can only bring harm.

For some infectious and allergic diseases, when a sufficient effect of antibacterial drugs has not been obtained, appropriate drugs are used for the purpose of hyposensitization: tuberculin for tuberculosis, vaccines for brucellosis, actinomycosis, candidiasis, etc. vaccine in increasing doses leads only to a short-term moderate decrease in PF - after 1-2 months. the previous level of the slow-type inverter is restored or even becomes higher. A similar phenomenon is observed in infectious-allergic diseases caused by sensitization by microbes in the foci of hron, infection - the effectiveness of hyposensitization in infectious-allergic bronchial asthma is much lower than in its atopic forms.

Due to the fact that the introduction of an allergen causes focal and sometimes severe general reactions, hyposensitization is contraindicated in cases of c. n. N of page, eyes, with diffuse changes in the liver, kidneys, with violations of cardiac activity, pregnancy. To suppress excessively strong inflammatory reactions, sometimes life threatening, the most effective are corticosteroid hormones, used in sufficiently large doses, with a possibly shorter course, and necessarily with iodine protection of antibiotics, since corticosteroids simultaneously significantly suppress immunity.

Antihistamines can have a certain effect only in case of immediate-type PC, for example, with helminthiasis, urticaria of microbial etiology. They reduce the wedge, manifestations of immediate allergy, but do not eliminate the cause, and after stopping them, the symptoms usually recur.

Prevention of infectious allergy by eliminating contact with the agent that caused its development is possible only in rare cases (detergents with microbial enzymes, antibiotics of microbial origin). Prevention of development And. And. with infections comes down to their prevention. In a patient with a developed infection, prevention of sensitization does not make sense, since delayed-type HP should be considered as one of the mechanisms of immunity. In patients with a tendency to allergic diseases, in order to prevent their development, careful and intensive treatment of acute respiratory diseases, foci of hron, infection is necessary.

Some features of infectious allergy under the action of bacterial toxins. The beginning of studying And. And. to bacterial toxins were studies by I.L. Krichevsky and N.V. Galanova (1934), who established that the cells of smooth muscles of the uterus guinea pigs, infected with B. abortus, more actively respond to the endotoxin of this microorganism than the same cells of intact animals.

Subsequently, Soviet scientists studied the reaction of various cells in the body to endo- and exotoxins of bacteria - the causative agents of brucellosis, tuberculosis, glanders, diphtheria, tetanus, botulism, anaerobic infections and various viruses.

bme.org

Bacterial allergy, due to hypersensitivity to bacterial allergens, usually develops in the presence of foci of chronic infection in the body, which can be localized in the tonsils, carious teeth, paranasal cavities, in the bronchopulmonary apparatus, intestines, and biliary system. Bacterial allergy it is formed for a long time, over several years, therefore, it is extremely rare before the age of three. Under the influence of bacterial allergens, infectious-allergic diseases are formed: infectious-allergic bronchial asthma, rhinitis, infectious-allergic urticaria. In the specific diagnosis of bacterial allergy, standard bacterial allergens produced by Kazan NIIEM: hemolytic streptococcus, hemolytic staphylococcus, Proteus mirabilis and vulgaris, Pseudomonas aeruginosa, enterococcus, Escherichia coli, group pneumococcus, Neisseria.
The first step in diagnosing a bacterial allergy is an allergic anamnesis. The characteristic anamnestic signs of bacterial allergy are the seasonality of the exacerbation (in the damp cold season), the connection between the exacerbation of the disease and hypothermia due to exacerbation of foci of chronic infection. An exacerbation of an infectious-allergic disease is often accompanied by febrile or subfebrile temperature, the appearance of symptoms of intoxication, and antibiotic therapy is effective in treatment. For infectious and allergic diseases, acute inflammatory processes in children with atopic diseases, especially in patients with atopic bronchial asthma. As a result, anamnestic overdiagnosis of infectious and allergic diseases often takes place. Table 2.15 shows that bacterial positive anamnesis (BqA) correlates with a complex of other tests in 67.16% of patients, of which 45.10% - with provocative ones. In 1/3 of cases, with a positive history, all other tests turned out to be negative, that is, bacterial sensitization was not detected. Thus, in more than half of the patients, the bacterial etiology of the disease suspected by history is not confirmed by a comprehensive allergic examination. With negative anamnesis data, 13.00% of children have a bacterial allergy, mainly subclinical. It follows from this that the history of bacterial allergy is not always reliable.
Skin testing with bacterial allergens is also not specific enough. Table 2.15 shows that only in 38.33% of cases positive the result of intradermal tests (ECT) correlates with the complex of other tests and in 9.45% - with provocative, and in 61.67% all other tests were negative, i.e., bacterial sensitization was not detected. This indicates a lack of specificity for a positive skin test with bacterial allergens. At the same time, their negative result is highly reliable, in which only 0.07% revealed subclinical bacterial allergy.
Other authors also point to the non-specificity of skin tests with bacterial allergens. So, in the observations of TS Sokolova, VA Fradkin (1978), 50% of healthy children received positive VCP with bacterial allergens. This indicates the need (to clarify the role of the allergen in the disease) use in the diagnosis of bacterial allergy, in addition to anamnesis and skin tests, other tests - provocative and laboratory. Among the latter, RLL is highly informative, positive the result of which coincides with the complex of other tests in 84.76%, but only in 13.36% - with provocative, that is, it reveals rarely manifest, but mostly subclinical allergy, and in some cases (15.24%) is false-positive. Its negative result is reliable. At the same time coincidence positive reactions PPN with other tests is observed only in 56.52, and with provocative - in 2.17% of cases. In 43.48% with a positive (mainly up to 0.15) result of PPN, bacterial allergy not installed. However, a negative PPI result is highly reliable. It should be noted that the intensity of ECP and laboratory tests does not reflect the degree of patient's hypersensitivity to the allergen (Fig. 2.9). Even sharply and very sharply positive. their results reflect both overt and subclinical allergies and false positives. In other words, skin and laboratory tests do not differentiate between overt and subclinical forms of bacterial allergy, which require a different therapeutic approach.

survincity.ru

About bacterial allergies

Bacterial allergy is a specific type of allergy, in which an allergic reaction develops to bacteria that are in the body, usually in the form of chronic foci of infection. Such chronic foci are most often localized in the tonsils, carious teeth, paranasal sinuses, in the bronchopulmonary tree, as well as in the intestines and kidneys. At the same time, bacterial allergy is formed for a long time, sometimes it takes years, so it most often occurs in adults or older children.

A bacterial allergy is that under the influence of bacterial agents and antigens that have entered the human body, infectious and allergic diseases are formed, for example, such as:

• Bronchial asthma;
• Allergic rhinitis, conjunctivitis;
• Infectious-allergic urticaria.

The above diseases are difficult to tolerate by patients, require a long and quality treatment... However, the sooner the patient discovers symptoms of allergy and seek a qualified medical help, the faster it will work specific treatment prescribed by doctors, and such a patient can forget about bacterial allergies forever.

Bacterial allergy symptoms

Bacterial allergy symptoms depend on from the type of bacteria that contribute to the development of an allergic reaction, as well as from the state of the human immune system. So, the following symptoms of bacterial allergy are distinguished:

1. Respiratory symptoms:
   • Cough and shortness of breath due to sensation of a lump in the throat;
   • Paroxysmal sneezing;
   • Itching in the nose and throat;
   • Clear, mucous nasal discharge;
   • Nasal congestion;
   • Smell disorder;
2. Symptoms of damage to the organ of vision:
   • Redness of the mucous membrane of the eyes;
   • Lachrymation;
   • Itchy eyes;
3. In some cases, join skin symptoms as:
   • Rashes and redness on the skin, which are also accompanied by itching;
4. Symptoms indicating a malfunction of the organs of the gastrointestinal tract:
   • Stomach pain;
   • Vomit;
   • Diarrhea.

In the most severe cases, symptoms of anaphylactic shock or Quincke's edema develop, the relief of which is possible only with the help of qualified emergency medical personnel.

Causes of bacterial allergies

The causes of bacterial allergies are reduced to the fact that the body has chronic foci of infection associated with untreated colds bacterial diseases(for example, pneumonia, sinusitis, etc.). And under certain conditions, for example, hypothermia and decreased immunity, these foci are activated, which triggers the course of a bacterial allergic reaction. Therefore, in order to fundamentally prevent the development of bacterial allergies, it is always necessary to completely eliminate the disease and not run it into a chronic form.

Bacterial allergy in children

Bacterial allergies in children are usually diagnosed not earlier than 3 years of age, because it develops against the background of chronic foci of infection in the body. Symptoms in children are the same as in adults, but sometimes they are brighter and more pronounced, which is associated with the immaturity of the child's immune system. Bacterial allergies in children need qualified and specialized treatment, which is aimed not only at relieving allergy symptoms, but also at eliminating and rehabilitating chronic foci of infection.

Treating bacterial allergies in children the doctors of our clinic "Lor-Asthma" are engaged, offering only safe, reliable and maximum effective techniques... Remember, the sooner you consult with your doctor, the sooner he determines the type of allergy and determines the specific type of allergen, the sooner you can start treating your baby, and the sooner he gets rid of the severe and unpleasant symptoms of bacterial allergy.

Treat your child using only high-quality and effective treatment methods! Namely such methods of treating bacterial allergies are suggested by doctors clinic "Lor-Asthma!

Bacterial allergy treatment

Treatment of bacterial allergies in our clinic"Lor-Asthma" is always carried out on the highest level! We treat both adults and children, relieving them of bacterial allergies, while always selecting treatment regimens individually.

Bacterial allergy treatment should begin with high-quality diagnostics. This is where our doctors begin. The first stage is the collection of an allergic anamnesis, which the attending physician finds out from the patient himself, or from the child's parents. Then, after just a few diagnostic procedures and based on the patient's history data, the doctor determines the type of allergy, and also determines the degree of its development.

After determining the type of allergen and determining the state of the patient's immunity, allergy treatment begins. As a treatment for bacterial allergies our specialists offer only proven, effective and high-quality methods, for example, such as:

1. Phytoapitherapy;
2. Apitherapy;
3. Lipid therapy;
4. UZIS therapy;
5. Capillary therapy.

Purpose of Bacterial Allergy Treatment- this is not only to eliminate the symptoms, but also to strengthen the immune system in general, as well as to eliminate chronic foci bacterial infection, which in the future allows you to prevent the development of relapses of allergies!

Sign up for a consultation about bacterial allergy

Questions from users on our site about bacterial allergies

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Word "microbe" traditionally associated with the idea of ​​something pathogenic. But allergenic properties are primarily possessed by microorganisms that are almost or completely harmless to humans, their natural cohabitants - for example, some staphylococci that live on the skin, and Escherichia coli.

In addition to unicellular organisms of a bacterial, plant or animal nature, viruses are also allergenic, primarily o-crosslinked respirators, influenza and parainfluenza viruses. There is no need to talk about pathogenicity or its absence: the very nature of the virus is such that it is, by definition, pathogenic for any living creature into whose DNA it is embedded.

According to one of the theories popular in modern allergology, an allergy to viruses is initially formed, and then, as if along the beaten path, an increased sensitivity to microbes is developed. This usually happens during childhood.

An extremely interesting question for theoreticians and disgusting for practitioners is what are the allergens of microbes and viruses. In principle, the situation is more or less clear; a virus is, roughly speaking, a bare genetic apparatus (DNA or RNA in a complex with proteins), and its allergens are either direct products of its genes, or some of the proteins that form the aforementioned complex. Well, and the microbe is a single-celled creature, which has a lot of various proteins, so there is plenty to choose from. But the problem is different. Any infectious agent has antigens against which the immune system a person produces antibodies - this is understandable. And now it turns out that some infectious agents also have allergens. Are these the same proteins or are they different? For example, are the influenza virus antigen and its allergen the same protein or are they different?

It seems logical to assume that they are different, since in response to their presence, different antibodies are usually produced: for allergens - mainly IgE, for antigens - all the rest (this scheme, of course, is extremely simplified). But look at how a microbial or viral allergy develops.

At first, a sick child now and then suffers from acute respiratory infections or flu, or even sore throats or bronchitis. As if everything is going according to schedule: high fever, cough, runny nose, etc., etc. - carried out intensive therapy antibiotics - the fever passes, the runny nose and cough, too - comes convalescence (this is a bushy word that doctors call the recovery phase). However, later, a typically flowing bronchitis is suddenly complicated by severe shortness of breath, prolonged obsessive coughing for many months ... The patient does not seem to stop hurting. And gradually shortness of breath, cough, wheezing and wheezing in the lungs become companions of his life. There are no signs of infection, but the listed symptoms are present. This means that a microbial or viral allergy has developed in the form of asthmatic bronchitis.

It turns out that the disease (or treatment for it?) Naturally flows into an allergy to its pathogen! Perhaps, after all, its antigens and allergens are the same substances. And what is important, in such cases, continuing to pump the child with antibiotics is completely useless and even harmful: along the way, an allergy to the medicine can also develop! It has been proven that with a combination of the action of an antibiotic and a microbe (or virus) on the body, heightened sensitivity to both of them is formed faster than separately.

What about allergies to colibacillus and other invisible and gentle symbionts (cohabitants) of a person - in theory, these creatures should not have any antigens, which means that painful sensitivity to them is a classic version of the "immunity error".

As a rule, allergic reactions to microbes and viruses are delayed. Immediate - for example, on pneumococcus, streptococcus, Neisseria, the same E. coli - are rarely observed.

What can you advise the public to avoid microbial and viral allergies? Is it just one thing: get sick less, temper like steel, do not disdain general strengthening procedures, do not be lazy to do exercises in the morning, and if you have already caught the flu, acute respiratory infections or other infection, please be healed until complete recovery. There is evidence that the development of allergic diseases caused by microbes and viruses is facilitated by foci of chronic infection in the tonsils, appendages of the uterus, gall bladder, intestines, in short, in any organs. Why is there a gallbladder - a leaky tooth, not sealed in time, can cause bronchial asthma! After all, caries is also caused by microbes. And during the flu epidemics that regularly shake our capital and other Russian cities, all the rules of hygiene and individual protection must be strictly observed.

In addition, please bear in mind that proteases and proteinases (enzymes that unravel proteins), which are now widely used in the production of washing powders, have been isolated from some bacteria. Not always a bacterial allergen - protease or proteinase, but nevertheless, patients with hypersensitivity to bacteria are advised to handle washing powders carefully: inhalation of their air suspension can cause an attack of bronchial asthma, and washing clothes with unprotected hands and even wearing clothes washed with such a powder are not safe for the skin.

• Household allergies
• Allergy to chicken protein
• Allergy types
• Eye allergy
• Allergy to chicken eggs

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V last years In clinical allergology, the problem of bacterial allergy is practically superseded by the notion of the leading role of atopy in the genesis of most allergic diseases.

At the same time, the connection between infection and allergic diseases, including bronchial asthma, is quite obvious.

The role of IgE-dependent processes in the pathogenesis of infectious allergy has been proven.

In this regard, there is currently interest in the possibility of SIT for infectious and allergic diseases, in particular for bronchial asthma. A promising problem is the development of effective vaccines for SIT. It should be noted that in allergology considerable experience has been accumulated in allergen-specific immunotherapy of patients with infectious-allergic bronchial asthma.

Despite this, in the defining current document SIT, bacterial vaccination is called ineffective (WHO Position Paper. Allergen immunotherapy: therapeutic vaccines for allergic diseases (Allergy. 1998, v53. N 44 (Suppl). specific treatment for microbial allergens is very effective, as evidenced by the works of both domestic and foreign authors.

Probably, the ineffectiveness of individual works on SIT with bacterial allergens can be explained by the incorrect selection of patients for treatment, the lack of appropriate skills for carrying out SIT by the doctor. In this regard, we devote a special section to the experience of conducting SIT for infectious allergies.

History of bacterial allergy problem

The problem of allergic reactions in infectious diseases finds its origins in the works of the German doctor R. Koch (R. Koch, 1843 - 1910), devoted to the study of tuberculosis. It is known that tuberculosis is one of the most severe infectious diseases, which, thanks to the observations of R. Koch and the works of other researchers, played the role of the so-called classical model of bacterial allergy.

In 1906 S. Pirguet reported important value scarification test in tuberculin diagnosis and introduced into medical practice the term "allergy" (from the Greek. "allos" - different, "ergos" - I act), denoting an altered reactivity of the body. Antibodies, which, as was thought earlier, are produced in the body under the influence of tuberculin, C. Pirguet called "ergines".

In Russia, the allergenic properties of bacteria were studied in the very first works on anaphylaxis and allergies.
Research by P.F. Zdrodovsky on infectious para-allergy made a significant contribution to the theory of allergy in general and bacterial allergy in particular. The phenomenon of generalized allergic reaction to Vibrio cholerae endotoxin discovered by him, as noted by A.D. Ado, is the first description of this type of reaction. Many terms, criteria and patterns of manifestation of allergic reactions were first established and firmly entered into allergology precisely on the basis of the study of bacterial allergy. Following studies on the allergenic activity of the causative agent of tuberculosis, works began to appear very quickly, indicating the allergenic effect of other microorganisms.

Particular attention was paid to the allergenic properties of gram-positive cocci, in particular, hemolytic streptococcus and pneumococcus. R. Lancefield's works on antigenic and allergenic characteristics hemolytic streptococci, which indicate that experimental studies have revealed the allergizing effect of their type-specific protein, the so-called M-substance of hemolytic streptococcus.

Extremely important stage development of research in the field of bacterial allergy opened the work of O. Swineford and his collaborators. At the end of the 40s, these researchers discovered allergenic properties in 14 species of various microorganisms, namely: hemolytic and green streptococcus, staphylococcus, catarrhal micrococcus, intestinal and Pseudomonas aeruginosa, Proteus, etc.

For the first time, the attention of researchers was drawn to the allergenic properties of those microbes, the commonwealth of which constituted the so-called normal microflora of the mucous membranes of the respiratory and intestinal tract.

The results of evaluating the hypersensitivity of patients with infectious-allergic BA to allergens of autogenous strains isolated from the mucous membranes of the bronchi of these patients are presented in table. eight.

Table 7. Microflora of pharynx, nose, bronchi in patients with infectious-allergic bronchial asthma

Table 8. Skin and bronchial reactions to bacterial allergens in patients with infectious-allergic bronchial asthma (according to V.N. Fedoseeva, 1980)

Among the allergens of these cultures (Neisseria, Pneumococcus, Staphylococcus, Klebsiella, Streptococcus, Sardines), Neisseria and Staphylococcus were the leading ones. Significant allergenic activity was noted in Klebsiella, however, the frequency of detection of this microbe in crops from the mucous membranes of the bronchi of patients does not exceed 10-15%. But in those cases when the microbe was present in the crops, the patient's hypersensitivity to the allergens of this microorganism was pronounced.

Currently, in allergological practice, it is widely used for specific diagnostics and therapy allergens (and vaccine forms) of infectious agents: tuberculin, malein, brucellin, lepromin, etc., as well as pathogenic and opportunistic representatives of the microflora of the mucous membranes of the respiratory tract of patients with respiratory-allergic diseases: allergens and vaccines from streptococci , staphylococci, pneumococci, etc.

Considering the history of the problem of bacterial allergy, it is possible, on the one hand, to emphasize the fact that it was during the study of infectious diseases that both the concept of "allergy" and such terms as "type of allergic reaction", "reaction of delayed and immediate type" , "Skin-allergic diagnostic tests", "tuberculin diagnostics" and others, which have become firmly established in allergology and are currently used.

On the other hand, it should be noted that allergenic activity is inherent not only in pathogens of infectious diseases, but also in representatives of the so-called opportunistic microflora of the respiratory tract of patients with respiratory allergic diseases. In addition, it is quite obvious that bacterial allergy has features due to both the properties of the microorganism and the reactivity of the patient's body with an infectious-allergic disease.

Khutueva S.Kh., Fedoseeva V.N.

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Allergenic bacteria have been the subject of study and research since 1909. It was at that time that they began to actively study different kinds allergies. Anaphylaxis was also of great interest. Since the doctrine of the types of allergies developed very quickly, it was revealed that the properties inherent in allergies in general do not always manifest themselves immediately, they can be detected after a certain period of time.

Bacterial allergens: how do they affect the human body?

There are two types of reactions that appear immediately from time to time. Firstly, this is the well-known anaphylactic shock, which people face much more often. And, secondly, bronchial asthma, which is also caused by bacterial effects, can become a reaction.

To this day, scientists and doctors deal only with those bacteria that have been identified with certain properties corresponding to an allergic reaction. They are studied due to the fact that the skin is subjected to sampling. They can have different strength of action: some weak, some strong. And today saprophytic microbes are the most powerful allergens in comparison with others. And their release occurs from those patients in whom the reaction manifested itself in the form of bronchial asthma.

In some cases, microbes of a certain type enter the human body and "live" there for a long period of time. Thus, sensitization occurs, and subsequently the development of bronchial asthma will occur.

Classification of bacteria allergens

To date, experts have assigned all such allergens to specific groups.

1. Antigen of the causative agent of an infectious disease. This kind includes an allergen such as tuberculin. It is produced by extracting tuberculosis microbacteria. In the above-described specific case, sensitization takes place, which is directly related to the causative agents of tuberculosis. This is already a classic version, which is used in order to most fully study the hypersensitivity of this species. Tuberculin is considered a recombinant allergen. It contains various lipids, which, in one way or another, affect how much long time will be spent on the formation of the appropriate reaction, and also increase the activity of the drug. It is worth noting that it is possible to reveal how tense a person's immunity to tuberculous pathogenic bacteria is due to the Mantoux test. Special bacteria that are involved in this process will elicit the reaction. In this case, there is one very important point: Mantoux should never be done if there are any diseases associated with the skin and possible infections. Also, contraindications include epileptic and allergenic properties. If on this moment the quarantine is in progress, then medical workers have the right to vaccinate only 30-31 days after it is removed.

2. Allergen of opportunistic bacteria. This group of allergens includes lepromin. It contains protein in the amount of 75%, polysaccharides, of which a total of 13% were detected, and nucleic acids, which also account for about 13%. Lepromine was made a long time ago, but it still remains the most common if leprosy needs to be diagnosed.

Bacterial allergens: how does activation occur?

An allergic reaction can be caused by a wide variety of substances: from substances with a simple composition to substances with a more complex composition.

Numerous experiments and studies carried out by scientists and modern representatives of medicine have quite definitely revealed the result. It is worth noting that they started by studying the chemical constituents of bacteria.

In this regard, the most active natural allergen was identified, which is called glycoprotein. If the amount of necessary particles in it is less than a predetermined level, then there will be no allergic reaction in this case. If the number of necessary particles in it is much higher (7-9 times) of the given level, then bacteria will not be able to cross a certain barrier, consisting of various tissues. This means that allergens will not in any way enter the mast cells.

The first thing to always pay attention to is the allergenic stimulus. It is he who is a kind of trigger and activator for lymphoid cells.

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