All possible allergens and bacteria. Characterization of bacterial allergy

Date: 19.07.2019

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V last years in clinical allergology problems bacterial allergies are practically supplanted by ideas about the leading role of atopy in the genesis of the majority 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 pathogenesis has been proven infectious allergy.

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 on the importance of the scarification test in tuberculin diagnosis and introduced 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. The works of R. Lancefield on the antigenic and allergenic characteristics of hemolytic streptococci are classic, 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 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, allergens (and vaccine forms) of pathogens of infectious diseases are widely used for specific diagnostics and therapy: 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 respiration - 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. respiratory tract 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.

The most common types of allergies in children are always accompanied by edema and other severe manifestations that all parents need to know about.

Until a few decades ago, the topic of allergy was not as extensively studied as it is now. In the old days, parents did not even suspect that an acute allergic reaction to an irritant was to blame for some of their children's illnesses.

Today, modern mothers and fathers, pediatricians conduct conversations about the manifestations of allergies in their child - when to worry and when not. Problems such as atopic dermatitis, allergic rhinitis, bronchial asthma and its harbinger allergic bronchitis is heard by many.

The response of the immune system to an excess of histamine in the blood is an allergic reaction. The appearance of histamine in the blood can provoke both an excess of any substance that is aggressive in its composition (pollen, chocolate, seafood, etc.) as well as a congenital reaction to an allergen. In the first case, the child may, for example, eat too much chocolate or citrus fruits and he will develop a rash on his body, in the second case, if an allergen enters the body, a more severe allergic reaction may occur.

The most common types of allergic reactions

Depending on the predisposition to the disease and the type of allergy itself, the symptoms of the disease may differ.

Atopic dermatitis

Atopic dermatitis - manifests itself in infancy.

The first "bell" of atopic dermatitis is a reddish rash, mainly in the mouth.

It can be as simple as small pimples, and flaky crusts. In some cases, children's atopic dermatitis disappears by 3-4 years, but sometimes it can accompany a person at an older age.

Most often, atopic dermatitis is a subspecies food allergies for example dairy products. It is not for nothing that modern pediatricians and allergists advise not to give cows to children under one year old, and even goat milk- it contains many substances that an undeveloped digestive system simply cannot digest and assimilate. An excess of these substances leads to the appearance of topical dermatitis.

Allergic rhinitis

This is inflammation and swelling of the nasopharyngeal mucosa, frequent nasal congestion, shortness of breath and profuse sneezing. The type of allergy that is most often seasonal in nature, but can be simultaneous (for example, a reaction to animals). It manifests itself when particles of an allergen enter the respiratory tract. This can be pollen, particles of animal hair, dust, etc. The most dangerous consequence lingering allergic rhinitis may become Quincke's edema.

Allergic bronchitis

This is a type of lower respiratory tract disease. Its symptoms are: severe barking cough, shortness of breath, asthma attacks, obstruction. The cough, usually dry, worse at night. Unlike viral and bacterial bronchitis, allergic bronchitis is not accompanied by an increase in body temperature.

This disease is a reaction to "air allergens" - particles of organisms and substances that the patient breathes in the air. Such a substance can be dust, and animal dander, feathers in the pillow, and even mold. In rare cases, such a reaction is observed with food allergens.

A feature of allergic bronchitis is that its appearance can provoke prolonged stress and physical activity.

Treatment and prevention

The first thing to do when a child develops any type of allergy is to give him an antihistamine.

It is better to choose from drugs of the second and third generation, since they are more effective and do not have strong side effects... For children under the age of three, antihistamines are sold in the form of syrup; older children can be given pills.

After stopping the first symptoms, you must contact an allergist and take required analyzes... In order to confirm the allergic reaction, and not the manifestation of another disease (for example, with bronchitis), a blood test for immunoglobulin E (IgE) is prescribed. Its presence in the body in a concentration exceeding allowable rate, means the manifestation of an allergic reaction. In the case of, for example, allergic bronchitis, such a strong excess normal values may mean a predisposition to developing asthma.

The tests passed and the prescribed treatment may be useless if contact with the allergen is not excluded at the initial stage. If it is not possible to do this completely, then you need to at least limit the cases of contact.

Allergy - insidious disease which can develop in a matter of minutes and provoke dangerous condition organism. You need to know your body and what and how it reacts, and have a good antihistamine in your medicine cabinet.

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OtekHelp.ru

An allergy is a reaction that protects the body from a micro-irritant. It can be in a cluster of dusty things, flowering plants, pungent odors, food.

This hypersensitivity can be inherited. The treatment of allergies in children must be entrusted to a doctor. Parents can find out about the baby's predisposition to allergies immediately after birth, since acute sensitivity will manifest itself already when an unusual product appears in the diet or when a medicine is administered.

How does the disease manifest

An allergic reaction can have many manifestations. The most characteristic ones are:

Rash (redness, hives).
Sneezing.
Coughing fits.
Watery eyes.
Swelling in the skin.
Itching (the most unpleasant symptom, as with strong scratching, wounds are formed, into which infection can easily get).
Asthma.
Stomach upset (rumbling, bloating, nausea, violent belching, abdominal pain).
Allergic rhinitis (nasal congestion, swelling, dry mucous membranes) can cause asphyxiation.

Anaphylactic shock is the most dangerous expression of the body's response to an irritant. He is accompanied by loss of consciousness, convulsions, intracranial pressure may decrease significantly. Often this is how an allergic reaction manifests itself after certain injections. medical supplies and poisonous insect bites, very rarely as a consequence of food allergies. It is impossible to help the patient on his own.

An allergic reaction can manifest itself in different parts body and last from a few minutes to several days. It depends on the individual sensitivity of your child's body. The temperature usually does not rise.

Allocate true and false allergies. Both species have similar symptoms, but the false one is not associated with the involvement of immunoglobulins. The true one evokes a reaction at the slightest contact with an irritating factor. With a false reaction, the stronger the large quantity the stimulus affects.

Localization of allergic reactions

Allergies can appear on a child's body in different places.

On the face. With food allergies, rashes and redness often appear on the cheeks, which may indicate that the provocateur is a cosmetic product.
On the neck. Allergen is found in clothing (wool, synthetics), jewelry. In infants, such rashes are called prickly heat and are associated with overheating.
On the arms and legs. Such a reaction can occur to any of the stimuli.
On the buttocks. In very young children, rashes on the pope can be associated with violations of hygiene rules or an incorrectly chosen diaper. In older people, it is more often associated with a reaction to cosmetical tools.

The nature of rashes, redness and other painful manifestations on the body will only be correctly determined by the doctor. After all, it is possible that the little man does not have an allergy, but a viral infection - chicken pox, measles, etc.

Allergy types

There are several types of allergies, which are classified depending on the pathogen:

Food	This type is very common among babies, the occurrence of a reaction to one or more foods predominates.
Respiratory (respiratory)	Inhalation route of penetration into the child's body.
Dusty	This type of allergy is distributed in a separate category due to the fact that the body reacts exclusively to ticks in the dusty air
Hay fever	The irritant is pollen, seasonality is one of the main signs, the disease in time exactly coincides with the flowering period and passes immediately after it
Insect allergy ( medical term- insect)	A mosquito or midge bite can be the root cause of the disease. Very often, such an allergy is evidenced by too strong swelling after a bite, which develops very quickly
Allergy to animals	Allergens are cats, dogs and other pets, their drool, skin scales, feathers, fluff, excrement
Medicinal	Reaction to a medication or any of its ingredients
The presence of helminths in the body	Worm infestations often provoke the development of allergies.

Food

Most often, provocateurs are citrus fruits (grapefruit, oranges, tangerines) or red berries, some types of meat, dairy drinks. Soda with a flavor enhancer and dye is no exception - it is better not to give such drinks to a child.

Up to the age of three, babies may develop a reaction to lactose. The root causes of food allergy include intestinal dysbiosis - a change in the species composition of bacteria in the intestine, which results in microbial imbalance.

Respiratory

This species is characterized by unpleasant sensations in the nasopharynx until suffocation. Caused by odors, flowering plants, animals with long hair.

Reactions can also occur to wall paint and mold. May become an impetus for the development of bronchial asthma.

Helminthic

It is provoked by the waste products of helminths, which are released into the blood. The disease is more severe and difficult to treat.

Allergy diagnostics

It is not easy to identify provocateurs of childhood allergies, since the spectrum of irritants is large at a young age. Particular attention is paid to the symptoms noticed, their development, and the diet.

Keeping a diary with a description of the household environment, manifestations of allergies, their frequency is mandatory. The tendency to allergies in relatives and friends is determined - heredity plays an important role.

Timely diagnosis of a painful condition consists of a set of measures:

Various methods are used to establish an accurate diagnosis:

General blood analysis. In the presence of helminths in the body, the number of eosinophils is increased, which can cause an allergic reaction.
Skin allergy tests - the irritant is applied to the forearm, in case of a reaction, the allergen is considered certain.
A test that provokes a reaction when a food irritant is injected under the tongue.

In case of a predisposition to allergies in a child different ages stimuli and reactions to them can change. For example, in babies, the body can react violently to a new product. Growing up a little, a reaction to odors or ragweed blooms may appear.

In adolescence, an allergen can be a cosmetic product (gel, cream, varnish). Symptoms may also change. Therefore, a diagnosis is necessary for every manifestation of an allergic reaction. An allergic reaction can also occur in a newborn. In this case, it is necessary to look for an irritant in the mother's diet, by eliminating it, relieve the crumb of unpleasant symptoms.

After identifying the allergen

Once the cause of the allergic reaction has been identified, the doctor will tell you how to treat the allergy in your child. As a rule, treatment is to exclude any contact with the source of the allergy.

If a food reaction is detected, foods that provoke allergies are excluded from the diet. They can be tried to be introduced later, when the child has matured a little. If the use of any product caused anaphylactic shock, it will have to be excluded from the diet for life.

With household allergies, large Stuffed Toys, carpets, woolen heavy rugs, feather beds, feather blankets and pillows. A reaction to cosmetics that occurs in older children indicates the need to replace cream, soap or washing powders ( detergents) that did not fit.

Temporary climate change - sanitary-resort treatment helps.

Drug therapy

For the treatment of allergies in a child, many remedies have been developed, the use of which helps to relieve unpleasant symptoms for the patient.

These are all kinds of tablets, ointments, syrups, solutions, creams, nasal sprays, inhalers.

The main types of therapy:

Local. Ointments, topical creams are prescribed to combat rashes, inflammation, redness and edema.
General. The diet is adjusted, drops, syrups, suspensions, tablets are prescribed.
Angiotropic therapy is designed to eliminate the root causes of allergies.
Symptomatic involves the removal or relief of unpleasant symptoms of the disease. Application is possible in advanced or chronic cases.

Types of drugs that can be prescribed by your doctor:

Antihistamines. They have an effect on the center of inflammation (drops, syrups, suspensions). Third-generation drugs should not have side effects - cause drowsiness, affect the work of the heart. Second-generation drugs have an effect on the work of the heart, especially if they have to be combined with antibiotics, antifungal drugs. Drugs of the first generation in the treatment of children are used extremely rarely because of the pronounced hypnotic effect.
Mast cell stabilizers are prescribed for asthma or bronchitis.
Hormonal treatment... When treating babies, it is practically not used, except for cases when other drugs have not given positive results(ointments, creams). Used to relieve local symptoms. Such treatment should last no more than 5 days. Hormone treatment can be given to a child over six months of age.
Diet therapy. Treatment is based on the principle of excluding an irritant from the diet in order to prevent the transition of allergies to more severe or chronic forms... If it is not possible to determine the allergen product, a special diet, eliminating the monotony of food.

Of course, individual preparations and dosages will be selected for each child.

Preventive measures

Periodic changes in climatic conditions can be attributed to the prevention of allergic diseases: trips to the sea (sea air), to the forest, to the mountains. Regular exposure of the baby to the fresh air and the sun helps to prevent and heal allergic reactions. Additionally, mud therapy, carbon and mineral baths are prescribed.

For food allergies, one way effective treatment- the strictest adherence to a diet that excludes allergenic foods, but the mandatory presence of essential vitamins and minerals in food. Milk can be replaced with fermented milk products, use dietary meats.

Daily morning exercises, rubbing off with a cool towel, walking in the fresh air, good nutrition will help strengthen the body's defenses.

DeteyLechenie.ru

In recent years, in clinical allergology, the problem of bacterial allergy has practically been supplanted by the concept 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.

History of bacterial allergy problem

In 1906, S. Pirguet reported on the importance of the scarification test in tuberculin diagnostics and introduced the term "allergy" into medical practice (from the Greek "allos" - different, "ergos" - I act), meaning 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.

An extremely important stage in the development of research in the field of bacterial allergy was opened by 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.

Bronchial asthma (BA) is a disease in which the bronchi are a "shock" organ and, in the case of an infectious-allergic genesis of the disease, the mucous membranes of the lower respiratory tract are "populated" different kinds pathogenic (klebsiella, pneumococcus), opportunistic (greening streptococcus, staphylococcus, neisseria, etc.) microbes and saprophytes (sarcin, diphtheroids, etc.) (Table 7). In total, up to 16 - 18 types of microorganisms are part of the microflora of the lower respiratory tract of patients with infectious asthma. The works of domestic and foreign researchers have proved the leading role of allergy to microbes - inhabitants of the mucous membranes of the bronchi of patients with BA in the pathogenesis of this disease.

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)

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.

medbe.ru

I.I. Balabolkin

Research Institute of Pediatrics, Scientific Center of Children's Health, Russian Academy of Medical Sciences, Moscow

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Allergic diseases are among the most common diseases in childhood... Based on data from different regions Russian Federation epidemiological studies, they affect up to 15% of the child population. The highest prevalence of allergic diseases is noted among urban children, and especially among children living in cities with a high level of air pollution by chemical by-products of industrial production and road transport.

Causes

A direct correlation is revealed between the degree of pollution by chemical substances and the prevalence of bronchial asthma and atopic dermatitis. High respiratory allergic morbidity occurs among children living in the humid climate of coastal regions. Rarely, allergic diseases are detected among rural children. A very common pathology among children is pollinosis, the occurrence of which is more often recorded among rural children than urban ones. However, in recent years, there has been a tendency towards an increase in the prevalence of pollinosis among urban children, which correlates with an increase in air pollution by chemical by-products of road transport.

In the antenatal period, a factor contributing to the sensitization of the body is a significant allergenic load on the fetus as a result of the mother taking medication, her excessive consumption of food products with sensitizing activity, a high level of exposure to pollen allergens and aeroallergens in homes, exposure to occupational chemical hazards, smoking. A viral infection transmitted by the mother during pregnancy can initiate fetal sensitization.

In the postnatal period, the risk of allergic reactions and diseases in children can increase the excessive use of highly allergenic foods, polypharmacy, high level aeroallergens in the home, unfavorable living conditions.

The high risk factors for the occurrence of allergic pathology in children include the burden of heredity with allergic reactions and diseases. Evidence has been obtained for the participation of immune response genes in the production of specific IgE antibodies, genetic determinism of anti-inflammatory cytokines, and bronchial hyperreactivity.

Food allergy plays an important role in the development of allergic diseases in children. The problem of food allergy in children is, first of all, the development of skin and gastrointestinal allergy to proteins of cow's milk, eggs, cereals, which prevails among the manifest forms of allergy in young children.

In recent years, there has been an increase in the development of drug allergy in children. Most often, its occurrence is noted for antibiotics of the penicillin series. Often, allergic reactions occur when sulfonamide and protein drugs, nonspecific anti-inflammatory drugs, antibiotics of other groups, and B vitamins are prescribed. Medications are the most common cause of systemic allergic reactions (anaphylactic shock, urticaria, Quincke's edema), acute toxic-allergic reactions (multiforme exudative erythema, Lyell's syndrome, Stevenson-Johnson syndrome), in a number of patients they cause an exacerbation of atopic dermatitis, bronchial asthma, allergic rhinitis and the occurrence of contact dermatitis.

Home aeroallergens (house dust allergens, Dermatophagoides pteronyssinus, Dermatophagoides farinaе) act as the leading cause of allergic respiratory diseases in children (bronchial asthma, allergic rhinitis). The importance of sensitization to house dust mites in the development of exacerbations of atopic dermatitis and combined manifestations of atopic dermatitis and bronchial asthma in children is essential. The occurrence of allergic respiratory diseases in a number of children is caused by sensitization to allergens of domestic animals (more often cats, dogs), bird feathers, cockroaches, dry food for fish kept in aquariums.

Sensitization to pollen allergens is causally significant in the development of the allergic process in 20% of children with allergic diseases, while the role of pollen sensitization in the formation of allergic pathology increases with the age of children. The peculiarity of the spectrum of pollen sensitization in various regions of Russia and the resulting marginal features of pollinosis in children are revealed. The hay fever recorded in the southern regions of the Russian Federation, caused by ragweed sensitization, is characterized by more heavy course... Pollen allergens are most often the cause of allergic diseases of the eyes and respiratory tract, less often - of the skin and internal organs.

A common cause of allergic pathology in children is sensitization to molds. Its occurrence is facilitated by the presence of pronounced allergenic activity in mold spores and their high prevalence in environment... When conducting an allergological examination, sensitization to mold allergens is found in 50% of children with bronchial asthma. Most often, these patients have hypersensitivity to fungi. Alternaria, Aspergillus, Candida, Penicillium... Often, sensitization to mold allergens is recorded in children suffering from atopic dermatitis and combined manifestations of atopic dermatitis and bronchial asthma. Sensitization to fungal allergens is more often found in children who have previously received repeated courses of treatment with penicillin antibiotics, and in children living in damp living quarters. Attachment of sensitization to molds greatly aggravates the course of bronchial asthma in childhood.

The development of allergic pathology in children can be promoted by bacterial sensitization. Most of the known microorganisms are allergenic. A higher level of sensitization is caused by non-pathogenic strains of microbes. Proteins and polysaccharides of staphylococci and streptococci have significant allergenic activity, Candida and colibacillus... They are capable of causing the development of IgE-mediated allergic reactions. In the blood serum of children with bronchial asthma, specific IgE antibodies to bacterial antigens... Bacterial allergies are more likely to develop if inflammatory process in the tonsils, sinuses nose, biliary tract, bronchi.

In children with bronchial asthma, atopic dermatitis, dermorespiratory syndrome, an exacerbation of the allergic process is often observed when acute respiratory viral infection, after which the patients have an increase in the level of total IgE in the blood serum. The increase in the IgE content in the peripheral blood found in these cases may be associated with the sensitizing effect of viruses on the body of children suffering from allergic diseases.

In the development of allergic diseases, changes in the functioning of the immune system are of decisive importance. The onset of atopic diseases is associated with IgE-mediated allergic reactions. Allergological examination of children suffering from atopic dermatitis, hay fever, atopic bronchial asthma, recurrent urticaria and Quincke's edema reveals an increase in the level of total IgE and specific IgE antibodies to various groups of exogenous allergens. Participation of IgG4 in the pathogenesis of atopic diseases in children is not excluded.

The importance of changes in cellular immunity in the development of atopic diseases in children is essential. The increase in total IgE production is a consequence of the interaction of macrophages, T and B lymphocytes. Overproduction of IgE is caused by the activation of Th2 lymphocytes and the associated increased synthesis of IL-4, IL-6, IL-10, IL-13.

The course of atopic diseases in children is accompanied by a violation of membrane lipid metabolism, an increase in the synthesis of prostaglandins, leukotrienes, thromboxanes, a factor that activates platelets; evidence was obtained for the participation of neuropeptides in the mechanisms of the development of allergic diseases.

Pathogenesis

The pathogenetic basis of atopic diseases (bronchial asthma, atopic dermatitis, allergic rhinitis, gastrointestinal allergy) is allergic inflammation. The allergic inflammation that occurs in the late phase of the allergic response is a consequence of excessive production and exposure to the cells involved in its development (eosinophils, macrophages, T-lymphocytes, neutrophils) of cytokines (IL-3, IL-5, IL-8, IL-16, GM -CSF, TNFa), leukotrienes. In children with atopic diseases, the allergic nature of inflammation is confirmed by the identification of eosinophilic-lymphocytic infiltration in biopsies of the mucous membrane of the bronchi, stomach, jejunum, skin, an increase in the concentration of eosinophilic cationic protein in the body's liquid biological media and tissues of the shock organ.

V modern conditions there is a tendency towards a more severe course of allergic diseases in children. This is confirmed by the identification of a significant number of patients with severe bronchial asthma, atopic dermatitis, an increase in hay fever in children with obstructive bronchial lesions, and the involvement of visceral organs in the allergic process during an epidemiological study. A more severe course of allergic diseases in children is observed in regions with massive air pollution with chemical compounds.

Diagnostics

In recent years, progress has been made in creating more informative methods of allergy diagnosis. In the work of allergy departments and offices, it is widely used enzyme immunoassay determination of specific IgE antibodies to allergens of house and library dust, Dermatophagoides pteronyssinus, Dermatophagoides farinae, pets, feathers, food, fungal and pollen allergens. The test of inhibition of the natural emigration of leukocytes into the oral cavity is promising for the diagnosis of drug allergy. To detect sensitization to various groups of allergens, it is possible to use the chemiluminescent allergosorbent test (IgE-MAST).

Drawing. The classic “face of an allergic person” in a child

Treatment

Therapy of allergic diseases in children is pathogenetic and is carried out taking into account the peculiarities of clinical manifestations, activity and severity of the allergic process.

Compliance with the principle of allergenic sparing in relation to a sick child is an important condition for achieving positive treatment results. Prevention of repeated contact with causally significant drug, food allergens and a decrease in the concentration of aeroallergens in the home help to reduce the manifestations of the disease. The exclusion of cow's milk from the diet of children of the first year of life, who are allergic to its proteins, and the replacement of cow's milk and nutritional mixtures based on it with soy mixtures contribute to the reverse development of the allergic process. In children with sensitization to aeroallergens in dwellings, this is facilitated by the implementation of preventive measures aimed at reducing the content of these allergens in dwellings.

Therapy for exacerbations of allergic diseases in children, it is based on the use of medications that inhibit the development of allergic reactions and allergic inflammation (sympathomimetics, methylxanthines, anti-mediator and anticholinergic drugs, glucocorticosteroids).

The basis emergency treatment of an attack of bronchial asthma constitutes bronchospasmolytic therapy. Selective b2-agonists (salbutamol, fenoterol, etc.) have the highest bronchospasmolytic activity. Inhalation of these drugs provides a quick restoration of bronchial patency. In cases of the development of an attack of bronchial asthma in young children and in severe exacerbations, it is most effective to use solutions of salbutamol and fenoterol through a nebulizer. In the event of severe attacks of bronchial asthma, sympathomimetic agents are administered by inhalation and at the same time glucocorticosteroids (hydrocortisone, prednisolone, dexamethasone) are prescribed parenterally. In children with mild attacks of bronchial asthma, restoration of bronchial patency can be achieved by prescribing ipratropium bromide or by combining ipratropium with fenoterol. Aminophylline has significant bronchospasmolytic activity. In cases of severe attacks of bronchial asthma and an asthmatic condition, infusion therapy with aminophylline and glucocorticosteroids is quite effective. If a patient's history reveals indications of the use of glucocorticosteroids to relieve severe broncho-obstructive syndrome, it is advisable to prescribe a short (up to 5 days) course of oral prednisolone treatment. Delay in the appointment of glucocorticosteroids in cases of severe attacks of bronchial asthma and asthmatic conditions may be the cause of an unfavorable outcome of bronchial asthma.

In children with allergic skin diseases (atopic dermatitis, urticaria, Quincke's edema, contact dermatitis), the reverse development of the inflammatory process on the skin is facilitated by the elimination of causally significant allergens, the appointment of antihistamines (H1-histamine blockers and ketotifen), the use of anti-inflammatory and non-steroidal anti-inflammatory drugs in case of moderate manifestations of atopic and contact dermatitis topical glucocorticosteroids in cases of severe inflammatory process on the skin, resistant to traditional therapy, contributes to the achievement of remission of the disease. The therapeutic correction of disorders in the digestive tract and central nervous system contributes to an increase in the effectiveness of treatment of children with atopic dermatitis and recurrent urticaria.

In the treatment of exacerbations perennial and seasonal allergic rhinitis effective antihistamines second and third generations (astemizole, loratadine, fexofenadine, cetirizine, ebastine), topical antihistamines (azelastine, levocabastine), as well as anti-inflammatory drugs (cromoglycic acid) and topical glucocorticosteroids (beclomethasone, fluticasone).

The basis preventive treatment with atopic diseases in children, anti-inflammatory pharmacotherapy is used. Anti-inflammatory activity is possessed by cromoglycate and nedocromil sodium, topical glucocorticosteroids. A slight anti-inflammatory effect was found in ketotifen, cetirizine, durant theophyllines. Our observations indicate a fairly high efficacy of sodium cromoglycate treatment in bronchial asthma, allergic rhinitis, allergic conjunctivitis, food gastrointestinal allergy. Achievement of remission in bronchial asthma in children is facilitated by therapy with nedocromil sodium. For severe allergies (bronchial asthma, atopic dermatitis, allergic rhinitis), the use of topical glucocorticosteroids is effective. An increase in the effectiveness of preventive treatment in children with bronchial asthma is facilitated by the appointment of durant methylxanthines and prolonged b2-agonists (salmeterol, formoterol).

In the treatment of children with allergic diseases, the use of new antiallergic drugs (ketotifen, astemizole, loratadine, fexofenadine, cetirizine, ebastine) is effective. Their appointment for atopic dermatitis, allergic rhinitis, hay fever, recurrent urticaria and Quincke's edema, atopic bronchial asthma helps to reduce the manifestations of the disease and achieve remission of the allergic process in a number of patients.

Allergen-specific immunotherapy is the leading treatment for children with atopic diseases. This method of treatment is most effective for pollinosis, allergic rhinitis, atopic bronchial asthma. The experience of the allergological department of the Research Institute of Pediatrics and the Scientific Center of Children's Health of the Russian Academy of Medical Sciences indicates the effectiveness of parenteral and non-invasive (endonasal, oral, sublingual) methods of specific immunotherapy in children with hay fever and atopic bronchial asthma.

The use of antileukotriene drugs (montelukast, zafirlukast) in children with bronchial asthma is effective. Their appointment helps to reduce exacerbations, more easy flow attacks, reducing breathing difficulties that occur at night, as well as in cases of exacerbations of bronchial asthma, arising from intolerance to nonspecific anti-inflammatory drugs, with physical strain.

The introduction of educational programs for parents of sick children contributes to an increase in the effectiveness of therapy for children with allergic diseases. Educational programs aim to teach parents to control the environment of the patient, properly carry out therapeutic and rehabilitation measures, correctly monitor the effectiveness of the treatment and teach patients with bronchial asthma to properly use the peak flow meter and inhalation devices for the administration of bronchospasmolytic and anti-inflammatory drugs.

The implementation of rehabilitation programs is an important direction in the health improvement of children with allergic diseases. In patients with bronchial asthma, rehabilitation treatment programs based on the use of respiratory and remedial gymnastics, massage, outdoor sports, swimming. In the rehabilitation of children with atopic dermatitis, the organization diet food, application of methods of physiotherapeutic influence. It has a beneficial effect on the course of bronchial asthma and atopic dermatitis in children. Spa treatment... In the rehabilitation of children with allergic diseases, it is essential dispensary observation after them.

The significant frequency of the development of allergic diseases in children necessitates a wide coverage of them. preventive vaccinations... Their implementation during the period of clinical remission of the allergic process against the background of anti-relapse treatment contributes to a favorable course of the post-vaccination period and a decrease in the frequency of exacerbations of allergic diseases associated with the administration of vaccines.

The further study of the epidemiology of allergic diseases and the creation on this basis of a rational system for organizing allergic care for children, the elucidation of regional risk factors for the occurrence of allergic diseases and the development of measures for the prevention of allergic pathology in childhood can contribute to a decrease in the level of allergic morbidity.

Literature:

Allergic diseases in children / Edited by M.Ya. Studenikina, I.I. Balabolkin. M., Medicine. 1998; 348.
Busse W.W. // Allergy and Clin.immunology. 1990; 85 (4): 671-83.
Mollica F. // Ann. Allergy. 1991; 66: 490-3.
Balabolkin I.I. O. A. Subbotina // Vestn. perinat. and pediatrics. 1994; 3: 26-8.
Balabolkin I.I. Bronchial asthma in children. M., Medicine, 1985; 176.
Borish L. // Immunol. Invest. 1987; 16 (6): 501-32.

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However, the development of an allergic reaction can cause and pathogenic microorganisms leading to the emergence various diseases... In this case, an infectious or viral allergy occurs in children.

General information

Viral allergy occurs as a result of penetration into the child's body various viruses.

The body's immune system gives out an appropriate reaction, secretes an increased number of mast cells, which must fight the pathogenic microflora.

With an increased sensitivity of the body to this irritant (virus cells), mast cells will be destroyed, as a result of which a substance is released into the body - histamine, which is toxic, and leads to the development of symptoms characteristic of allergies.

Moreover, this reaction can occur not only to the presence of the virus itself, but also to the waste products of this microorganism.

There is also such a thing as an infectious allergy, which occurs when not only virus cells enter the child's body, but also of various kinds bacteria, fungal microorganisms.

This type of allergic reaction develops against the background of other diseases, the causative agents of which are this or that infection.

What is an allergen?

An infectious viral allergy occurs in a child when his body comes into contact with:

Causes of occurrence

The main reason for the development of the disease is considered to be the penetration into the child's body. pathogen infection.

In addition, it is necessary that the child's body is distinguished by increased sensitivity to the microorganism and its waste products.

In order for a child to develop an allergic reaction to viruses, bacteria and other pathogenic microflora, the presence of such factors is necessary how:

Such can provoke the development of the disease serious illness like: syphilis, tuberculosis, leprosy, anthrax, plague, dysentery, typhus, brucellosis, fungal infections of the skin and internal organs.

Even an insignificant content of pathogens in the child's body can cause the development of an allergic reaction.

This situation arises, for example, when conducting certain infectious tests(such as the Mantoux reaction), when a small amount of a drug containing a virus or other infection is injected into a child's body to determine its sensitivity.

Can allergies in children have a cumulative effect? Find out about it from ours.

Classification and types

Depending on what caused the development of the allergic reaction, the following types of infectious allergy are distinguished:

viral(developing as a result of the penetration of the pathogen virus into the child's body);
bacterial(arising from contact with pathogenic bacteria);
fungal(arising from a fungal infection of the body, that is, the skin, nails, internal organs).

Symptoms and Signs

Viral allergy in a child - photo:

You can recognize the development of viral allergies by the following characteristic manifestations this ailment, such as:

Redness of certain parts of the body, the formation of specific nodular or blistering rashes on them.
Severe itching of the skin.
Nasal congestion, appearance transparent secretions from the nasal cavity.
Lachrymation, development of signs of conjunctivitis.
Disruption of the digestive system, manifested in the form of painful sensations in the abdomen, stool disorders, the appearance of gagging.
Severe dry cough, the attacks of which give the child serious discomfort.
Difficulty breathing, the child develops shortness of breath, breathing becomes heavy and noisy.
Enlargement of the lymph nodes, most often located in the area where the virus enters the body.
Increase in body temperature (sometimes hyperthermia occurs suddenly, temperature indicators reach high levels).

Diagnostics

The diagnosis begins with the collection of an anamnesis of the disease.

In particular, the doctor reveals an increased sensitivity of the child's body to allergic reactions, burdened heredity, conditions under which characteristic allergy symptoms(whether the child had any viral disease, the nature and duration of its course).

It also matters how often the child gets sick. viral diseases, since children most susceptible to their development often have a corresponding type of allergy.

Further, the patient is examined, the characteristic symptoms of the pathology are identified. Necessary and laboratory research, in particular, a blood test to determine the number of mast cells and the rate of their decay.

Differential

When an infectious allergy occurs it is very important to identify the cause a given reaction of the child's body, that is, a specific pathogen.

Held differential diagnostics post-vaccination allergy. For this, the child is prescribed various tests (skin or subcutaneous), for example, the Mantoux reaction.

After that, the doctor monitors the reaction of the little patient's body. In the presence of allergies after such tests the child develops the corresponding symptoms of the disease, in particular:

redness of the skin at the injection site, the appearance of a painful papular formation in this area;
the death of tissue cells in this area;
deterioration of the general well-being of the child.

Why is it dangerous?

Viral allergies can lead to various types of complications associated with breathing disorders (for example, the appearance of severe suffocation, which can lead to the death of the child), damage to the eyes, joints (infectious-allergic arthritis), significantly impairing the quality of life of the child.

When internal organs are damaged, their functionality is significantly reduced, which also contributes to the development of certain health problems.

Treatment

The main method of treatment is taking medications prescribed by a doctor.

Allergies can be caused by various reasons (bacteria, viruses, fungi), therefore, only a doctor should select a medicine, based on this reason.

So, antiviral drugs will not give any effect for bacterial or fungal allergies, while they cope with the viral type of ailment quite effectively. Therefore, before starting treatment, it is necessary to identify the allergen, and this can only be done by a doctor in a clinic.

Medication

The child is prescribed an appointment medicines the following groups:

Traditional medicine

Time-tested traditional medicine will help relieve unpleasant allergy symptoms. For example, it helps well against rashes and itching. sea buckthorn oil or rosehip oil.

This remedy is necessary several times a day. lubricate the affected skin... The oil has a calming, anti-inflammatory effect, promotes rapid regeneration of damaged skin. For the same purposes, you can use fresh sea buckthorn berries or rose hips.

Dandelion leaf infusion has a pronounced restorative effect, helps children's body better deal with disease-causing viruses.

To prepare the product, you need to take 2 tablespoons. chopped leaves, pour them with a glass of boiling water.

Give the child half a glass 2 times a day.

other methods

If the child's body is prone to viral allergies, it is necessary to take measures to strengthen immunity... For this, a course of immunotherapy with drugs prescribed by a doctor is recommended.

In addition, it is important to adjust the baby's lifestyle, to provide him with a long stay in the fresh air, adequate physical activity.

In some cases, the baby is prescribed the introduction of minimal doses of the allergen. This contributes to the restructuring of the child's immunity, the habituation of his body to the presence of the pathogen.

Prophylaxis

For preventing the development of allergic attacks necessary:

An allergic reaction to infections and viruses is a very common phenomenon in children, especially among those who often suffer from various kinds of diseases of a viral or bacterial nature.

In order to get rid of the manifestations of allergies, it is necessary to identify the pathogen, and only after that start treatment. The success of therapy largely depends on this.

You can learn about the causes of allergies in infectious diseases from the video:

We kindly ask you not to self-medicate. Make an appointment with a doctor!

The study of allergenic bacteria began as early as 1909, when allergies and anaphylaxis were studied. The development of the theory of allergy has shown that allergic properties can be detected not only immediately, but also after some time.

Among the reactions that can occur immediately, there may be both bronchial asthma caused by bacteria.

Bacteria that have allergenic properties are still being studied; their study is carried out by sampling skin tissues. The strongest effect is possessed by allergens from saprophytic microbes that are released from patients.

The participants in pathogenic microbial species are very small, and in other types of allergic diseases, one has to approach the assessment of the values of saprophytes in a new way. In this case, we are not talking about the causative agents of the disease, but about the fact that some types of microbes can settle in the body and stay in it for a very long time, this can cause sensitization and a disease such as bronchial asthma may appear.

Currently, bacterial allergens are usually divided into two groups:

Antigen of the causative agent of an infectious disease:

This type of allergens includes tuberculin, which was obtained by extracting the allergen from the microbacteria of tuberculosis. Sensitization to tuberculosis pathogens has become a classic in the study of delayed-type hypersensitivity. Tuberculin-. In its composition, tuberculin contains lipid impurities, which affect the duration of the formation of the reaction and contribute to the activity of the drug. The antigens of this type of pathogen were studied one of the very first.

Recombinant allergen injections

The Mantoux test is a diagnosis of a method for studying the strength of immunity to pathogens of tuberculosis, which is carried out using special microbacteria - tuberculin and the reaction is monitored. Mantoux is not done if there are any diseases on the skin, chronic and infectious diseases, epilepsy, allergies, quarantine. The vaccination is done a month after the quarantine is lifted.

Allergen of opportunistic bacteria:

This includes lepromin, which contains 75% protein, 13% polysaccharides and about 13% nucleic acids. Many years have passed since the manufacture of lepromin, and it is still the most common in the diagnosis of leprosy.

Leprosy bacteria

Lepromatous tissue extract

Allergen activation

Allergies can be caused by various substances and simple and complex protein, protein-lipid and protein-polysaccharide complexes.

Based on the result of numerous experiences and research modern medicine, who studied the chemical composition, it can be assumed that natural allergens in most cases are glycoprotein with M from 10-90 kD. If the fraction with M is less than 10 kD, then they cannot form an effective bridge by themselves and therefore an allergic reaction does not occur.

An antigen with M greater than 70-90kD has no ability to penetrate the barrier tissues, and allergens do not reach the mast cells.

An allergenic stimulus is the very first signal that triggers the activation of lymphoid cells.

To a greater extent, sensitization to this type of bacteria is manifested if there is infectious diseases of varying complexity: bronchial asthma, chronic pneumonia, tonsillitis, streptococcus allergen.

People with atopic dermatitis are at increased risk of developing infectious complications skin. 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 reasons 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 severe 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).

Confirmed appearance clinical signs atopic dermatitis after application of staphylococcal exotoxin to intact skin healthy person... 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 thereby 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 can act as allergens themselves), in combination with common allergens, worsen the eczematous process in the skin, inducing a T-cell response, increasing and maintaining chronic skin inflammation in 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.

Recently, much attention has been paid 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 antibiotic 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 skin manifestations in patients with poorly controlled course of atopic dermatitis after antistaphylococcal therapy.

However, the effect antibacterial drugs with atopic dermatitis has not been proven, although a number of studies have noted positive effect 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.