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Аллергический ринит и астма у детей: возможности интегрированного лечения
Аллергический ринит и астма у детей: возможности интегрированного лечения
Суровенко Т.Н., Глушкова Е.Ф., Краснова Ю.Н., Иванова Е.В. Аллергический ринит и астма у детей: возможности интегрированного лечения. Consilium Medicum. Педиатрия (Прил.). 2016; 1: 78–83.
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Аннотация
Аллергический ринит нередко является частью системного воспалительного процесса, связанного с другими воспалительными состояниями, такими как астма. Бронхиальная астма и ринит – гетерогенные заболевания, но большинство детей страдают от IgE-зависимой (атопической) астмы, связанной с аллергическим ринитом, который определяет возможность комплексного лечения обоих заболеваний. Исключение контакта с аллергеном, образование пациента, аллерген-специфическая иммунотерапия, а также некоторые лекарственные препараты, такие как ингибиторы лейкотриеновых рецепторов-1 и топические глюкокортикостероиды, наиболее эффективны. Эпидемиология обоих заболеваний и влияние терапии аллергического ринита на течение атопической астмы, роль монтелукаста и будесонида в лечении, эффективность, безопасность и основные механизмы обсуждаются в этой статье.
Ключевые слова: аллергический ринит, бронхиальная астма, лечение.
AR is often a part of a systemic inflammatory process associated with other inflammatory conditions as asthma. Bronchial asthma and rhinitis are the heterogeneous disease but the majority of children suffer from IgE-dependent (atopic) asthma associated with allergic rhinitis, which defines opportunity of integrated treatment for both diseases. The allergen avoidance, patient’s education, allergen-specific immunotherapy (SIT) and some drugs as Cysteinyl Leukotriene Receptor-1 Antagonists and topical corticosteroids meets this approach best of all. The epidemiology both conditions and influence of allergic rhinitis therapy on atopic asthma, role of montelucast and budesonide in treatment, efficacy, safety, and basic mechanisms are discussed in the article.
Key words: allergic rhinitis, asthma, therapy.
Ключевые слова: аллергический ринит, бронхиальная астма, лечение.
________________________________________________
AR is often a part of a systemic inflammatory process associated with other inflammatory conditions as asthma. Bronchial asthma and rhinitis are the heterogeneous disease but the majority of children suffer from IgE-dependent (atopic) asthma associated with allergic rhinitis, which defines opportunity of integrated treatment for both diseases. The allergen avoidance, patient’s education, allergen-specific immunotherapy (SIT) and some drugs as Cysteinyl Leukotriene Receptor-1 Antagonists and topical corticosteroids meets this approach best of all. The epidemiology both conditions and influence of allergic rhinitis therapy on atopic asthma, role of montelucast and budesonide in treatment, efficacy, safety, and basic mechanisms are discussed in the article.
Key words: allergic rhinitis, asthma, therapy.
Полный текст
Список литературы
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28. Kim SB, Lee JH, Lee J et al. Montelukast for bronchopulmonary dysplasia Korean
J Pediatr 2015; 58: 347–53.
29. Bisgaard H, Zielen S, Luz Garcia-Garcia M et al. Montelukast Reduces Asthma Exacerbations in 2- to 5-Year-Old Children with Intermittent Asthma. Am J Resp Crit Care Med 2005; 171: 315–22.
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2. Bousquet J, Khaltaev N, Cruz A et al. ARIA Update 2008. Allergy 2008; 63: 160.
3. Brozek JL, Bousquet J, Baena-Cagnani CE et al. Allergic rhinitis and its impact on asthma 2010 revision. J Allergy Clin Immunol 2010; 126: 466–76.
4. Global'naya initsiativa po bronkhial'noy astme. Global'naya strategiya lecheniya i profilaktiki bronkhial'noy astmy (peresmotr 2015 g.) GINA. Updated 2015 www.ginasthma.org. [in Russian]
5. Integrated care pathways for airway diseases (AIRWAYS-ICPs). Eur Respir J 2014; 44: 304–23.
6. Papadopoulos NG, Bernstein JA, Demoly P et al. Phenotypes and endotypes of rhinitis and their impact on management: a PRACTALL report. Allergy 2015; 70: 474–94.
7. Settipane G, Settipane RJ, Hagy GW. Long term risk factors for developing asthma and allergic rhinitis: a 23 year follow up study of college students. Allergy Proc 1994; 15: 21–5.
8. Leynaert B, Bousquet J, Neukirch C et al. Perennial rhinitis: An independent risk factor for asthma in nonatopic subjects. J Allergy Clin Immunol 1999; 104: 301–4.
9. Balabolkin N.I. Allergiia u detei i ekologiia. Ros. pediatr. zhurn. 2002; 5: 4–8. [in Russian]
10. Barnes KC. Atopy and asthma genes – where do we stand. Review. Allergy 2000; 55: 803–17.
11. Munir A, Kjellman M, Bjorkstein B. Exposure to indoor allergens in early infancy and sensitization. J Allergy Clin Immunol 1997; 100: 177–88.
12. Fedoseev G.B., Labkovskaia N.A., Bobrova E.E. Kleshchevaia allergiia u bol'nykh bronkhial'noi astmoi: metody diagnostiki i lecheniia. Allergologiia. 1998; 4: 8–11. [in Russian]
13. Surovenko T.N., Zheleznova L.V. Akarofauna zhil'ia i ee rol' v razvitii allergicheskogo vospaleniia dykhatel'nykh putei. Allergologiia. 2003; 1: 11–4. [in Russian]
14. Surovenko T.N., Nevzorova V.A., Ovchinnikova O.V., Markelova E.V. Sistemnaia i lokal'naia sekretsiia interleikina-4 i immunoglobulina E pri bronkhial'noi astme i allergicheskom rinite. Med. immunologiia. 2002; 4-5: 559–64. [in Russian]
15. Gushchin I.S. Allergicheskoe vospalenie i ego farmakologicheskii kontrol'. M.: Farmarus Print Media, 1998. [in Russian]
16. Theron J, Steel HC, Tintinger GR et al. Cysteinyl Leukotriene Receptor-1 Antagonists as Modulators of Innate Immune Cell Function. J Immunol Res 2014; ID 608930.
17. Passalacqua G, Canonica GW. Treating the allergic patient: think globally, treat globally. Allergy 2002; 57 (10): 876–83.
18. Papadopoulos NG, Bernstein JA, Demoly P et al. Phenotypes and endotypes of rhinitis and their impact on management: a PRACTALL report. Allergy 2015; 70: 474–94.
19. Cox LS, Hankin C, Lockey R. Allergy immunotherapy adherence and delivery route: location does not matter. J Allergy Clin Immunol Pract 2014; 2: 156–60.
20. Vita D, Caminiti L, Ruggeri P, Pajno GB. Sublingual immunotherapy: adherence based on timing and monitoring control visits. Allergy 2010; 65: 668–9.
21. Gushchin I.S., Kurbacheva O.M. Allergiia i allergenspetsificheskaia immunoterapiia. M.: Farmarus Print Media, 2010. [in Russian]
22. Nenasheva N.M. Atopicheskaia bronkhial'naia astma: rol' allergen-spetsificheskoi immunoterapii. Ros. allergol. zhurn. 2015; 6: 4–67. [in Russian]
23. Leadford DK. Pharmacological treatment of allergic disease. Global atlas of allergy. 2014; 281–4.
24. Kam Lun Е, Hon Ting, Fan Leung, Leung AKC. Clinical effectiveness and safety of montelukast in asthma. What are the conclusions from clinical trials and meta-analyses? Drug Des Development Ther 2014; 8: 839–850.
25. Scott JP, Peters-Golden M. Antileukotriene Agents for the Treatment of Lung Disease. Am J Resp Crit Care Med 2013; 188: 538–44.
26. Belhassen M, de Pouvourville G, Laforest L et al. Effectiveness of Montelukast on asthma control in infants: methodology of a French claims data study. BMC Pulmonary. Medicine. 2015; 15: 51.
27. Bisgaard H, Flores-Nunez A, Goh A et al. Study of Montelukast for the Treatment of Respiratory Symptoms of Post–Respiratory Syncytial Virus Bronchiolitis in Children. Am J Resp and Crit Care Med 2008; 178: 854–60.
28. Kim SB, Lee JH, Lee J et al. Montelukast for bronchopulmonary dysplasia Korean
J Pediatr 2015; 58: 347–53.
29. Bisgaard H, Zielen S, Luz Garcia-Garcia M et al. Montelukast Reduces Asthma Exacerbations in 2- to 5-Year-Old Children with Intermittent Asthma. Am J Resp Crit Care Med 2005; 171: 315–22.
30. Baena-Cagnani CE. Safety and tolerability of treatments for allergic rhinitis in children. Drug Saf 2004; 27: 883–98.
31. Aubert-Wastiaux H, Moret L, Le Rhun A et al. Topical corticosteroid phobia in atopic dermatitis: a study of its nature, origins and frequency. Br J Dermatol 2011; 165: 808–14.
32. Lindqvist N, Balle VH, Karma P et al. Long-term safety and efficacy of budesonide nasal aerosol in perennial rhinitis. A 12-month multicentre study. Allergy 1986; 41: 179–86.
33. Skoner D, Rachelefsky G, Meltzer E et al. Detection of growth suppression in children during treatment with intranasal belcomethasone dipropionate. Pediatrics 2000; 105: 23.
34. Mener DJ, Shargorodsky J, Varadhan R, Lin SY. Topical intranasal corticosteroids and growth velocity in children: a meta-analysis. Int Forum Allergy Rhinol 2015; 5: 95–103.
35. Emin O, Fatih M, Emre D, Nedim S. Lack of bone metabolism side effects after
3 years of nasal topical steroids in children with allergic rhinitis. J Bone Miner Metab 2011; 29: 582–7.
36. Kurbacheva O.M., Shvets S.M. Intranazal'nye kortikosteroidy v lechenii allergicheskogo rinita. Ros. allergol. zhurn. 2016; 6: 71–8. [in Russian]
37. Bousquet J, Khaltaev N, Cruz A et al. ARIA Update. Allergy 2008; 63: 160.
38. Lipworth BJ, Jackson CM. Safety of inhaled and intranasal corticosteroids: lessons for the new millennium. Drug Saf 2000; 23: 11–33.
39. Muller C, Ahlstrom H, Henricson KA et al. Safety of nasal budesonide in the long-term treatment of children with perennial rhinitis. Clin Exp Allergy 2003; 6: 816–22.
40. Kurbacheva O.M., Pol'ner S.A., Smirnov D.S. Allergicheskii rinit. Vechnaia problema i ee sovremennoe reshenie. Meditsinskii sovet. Otorinolaringologiia. 2015; 5: 84–91. [in Russian]
2. Bousquet J, Khaltaev N, Cruz A et al. ARIA Update 2008. Allergy 2008; 63: 160.
3. Brozek JL, Bousquet J, Baena-Cagnani CE et al. Allergic rhinitis and its impact on asthma 2010 revision. J Allergy Clin Immunol 2010; 126: 466–76.
4. Глобальная инициатива по бронхиальной астме. Глобальная стратегия лечения и профилактики бронхиальной астмы (пересмотр 2015 г.) GINA. Updated 2015 www.ginasthma.org. / Global'naya initsiativa po bronkhial'noy astme. Global'naya strategiya lecheniya i profilaktiki bronkhial'noy astmy (peresmotr 2015 g.) GINA. Updated 2015 www.ginasthma.org. [in Russian]
5. Integrated care pathways for airway diseases (AIRWAYS-ICPs). Eur Respir J 2014; 44: 304–23.
6. Papadopoulos NG, Bernstein JA, Demoly P et al. Phenotypes and endotypes of rhinitis and their impact on management: a PRACTALL report. Allergy 2015; 70: 474–94.
7. Settipane G, Settipane RJ, Hagy GW. Long term risk factors for developing asthma and allergic rhinitis: a 23 year follow up study of college students. Allergy Proc 1994; 15: 21–5.
8. Leynaert B, Bousquet J, Neukirch C et al. Perennial rhinitis: An independent risk factor for asthma in nonatopic subjects. J Allergy Clin Immunol 1999; 104: 301–4.
9. Балаболкин Н.И. Аллергия у детей и экология. Рос. педиатр. журн. 2002; 5: 4–8. / Balabolkin N.I. Allergiia u detei i ekologiia. Ros. pediatr. zhurn. 2002; 5: 4–8. [in Russian]
10. Barnes KC. Atopy and asthma genes – where do we stand. Review. Allergy 2000; 55: 803–17.
11. Munir A, Kjellman M, Bjorkstein B. Exposure to indoor allergens in early infancy and sensitization. J Allergy Clin Immunol 1997; 100: 177–88.
12. Федосеев Г.Б., Лабковская Н.А., Боброва Е.Е. Клещевая аллергия у больных бронхиальной астмой: методы диагностики и лечения. Аллергология. 1998; 4: 8–11. / Fedoseev G.B., Labkovskaia N.A., Bobrova E.E. Kleshchevaia allergiia u bol'nykh bronkhial'noi astmoi: metody diagnostiki i lecheniia. Allergologiia. 1998; 4: 8–11. [in Russian]
13. Суровенко Т.Н., Железнова Л.В. Акарофауна жилья и ее роль в развитии аллергического воспаления дыхательных путей. Аллергология. 2003; 1: 11–4. / Surovenko T.N., Zheleznova L.V. Akarofauna zhil'ia i ee rol' v razvitii allergicheskogo vospaleniia dykhatel'nykh putei. Allergologiia. 2003; 1: 11–4. [in Russian]
14. Суровенко Т.Н., Невзорова В.А., Овчинникова О.В., Маркелова Е.В. Системная и локальная секреция интерлейкина-4 и иммуноглобулина Е при бронхиальной астме и аллергическом рините. Мед. иммунология. 2002; 4-5: 559–64. / Surovenko T.N., Nevzorova V.A., Ovchinnikova O.V., Markelova E.V. Sistemnaia i lokal'naia sekretsiia interleikina-4 i immunoglobulina E pri bronkhial'noi astme i allergicheskom rinite. Med. immunologiia. 2002; 4-5: 559–64. [in Russian]
15. Гущин И.С. Аллергическое воспаление и его фармакологический контроль. М.: Фармарус Принт Медиа, 1998. / Gushchin I.S. Allergicheskoe vospalenie i ego farmakologicheskii kontrol'. M.: Farmarus Print Media, 1998. [in Russian]
16. Theron J, Steel HC, Tintinger GR et al. Cysteinyl Leukotriene Receptor-1 Antagonists as Modulators of Innate Immune Cell Function. J Immunol Res 2014; ID 608930.
17. Passalacqua G, Canonica GW. Treating the allergic patient: think globally, treat globally. Allergy 2002; 57 (10): 876–83.
18. Papadopoulos NG, Bernstein JA, Demoly P et al. Phenotypes and endotypes of rhinitis and their impact on management: a PRACTALL report. Allergy 2015; 70: 474–94.
19. Cox LS, Hankin C, Lockey R. Allergy immunotherapy adherence and delivery route: location does not matter. J Allergy Clin Immunol Pract 2014; 2: 156–60.
20. Vita D, Caminiti L, Ruggeri P, Pajno GB. Sublingual immunotherapy: adherence based on timing and monitoring control visits. Allergy 2010; 65: 668–9.
21. Гущин И.С., Курбачева О.М. Аллергия и аллергенспецифическая иммунотерапия. М.: Фармарус Принт Медиа, 2010. / Gushchin I.S., Kurbacheva O.M. Allergiia i allergenspetsificheskaia immunoterapiia. M.: Farmarus Print Media, 2010. [in Russian]
22. Ненашева Н.М. Атопическая бронхиальная астма: роль аллерген-специфической иммунотерапии. Рос. аллергол. журн. 2015; 6: 4–67. / Nenasheva N.M. Atopicheskaia bronkhial'naia astma: rol' allergen-spetsificheskoi immunoterapii. Ros. allergol. zhurn. 2015; 6: 4–67. [in Russian]
23. Leadford DK. Pharmacological treatment of allergic disease. Global atlas of allergy. 2014; 281–4.
24. Kam Lun Е, Hon Ting, Fan Leung, Leung AKC. Clinical effectiveness and safety of montelukast in asthma. What are the conclusions from clinical trials and meta-analyses? Drug Des Development Ther 2014; 8: 839–850.
25. Scott JP, Peters-Golden M. Antileukotriene Agents for the Treatment of Lung Disease. Am J Resp Crit Care Med 2013; 188: 538–44.
26. Belhassen M, de Pouvourville G, Laforest L et al. Effectiveness of Montelukast on asthma control in infants: methodology of a French claims data study. BMC Pulmonary. Medicine. 2015; 15: 51.
27. Bisgaard H, Flores-Nunez A, Goh A et al. Study of Montelukast for the Treatment of Respiratory Symptoms of Post–Respiratory Syncytial Virus Bronchiolitis in Children. Am J Resp and Crit Care Med 2008; 178: 854–60.
28. Kim SB, Lee JH, Lee J et al. Montelukast for bronchopulmonary dysplasia Korean
J Pediatr 2015; 58: 347–53.
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J Pediatr 2015; 58: 347–53.
29. Bisgaard H, Zielen S, Luz Garcia-Garcia M et al. Montelukast Reduces Asthma Exacerbations in 2- to 5-Year-Old Children with Intermittent Asthma. Am J Resp Crit Care Med 2005; 171: 315–22.
30. Baena-Cagnani CE. Safety and tolerability of treatments for allergic rhinitis in children. Drug Saf 2004; 27: 883–98.
31. Aubert-Wastiaux H, Moret L, Le Rhun A et al. Topical corticosteroid phobia in atopic dermatitis: a study of its nature, origins and frequency. Br J Dermatol 2011; 165: 808–14.
32. Lindqvist N, Balle VH, Karma P et al. Long-term safety and efficacy of budesonide nasal aerosol in perennial rhinitis. A 12-month multicentre study. Allergy 1986; 41: 179–86.
33. Skoner D, Rachelefsky G, Meltzer E et al. Detection of growth suppression in children during treatment with intranasal belcomethasone dipropionate. Pediatrics 2000; 105: 23.
34. Mener DJ, Shargorodsky J, Varadhan R, Lin SY. Topical intranasal corticosteroids and growth velocity in children: a meta-analysis. Int Forum Allergy Rhinol 2015; 5: 95–103.
35. Emin O, Fatih M, Emre D, Nedim S. Lack of bone metabolism side effects after
3 years of nasal topical steroids in children with allergic rhinitis. J Bone Miner Metab 2011; 29: 582–7.
36. Kurbacheva O.M., Shvets S.M. Intranazal'nye kortikosteroidy v lechenii allergicheskogo rinita. Ros. allergol. zhurn. 2016; 6: 71–8. [in Russian]
37. Bousquet J, Khaltaev N, Cruz A et al. ARIA Update. Allergy 2008; 63: 160.
38. Lipworth BJ, Jackson CM. Safety of inhaled and intranasal corticosteroids: lessons for the new millennium. Drug Saf 2000; 23: 11–33.
39. Muller C, Ahlstrom H, Henricson KA et al. Safety of nasal budesonide in the long-term treatment of children with perennial rhinitis. Clin Exp Allergy 2003; 6: 816–22.
40. Kurbacheva O.M., Pol'ner S.A., Smirnov D.S. Allergicheskii rinit. Vechnaia problema i ee sovremennoe reshenie. Meditsinskii sovet. Otorinolaringologiia. 2015; 5: 84–91. [in Russian]
Авторы
Т.Н.Суровенко*1, Е.Ф.Глушкова2, Ю.Н.Краснова3, Е.В.Иванова1
1 ГБОУ ВПО Тихоокеанский государственный медицинский университет Минздрава России. 690002, Россия, Владивосток, пр. Острякова, д. 2;
2 ФГБУ ГНЦ Институт иммунологии ФМБА России. 115478, Россия, Москва, Каширское ш., д. 24, корп. 2;
3 ГБОУ ДПО Иркутская государственная медицинская академия последипломного образования Минздрава России. 664049, Россия, Иркутск, м/р Юбилейный, д. 100
*sourov@inbox.ru
1 Pacific State Medical University. 690002, Russian Federation, Vladivostok, pr. Ostryakova, d. 2;
2 Institute of Immunology. 115478, Russian Federation, Moscow, Kashirskoie sh., d. 24, str. 2;
3 Irkutsk State Medical Academy of Continuing Education. 664049, Russian Federation, Irkutsk, m/r Yubileynyy, d. 100
*sourov@inbox.ru
1 ГБОУ ВПО Тихоокеанский государственный медицинский университет Минздрава России. 690002, Россия, Владивосток, пр. Острякова, д. 2;
2 ФГБУ ГНЦ Институт иммунологии ФМБА России. 115478, Россия, Москва, Каширское ш., д. 24, корп. 2;
3 ГБОУ ДПО Иркутская государственная медицинская академия последипломного образования Минздрава России. 664049, Россия, Иркутск, м/р Юбилейный, д. 100
*sourov@inbox.ru
________________________________________________
1 Pacific State Medical University. 690002, Russian Federation, Vladivostok, pr. Ostryakova, d. 2;
2 Institute of Immunology. 115478, Russian Federation, Moscow, Kashirskoie sh., d. 24, str. 2;
3 Irkutsk State Medical Academy of Continuing Education. 664049, Russian Federation, Irkutsk, m/r Yubileynyy, d. 100
*sourov@inbox.ru
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