Алергічні захворювання в дітей: сучасний погляд на проблему

Abstract

Aim: review of modern data of scientific medical literature regarding the prevalence, comorbidity, risk factors, features of pathogenesis, diagnosis, principles of treatment and prevention of allergic diseases in children. In recent years, the number of allergic diseases (ADs) has been increasing, especially among children. Approximately 20% of the world's population suffers from these diseases. Comorbid ADs are quite common. Thus, in 67–85% of children, allergic rhinitis is combined with bronchial asthma. Children with atopic dermatitis are diagnosed with allergic rhinitis in 61,8% of cases, and bronchial asthma in 29,4% of cases. The risk of developing bronchial asthma or allergic rhinitis is higher in children with food polysensitization, and infants and young children with atopic dermatitis have a high risk of developing both food allergy and asthma and allergic rhinitis. According to modern data, most ADs have common causal mechanisms. In the development and progression of asthma and allergic rhinitis and atopic dermatitis, the hypotheses of mechanistic damage of the epithelial barrier and biodiversity, related to each other, are considered. In ADs, mechanisms related to allergen-specific immunoglobulin E and non-allergic coexisting mechanisms play an important role. In addition, views on the formation of the sequence of the development of ADs ("allergic march") from the perspective of multimorbidity and phenotyping are increasingly expanding. Pathogenetic treatment of ADs is aimed at controlling the chronic T-helper 2, caused by the inflammatory process in target organs. Secondary and tertiary prevention of ADs in the early stages improves the quality of life of patients and improves the course of atopic conditions. Conclusions. The prevalence of ADs in modern conditions is pandemic in nature. The hypothesis of mechanical damage to the epithelial barrier is significant in the development of ADs. ADs, in particular in children, can be combined, creating multi- and comorbid conditions, and aggravate the course of these diseases. Timely diagnosis of ADs is important, and a personalized approach to the treatment and prevention of ADs is considered the most rational.