Allergic Complications Research Articles

Systemic anaphylaxis following centipede envenomation: A case report and review of literature

ABSTRACT Centipede envenomation is usually not life-threatening. They usually present with local symptoms of swelling and pain. Centipede venoms contain large amounts of allergenic proteins that can pose a risk of allergic complications following the bite. Here, we report a rare but important case of systemic anaphylaxis in the form of abdominal pain immediately following a centipede bite that subsided after adrenaline administration. Knowledge of this systemic anaphylaxis is essential for timely management of centipede envenomation.

The most common contact lens-related complications: A brief review of the literature

Introducion and purpose Millions of people use contact lenses every day. Their primary and most common use is correcting refractive errors. Despite their beneficial purpose, contact lens use has many complications. It is estimated that 5 to 50% of patients may develop at least a single complication. The state of knowledge Contact lens-related complications are multifactorial. One of the main reasons for contact lens discontinuation is contact lens discomfort. Patients most often report dryness, burning, and irritated eyes. Other disorders can be briefly divided into conjunctival and corneal complications. The most common conjunctival and allergic complication of contact lens use is giant papillary conjunctivitis. Other significant conditions involving the conjunctiva can also be superior limbic keratoconjunctivitis or allergic or toxic conjunctivitis. Corneal complications, on the other hand, seemed to be much more severe. These include superficial punctate keratitis, peripheral corneal ulceration, and contact lens-related keratitis. Also, abrasion can occur due to improper eye hygiene or mechanical damage during lens replacement. It should also be remembered that prolonged use of lenses can lead to hypoxia and corneal edema. Summary This paper briefly outlines the possible complications of contact lens use. It is important to remember that despite their appropriate use, sometimes significant complications can occur. Noteworthy, corneal, or conjunctival complications require discontinuation of the lenses and appropriate treatment.

Interest of Locoregional Analgesia for the Management of Pulmonary and Hepatic Hydatid Cyst Disease

Introduction: Pulmonary and hepatic hydatid disease requires complex management. Analgesia is a key element. Objective: Assess the interest of epidural and paravertebral analgesia. Methods: Retrospective study of 8 patients undergoing surgery for pulmonary and hepatic cysts under locoregional analgesia. Comparison of pain scores, hemodynamic and respiratory stability. Results: Effective analgesia observed without instability. One allergic complication noted. Conclusion: These techniques seem interesting in this context. Comparative studies are needed.

Diagnosis and Treatment of Perioperative Allergic Complications: A Practical Review.

Reported drug allergies are commonly encountered by surgeons and can lead to uncertainty in selecting an appropriate agent due to concerns of associated risks with related and cross-reactive drugs. This uncertainty can ultimately lead to increased infection rates. A literature review was conducted in PubMed using a combination of the terms "allergy," "allergic reaction," "anaphylaxis," and "surgery," "surgical," or "operating room" for articles published within the last 10 years. Publications identified with these search terms were then filtered for review articles, sorted by "best match," and a maximum of 100 articles were manually reviewed for each combination of search terms. Search results yielded 46,484 articles, 676 of which were ultimately included for manual review, based on selection criteria. Specifically, articles selected for inclusion focused on surgical allergic reactions that were either related to mechanism of action, causative agent for the allergic reaction, timing of allergic reaction, or recommendations for appropriate management. Allergic reactions can be a common occurrence in the operative room. Knowledge of likely causative agents, timing of a reaction to various agents, and appropriate management in the immediate and delayed setting can improve outcomes and safety for plastic surgery patients.

Therapeutic apheresis: is it safe in children with kidney disease?

BackgroundTherapeutic apheresis (TA) is already used to treat various diseases in the field of nephrology. The aim of this study was to evaluate the frequency and types of complications that occur during TA in children with kidney disease.MethodsRecords of children (≤ 18 years) who underwent TA between 2007 and 2022 were retrospectively reviewed. Children with missing data and those with a diagnosis of nonnephrological disease were excluded.ResultsA total of 1214 TA sessions, including 1147 therapeutic plasma exchange (TPE) sessions and 67 immunoadsorption (IA) sessions, were performed on the 108 patients enrolled in the study. Forty-seven percent of the patients were male, and the mean age was 12.22 ± 4.47 years. Posttransplant antibody-mediated rejection (64.8%) and hemolytic uremic syndrome (14.8%) were the most common diagnoses indicating TA. Overall, 17 different complications occurred in 58 sessions (4.8%), and 53 sessions (4.6%) were not completed because of these complications. The distribution of complications among the patients was as follows: 41.4% had technical complications, 25.9% had allergic complications, and 32.7% had others. The most common technical complication was insufficient flow (37.5%). The incidence of complications was greater in patients aged 3–6 years than in patients in the other age groups (p = 0.031). The primary disease, type of vascular access, and rate of fresh frozen plasma/albumin use were similar between patients with and without complications (p values of 0.359 and 0.125 and 0.118, respectively).ConclusionsOur study showed that complications occurred in only 4.8% of TA sessions. The most common complication was technical problems.Graphical A higher resolution version of the Graphical abstract is available as Supplementary information

Co-Occurrence of Familial Mediterranean Fever and Hematologic Malignancies: Case Report Series

Introduction: Familial Mediterranean Fever (FMF) is an autosomal recessive genetic disorder primarily found among individuals of Mediterranean descent, including Armenians, Italians, Greeks, Arabs, Turks and Jews. In the Armenian population, approximately 90% of FMF cases are associated with three main mutations (M694V, V726A, and M680I) in two alleles of MEFV gene, while more than 300 MEFV variants have been reported worldwide. The homozygous M694V genotype is associated with frequent renal failure due to amyloidosis. Clinical manifestations of FMF include periodic attacks of diffuse serositis with pain and fever that are treated with colchicine or biologic therapy. There is a scarcity of data on patients with FMF and hematologic malignancies. Limited data makes it difficult to generate evidence-based recommendations for the management of these patients, which is mostly based on expert opinions or few case reports. Here we report the case series of patients from Armenia with simultaneous presence of FMF and hematologic malignancies (FMFHM) and evaluate their management challenges. Methods: Data was collected from the Armenian National Registry of Blood Disorders, at the Hematology Center after Prof. R. Yeolyan, and through personal interviews conducted with each patient. Hematology Center is the only institution in Armenia managing hematologic malignancies. We have analyzed 8 patients diagnosed with both FMFHM during 2000-2020, treated in the pediatric (1 patient) and adult (7 patients) hematology departments. Results: 8 patients with FMFHM were identified, from which 4 were diagnosed with myeloproliferative neoplasms (MPN), 2 with acute leukemia (AL), and 2 with non-Hodgkin lymphoma (NHL). The median age of patients was 46, range 20-60 years. Only 5 (62.5%) of patients were regularly taking colchicine for FMF, while the rest refused it. Four MPN patients received treatment only with oral medications (tyrosine kinase inhibitors, hydroxyurea). Autologous hemopoietic stem cell transplantation (auto-HSCT) was performed in 1 NHL patient after indicated 1 st and 2 nd line immuno-chemotherapy. Another 2 AL patients and one NHL patient received protocol-based respective chemotherapy regimens. Moderate gastrointestinal (GI) complications (e.g., epigastric pain, nausea, vomiting, intestinal discomfort) was experienced by 7 (87.5%) patients. Allergic reactions (e.g., moderate skin rash, itching) were seen in 5 patient (62.5%), of which one developed severe anaphylactic shock. A patient with FMF and PMF had ischemic stroke caused by thrombi. Arterial hypertension occurred in 3 (37.5%). Only in one patient reduction of colchicine dosage was performed (1mg/day was reduced to 0.6mg/d), because of interaction with imatinib. The rest of patients received chemotherapy and colchicine treatment as indicated. All 8 patients are alive, 5 of them are in hematologic or molecular remission, two of which received concurrent colchicine treatment. One patient in remission developed renal failure due to FMF (colchicine was refused). Two patients with MPN treated with colchicine experienced disease stabilization. Conclusion: In conclusion, the concurrent appearance of FMFHM may potentially increase the risk of GI side effects, allergic complications, and arterial hypertension, however definitive conclusions require further investigations in larger patient cohorts. While the overall treatment responses were largely positive, the association between MEFV and HM mutations warrants deeper exploration to provide more precise drug administration recommendations for colchicine and cancer medications. Future studies in this area will contribute to a better understanding of the interplay between these conditions and guide optimal treatment strategies.

Clinical cases of tattoo-associated dermatoses

The aim of the work is to analyze clinical cases of tattoo-associated skin reactions as an example of the algorithm of differential diagnosis of dermatoses of this group.
 Materials and methods. The personal observation of two clinical cases related to tattooing for aesthetic reasons and the appearance of a pathological reaction on the skin after the introduction of dyes is described. In addition to the visual assessment of the clinical picture, the final confirmation of the diagnosis was based on pathohistological examination.
 Results. Variability of clinical manifestations associated with tattooing is presented. The first clinical case is represented by the symmetrical appearance of a rash in the form of small papules up to 0.3–0.4 cm in diameter with clear borders, pink in color, and rounded in shape in the area of the eyebrows after their tattooing. Morphologically, the effect of black pigment on the skin in this case is represented by non-specific granulomatous inflammation. The second clinical case is characterized by the appearance of a plaque with hyperkeratosis phenomena and subjective complaints of slight itching at the site of red tattoo dye injection. Pathohistological examination indicated dermatitis of the mixed group (lichenoid interface and granulomatous), which is most correspond to an allergic reaction to tattoo pigment.
 Conclusions. The increase in the number of patients with tattoos requires a wider consideration of the complications that can be provoked by the artificial injection of dyes into the skin. Despite the advantage of allergic complications after tattooing, the risk of systemic diseases should raise the level of vigilance of practicing physicians regarding the timely diagnosis of sarcoidosis or aggressive neoplasia. The pathohistological examination is the “gold standard” for the final verification of complications after the artificial injection of pigment into the skin.

Редкие клинические случаи поражения глазной поверхности различной этиологии

The article presents several rare cases from clinical practice. In particular, they concern conjunctivitis, which was the first sign of COVID 19 infection, corneotoxic corneal lesions in the form of an extensive ulcer due to the abuse of local anesthetic oxybuprocaine. Other clinical cases of ocular surface damage are associated with vaccination against a new coronavirus infection, namely with the development of adenoviral keratoconjunctivitis after LASIK refractive intervention and subsequent early (after 5 days) immunoprophylaxis with the Gam-COVID-Vac vaccine, as well as with such a rare allergic complication as toxic epidermal necrolysis or Lyell's syndrome. Finally, a clinical case is presented on the membranous, hyperergic form of epidemic keratoconjunctivitis, which requires the attention of ophthalmologists, primarily in relation to differential diagnosis with true diphtheria lesions of the conjunctiva. Keywords: rare clinical cases, ocular surface, corneotoxic lesion, corneal ulcer, COVID 19, vaccination, toxic epidermal necrolysis, adenoviral conjunctivitis, hyperergic form

Allergic Complications of Hyaluronidase Injection: Risk Factors, Treatment Strategies, and Recommendations for Management.

Hyaluronidase is used as a reversal agent for hyaluronic acid fillers and to increase the diffusion of other medications after infiltration. Cases of hyaluronidase allergy have been described in the literature since 1984. However, it is still frequently misdiagnosed. This review aims to summarize the current literature to describe the clinical picture of hyaluronidase allergy and identify any risk factors associated with its development, as well as provide recommendations for management in plastic surgery. A digital search of PubMed, Scopus, and Embase databases was performed by two reviewers following the PRISMA guidelines. This search identified 247 articles. Two hundred forty-seven articles were identified, and 37 of them met the eligibility criteria. One hundred six patients with a mean age of 54.2 years were included in these studies. History of allergy to other substances (timothy grass, egg white, horse serum, penicillin, insect bites, wasp venom, thimerosal, potassium, histamine, phenylmercuric acetate, and nickel) and allergic diseases (asthma, dermatitis, atopy, rhinitis) was reported. A large portion of the patients with a history of repeated exposure (2-4) experienced the symptoms with their second injection. Nonetheless, there was no significant association between time to allergy development and the number of exposures (P = 0.3). Treatment with steroids +/- antihistamines resulted in the rapid and predominantly complete reversal of the symptoms. Prior injections or sensitization by insect/wasp venom might be the primary factor associated with hyaluronidase allergy development. The time between the repeated injections is not a likely contributor to the presentation. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Guideline on the investigation and management of acute transfusion reactions.

Guideline on the investigation and management of acute transfusion reactions.

Jellyfishes—Significant Marine Resources with Potential in the Wound-Healing Process: A Review

The wound-healing process is a significant area of interest in the medical field, and it is influenced by both external and patient-specific factors. The aim of this review paper is to highlight the proven wound-healing potential of the biocompounds found in jellyfish (such as polysaccharide compounds, collagen, collagen peptides and amino acids). There are aspects of the wound-healing process that can benefit from polysaccharides (JSPs) and collagen-based materials, as these materials have been shown to limit exposure to bacteria and promote tissue regeneration. A second demonstrated benefit of jellyfish-derived biocompounds is their immunostimulatory effects on growth factors such as (TNF-α), (IFN-γ) and (TGF), which are involved in wound healing. A third benefit of collagens and polysaccharides (JSP) is their antioxidant action. Aspects related to chronic wound care are specifically addressed, and within this general theme, molecular pathways related to tissue regeneration are explored in depth. Only distinct varieties of jellyfish that are specifically enriched in the biocompounds involved in these pathways and live in European marine habitats are presented. The advantages of jellyfish collagens over mammalian collagens are highlighted by the fact that jellyfish collagens are not considered transmitters of diseases (spongiform encephalopathy) or various allergic reactions. Jellyfish collagen extracts stimulate an immune response in vivo without inducing allergic complications. More studies are needed to explore more varieties of jellyfish that can be exploited for their biocomponents, which may be useful in wound healing.

Allergy identification for neurosurgical patients: updates for management.

Allergic reactions in neurosurgical procedures are uncommon, but they are detrimental to a patient's prognosis and recovery. By synthesizing data collected from other surgical fields, possible triggers and alternatives have been identified. Current treatment guidelines involve stabilizing the patient in emergency situations, symptom management, and identification of causative allergens. Preoperative allergy screening is uncommon due to the low prevalence of perioperative hypersensitivity reactions. However, preoperative questionnaire screening can identify when preoperative allergy screening, premedication, or use of a material alternative is necessary. Greater emphasis on material alternatives, increased preoperative screening, and more data can improve the prognosis of neurosurgical patients at risk of perioperative allergic complications.

Safety of mRNA COVID-19 vaccinations in patients with allergic diseases

ObjectivesThe aim of this study was to determine the degree of safety and possible risk of acute allergic reactions following mRNA COVID-19 vaccination among a group of patients predisposed to allergic diseases. Study designThe study survey took place between May 2021 and February 2022. Each participant completed an initial pre-vaccination questionnaire during patient eligibility assessment for vaccination, and two subsequent questionnaires were completed approximately 21 days after the first and second doses of vaccination. MethodsThe study included 52 patients aged >18 years. Participants were a select group of patients who, due to a history of severe allergic disease, were not eligible for vaccination at the COVID-19 Vaccination Points available in Poland. ResultsNone of the patients developed serious allergic complications in the form of anaphylaxis. There were no statistically significant differences between the first vaccination and the second vaccination in terms of symptoms, the time of onset and duration. The age of the participants did not correlate statistically with the occurrence of symptoms following the first or second vaccination. ConclusionsBased on the study results, it can be concluded that mRNA COVID-19 vaccines show a favourable safety profile for patients with a history of allergic disease and constitute the optimal strategy for fighting the SARS-CoV-2 pandemic. The study results support the recommendation of COVID-19 vaccinations for people predisposed to allergic diseases due to the clear benefits of vaccination over the possible risk of adverse events.

The systemic immune response due to cholesterol crystal embolization syndrome: a case report

BackgroundCholesterol crystal embolization syndrome (CES) occurs when an atherosclerotic plaque causes small-vessel embolization, resulting in multi-organ damage. Although CES is pathologically characterized by an infiltration of eosinophils, the implication of the systemic inflammatory response represented by hypereosinophilia is unclear in clinical practice. Herein we present the case of a patient diagnosed with CES who developed multiple allergic organ injuries, including daptomycin-related dermatitis and later vancomycin-induced acute tubulointerstitial nephritis, which was successfully treated by the withdrawal of each medicine with or without corticosteroid therapy, one by one.Case presentationA 76-year-old Japanese man diagnosed with thoracic aneurysm rupture underwent total arch replacement through the open stent graft technique. Postoperatively, he developed methicillin-resistant Staphylococcus epidermidis bacteremia, which was treated with daptomycin. Subsequently, he presented with palpable purpura on both dorsal feet, erythema around his body, and hypereosinophilia. Daptomycin was replaced with vancomycin due to suspicion of drug-induced erythema. The erythema gradually faded. On nine days after vancomycin therapy, the systemic erythema rapidly reappeared followed by acute renal failure. The renal function decline prompted hemodialysis. A skin biopsy revealed cholesterol embolization, whereas a kidney biopsy revealed acute tubulointerstitial nephritis. After vancomycin discontinuation and initiation of systemic corticosteroid treatment, his kidney function was restored to the baseline level.ConclusionsThe present case highlights cholesterol embolization can cause allergic complications in addition to direct organ damage.

Assessing the prevalence and severity of asthma, rhinitis, and eczema among schoolchildren (6–7 and 13–14 years old) in Khuzestan, Iran: a cross-sectional survey

BackgroundAsthma and allergic complications are the most common chronic disorders in children and adolescents. This study aimed to determine the prevalence and severity of asthma, allergic rhinitis, eczema among schoolchildren, and some related risk factors.MethodsThe cross-sectional study was performed in 2019 and involved 4000 students aged 6–7 years and 4000 students aged 13–14 years (both girls and boys) from urban schools in Khuzestan Province, southwestern Iran. We used the multi-stage sampling method. Data were collected using the Persian version of the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire.ResultsThe prevalence of current wheeze, wheeze ever and asthma ever in the age group of 6–7 years was 3.8, 4.5, and 1.8%, respectively; in the age group of 13–14 years, it was 4.4, 5.9, and 3.4, respectively. In terms of gender, males (4.9, 6.0, and 2.7 percent, respectively) had substantially higher rates of current wheeze, wheeze ever, and asthma ever compared to the girls (2.8, 3.6, and 2.0 percent, respectively) (p < 0.001). The prevalence of rhinitis, Hay fever, and eczema among young people was 5.3%, 3.5%, and 1.0%, respectively. Current wheeze was more common in children with allergic rhinitis in the last 12 months (30.3% vs. 2.7%, p < 0.001), Hay fever (32.8% vs. 0.3%, p < 0.001) and eczema (27.8% vs 3.8%, p < 0.001), compared to children who did not.ConclusionsThe prevalence and severity of asthma symptoms were significantly associated with allergic rhinitis, eczema, and gender.

An epidemiological survey of anhidrotic/hypohidrotic ectodermal dysplasia in Japan: High prevalence of allergic diseases.

Anhidrotic/hypohidrotic ectodermal dysplasia (A/HED) is a congenital disorder characterized by anhidrosis/hypohidrosis and inadequate hair and dental dysplasia. Large-scale case studies of patients with A/HED have already been conducted overseas, while there has been no large-scale study, but only a few case reports in Japan. Furthermore, an epidemiological study of this disease has not been conducted in Japan to date. The purpose of this study was to investigate the clinical characteristics of A/HED patients, the status of genetic aberrations and complications of A/HED in Japan. Initially, we conducted a physician-initiated questionnaire survey of A/HED patients who visited medical institutions across Japan to investigate their backgrounds, clinical symptoms, genotypes, diagnostic methods and complications of A/HED. We also investigated the presence or absence of various allergic diseases (atopic dermatitis-like skin manifestations, bronchial asthma and food allergies). Questionnaires were also obtained from 26 patients with ectodermal dysplasia (ED) who visited four medical institutions. We compared the incidence of allergic diseases in healthy controls in a similar study to that of patients. Twenty-four of those patients were considered to have A/HED, of which 18had a confirmed genetic diagnosis and were genotyped. All patients had anhidrosis or hypohidrosis, hair and dental dysplasia, and unique facial appearance; 23 patients had several cutaneous manifestations and seven patients had periorbital pigmentation. In addition, there was a significantly higher incidence of atopic dermatitis-like cutaneous manifestations, bronchial asthma and food allergies in the A/HED patients than in healthy controls. We report the results from a questionnaire survey of 24 patients with A/HED. This is the first report of a large number of A/HED patients in Japan. This study clarifies the status of clinical diagnosis and genetic testing of A/HED patients in Japan, as well as the characteristics of their skin symptoms and allergic complications.

Cesarean section incisional infiltration with lidocaine and Epinephrine versus Lidocaine alone in reducing postoperative pain. A randomized controlled double-blinded clinical trial

Abstract Background Cesarean section delivery is becoming more frequent. Childbirth is an emotion-filled event and the mother needs to bond with her newborn baby as early as possible. Any intervention that leads to improvement in pain relief is worthy of investigation Aim of the Work to assess the efficacy and safety adding ef Epinephrine to lidocaine 2% in dose-related manner 1:200.000 in prolongation of anesthetic effect of lidocaine as a local anesthetic to reduce post; caesarean section pain after general anesthesia. Patients and Methods A total number of 200 women planned for elective caesarean section at Shams University Maternity Hospital Was recruited, 2 groups were randomized with a study group included 100 women received lidocaine 2% and epinephrine in dose-related manner and a control group included 100 women received lidocaine 2% only. Results women who received lidocaine and epinephrine were more satisfied and hadsignificant more time after caesarean section free of pain in comparison to women who received lidocaine only by 120 minutes. Also. adding Of epinephrine helped in decrease in amount of analgesic consumption after caesarean section. Women who received lidocaine and epinephrine started breast feeding and mobilization earlier than women who received lidocaine only. Epinephrine prolonged the action of lidocaine as a local anesthetic, this prolongation of action of local anesthetic had a significant effect in early mobilization and breast feeding and decrease in cost of analgesics. Nobody in our candidate had a post-operative infection, past operative pyrexia, Allergic reactions tar general anesthesia or complications with local anesthesia. Conclusion Adding of epinephrine to local anesthetics (such as lidocaine 2% in dose-related manner 1:200.0000) prolonged anesthetic effect by more than double of its original anesthetic time, This prolongation on anesthetic effect of local anesthesia by epinephrine helps in eariy mobilization; early breast feeding and less hospital duration stays. No complications (local nor systemic) developed with local infiltration of post-caesarean section incision with lidocaine 2% even aficr adding epinephrine in dose-related manner 1:200.000

Lineage-Specific Chimerism and Outcome After Hematopoietic Stem Cell Transplantation for DOCK8 Deficiency

Bi-allelic variants in the dedicator of cytokinesis 8 (DOCK8) gene cause a combined immunodeficiency, characterized by recurrent sinopulmonary and skin infections, food allergies, eczema, eosinophilia, and elevated IgE. Long-term outcome is poor given susceptibility to infections, malignancy, and vascular complications. Allogeneic hematopoietic stem cell transplantation is currently the only curative treatment option and has shown promising outcome. The impact of mixed chimerism on long-term outcome is unclear. We reasoned that reversal of disease phenotype would depend on cell lineage-specific chimerism. DOCK8 variants were confirmed by Sanger and/or exome sequencing and immunoblot and/or intracellular flow cytometry. Donor chimerism was analyzed by XY-fluorescence in situ hybridization or quantitative short tandem repeat PCR. Outcome was assessed by laboratory tests, lymphocyte subsets, intracellular DOCK8 protein flow cytometry, T-cell proliferation analysis, and multiparameter immunoblot allergy screening. We report on nine patients, four of whom with mixed chimerism, with a median follow-up of 78 months after transplantation. Overall, we report successful transplantation with improvement of susceptibility to infections and allergies, and resolution of eczema in all patients. Immunological outcome in patients with mixed chimerism suggests a selective advantage for wild-type donor T-cells but lower donor B-cell chimerism possibly results in a tendency to hypogammaglobulinemia. No increased infectious and allergic complications were associated with mixed chimerism. Aware of the relatively small cohort size, we could not demonstrate a consistent detrimental effect of mixed chimerism on clinical outcomes. We nevertheless advocate aiming for complete donor chimerism in treating DOCK8 deficiency, but recommend reduced toxicity conditioning.

The problem of the potentially danger of an aggressive autoimmune nature of immunity in women during the vaccination of sportswomen against the COVID-19 coronavirus: solutions

With the beginning of the mass vaccination against the coronavirus COVID-19, the problem of the potentially of the danger of the aggressive autoimmune nature of immunity in women during the vaccination of sportswomen against the coronavirus COVID -19 arose.&#x0D; Objective of the study: to determine ways to solve the problem potentially of the danger of an aggressive autoimmune nature of immunity in women when vaccinating sportswomen against the COVID -19 coronavirus. Research methods: methods of theoretical analysis of scientific literature are used: generalizations, synthesis, abstractions, formalizations. Research results and conclusions: ways were identified to solve the problem potentially of the danger of an aggressive autoimmune nature of immunity in women when vaccinating sportswomen against the COVID-19 coronavirus. The potential danger of aggressive autoimmune immunity in women can be a significant problem for vaccination of athletes against coronavirus COVID -19, especially if there is significant physical activity in their sports activities with manifestations of physical allergies. When determining the possibility of vaccination of female athletes against coronavirus COVID -19, it is recommended to conduct a special medical and allergological examination and survey of female athletes using special questionnaires and, if there are indications, send female athletes for consultation to an allergist. It was concluded that when vaccinating against the COVID-19 coronavirus, priority should be given to athletes to prevent them from developing allergic complications. If indicated, sportswomen must undergo a special allergic diagnosis.

Pharmacologic activities of phytosteroids in inflammatory diseases: Mechanism of action and therapeutic potentials.

Natural products and their derivatives are known to be useful for treating numerous diseases since ancient times. Because of their high therapeutic potentials, the use of different medicinal plants is possible to treat varied inflammation-mediated chronic diseases. Among natural products, phytosteroids have emerged as promising compounds mostly because they have diverse pharmacological activities. Currently, available medications exert numerous systemic toxicities, including hypertension, immune suppression, osteoporosis, and metabolic abnormalities. Thus, further research on phytosteroids to subside these complications is of significant importance. In this study, the information on phytosteroids, their types, and actions against inflammation, and allergic complications was collected by a systematic survey of literature on several scientific search engines. The literature review suggested that phytosteroids exhibit antiinflammatory action via different modes through transrepression or selective COX-2 enzymes. Also, in silico ADMET analysis was carried out on available phytosteroids to uncover their pharmacokinetic properties. Our analysis has shown that eight compounds: withaferin A, stigmasterol, β-sitosterol, guggulsterone, diosgenin, sarsasapogenin, physalin A, and dioscin, -isolated from medicinal plants show similar pharmacokinetic properties as compared to dexamethasone, commercially available glucocorticoid. These phytosteroids could be useful for the treatment of inflammatory diseases, such as rheumatoid arthritis, inflammatory bowel diseases, multiple sclerosis, asthma, and cardiovascular diseases. Thus, systematic research is required to explore potent phytosteroids with lesser side effects, which might substitute the current medications.