Asthma Research Articles

#1972 Changes in vegetative hemodynamic relationship in the comorbid state of patients with respiratory pathology

Abstract Background and Aims The parameters of the vegetative nervous system (VNS) and its relationship with the function of the central and renal vessels in patients with bronchial asthma (BA) in comorbidity with glomerular filtration dysfunction of the kidneys were studied and the above-mentioned indicators of complex treatment regimens were determined. Since the tension of neuropsychiatric predictors negatively affects the state of hemodynamics and internal organs directly of the VNS. The constant hyperactivity of this system due to chronic inflammatory processes is the starting point of vegetative imbalance. Method 68 patients with comorbidity with glomerular filtration dysfunction of the kidneys and 30 healthy individuals were examined. Studies were conducted in 36 patients with BA grade II-III (group 1, in which the level of glomerular filtration rate of the kidneys was determined by eGFRCKD-EPI ≥6 ml/min/1.73 m2) and 32 patients with BA grade IV (group 2, they were determined by eGFRCKD-EPI ≥60 ml/min/1,73m2). The functional state of the peripheral VNS was studied by cardiointervalography (CIG) using methods of mathematical analysis of indicators: Mode (Mo, sec.) and mode amplitude (AMo, %); Vasodilation of dependent endothelium (VDE) was determined by hyperreactive brachial artery Dopplerography test: maximum systolic velocity (Vmax) and vascular resistance index (IR). Results On the first day of admission to the hospital, patients were examined by the VNS meth, where eitonia and vagotonia were detected in practically healthy people, and hypersympathicotonia was determined in patients with BA with disorders of central and renal hemodynamics. A significant decrease in Mo parameters and an increase in AMo levels were analyzed when compared with the reference parameters of healthy individuals. This reflects the tension of the sympathetic department, and parasympathicotonia, on the contrary, decreased. There is a decrease in the ability of PA vessels to actively vasodilate due to an imbalance in the tone of the VNS. In the results of the hyperemic test, it was analyzed that in patients with BA in comorbidity with glomerular filtration dysfunction of the kidneys, the Vmax of blood flow decreases, and IR increases in parallel with the severity of the disease. All patients underwent complex therapy with halotherapy for 20 minutes daily and resonance therapy for the area of both kidneys for 5 minutes of exposure, once a day, for 10 days. After the course of treatment, there was a positive dynamics in the functional parameters of the state of the VNS. The indicators of CIG were analyzed, where hypaticotonia decreased by 6.7%, and the parameters of the parasympathetic system improved to 5.3%. Conclusion At the heart of the elevation of maladaptive processes of chronic respiratory inflammation, hypoxia of brain structures and dysfunctions of glomerular filtration of the kidneys, vegetovisceral imbalance develops. The regimens of complex therapy have a positive effect, both anti-inflammatory at the visceral level and a calming effect on the VNS.

Diaphragmatic Ultrasound in Children With Asthma Exacerbations.

Asthma is a leading cause of pediatric emergency department visits, yet few tools exist to objectively measure asthma severity. Diaphragmatic ultrasound (DUS) is a novel method of assessing respiratory distress; however, data are lacking for children.Our primary aim was to determine if diaphragmatic excursion (DE), diaphragmatic thickening (DT), or diaphragmatic thickening fraction (TF) correlated with asthma severity as determined by the Pediatric Respiratory Assessment Measure (PRAM) score. Secondarily, we examined if these parameters correlated with need for respiratory support and evaluated interrater reliability. We conducted a prospective study of children 5-18 years presenting to a pediatric emergency department with an asthma exacerbation. Diaphragmatic ultrasound was performed by a trained pediatric emergency medicine sonologist in subcostal (DE) and midaxillary (DT). Thickening fraction was calculated from DT values as previously described in literature. To evaluate interrater reliability, a subset of subjects had DUS performed by a second sonologist. We enrolled 47 subjects for a total of 51 encounters. The mean age was 9.1 ± 3.7 years. Twenty-five (49%) had mild, 24 (47%) had moderate, and 2 (4%) had severe asthma. There was a significant difference in midaxillary DT and TF between children with mild and moderate asthma ( P = 0.02; mean difference, 0.2 mm; 95% confidence interval [CI], 0.03-0.4 and P = 0.02; mean difference, 0.11 mm; 95% CI, 0.02-0.2, respectively). No difference was found in subcostal DE ( P = 0.43; mean difference, 1.4 mm; 95% CI, -2.1 to 4.8). No association was found between use of positive pressure and DUS parameters. Fourteen encounters had 2 sonologists perform DUS, with strong interrater reliability found for midaxillary DT (Pearson correlation, 0.56) and poor association for subcostal DE (Pearson correlation, 0.18). In this pilot study, we conclude that DUS may be helpful in assessing severity of asthma. The midaxillary view assessment for DT and TF had the best correlation with asthma severity and the best interrater reliability. Future studies may benefit from focusing on the midaxillary view for DT and TF.

#2864 IgA dominant post-infectious glomerulonephritis secondary to the infected left ankle joint in a non-diabetic patient, a case report

Abstract Introduction Post-infectious glomerulonephritis (PIGN) is an immune complex glomerulonephritis that commonly affects children and young adults following beta haemolytic Streptococcal throat or skin infections. Kidney biopsy is characterised by Segmental or global endocapillary hypercellularity, and crescents may be present. In immunofluorescence, post-infectious glomerulonephritis typically shows IgG and C3 deposition. A rare type of PIGN is IgA-dominant post-infection glomerulonephritis. It commonly occurs in the setting of active infection. It usually presents in patients > 60 years old with diabetes mellitus, alcohol consumption, and Staphylococcal infections. It can present with RPGN, AKI, and nephrotic syndrome. Hypocomplementemia can be present, and immunofluorescence is characterised by IgA dominance with C3 co-dominance and no IgG. Despite the strong association with Staph aureus, however, it has been reported with other types of infections. The main line of treatment is antibiotic eradication of the infection. Steroids can be used based on the severity of the lesion and the presence of crescents. Its prognosis is worse than that of the traditional PIGN. In this case, we report a case of IgA-dominant post-infectious glomerulonephritis secondary to left ankle osteomyelitis with Staph aureus infection. Case Presentation A 65-year-old lady had open reduction and internal fixation of a left trimalleolar ankle fracture in June 2023 at a district general hospital. Unfortunately, the post-operative course was complicated by wound infection. The wound swab showed Heavy growth of Staphylococcus aureus. This was followed by Acute Kidney Injury (AKI) stage 3; therefore, she was transferred from her hospital to our renal ward. On admission to the ward, her creatinine was 388 μmol/L(baseline creatinine was 73 μmol/L one month before admission), urine dipstick was positive for blood and protein, and urine protein creatinine ratio was 480 mg/mmol. She had only a medical background of bronchial asthma for which she was only on Inhalers (Beta Agonist) as a regular medication. CT scan of the left ankle revealed appearances consistent with osteomyelitis of both the lateral and medial malleoli. This finding was discussed with microbiology and orthopaedic teams, and the patient was started on intravenous antibiotics (Vancomycin followed by doxycycline). A kidney biopsy was done. Mesangial electron-dense deposits were identified. Immunohistochemistry revealed IgA dominant, predominantly mesangial positivity, with associated C3. The picture was consistent with IgA acute glomerulonephritis associated with S. aureus, which is a post-infectious Glomerulonephritis with dominant IgA staining (rather than conventional IgA nephropathy). With proper intravenous hydration and antibiotics, her inflammatory markers started to improve, and her renal chemistry followed the inflammatory markers, and her last creatinine improved to 146 μmol/L, eGFR 31 ml/min and UPCR was 40 mg/mmol. Discussion IgA-dominant post-infectious glomerulonephritis is now a distinct form of PIGN, which usually presents with acute kidney injury, haematuria, and proteinuria and is typically related to Staph aureus infection. In contrast to typical IgA nephropathy, there is no role for steroid or immunosuppression in the treatment of IgA-dominant post-infectious glomerulonephritis, and the treatment is mainly dependent on the treatment of infection.

Pulmonary Rehabilitation of Post-COVID-19 Patients with Bronchial Asthma (Review)

Respiratory diseases rank among the most prevalent ailments affecting both adults and children, marked by diverse clinical manifestations, frequent complications and exacerbations. Long-term hypoxia can disrupt normal metabolic activities, leading to functional impairments and occasionally organic changes in other organs and systems. Bronchial asthma represents a significant global health issue, affecting an estimated 300 million individuals worldwide. Its prevalence is on the rise in many developing countries.Objective — to synthesise literature data concerning the characteristics and frequency of pulmonary rehabilitation usage in patients with bronchial asthma post-COVID-19. Many patients experience persistent and progressive symptoms that hinder daily activities and result in a reduced overall quality of life. This reduction in quality of life can lead to decreased work productivity and increased healthcare costs. Continuous treatment and the development of prevention strategies are essential to mitigate exacerbations and various complications. Furthermore, this issue has gained increased relevance in the context of the COVID-19 pandemic.Coronavirus infection impacts not only the respiratory system but the entire body. Therefore, for optimal recovery and a faster return to normal life post-illness, it is recommended to integrate respiratory exercises with strengthening rehabilitation measures and moderate physical activities, tailoring the regimen to the overall health condition of the individual. Pulmonary rehabilitation for patients with bronchial asthma post-COVID-19 represents a pertinent and effective treatment method but requires broader implementation within the modern healthcare system.

Medicinal and Aromatic Weed Diversity in Botanic Garden and their Sustainable Utilisation for Conservation

Total 81 weeds belonging to 59 genera and 31 families growing in the University botanic garden at Sagar were found medicinally important. Various parts of all the weeds have been analyzed for their medicinal utility. Out of 81 weeds, leaves of 64 plants are found useful for various disorders. This is followed by root of 25 plants which are medicinally important. Disease wise analysis has also been carried out. Analysis reveals that for cut, wounds, boils and burns about 29 weed plants are used, whereas 21 weed species each are used for asthma and skin diseases.

Ethnomedicinal Plants of Betul District, Madhya Pradesh

The paper deals with ethnomedicinal information on 54 plant species (belonging to 33 families) collected from field survey amongst three tribes viz., Gond, Korku and Gaiki of Betul district, Madhya Pradesh. An analysis of data has indicated that eight plant species are employed as antidote to snake bite and scorpion sting, six to treat fever. five for rheumatism, four to treat cold, cough, skin diseases, as anthelmintic and tonic, and three for stomach diseases while two species to treat impotency, cuts, wounds and as diuretic. On the other hand, only single species has been referred for a number of other ailments like eye diseases, spermatorrhoea, spleen enlargement, tuberculosis, mouth sore, boil, asthma, liver disorder, toothache, bone fracture, abortifacient, antifertility, and in veterinary. Further, a comparison with the concerned literature has revealed that 23 ethnomedicinal uses of plants have not been reported earlier.

Factors affecting asthma control in pregnancy: A cross-sectional study.

Asthma control in pregnant women remains of utmost importance; suboptimal control can have adverse repercussions on both fetal and maternal health. The objective was to identify the factors that affect asthma control in pregnant Pakistani women presenting to a tertiary care hospital. This descriptive, cross-sectional research was conducted at KRL General Hospital between 1st November 2022 to 30th April 2023. Non-probability technique was used to sample one hundred and forty-five pregnant women with confirmed bronchial asthma irrespective of their trimester presented. Data regarding demographics and factors affecting asthma control was collected. The mean age was 30.39 ± 4.33 years, with two-thirds (65%) being multiparous. Approximately 48% of participants were non-compliant with treatment, and less than 40% achieved adequate asthma control. A chi-squared test applied showed that multiparity (p = 0.003), treatment compliance (p < 0.001), BMI (p < 0.001), and proper inhaler technique (p < 0.001) were statistically significant factors affecting asthma control in pregnant women while, the level of education and household income did not exhibit a significant association. Multiple regression analysis qualified higher BMI, multiparity, treatment compliance, and inhaler technique as significant predictors of asthma control amongst pregnant women. Ensuring asthma control during pregnancy is important. This study identified BMI, multiparity, inhaler technique, and treatment compliance as factors that affect asthma control in pregnant women. Addressing these factors through regular antenatal check-ups can significantly mitigate risks and promote the optimal health of both maternal and fetal lives.

Efficacy of benralizumab in severe eosinophilic asthma: results of a real clinical practice prospective study BEST in Russia

The study of the efficacy of biological therapy in patients with severe bronchial asthma in real world settings is a relevant task since observational research programs allow answering questions that fall out of focus with a strict selection of patients in RCT. Multicenter studies are prioritized because they allow combining and systematizing additional previously undescribed data in a wider population.The aim of the BEST study (Real World Evidence of Benralizumab in Eosinophilic Severe AsThma in Russia) was to confirm the clinical effectiveness of benralizumab regarding change of disease control and quality of life (QoL) level associated with respiratory status in patients with eosinophilic phenotype of uncontrolled severe asthma in real clinical practice in Russia.Methods. An open-label non-randomised multicenter study was conducted involving 59 adult patients with severe eosinophilic asthma. Benralizumab was prescribed according to indications used in routine practice in addition to maintenance therapy. The duration of follow-up was 56 weeks. Disease control level was assessed using the Asthma Control Questionnaire-5 (ACQ-5), and QoL associated with respiratory status was assessed using the St. George’s Respiratory Questionnaire (SGRQ). Patients’ Global Impression of Change (PGIC) and Patients’ Global Impression of Severity (PGIS) were used for subjective assessments of the well-being of patients. The frequency of exacerbations, usage of systemic corticosteroids (SCS), and functional parameters were also evaluated.Results. The use of benralizumab led to a clinically significant improvement in ACQ-5 and SGRQ scores, a significant decrease in the frequency of exacerbations and a significant increase in pre- and post-bronchodilation FEV1 and FVC. There was an improvement in the well-being of patients according to the PGIC and PGIS scales. The SCS dose did not change. The therapeutic effect of benralizumab occurred quickly and persisted throughout the whole study, demonstrating the most significant changes in effectiveness values by the 56th week of treatment.Conclusion. The use of benralizumab in real clinical practice significantly improved the control of severe eosinophilic asthma and QoL of patients and was associated with a favorable safety profile.

Sensitization to Food and Aero-Allergens in Children with Coeliac Disease Assessed with the Use of a Multiplex Molecular Diagnostic Technique

(1) Background. Coeliac disease (CD) often co-occurs with autoimmune conditions or genetic syndromes, but there are few studies on the co-existence of CD and immunoglobulin E (IgE)-mediated allergies. The purpose of this study was to assess sensitization to food and aero-allergens in pediatric patients with CD. (2) Methods. A multiplex ALEX®2 test was used to determine specific IgEs (sIgEs). (3) Results. The study included 108 children newly diagnosed with CD. Allergen extract- and/or allergen molecule-sIgEs were detected in 49.1% of children. Most children (41.5%) were sensitized to both inhalant and food allergens. The three most common aero-allergens (timothy pollen, ryegrass, silver birch) were molecules Phl p 1, Lol p 1, and Bet v 1. The most common food allergens (hazelnut, apple, and peanut) were Cor a 1, Mal d 1, and Ara h 8 molecules of the PR-10 subfamily. Patients were not sensitized to cereal allergens containing gluten. Spearman’s rank correlation analysis of sensitized patients showed a significant positive relationship (r = 0.31) between the patients’ age and the occurrence of positive sIgEs (≥0.3 kUA/L) for inhalant allergen molecules (p = 0.045). In sensitized patients, mainly symptoms of inhalant allergy were observed, such as hay fever, conjunctivitis, and bronchial asthma. (4) Conclusions. The current study indicates the co-occurrence of IgE sensitization to food and inhalant allergens in children with CD. The study highlights the need to take a closer look at the diagnosis of IgE-mediated allergy in patients with CD, which may help in their care and lead to a better understanding of the relationship between CD and IgE-mediated allergy.

TOLL-LIKE RECEPTORS AND BRONCHIAL ASTHMA: PART 1

Bronchial asthma is a chronic disease of the respiratory tract, which is formed by the action of endogenous factors and environmental influences. At the same time, T-helpers of the second type play a major role in the development of bronchial asthma, causing hyperreactivity and inflammation of the respiratory tract. However, the data that bronchial asthma in most cases is an allergic, eosinophilic, T-helper-mediated disease of the second type is insufficient to establish complete control over the course of disease. This is probably due to the fact that endogenous factors play an important role in the pathogenesis of asthma, knowledge of which is currently limited. Toll-like receptors are an established element of the development of bronchial asthma. Their insufficient function or, conversely, the launch of an excessive immune response is associated with the initiation of the disease or its exacerbations. Expanding the understanding of Toll-like receptors leads not only to a more detailed understanding of the pathogenesis of bronchial asthma, but also to the application of this knowledge in practice.

Comparative characterization of interleukin genotypes and risks of bronchial asthma phenotypes in children

The present paper analyses genetic predictors of various endotypes and phenotypes of bronchial asthma in children. The review of data on the structure and prevalence of single-nucleotide polymorphisms of interleukin genes demonstrates their correlation with the risk of virus-induced and allergen-induced phenotypes of bronchial asthma. Significant differences in genotypes correlate with aberrant production of interleukin and the risks for developing various phenotypes of the disease. The studies into genetic factors indicate the significance of functional polymorphisms of interleukin genes as predictors associated with phenotypes and risk of the disease.

Interrelation between gut microbiota and bronchial asthma

Bronchial asthma is a chronic disease of the respiratory tract, and its etiology and pathogenesis have not been studied adequately. Many authors suggest that intestinal microbiota significantly contributed to its etiology. The existence of a gut–lung connection, through which bacterial metabolites influence airway sensibilization, has been proven. Certainly, the formation of this connection in childhood is important. This study provides a review of indigenous and foreign studies concerning the influence of the quantitative and qualitative compositions of intestinal microbiota and certain metabolites of commensals on the manifestation of bronchial asthma. This topic is relevant because of the widespread overuse of antibiotic therapy and the availability of possible ways to prevent the development of bronchial asthma if the influence of the microbiota on its pathogenesis is detected. This study also tried to examine the influence of antibiotic therapy on pregnant women and young children at risk of bronchial asthma, a relationship confirmed in many studies. Despite the large number of studies, the use of probiotics for the treatment and prevention of this disease is still debatable.

Therapeutic Potential of Vitamin D in Asthma Control

In 2019, according to WHO estimates, 262 million people were affected by asta, resulting in 455,000 deaths. Asthma, is a chronic inflammatory disease of the airways that causes reversible bronchoconstriction, making it difficult for patients to breathe. Exacerbations of the disease can be caused by a variety of factors but share similar symptoms such as wheezing, coughing, shortness of breath and chest tightness. Severe asthma exacerbations are defined as symptoms that do not respond to inhaled medications and improve only after oral or intravenous steroid administration. Asthma-related deaths often occur during exacerbations. Vitamin D, which is produced naturally in the body and found in some foods, is a steroid-derived vitamin. Adequate doses of this vitamin, administered through medication or supplements, can be used to maintain its proper levels in the organism. Vitamin D is essential for regulating calcium levels in the body and for bone remodeling. It also has immunomodulatory effects, affecting both innate and adaptive immunity. This partly explains its association with changes in the airway epithelium that occur as a result of inflammation in asthma. The study aims to summarize the current knowledge on the relationship of vitamin D with asthma symptom control. The present study is based on literature available in scientific databases from 2013-2016, such as PubMed, Corchane Library and Google Scholar, using the following keywords: "vitamin D" and "asthma." Vitamin D deficiency is prevalent in children and adults worldwide. A critical analysis of the literature reveals that the therapeutic administration of vitamin D has no apparent advantage in treating asthma, especially in children. Nevertheless, for adults with mild asthma, vitamin D supplementation shows promise for improved outcomes. However, there is a pressing need for large-scale clinical trials to determine the efficacy and safety of this therapeutic approach for both age groups.

Extracorporeal Membrane Oxygenation (ECMO) in a child with near-fatal bronchial asthma

No abstract available.

Preparation and impregnation of deep eutectic solvents containing zileuton onto adsorbents to elicit the biopharmaceutical attributes

Deep eutectic solvent (DES) is a contemporary and eco-friendly solvent recently exploited to modulate the solubility of drugs. Herein, we developed DESs for an increment of solubility and bioavailability of zileuton (ZLT). ZLT is an anti-inflammatory drug categorized as an inhibitor of the enzyme 5-lipoxygenase commonly prescribed for treating chronic bronchial asthma. However, its therapeutic uses are limited owing to its poor water solubility. Several stable DESs were developed and assessed for viscosity, pH, and solubility. The DES comprising ChCl: EG (1:3) exhibits an excellent ZLT solubility (57.27 ± 0.14 mg/mL). The molecular and electrostatic interaction was assessed through a conductor-like screening model for real solvents (COSMO-RS). Further, 1H NMR analysis, FTIR, and digital microscopy were used to investigate the molecular transition in the chosen DES-ZLT. The DES in a liquid state possesses several drawbacks, such as instability, volatility, and dose precision. Therefore, a wet impregnation approach utilizing inert carriers such as Aerosil-200 and Avicel PH-102 was performed for the solidification of liquid DES. The solidified DES-ZLT was characterized by DSC and PXRD techniques and indicated the existence of ZLT in a highly dissolved state. Furthermore, solid DES-ZLT showed a significant increment in the dissolution studies, resulting in a 2.91 fold rise in oral bioavailability of ZLT. Hence, the presented study proves a well-organized and proficient development of a solid DES system to ameliorate the solubility and stability aspects of ZLT, which could provide the template for promising drugs that lack therapeutic effectiveness owing to solubility issues.

Control status and follow-up of acute attacks in children with bronchial asthma with normal pulmonary ventilation function

To investigate the control status of bronchial asthma (referred to as "asthma") in school-age children with normal pulmonary ventilation function and the occurrence of acute attacks within 1 year of follow-up. A retrospective analysis was conducted on clinical data of 327 children aged 6-14 years with bronchial asthma and normal pulmonary ventilation function from April to September 2021. Based on the measured value of one second rate (FEV1/FVC), the children were divided into the ≥80% group (267 cases) and the <80% group (60 cases). The pulmonary ventilation function, asthma control level, and occurrence of acute attacks within 1 year were compared between the two groups. The baseline pulmonary ventilation function in the <80% group was lower than that in the ≥80% group, and the proportion of small airway dysfunction was higher than that in the ≥80% group (P<0.05). After standardized treatment for 1 year, the small airway function indices in the <80% group improved but remained lower than those in the ≥80% group (P<0.05). The rate of incomplete asthma control at baseline was 34.6% (113/327), and the asthma control level in the <80% group was lower than that in the ≥80% group (P<0.05). After standardized treatment for 1 year, the asthma control level in the <80% group remained lower than that in the ≥80% group, and the proportion of acute asthma attacks was higher than that in the ≥80% group (P<0.05). Approximately one-third of school-age children with asthma still have incomplete asthma control when their pulmonary ventilation function is normal. Among them, children with measured FEV1/FVC<80% have an increased risk of acute asthma attacks and require close follow-up and strengthened asthma management.

Narrative review on the spectrum of diseases prevalent among substance-addicted populations and their interconnected health dynamics

Substance addiction is a complex phenomenon characterized by the dysfunction of the brain's reward system and neuroplasticity, leading individuals to lose control over their behaviour. This review explores the diverse health implications of addiction, including its impact on liver diseases, cardiovascular conditions, respiratory issues, cancers, infectious diseases, gastrointestinal problems, and mental disorders. Heavy alcohol consumption, tobacco use, illicit drug abuse, and prescription drug misuse contribute significantly to these health burdens, affecting various organs and systems in the body. Respiratory issues arise from tobacco smoking, inhalation of illicit drugs, and volatile chemicals, causing chronic obstructive pulmonary disease, lung cancers, and bronchial asthma. Substance addiction is also linked to various cancers, particularly lung cancer from tobacco, oral cancers from tobacco and alcohol, and oesophageal cancers from alcohol and prescription drugs. Furthermore, addictive substances impair immunity, making individuals more susceptible to infectious diseases like pneumonia, tuberculosis, and HIV/AIDS, especially among injection drug users. The interconnected nature of substance addiction with mental health disorders, genetic factors, environmental influences, and social determinants underscores the need for comprehensive public health strategies. These strategies should encompass education, prevention programs, access to treatment and support services, harm reduction approaches, and destigmatization efforts to address substance addiction comprehensively and improve overall health outcomes for individuals and communities.

Bariatric Surgery in Asthma: A Narrative Review.

Nearly 60% of asthmatics in the USA suffer from obesity. Asthma is a comorbid condition alongside obesity, commonly accompanied by conditions such as hypertension and type 2 diabetes. The positive effect of bariatric surgery on patients suffering from hypertension and type 2 diabetes, which leads to either a reduction in the dose of medication taken for the aforementioned diseases or the withdrawal of the disease, is quite well proven in the literature. Currently, the impact of bariatric operations on the control and course of bronchial asthma and pharmacological treatment has not been fully recognized and described, requiring further research; therefore, the following review of the literature was conducted.

CONTEMPORARY STATE OF DIAGNOSIS AND TREATMENT OF BRONCHIAL ASTHMA AMONG CHILDREN

This paper provides a brief overview of the current state of diagnosis and treatment of bronchial asthma among the pediatric population, given the increasing incidence worldwide. Materials and methods: Wiley, PubMed, Web of Science, Scopus databases and health compilations of the Republic of Kazakhstan over a five-year period (2018-2023) were used for this review. Currently, the WHO European Region is facing a significant threat from the growing incidence of preventable noncommunicable diseases (NCDs), among which chronic respiratory diseases are highlighted. These diseases not only reduce the quality of life of individuals but also cause substantial economic damage to families, communities, and countries as a whole, which underscores the relevance of our chosen topic. According to expert estimates, there are more than 350 million people worldwide with bronchial asthma, with about 5-10% of cases being among the pediatric population. In Kazakhstan, there is a steady trend of increasing incidence worldwide.

Phenotypes of occupational bronchial asthma from the standpoint of molecular genetic typing (polymorphisms rs2069812 of the IL-5 gene and rs1837253 of the TSLP gene)

Introduction. Currently, occupational bronchial asthma is considered as a pheno typically and genetically heterogeneous disease. Molecular genotyping opens up new op portunities in assessing the development, predicting the characteristics of the course and personalized approach to pharmacotherapy of occupational bronchial asthma, as well as in developing an individual strategy for its prevention. The purpose of the study is to determine clinical, immunological and genetic markers of the risk of developing PrAD under conditions of exposure to sensitizing substances based on the results of assessing the rs2069812 polymorphic variants of the IL5 gene and the rs1837253 polymorphic variants of the TSLP gene. Materials and methods. The study included 170 patients with various phenotypes of PBA and 50 controls. Genotyping was performed by real-time polymerase chain reaction using primers and probes designed using PrimerQuest (Intergrated DNA Technologies, Inc.). Re sults. The study identified for the first time genetic markers of PBA risk under conditions of exposure to sensitizing substances: polymorphic variants rs2069812 of the IL-5 gene and polymorphic variants rs1837253 of the TSLP gene. This allows us to recommend the deter mination of these immunological parameters and genetic markers during in-depth periodic medical examinations of people working under conditions of exposure to sensitizing and irri tating substances, for differential diagnosis of various phenotypes of occupational bronchial asthma. Limitations of the study. The study has regional (Samara region) and professional (in terms of detailing working conditions in the comparison groups studied) limitations. Conclusion. Identified genotypic features in various phenotypes of occupational bronchial asthma, established profiles of genotypes of occupational bronchial asthma can optimize the approach to early diagnosis, prognosis and prevention and pharmacotherapy of this dis ease, as well as recommend a list of genetic studies for use during preliminary and periodic medical examinations, in-depth examination of patients occupational bronchial asthma in occupational disease clinics and occupational pathology centers, to establish a genetic pre disposition to the development of occupational bronchial asthma, rational employment in professions associated with sensitizing and irritating substances.