What is an atopic march. "Atopic march" and antihistamines: is preventive therapy possible? Emollients for newborns

Age features of the formation of allergic diseases. Atopic march.

At all periods of life, even at the time of preexistence, various risk factors for the development of allergies affect the child's body:

Unfavorable state of health of parents before conception,

Burdened heredity.

Unfavorable course of pregnancy and childbirth,

Exposure to food, infectious antigens and environmental AG.

The process of sensitization develops evolutionarily, starting from the prenatal stage. when a potential sensitization is laid. And after birth, there is a progressive expansion of its “bridgehead” in the form of a manifestation of the “allergic march” already in early childhood.

Primarily, from the first months of life, develops foodallergy, which is the main and often the only cause of allergic diseases in children of the first three years of life. (due to early transition to artificial feeding.) With adequate therapy, it clinically fades, although latent sensitization can persist for many years, and often remains undetected. Thus, food allergy in infancy is the first clinical manifestation of the "atopic march".

Continued use of allergenic foods increases the degree of food polysensitization and often contributes to the development against its background of other types of allergies in a certain sequence:

Household and epidermal from 2 - 3 years of age,

Pollen and bacterial - from 5-7 years; they do not replace each other, but are layered.

At the same time, at first, these types of sensitization are of a subclinical nature, being realized in manifest forms after 6-12 months with continued contact with a specific allergen. This contributes, on the one hand, to the formation of combined sensitization, the frequency and degree of which progressively increases with the duration of the disease.

On the other hand, it determines the age-related features of the structure of sensitization, namely: the leading types of sensitization are in children under three years old - food, at the age of 4-6 years - food and household, more than half in combination, and after 7 years in addition to two the previous one is also pollen and bacterial with a predominance of polycombined variants.

May develop at all ages drug allergy.

It should be emphasized that the development of the main types of sensitization is completed by 6-7 years, and subsequently there is a transformation of the subclinical stage into a manifest one, which leads to the formation of polyallergy and polyetiology of diseases that increase the severity of their course.

The identified regularities in the formation of allergies in children are due to the age-related anatomical and physiological characteristics of organs and systems, the degree of their maturity during the period of antigenic load, especially excessive.

atopic march- this is a chronological sequence of the formation of sensitization and clinical transformation of allergy symptoms depending on the age of a child with an atopic constitution: atopic dermatitis (AD), bronchial asthma (BA), allergic rhinitis (AR), etc. Atopic march is a natural course of development of manifestations of atopy. It is characterized by a typical sequence of development of clinical symptoms of atopic disease, when some symptoms become more pronounced, while others subside.

"Atopic march" is formed in the period of intrauterine development, and is clinically manifested in early childhood and often accompanies the patient throughout life.

Clinical symptoms of the "allergic march" The manifestation of the disease begins with symptoms of a food allergy, often manifested atopic dermatitis. It debuts mainly in the 1st year of life and is the first manifestation of atopic diseases.

In young children, one of the leading provocateurs of allergic diseases are food hypertension: cow's milk, eggs, cereals, fish, soy. With age, the spectrum of food antigens changes both in quality and frequency of detection, the importance of tick-borne and infectious antigens (Staphylococcus aureus and Candida albicans) increases. Of great importance in the occurrence of food allergies belongs to the violation of the morphofunctional state of the digestive tract. The formation of the biocenosis of the digestive tract largely depends on breastfeeding. The colonization of the intestine by pathogenic microorganisms is inversely related to the presence of secretory immunoglobulins and other protective factors that come with mother's milk. The adult type of microbiocenosis is formed by the 18th month of life. The earlier formation of the “microbial landscape” of the intestine according to the adult type contributes to the development of gastrointestinal allergies.

First manifestations atopic dermatitis- erythematous elements, vesicles, weeping - in most children occur at the 3-4th month of life.

At the 2nd year of life, the processes of infiltration and lichenification with localization on the extensor and flexion surfaces of the extremities predominate, but by the end of the 2nd year of life, the process covers mainly the flexion surfaces, and subsides on the face. In the second age period - from 2 to 12-13 years - AD becomes chronic. In the third age period (adolescents and adults), excoriations, papules, foci of lichenification and skin infiltration prevail. Typical is the localization of the process on the elbow and knee bends, on the back of the neck, the skin of the eyelids, the back of the hands and joints.

The peak of asthma development falls on the age of 5, allergic rhinitis - on adolescence. The first manifestations of wheezing syndrome in half of the children occur before the age of 2 years. The peak of intermittent (seasonal) AR is observed in adolescents. With regard to persistent (chronic) AR, it should be said: the difficulties of diagnosing infectious and AR at an early age, as well as the stereotype of medical thinking about the predominantly infectious etiology of rhinitis, contribute to the fact that exacerbation of a nasal allergic reaction is often perceived as another infection, so the diagnosis of AR is established late. Difficulties arise also in the diagnosis of exacerbations of AR, the trigger of which is often a viral infection. Since the stages of the development of the "allergic march" are considered, first of all, as a consistent transformation of the clinical manifestations of atopy into BA, one should remember those children in whom BA begins with broncho-obstructive syndrome at an early age (47% of cases). Broncho-obstruction or pseudocroup (acute stenosing laryngotracheitis), regardless of the causes of their occurrence (80% - ARVI), subsequently recurs in 53% of children. Over time, in 2/3 of children, the recurrence of BOS stops, and BA develops in 23.3% of patients. Risk factors for BOS recurrence: family history of atopy; increased serum IgE levels; inhalation sensitization; second hand smoke; male gender.

Conclusions:

1) Atopic diseases often occur in children with a genetic predisposition to allergic diseases, especially on the maternal side. Their formation is facilitated by food sensitization of mothers during pregnancy, early transfer of children to artificial feeding, and early (in the first year of life) food sensitization in children.

2) Clinical manifestations of atopic diseases in children are characterized by a sequence of development of allergy symptoms and sensitization with the onset of AD in the first year of life. With the age of the child, the spectrum of allergens expands, and in children older than 6 years, polyvalent sensitization already predominates, a respiratory syndrome is formed, which, as it progresses, leads to the development of combined forms of atopic diseases (dermatitis, asthma, rhinitis).

3) For children suffering from atopic diseases, regardless of the options for their combination, significant disorders are characteristic of immunity indicators: cellular, humoral and local, which are generally characterized by an increase in CD3 + - (P<0,05), иммунорегуляторного индекса (Р<0,01), содержания эозинофилов в периферической крови, снижением количества CD8+, CD20+-клеток (Р<0,01) и фагоцитарного числа (Р<0,01), а также повышением концентрации IgE в сыворотке крови и снижением концентрации IgA (Р<0,05) в крови и в слюне.

2
1 BU VO KhMAO - Yugra KhMGMA, Khanty-Mansiysk
2 Russian Medical Academy of Continuous Professional Education, Ministry of Health of the Russian Federation, Moscow; GBUZ "Children's City Clinical Hospital. PER. Bashlyaeva" DZ of Moscow

For citation: Girina A.A., Zaplatnikov "Atopic March" and antihistamines: is preventive therapy possible? // RMJ. 2012. №2. S. 72

Allergic diseases are one of the most common human diseases in economically developed countries. At the same time, the key link in the pathogenesis of allergic diseases is the hypersensitivity reaction to the allergen, initiated by various immunological mechanisms. In cases where the main mechanism for the development of hypersensitivity is a reaginic - IgE-mediated - type of reaction, atopy is stated (from the Greek atopia - something unusual, oddity), and the diseases that have developed during this are atopic.

It has been established that atopic diseases develop in individuals with a hereditary predisposition to atopy. At the same time, the very concept of atopy was proposed as early as 1923 (Coca & Cooke), long before the deciphering of its pathogenetic mechanisms and the relationship of atopic diseases with a genetic predisposition to IgE-mediated hypersensitivity. Initially, bronchial asthma and hay fever were considered atopic diseases, but already in 1933 (Wiese & Sulzberg) atopic dermatitis was added to them based on the association of this form of eczema with bronchial asthma and allergic rhinitis. Currently, atopic diseases include atopic dermatitis, allergic rhinitis and conjunctivitis, atopic bronchial asthma, allergic urticaria and Quincke's edema, as well as anaphylactic shock.
Most authors studying allergic diseases note a certain sequence in the occurrence of clinical manifestations of atopy. This sequence is called the "atopic march". The "atopic march" is understood as the natural course of atopic diseases, characterized by an age sequence of sensitization and clinical symptoms, which often tend to spontaneous remission. Figure 1 clearly shows the frequency of occurrence of symptoms of atopic dermatitis, allergic rhinitis and bronchial asthma, depending on the age when the clinical manifestations of these diseases occurred.
It should be noted that the results of a series of independent studies reliably indicate that in most cases the first clinical manifestations of IgE-mediated (reaginic) hypersensitivity are symptoms of atopic dermatitis. Thus, in Germany in 1999, a large-scale multicenter study was completed, during which 1314 children studied the age and anamnestic aspects of the manifestation of atopic diseases based on 7-year monitoring, starting from the neonatal period.
M. Kulig et al. (1999) found that in general, 69% of children who already had symptoms of atopic dermatitis by 3 months of age, later - by 5 years of age - were sensitized to aeroallergens. At the same time, the authors paid special attention to the group of children with a high risk of developing atopic diseases. Thus, 38% of 1314 children included in the study had anamnestic (atopy in at least 2 family members) or laboratory (IgE in cord blood > 0.9 kU/l) risk factors. By the age of 5, the frequency of sensitization to aeroallergens in this group increased to 77%. At the same time, they significantly more often had not only laboratory markers of sensitization, but also clinical symptoms of allergic lesions of the respiratory tract. So, at the age of 5 years, the frequency of bronchial asthma and/or allergic rhinitis in children from the risk group was 50%, while in the comparison group it did not exceed 12%.
Based on the data obtained, the authors conclude that there is a clear relationship and consistent formation of atopic dermatitis, early sensitization and the development of allergic diseases of the respiratory tract, especially in children at risk. Similar results were obtained in the implementation of other research projects. At the same time, J.M. Spergel and A.S. Paller (2003), having conducted several prospective studies, not only state that atopic dermatitis precedes the development of bronchial asthma and allergic rhinitis, but also indicate the pathogenetic relationship of these diseases.
The study of the features of the "atopic march", the age aspects of the onset of clinical manifestations of various allergic diseases and the sequence of their manifestation (primarily atopic dermatitis, allergic rhinitis, bronchial asthma) are also presented in other works, both domestic and foreign authors. Yes, H.L. Rhodes et al. (2001) carried out longitudinal monitoring of the state of health of 100 infants from families with a burdened hereditary history of atopy. The results of the 22-year follow-up showed that the incidence of atopic dermatitis was maximum in the first year of life, peaking at 12 months of age (20%), and then decreased to 5% by the end of the study. Meanwhile, at the same time, the prevalence of allergic rhinitis slowly increased and increased from 3 to 15% over time. The percentage of patients whose parents reported wheezing increased from 5% in the first year to 40% of those remaining in the study in the last year.
Similar data were obtained in a repeated prospective study, when the health status of 94 children with atopic dermatitis was monitored for 8 years. It was especially emphasized that atopic dermatitis was the first clinical manifestation of reaginic hypersensitivity. At the same time, the authors noted that over time, a regression in the severity of symptoms of atopic dermatitis occurred in 84 out of 92 children. However, the decrease in the frequency of manifestations of atopic dermatitis was accompanied by the manifestation of other atopic diseases. Thus, 43% of patients developed bronchial asthma during 8 years of follow-up, and 45% developed allergic rhinitis. Of particular interest was the fact that only in children with minimal manifestations of atopic dermatitis, the formation of allergic rhinitis or bronchial asthma was not observed in the future, while in severe cases of atopic dermatitis, the development of bronchial asthma occurred in 70% of patients. This allowed the authors to conclude that the severity of atopic dermatitis, along with serum levels of total and specific IgE, can be considered as risk factors for the subsequent development of bronchial asthma.
The International Study of Asthma and Allergies in Children, which studied the prevalence of atopic dermatitis, allergic rhinitis and bronchial asthma worldwide using validated questionnaires, also showed the relationship between the analyzed diseases and their consistent manifestation. At the same time, a strong correlation was established between the prevalence of atopic dermatitis and the frequency of allergic rhinitis and bronchial asthma.
Of particular interest are the results of the ETACTM study, which not only studied the characteristics of the timing of the manifestation of atopic diseases in children, but also analyzed the clinical efficacy and the possibility of stopping the "allergic march" using the modern antihistamine Zyrtec.
Zyrtec is a 2nd generation antihistamine drug that is characterized by significant clinical efficacy and a high safety profile. Zyrtec affects the early histamine-dependent stage of allergic reactions, and also limits the release of inflammatory mediators at the late stage of an allergic reaction, reduces the migration of eosinophils, neutrophils and basophils, and stabilizes mast cell membranes. It has been established that the drug eliminates the skin reaction to the introduction of histamine, specific allergens, as well as to cooling, reduces histamine-induced bronchoconstriction in mild bronchial asthma. In therapeutic doses, Zyrtec has practically no anticholinergic and antiserotonin effects, and also does not cause a sedative effect. Unlike many other H1-blockers, Zyrtec is practically not metabolized in the body, which determines its faster, more pronounced and prolonged therapeutic effect, as well as the absence of a negative effect on the electrophysiology of the heart. It should also be noted that in the case of simultaneous use of the drug Zyrtec with other medicines, the risk of developing drug interactions is minimal. Safety, high efficiency and good tolerability of the drug Zyrtec, as well as the presence of a pediatric form of release (drops) determine the possibility of its use in children from 6 months of age.
The ETACTM study was conducted at 56 centers in 13 countries. The design of the ETACTM study met the requirements of a double-blind, placebo-controlled study. A total of 817 children with risk factors for atopy were included in the study. The children were randomized by random distribution into 2 groups, one of which they have been in for 18 months. took Zyrtec in age dosages, and in another group for 18 months. placebo was used. After the end of therapy, follow-up of children continued for the next 18 months. . The results of the study showed that early inclusion and prolonged use of Zyrtec in children with atopic dermatitis not only helps to stop the symptoms of the disease, but also reliably prevents the development of respiratory allergy symptoms (Fig. 2 and 3). So, if 54% of children from the control group after 36 months. from the beginning of the observation, bronchial asthma was formed, then in children who received Zirtek - symptoms of respiratory allergies occurred only in 28% of cases. At the same time, J.O. Warner (2001) emphasizes that the preventive effect of Zyrtec was noted both in children sensitized to house dust allergens and in pollen sensitization (Fig. 3). Of particular note is that the prolonged course of treatment with Zyrtec was not accompanied by an increase in the incidence of side effects and adverse events, which emphasizes the high safety profile of the drug.
Thus, the inclusion of modern effective and safe blockers of histamine H1 receptors in the complex treatment of children with allergies allows not only to achieve a decrease in the severity of the symptoms of the disease and the development of their relapses, but can also stop the further development of the "atopic march".

Literature
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2. Allergology / ed. R.M. Khaitova, N.I. Ilyina. - 2nd ed., corrected. and additional - M ..: GEOTAR-Media, 2009. - 256 p.
3. Children's allergology./ Ed. A.A. Baranova, I.I. Balabolkin. - M.: GEOTAR-Media, 2006.
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6. Settipane R.A. Demographics and epidemiology of allergic and nonallergic rhinitis // Allergy Asthma Proc.- 2001.- Vol. 22.- P. 185-189.
7. Balabolkin II Atopy and allergic diseases in children // Pediatrics. - 2003. - No. 6. - S. 99-102.
8. Holoway J.W., Beghe B., Holgate S.T. The genetic basis of atopic asthma // Clin. Exp. Allergy.- 1999.- Vol. 29(8).-P.1023-1032.
9. National program "Bronchial asthma in children: treatment strategy and prevention." - 3rd ed., Rev. and additional .- M: Atmosphere, 2008.- 108 p.
10. Global Initiative for Asthma. Global strategy for asthma management and prevention, 2010.
11 Holgate S.T. Allergy.- Mosby International, 1996.
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18. Girina A.A. The effectiveness of immunoprophylaxis of ARVI and influenza in children with bronchial asthma: abstract of the thesis. dis. cand. honey. nauk.- M, 2009.- 24 p.
19. State register of medicines. - M.: MZiSR RF (Internet version www/drugreg.ru, updated 21.12. 2011).
20 Warner J.O. A double-blinded, randomized, placebo-controlled trial of cetirizine in preventing the onset of asthma in children with atopic dermatitis: 18 months treatment and 18 months posttreatment follow-up // J. Allergy Clin. Immunol.- 2001.- Vol. 108.- P. 929-937.

Autolymphocyte therapy is the only treatment for "atopic march" in children!

Children are treated by the method "Autolymphocytotherapy" after 5 years.

The "Autolymphocytotherapy" method, in addition to the treatment of "Atopic March", is widely used for: atopic dermatitis, urticaria, Quincke's edema, bronchial asthma, allergic rhinitis, hay fever, food allergies, allergies to household allergens, to pets, allergies to cold and ultraviolet rays (photodermatitis).

ALT METHOD ELIMINATES INCREASED SENSITIVITY OF THE ORGANISM TO SEVERAL ALLERGENS AT ONCE, DIFFERING FAVORITELY FROM ASIT.

Allergy to grass pollen

The essence of the "ALT" method is to use your own immune cells - lymphocytes to restore the normal function of the immune system and reduce the body's sensitivity to various allergens.

Autolymphocytotherapy is carried out on an outpatient basis, in an allergological office by appointment and under the supervision of an allergist-immunologist. Lymphocytes are isolated from a small amount of the patient's venous blood under sterile laboratory conditions.

The isolated lymphocytes are injected subcutaneously into the lateral surface of the shoulder. Before each procedure, the patient is examined in order to individually prescribe the dose of the administered autovaccine. In addition to its own lymphocytes and saline, the autovaccine does not contain any drugs. Treatment regimens, the number and frequency of administered immune cells depend on the severity of the disease.

Autolymphocytes are administered in gradually increasing doses with an interval between injections of 2 to 6 days. Course of treatment: 6-8 procedures.

Normalization of the functions of the immune system and a decrease in the body's sensitivity to allergens occurs gradually. The expansion of the hypoallergenic diet is carried out within 1-2 months. Cancellation of supportive symptomatic therapy is also carried out gradually under the supervision of an allergist. The patient is given the opportunity of 3 free repeated consultations within 6 months of observation after the end of the course of treatment using the Autolymphocytotherapy method.

The effectiveness of treatment is determined by the individual characteristics of the immune system. This process to a certain extent depends on the patient's compliance with the allergist's recommendations during the period of treatment and rehabilitation.

You can find possible contraindications on a separate page.

Ask a question to a specialist

The effectiveness of the treatment of individual symptoms of the "Atopic March" by the ALT method

A significant decrease in the level of total IgE was also established in 70% of cases, and a significant decrease in the level of specific IgE antibodies to household, pollen, food and fungal allergens, which is most pronounced in food and pollen allergies.

Benefits of treating atopic march with ALT

We treat the cause of the disease, not its symptoms

Minimum contraindications

No hospitalization or separation from work required

The course of treatment is only 3-4 weeks

1 procedure takes only 1-2 hours

Possible treatment in the absence of persistent remissions

Autolymphocytotherapy can be combined with any symptomatic treatment

THE METHOD IS AUTHORIZED BY THE FEDERAL SERVICE FOR SUPERVISION IN THE SPHERE OF HEALTH

How much does a child's treatment cost?

Cost of 1 procedure - 3700 rubles. The cost of a course of subcutaneous autolymphocytotherapy (6-8 procedures), respectively, is 22 200-29 600 rubles.

After a course of ALT, 3 free consultations are held by an allergist within 6 months of observation. If it is necessary to repeat the course of treatment of atopic march in a child, an individual system of discounts is provided.

The initial allergy screening is done according to Department of Health standards. Previous examinations and tests for IgE and allergens in other medical institutions are taken into account.

You can donate blood for allergens and IgE at medical centers where ALT is performed in 2020.

Allergist-immunologist Logina Nadezhda Yurievna will receive you in Moscow on a weekday

• Fill out an application for admission

Allergic diseases have recently become common, second only to viral infections. Moreover, atopic pathologies occupy a leading position in both adults and children.

Skin atopy is a hereditary predisposition to the possibility of allergic reactions. In order to properly approach the treatment of the problem, it is important to know the causes, manifestations and methods of diagnosing the disease.

Atopy: what is it?

The term "atopy" refers to the presence in the body of a genetic abnormality of the immune system. That is, there is a certain ability to produce an excess amount of antibodies (immunoglobulin E) to the action of various allergens. When these antibodies combine with allergens, a pronounced reaction is activated.

Therefore, it turns out that the immune system, due to excessive protein production, cannot function normally and perform its protective function.

And it is she who creates the prerequisites against which the symptoms of an atopic disease appear.

What are the forms of pathology?

The atopic group consists of allergic forms of rhinitis, dermatitis and bronchial asthma, as well as hay fever (that is, a reaction to pollen). The disease begins in infancy with the appearance of atopic dermatitis, which can gradually be supplemented by rhinitis or asthma. They are classic forms of atopy that last year-round.

Atopic rhinitis

"Allergic rhinitis" or atopic rhinitis is an inflammatory process that occurs in the nasal mucosa and is caused by external stimuli. The disease often appears in childhood, when the child is just beginning to encounter various allergens. It can run both seasonally and all year round. It all depends on the provoking factor.

The main symptoms of the disease include:

• nasal congestion, which makes it necessary to breathe through the mouth;
• impaired sense of smell;
• sneezing that occurs after contact with an irritant or in the morning;
• puffiness;
• itching in the nose;
• lacrimation;
• mucous watery discharge.

Perennial atopic rhinitis is often complicated by secondary infections, because due to mucosal edema, blockage of the paranasal sinuses occurs.

The disease has a hereditary predisposition and occurs in children with a family history of urticaria, allergic asthma and other types of atopy. Therefore, a thorough history taking is very important in the diagnosis.

Dermatitis

It is a chronic skin disease that occurs due to allergic exposure. The degree of spread of the disease will depend on the etiology and the right treatment.

The primary elements of dermatitis are various skin rashes (spots, vesicles, blisters). Other manifestations include:

• swelling of the affected areas;
• itching, the strength of which depends on the degree of irritation of the nerve endings;
• in the area that has undergone inflammation, the temperature rises;
• there is a burning sensation.

The rest of the symptoms are variable, they depend on the form of the disease and provoking factors.

Chronic dermatitis rarely acts as an independent disease, occurring together with bronchial asthma, rhinitis or hay fever. Most women suffer from pathology (65% of patients). The main cause of dermatitis is a genetic predisposition, especially in the female line.

Bronchial asthma - atopic form

It is a chronic lesion of the respiratory tract. This disease develops against the background of a genetic tendency to atopy. And the provoking factor is the external impact of various non-infectious allergens (household, food, plant or animal substances).

Atopic asthma is often diagnosed in childhood and has severe manifestations of allergic reactions. Pathology affects in most cases boys. The first symptoms may appear from the second year of life. There is an asthmatic attack of suffocation, accompanied by sneezing, nasal congestion, dry cough.

With prolonged contact, seizures can last for days. This poses a threat to the life of the patient due to respiratory failure or cardiac arrhythmias. Bacterial infections can also become complications.

Urticaria, hay fever, Quincke's edema

Other common allergic manifestations resulting from the reaction of the immune system to contact with external stimuli include:

• Quincke's edema is a lesion of the deep layers of the dermis of a localized and acutely developing nature. During an allergic reaction, the mucous membranes are affected, the temperature or blood pressure rises, chills, abdominal pain, and nausea appear. In the future, there may be violations in the work of various organs or systems. The most negative development option is anaphylactic shock, accompanied by a sharp decrease in pressure and impaired blood supply to internal organs.
• Urticaria is a disease in which a rash appears on the skin. The appearance of urticaria is preceded by contact with an allergen (on food or drugs). The reaction begins with severe itching when the affected areas of the skin are scratched. Only after that a typical allergic rash appears, consisting of small blisters.
• Hay fever is a complex of atopic diseases provoked by plant pollen. Therefore, for the symptoms of nature, seasonality and cyclicality. The main manifestations of hay fever include swelling or nasal congestion, itching, skin rashes, impaired sense of smell, dry cough, suffocation, sneezing.

What is the difference between allergic dermatitis and atopic dermatitis?

Distinguishing atopic dermatitis from other forms of allergies is quite difficult. Several symptoms can help in this matter:

• The condition of the mucous membranes - during an allergy they become inflamed, and with atopy they turn red, but do not inflame.
• Duration - redness caused by allergies will go away on its own in a few days. Only itching of the affected areas can cause discomfort. Manifestations in atopic dermatitis do not go away without medical treatment. At the same time, indigestion occurs, weakness or dizziness is felt.
• General well-being - the atopic form negatively affects the nervous system, which causes a strong decline in strength, fatigue, and decreased performance. These symptoms do not bother with ordinary allergies.

There are differences between these concepts and in the mechanism of occurrence. Atopic dermatitis is genetic in nature and aggravated due to external influences. Whereas the allergic form is provoked by an allergen that enters the body along with food or air.

To treat allergies, it is enough to eliminate the provoking factor. While atopy requires drug therapy aimed at normalizing the functioning of the immune system.

Causes contributing to the appearance of pathology

Atopic allergies occur due to a number of reasons, which include:

Allergic reactions can occur to any of these groups. The more factors that influence the occurrence of pathology, the more severe the form of the disease will be.

"Atopic March": what is it?

There are three main allergic diseases: atopic dermatitis, runny nose (or conjunctivitis) and asthma. Each has specific symptoms. When they succeed each other in stages, it is an atopic march. Moreover, the trigger mechanism is a skin allergy.

The characteristic features of the disease are:

• the problem appears in early infancy;
• atopic dermatitis further portends the appearance of conjunctivitis or rhinitis, after which asthmatic disease develops;
• when analyzing blood plasma, an increased level of immunoglobulin E is observed.

All three types of diseases are components of one process, therefore complex treatment is required. With qualified and timely therapy, started in childhood, the atopic march can be stopped.

Why does the skin suffer in pathology?

A disease such as atopy implies an increased sensitivity of the skin to allergens, which leads to a change in its protective properties. Therefore, even to minimal irritants, hyperactivity of the skin is observed.

The aggravation of the disease contributes to the violation of the epidermis, which most often occurs due to excessive dryness. At the same time, severe itching appears. Violation of the integrity of the skin leads to the fact that irritating agents easily and quickly penetrate into the deep layers of the epidermis, causing an increase in the inflammatory response.

Reduced barrier function of the skin leads to the penetration of bacteria, fungi or viruses into the body, which only worsens the course of the disease. In addition, it is not always possible to identify the provoking factor.

Symptoms of the disease in children and adults

Despite the decisive role of the hereditary factor in the appearance of atopy, the symptoms of pathology can appear even in those children whose parents are completely healthy. Therefore, it is important to know the main atopic manifestations that are observed already in early childhood:

• On the part of the skin - there are rashes on the skin, characteristic of dermatitis, urticaria or eczema.
• In the oropharynx - the voice becomes hoarse, dryness in the mouth is felt, Quincke's edema is possible.
• Respiratory system - there is difficulty breathing, constant nasal congestion, bronchial cough.
• Neurological apparatus - with atopy, headaches, fainting or dizziness are possible.
• Gastrointestinal tract - abdominal cramps, nausea, diarrhea, vomiting.
• The cardiovascular system is characterized by the appearance of low blood pressure or arrhythmia.

It turns out that an atopic disease is characterized by both allergic symptoms and general disorders in the work of many internal organs. Since the external manifestations of the pathology are immediately noticeable, it is important to immediately find the allergen and minimize contact with it.

Dr. Komarovsky: atopic manifestations in a child and an infant

The well-known children's doctor Evgeny Komarov repeatedly covers the causes of atopic manifestations in infants and methods of their treatment in his articles. He believes that the symptoms of pathology occur in the first year of life. The insidiousness of the disease lies in its ability to change.

The main symptom of an allergic form of dermatitis is a skin rash: red or pink, rare or continuous. It is accompanied by severe skin itching, which causes severe discomfort to the baby. The rash is most often concentrated on the face, arms or legs, in rare cases on the abdomen and chest.

Dr. Komarov notes that parents often consider atopic manifestations to be skin ailments. But this is not true, since the basis of the disease is a genetic factor.

Diagnosis of the disease

Identification of the problem begins with the collection of a family history. Methods for diagnosing atopy include the following activities:

• Skin allergy testing - evaluates the reaction of the skin to contact with various types of allergens. For diagnostics, you can use the prick test, when the epithelium is damaged by a thin needle containing an allergen. Another type of study is skin testing, when an applicator soaked in an allergen is applied to an intact area of ​​the skin.
• A blood test for an immunological study aimed at finding and determining the amount of a protein involved in allergic reactions (immunoglobulin E).

To make a diagnosis, any of these methods are used. If the result did not reveal the presence of a relationship between the increased production of immunoglobulin E by the body, then the atopic nature of the disease is excluded.

Fadiatop for children: allergy or not, description of the allergen test procedure

One of the comprehensive studies developed for children under 5 years old is Fadiatop. Its action is aimed at identifying a predisposition in a young child to allergic reactions to major food or inhalation allergens. At the same time, the study reveals the presence of atopy, after which it is possible to look for the causative allergen.

To perform the analysis, you will need to donate blood in the morning on an empty stomach, since serum is the material for the study. No special preparation is required before the test. It is enough that the last meal was at least 8 hours ago.

The Fadiatop test includes 11 different allergens that most often occur in childhood. This diagnostic method allows you to identify the level of globulins not to one specific allergen, but to a whole group of provoking factors.

The quality and accuracy of the study are not affected by age characteristics, the state of health of the patient or his skin, as well as the use of antihistamines.
Fadiatop is completely safe and great for children, since skin contact with the allergen is excluded (unlike skin tests).

Treatment options for atopy in adults

Successful treatment of atopic diseases largely depends on the identification and elimination of the offending allergen. For this, special attention should be paid to personal hygiene and thorough cleaning of the premises.

These measures will help reduce the risk of allergic symptoms, but will not cure the disease. Therefore, in atopy, two main therapeutic areas are used:

• Maximum cessation of contact with the allergen and further control of the environment as preventive measures.
• Symptomatic treatment of allergic manifestations: taking medications, using local remedies, physiotherapy and diet therapy.

Drug treatment is aimed at blocking and relieving symptoms, as well as restoring the normal functioning of the immune system. For this, doctors prescribe antihistamines, homeopathic and immunomodulatory drugs. If an adult patient experiences severe itching or sleep disturbances, he is prescribed medications that have a sedative effect.

The dosage and choice of drugs is individual, depending on the specifics of the disease and the state of the body as a whole.

Therapy of the disease in children

For pediatric patients, the treatment of atopy focuses on the complete cessation of contact with allergens. The basic principles of therapy for the disease in children consist of the following measures:

• prescription of antihistamines;
• hypoallergenic diet;
• anti-inflammatory ointments are used as local remedies;
• sedatives are used to relieve itching;
• with advanced forms, basic therapy is used, aimed at suppressing inflammation in the body;
• when infections enter the body, antibacterial agents are prescribed;
• prescribed vitamin complexes aimed at strengthening the body as a whole.

Emollients: the basic concept, what is their role in atopic skin?

In atopic dermatitis, the patient's skin is dry to the touch, with thickened rough areas of the epidermis. At the same time, reduced elasticity is observed. Therefore, such skin requires special care.

There are various emollients, that is, moisturizers. These products do not contain classical medicinal substances. Fatty alcohols, fats, esters, paraffin wax, silicones - all these components are emollients. Their action is aimed at moisturizing the skin, as well as relieving inflammation.

Thanks to their natural composition, they help fight the following problems:

• contribute to the rapid penetration of medicinal components through the layers of the dermis;
• help fight infectious skin diseases, therefore they are actively used in the treatment of dermatitis;
• moisturizing and increasing the elasticity of the dermis.

Since emollients are separate substances with different properties, they give the best effect together. But when choosing a drug, it is important to study the composition, since some auxiliary components can cause allergic reactions.

How often should the drug be applied to the skin?

With atopic dermatitis, the patient's skin becomes very dry. Therefore, the more often moisturizers are applied, the less it will be injured. Experts do not make any restrictions on the number of applications of emollients on the skin. They recommend using moisturizers as often as possible. The main thing is to monitor the reaction of the skin to the components that make up the preparation.

Names of emollients for adults

The pharmaceutical market has a huge selection of emollients designed for any manifestation of atopy. The price will vary depending on the composition of the drug. A suitable emollient is selected by a specialist, since each of these agents has its own characteristics and principle of action on the dermis. Therefore, the selection takes into account the type of skin.

The list of funds aimed at the treatment of atopy in adults includes dozens of drugs from post-Soviet countries and foreign production. Among the huge selection of emollients, Trixer, Exomega, Topikrem, Excipial M, Lipikar have a good effect. The use of these drugs is an essential component of the successful treatment of atopic dermatitis.

Children's drugs

With atopic dermatitis in children, emollients are one of the main tools that help relieve unpleasant symptoms and moisturize dry skin. To choose the right remedy, you should contact your pediatrician. It will help you choose an effective, and most importantly, safe drug for children's skin.

The most common emollients intended for young patients are Locobase, La Roche-Posay, Emolium, Mustella Stelatopia. They contain natural fats, paraffin, silicone, essential oils and wax, thanks to which you can relieve the symptoms of dermatitis and prevent relapse.

Emollients for newborns

Immediately after the birth of a child, parents are very careful about the choice of drugs. Therefore, with atopy in infants, experts recommend Topikrem, Physiogel, A-Derma milk or Dardiya balm. These drugs treat redness with dermatitis, nourish and restore the delicate skin of the baby. Milk A-Derma is perfect as a prophylactic, especially in families with a burdened anamnesis.

Diet therapy for atopic dermatitis

The main direction in the prevention of atopic dermatitis is to eliminate potential allergens from the diet. These include:

• citrus;
• chocolate;
• cow's milk;
• nuts;
• fish;
• sausages;
• spices.

In the future, it is necessary to monitor the body's reaction to any new foods that are introduced into the diet. This is especially true for pregnant and lactating mothers with a history of atopic diseases.

Preventive measures of the disease in adults and children

The basis of preventive measures is the creation of such living conditions in which contact with the allergen is reduced to a minimum. Prevention measures include:

• personal hygiene;
• exclusion from life of factors that provoke pathology;
• proper skin care using hypoallergenic products - includes cleansing, moisturizing and nourishing the skin;
• adherence to a certain diet;
• creating a certain home environment where provoking allergens will be excluded - for this, wet cleaning is regularly carried out.

Since atopy is a hereditary disease, it will not be possible to completely get rid of it. Therefore, it is important to control its course, adhere to the treatment prescribed by the doctor, and to prevent exacerbations, do not forget about preventive measures.

Atopy in cats and dogs

Not only a person suffers from hereditary allergic diseases. This is a common problem in our pets. Atopy in dogs or cats is a predetermined problem, as they are already born with the genes responsible for causing allergic reactions to external stimuli. Animals with this problem are especially vulnerable in the first few months of life.

Causes of the disease

The main reason for the appearance of allergic reactions in animals is a hereditary predisposition. But the main provoking factor that triggers the development of the disease is considered to be contact with the allergen.

Pollen, certain types of plants, insects (for example, fleas, ants, ticks) or their waste products can provoke the disease. Therefore, atopy in animals is most often a seasonal problem, the peak of which occurs in the spring and summer.

Signs and symptoms

Various allergens first enter the body of a dog or cat with a burdened heredity through the respiratory, digestive, and skin integuments. In response to this, to fight the allergens, the immune system launches specific antibodies. They are released in a huge volume, which leads to the appearance of inflammation, itching or swelling of the skin. The condition is aggravated by fungal or bacterial infections.

Atopy in cats or dogs has symptoms similar to hay fever that occurs in humans. The only addition is the fact that the animals also itch a lot. Intolerable itching is the main symptom that leads to severe scratching of the affected areas. And this becomes an excellent environment for the penetration and reproduction of infections.

Other symptoms that may occur in an affected animal include:

• tearing, which can lead to conjunctivitis;
• sneezing with clear discharge from the nose;
• cough appears;
• purulent wounds appear at the site of scratching.

Quite often, owners of cats or dogs confuse these symptoms with other diseases. And until the problem is recognized, it may take several months. This aggravates the condition of the animal, aggravating its treatment.

Diagnostics

Diagnosis requires a thorough history and physical examination of the animal. After that, clinical tests of urine, feces and blood are carried out. Sowing on fungal infections is taken. Additionally, skin scraping and intradermal testing are performed. All these activities will help eliminate possible potential diseases of the animal.

Treatment of pathology in animals

The difficulty of treating the disease in animals lies in the variety of allergic or other external factors. This explains the differences in symptoms, as well as the unpredictability of the body's response to treatment.

All therapeutic measures are aimed at stopping the symptoms of the disease. An integrated approach is required, including various interventions:

• eliminate the allergen and minimize future contact with it;
• antihistamines are used to relieve itching, for example, Suprastin;
• in advanced cases, antifungal drugs are used;
• You can treat the skin locally with creams (Nystaform, Travocort);
• in parallel, appropriate treatment of the affected organs (eyes, ears) is carried out;
• a permanent hypoallergenic diet is prescribed for the animal.

Pathology treatment for the animal is prescribed for life. Therefore, when choosing drugs, the veterinarian takes into account possible side effects.

How to control illness in your pet

Since atopy in pets is not curable, it must be carefully managed. And although it is unlikely that the owner of the pet will be able to avoid all allergens, you can at least protect the animal from obvious provoking factors - dust, pollen, insects. To do this, special attention should be paid to the hygiene of the dog or cat, as well as the cleanliness of the room. When the allergy season begins, you need to prepare in advance - purchase medications and, when the first symptoms appear, begin therapeutic measures.

Atopy is a severe, and most importantly, lifelong problem for a person or animal. Therefore, to alleviate symptoms and reduce the frequency of relapses, it is very important to choose the right treatment, adhere to basic preventive methods and pay special attention to proper, hypoallergenic nutrition.

The term "atopy", which comes from the Greek word "alien", was first introduced in 1922 to define forms of hypersensitivity of the body to environmental factors.

Manifestations of atopy are various allergic diseases and their combinations. Their natural development during a person's life is called "allergic" or "atopic march". What does he look like? The first signs of atopy appear shortly after the birth of a child in the form of a food allergy and reach their peak by the middle of the first year of a child's life. At the same age, there is an increase in the symptoms of atopic dermatitis.




In the future, the prevalence of atopic dermatitis decreases. But the symptoms of bronchial asthma gradually increase, which by the age of 6-7 come to the fore. However, by adolescence, allergic rhinitis begins to take a leading position. The whole atopic triad, from the point of view of Tibetan medicine, refers to the "disturbance" of one of the three doshas "wind", "bile", "mucus".




In childhood, the disease is more often caused by a violation of "mucus" and "bile". Can the atopic march be stopped with ancient medicine methods? ATOPIC DERMATITIS (AD) is divided into three successive phases: infant, child and adult, and each has characteristic features. In children, the extensor surfaces of the limbs, the neck, the ulnar and popliteal fossae, the back of the hand are usually affected; in adults, the skin of the face and neck (red face syndrome), the décolleté and the skin of the hands, feet, and fingers are more often affected.




"Weepy" symptoms usually indicate the addition of a secondary infection. But in any phase, dry skin, pruritus, thickening of the skin, peeling, hyperemia and rashes typical of each age are typical. According to several studies, approximately half of patients with AD subsequently develop bronchial asthma, especially when it is severe, and two-thirds develop allergic rhinitis.




Therefore, it is so important that treatment is aimed not only at preventing exacerbations of atopic dermatitis itself, but also at preventing the development of other forms of atopic disease. Modern medicine is practically powerless in front of atopic dermatitis. The emphasis is on the exclusion or reduction of contact with the allergen, the appointment of antihistamines, enzymes and vitamin preparations.




Unnecessarily often, doctors use hormonal and immunosuppressive drugs to treat children. However, the disappearance of skin symptoms in practice means only the withdrawal of the disease inside. Considered from the point of view of Tibetan medicine, this disease is quite treatable - since the reasons for its development have been clarified. All skin diseases are part of the general lesion of the body based on the perturbation of the constitutions "wind" (nervous system), "bile" (digestion) and "mucus" (lymphatic and endocrine systems),

The root cause of violations of these systems is the wrong way of life and nutrition. At the same time, the skin is a mirror reflection of the state of the body and the functioning of internal organs. In the child's body, over all other vital principles, the "cold" constitution "mucus" prevails (it symbolizes growth, development). Very often, non-compliance with the elementary rules of a healthy lifestyle and nutrition can easily unbalance Mucus in a fragile child's body, and lead to a breakdown of other vital principles in the body - "wind" and "bile".

Any external manifestations, changes in the color and texture of the skin, itching and others are perceived as a signal of these disorders that have gone far enough. Parents, following the recommendations of doctors, with food allergies and atopic dermatitis follow a "strict diet". This is where the root of the trouble lies. For example, a child's diet includes foods such as oatmeal and rice porridge, pork, zucchini, pumpkin, onions, dill, olive oil, sour cream, goat's milk and cottage cheese, juices, and some fruits.

What happens? Instead of a therapeutic effect, such a “diet” only worsens the condition of a child prone to allergies. All of these foods are "cold". Especially pork, bananas, sour cream, goat's milk and goat's milk curd, water and juices. They slow down metabolic processes in the body, and in particular suppress the "fire" of the stomach - its "fiery warmth", accumulate mucus in the body. Additional factors in the development of atopic dermatitis are frequent hypothermia of the child (including as a result of parents' passion for hardening!), Experienced stress or nervous situation in the family.

In addition, such medicines of modern medicine that are often used in pediatric practice, such as multivitamins, enzymes, immunomodulators, are “Yin” means and also cause an increase in mucus in the body and bile disorder (failure in the digestive system), disrupting metabolic processes in the body. ALLERGIC RHINITIS is the final stage in the development of the atopic march. Watery eyes, stuffy nose, sneezing, itching, asthma attacks, weakness - these are its signs. Atopic rhinitis is often combined with bronchial asthma, but it also exists independently in the form of two forms: an acute form, more often seasonal (pollinosis, hay fever) and year-round allergic rhinitis.

These forms are combined with conjunctivitis (inflammation of the mucous membranes of the eye) - usually spring, occurring as an allergic reaction to pollen. The main symptoms of allergic rhinitis: spontaneous sneezing, itchy nose, congestion, watery eyes. During allergic rhinitis, several stages are observed: from periodic nasal congestion to permanent, when chronic edema develops and, possibly, the appearance of polyps - growths of the nasal mucosa or paranasal sinuses, which gradually close the nasal passages.

Allopaths usually prescribe vasoconstrictors and antihistamines, but these are only symptomatic treatments and improve the patient's condition temporarily. Treatment of atopic dermatitis Treatment of allergic diseases implies, first of all, proper nutrition. There should be yang on the table, i.e. "hot" food. To do this, boiled and stewed foods should be served to the table with heat, with heat, and must be seasoned with spices. Any are good - pepper, ginger, cardamom, coriander, onion, garlic and others, as well as table salt. Food must contain sour, salty and spicy tastes.

A ginger drink that includes all three tastes (spicy, sour, and sweet) and contains Yang energy is very beneficial. From meat, horse meat, lamb and beef are recommended (it contains medium and slightly warm elements) - stewed and seasoned; if you cannot do without milk, be sure to boil it, raw vegetables and fruits are contraindicated, they are best served stewed, baked or boiled, berries, dried fruits and nuts are suitable instead of sweets and cakes. It is better to drink compotes, fruit drinks, jelly.

Symptoms of atopic dermatitis disappear within a week - provided proper nutrition. The Naran clinic has accumulated extensive experience in the treatment of bronchial asthma and allergic rhinitis. Tibetan medicine has unique herbal remedies for removing excess mucus from the body: Jubril, Dali-16, Pangen-12, Pangen-15, Darbu-5, Darbu-19, Sambru. A wonderful effect is given by such procedures as acupressure, cauterization with wormwood cigars, stone therapy, vacuum therapy.

The method of complex treatment developed by us helps people of any age to either completely get rid of asthma and obsessive rhinitis, or control the symptoms of the disease - not to give the disease a chance to take over. Svetlana Choyzhinimaeva's advice Heating with wormwood cigars can be done at home - this method increases blood flow to vital areas and points, and through them to the lungs and bronchi. The first point - he-gu (closed valley) - is located in the geometric center of the triangular skin membrane that connects the thumb and forefinger of the hand. These points warm up on both hands.

Article author: Choyzhinimaeva Svetlana Galsanovna - Therapist, candidate of medical sciences, member of the International Association of Tibetan Medicine Physicians, founder and chief physician of the Naran clinic.