[Features of inflammatory endotypes and phenotypes in chronic rhinosinusitis]. / Osobennosti endotipov i fenotipov vospaleniya pri khronicheskom rinosinusite.

Recently, significant progress has been made in identifying the cellular and molecular mechanisms responsible for the pathogenesis of chronic rhinosinusitis (CRS). Cohort studies of CRS have led to advances in the clinical understanding of this disease. New therapeutic agents have been approved or are undergoing clinical trials to expand treatment options for this disease. One of the promising areas in medicine is the provision of personalized clinical care. From this perspective, CRS can be divided into three different endotypes depending on the type of underlying inflammatory response. In the United States, CRS with and without nasal polyps is predominantly characterized as the second inflammatory endotype. CRS with nasal polyps (about 17%) and without nasal polyps (up to 20%) belongs to the 1st and 3rd inflammatory endotypes, respectively. And if for the second inflammatory endotype the effectiveness of targeted biological therapy is beyond doubt, then for the first and third inflammatory endotypes the principles of such conservative therapy are under active development. Moreover, large validated studies to confirm associations between CRS phenotypes and endotypes, as well as to find effective biological markers of inflammatory endotypes, remain to be performed.

[The role of cytokine gene polymorphisms in the development of hypertrophy of the tonsils of the lymphoid pharyngeal ring and atopic march in the children].

Interleukin 1-beta (IL-1b), its endogenous receptor antagonist (IL-1 Ra), and interleukin IL-4 have been shown to play a role in immunopathological processes, such as the development of hypertrophy of the tonsils of the lymphoid pharyngeal ring and atopic march. However, the influence of Il-1 and IL-4 gene polymorphisms as etiological factors of this pathology remains obscure. The objective of the present work was to study characteristics of gene polymorphisms of proinflammatory and proallergic cytokines depending on the degree of hypertrophy of the tonsils of the lymphoid pharyngeal ring (LPR) and atopic march to selected species of the opportunistic pathogenic biota. Polymorphisms of the following genes were investigated in the children, residents of the Kemerovo region, presenting with hypertrophic tonsils of LPR: IL-1b+3953 (C->T), IL4 (70 bp VNTR), and IL-1Ra (86 bp VNTR). IL-1b, IL-1Ra, and IL-4 genotypes were determined by PCR of autosomal DNAs obtained from 129 children presenting with hypertrophic tonsils and 41 healthy children with the use of conventional genetic-statistical methods. Odds ratios (ORs) were estimated by the logistic regression models for each locus and after adjusting polymorphisms for the neighbouring loci. The 2R, 2R, Il-1Ra and T, T IL-1b genotypes occurred more frequently in the patients with isolated adenoid vegetations (20.93% and 25.58% respectively) than in the healthy children (4.95%) (OR=3.78, p=0.049; OR=3.25, p=0.047). The results of this study indicate that IL-1b and IL-1Ra gene polymorphisms play a role in the development of clinically significant features in the lymphoid pharyngeal ring.

[The use of the antidepressant citalopran for the treatment of chronic pharyngitis and pharyngeal neurosis].

The analysis of the efficacy of citalopran for the treatment of chronic pharyngitis and pharyngeal neurosis was carried out. The positive outcome of the treatment was documented in 95% of the patients.