THE ROLE OF FRACTALKINE AND MONOCYTE CHEMOATTRACTANT PROTEIN-1 IN THE PROGRESSION OF ASTHMA.

To improve the effectiveness of diagnosis and prediction of adverse asthma comorbid conditions based on research of clinical manifestations features, functional disorders of the airways and endothelial dysfunction. 79 patients were selected for the study. All the patients were divided into 3 groups: group 1 - patients with asthma (n-22); group II (n-24) - patients with asthma + diabetes mellitus type 2; group III (n-33) - patients with asthma + obesity + arterial hypertension (AH) and control group (n-17) - healthy people. All the patients underwent clinical examination. Spirography indicators were tested, and full patients' examination was conducted. The levels of fractalkine (CX3CL1) and Monocyte Chemoattractant Protein - 1(MCP-1) were determined by Enzyme-linked immunosorbent assay (ELISA) test using Ray Bio® Human Fractalkine system manufactured by Ray Biotech, Inc., USA; "Human MCP-1" (eBioscience, Austria), respectively. Statistical processing of parameters of endothelial function, МСР-1 andCX3CL1, depending on comorbid pathology, has identified statistically significant elevated level of the separametersinall studied groups. The most pronounced changes of both parameters were registered in group 2 patients, indicative of the most significant manifestations of endothelial dysfunction in this patient group.Assessment of endothelium dysfunction markers depending on external respiration function was performed. It has been found out that МСР-1 affects vital pulmonary capacity (χ2=14.466; р=0.002) and forced expiratory volume in 1 second (FEV1) (χ2=8.471; р=0.037). Besides, CX3CL1 exerts influence on these parameters as well (χ2=19.385, р=0.001); (χ2=11.476, р=0.009), respectively. The decrease in rate parameters, in particular, FEV1, MEF 25, MEF 50, and MEF 75, was identified in all patient groups. Based on these data, we can assume that patients with a combination of asthma and diabetes mellitus type 2 demonstrate more cases of endothelial malfunction, leading to the worsening of respiratory function, compared to the group with asthma, obesity and arterial hypertension and a group without comorbidity.

EAACI Position paper on the standardization of nasal allergen challenges.

Nasal allergen challenge (NAC) is an important tool to diagnose allergic rhinitis. In daily clinical routine, experimentally, or when measuring therapeutic success clinically, nasal allergen challenge is fundamental. It is further one of the key diagnostic tools when initiating specific allergen immunotherapy. So far, national recommendations offered guidance on its execution; however, international divergence left many questions unanswered. These differences in the literature caused EAACI to initiate a task force to answer unmet needs and find a consensus in executing nasal allergen challenge. On the basis of a systematic review containing nasal allergen challenges of the past years, task force members reviewed evidence, discussed open issues, and studied variations of several subjective and objective assessment parameters to propose a standardized way of a nasal allergen challenge procedure in clinical practice. Besides an update on indications, contraindications, and preparations for the test procedure, main recommendations are a bilaterally challenge with standardized allergens, with a spray device offering 0.1 mL per nostril. A systematic catalogue for positivity criteria is given for the variety of established subjective and objective assessment methods as well as a schedule for the challenge procedure. The task force recommends a unified protocol for NAC for daily clinical practice, aiming at eliminating the previous difficulty of comparing NAC results due to unmet needs.