[Biomarkers of angiogenesis and endothelial dysfunction in children and adolescents with chronic viral hepatitis.]

At some works, it has been shown there are signs of damage and endothelium dysfunction in patients with chronic viral hepatitis (CVH) and liver cirrhosis of viral etiology the severity of these conditions depends on the severity of the pathological process. Evaluation of the role of angiogenic factors and endothelial dysfunction in persistent of CVH in children and adolescents. 35 patients were examined: of which 11 with chronic hepatitis B (CHB) and 24 with chronic hepatitis C (CHC). The reference group consisted of 120 practically healthy persons of the corresponding age and sex. VEGF-A, angiotensin (ANG), soluble receptors of VEGF-A (sVEGF-R1 и sVEGF-R2) and trombomodulin (TM) have been investigated in serum by enzyme immunoassay using special kits (BCM Diagnostics, USA). Other endothelial dysfunction markers as von Willebrand factor (vWf) was determined in blood plasma by immunoturbidimetry (Siemens, Germany), plasminogen (PLG) was investigated due to extended coagulation. In children with CVH, regardless of etiology, the concentration of VEGF-A was significantly lower, and sVEGF-R2, sVEGF-R1 and TM was higher than in children without liver disease (p <0.001, p <0.05, p <0.01, p <0.001, respectively). The concentration of TM and the level of PLG activity in patients with CHC were slightly higher than in CHB. Decreased level of VEGF-A and increased expression of its soluble receptors indicate enhanced inhibition of angiogenesis in CVH, which may indicate the pathogenetic role of this phenomenon in the development of liver damage in CHC.

[The mode of evaluation of sensibilization of children to grain herbs under respiratory allergy.]

The sensibilization of patients to allergens of grain herbs is characterized by expressed crossed allergic reactions to pollen of various representatives of the given family. The investigation of antibody response to allergens of grain herbs and also data of epidemiological studies, results of world and national studies permitted to develop and propose a new mode of diagnostic of allergy with evaluation of level of sensibilization of patient and also qualitative detection in blood serum the level of specific immunoglobulins E (IgE) to allergens of grain herbs. The parameter «concentration of IgE to allergens of cocksfoot¼ - IgE(g3) - is a key one for evaluating in blood serum of patients content of IgE to allergens of grain herbs matched to cocksfoot: randall, timothy, Kentucky bluegrass, field brome, meadow foxtail, French ryegrass. To calculate concentration of IgE to allergens of the mentioned grasses detection of IgE(g3) is necessary and sufficient. The elaborated prognostic table permits evaluating degree of ensibilization of patient to various grain herbs and also detecting concentration of IgE expressed in units kE per l without application of additional serological analyses. Therefore, the elaborated technique permits reducing number of «in vitro¼ tests and minimizing number of blood sample of patient and also speeding up receiving of information concerning sensibilization profile of patient.

[The diagnostic detection of sIgE to allergens of trees' pollen by rest-system «Alkor-Bio¼ and Immunocap technique.]

The article presents the results of preliminary analysis of 320 pair results of testing of children with bronchial asthma and/or allergic rhinitis conditioned by tree pollen. The imported and national test-systems ImmunoCAP and Alkor-Bio were applied. The detailed analysis of study results of the mentioned tests demonstrated that detection of levels of allergen-specific IgE in patients using test-systems Alkor-Bio and ImmunoCAP shows high degree of data matching related to a number of tree allergens. The application of national test-system Alkor-Bio can be considered as an alternative to import methods in evaluation of levels of sIgE to allergens of alder tree, birch, hazel, willow, poplar, pine.

[Peculiarities of Allergy Diagnosis in Children].

Allergic disease is a serious problem in practical healthcare. Over the last 40 years there has been exponential growth in the prevalence. According to the world health organization information, allergic diseases are at the 2nd place in prevalence the children, behind the viral infections. Their frequency and severity are increasing. In this regard, the relevance of timely and skilled diagnostic allergopathology is most important. In this study the current state of the question of allergy diagnostics is considered, the international experience is summarized and the approach to the allergy diagnosis based on use of step-by-step identification of a causal and significant factor of allergic reactions is offered. On the basis of the analysis of relevance and the importance for patients of one or the other allergens (taking into account a source of allergens and age of patients) use of a step-by-step allergy diagnostics algorithm is offered. The first step is definition of clinical implications of an allergy. It means direct contact of the phisition with the patient, clarification of its complaints, clinical symptoms, medical history disease. The second step is the confirmation of IgE-dependent mechanism. It involves the using of screening tests that are selected depending on the clinical symptoms and seasonality manifestations (the screening module). The third step is to identify the source of the allergens that are most meaningful for the patient with using test panels (modules). The panels include the most common and clinically relevant triggers of allergic reactions. The fourth step is the search for an individual significant allergens, which were not included in the diagnostic modules. On the fifth step, we plan to conduct component-divided diagnostics and detect the antibodies to unique components of significant allergens. The developed diagnostics algorithm, corresponds to needs of both the adult, and children's population and provides the personalized approach to the patients.

[Current status of vascular remodeling and angiogenesis in chronic liver diseases].

The review focuses on the analysis of researches on the pathophysiology of liver vascular bed, mesenteric vessels, as well as the characteristics of angiogenesis in CLD. The results of this review shows that one of the most important areas of research is soluble vascular endothelial growth factor receptors, disclosing their importance for prognosis and treatment of diseases that occur with severe disorders of angiogenesis, including in CLD.

[The experience of applying system of continuous monitoring of content of glucose in children with glycogen disease].

The sampling included 23 children with glycogen disease. All patients were examined using system of continuous monitoring of content of glucose applied during 72 hours. It was established that hypoglycemia was detected in 19 (82.6%) children. At that, in 7 (30.4%) children the level of glucose was below detected range (< 2.2 mmol/l). In patients ignoring proposed recommendations (lack of compliance) expression of hypoglycemia was reliably higher than in children being on a diet and following recommendations of physician. In primary patients as compared with secondary patients rate and duration of hypoglycemia in blood serum activity of aspartate aminotransferase also was reliably higher. Independently of all that, the more frequently hypoglycemia developed the more expressed hypoglycemia was. Therefore, continuous monitoring of content of glucose in intercellular fluid is an effective instrument for detecting degree of compensation of carbohydrate metabolism in patients with glycogen disease. The day continuous monitoring of level of glucose permits to provide the most complete picture of fluctuations of glycaemia during a day. The obtained data can be used as a basis for composing an optimal algorithm of diet therapy.

[About Minimization of Expenses on Allergy Diagnosis in Children: Analysis of Consistency of in Vitro- and in Vivo-Allergic Examinations Results].

UNLABELLED: High morbidity rate of atopic diseases among children, including high importance of grass pollen as a sensitizing agent, determine the relevance ofstudies on diagnostic examination systems for appointment of adequate therapy. The research of the most relevant allergens for patients to excludeof duplicating and uninformative tests became urgent after development of a new type of diagnostic tests that does not require expensive equipment. The objective of this research was to evaluate the results of in vitro- and in vivo-diagnostic examinations of children with various forms of atopic disease caused by pollen of meadow grasses, and to choose the most significant prognostic parameters for the diagnosis. METHODS: 277 children aged 4-16 years with various forms of atopic disease were included in the study. There were performed skin prick tests and determination of IgE-antibodies levels to allergen extracts of cocksfoot (g3), meadow fescue (g4), timothy grass (g6). RESULTS: In the studied group of patients 32-50% of children have antibodies to grass allergens. There was a close correlation of antibody response on the investigated allergens, quantitative coincidence of IgE-antibodies to g3 andg4 allergens levels. IgE (g6) concentration was close to the IgE(g3) and IgE(g4) levels (85.0 ± 21.6%). Analysis of the skin tests results showed that 44% of patients have a positive response to grass allergens, and in vivo-tests results coincide with serologicaltests results, mostly in a qualitative sense. The most significant relationship was noted between in vivo and in vitro-tests in the results of testing the response to meadow fescue pollen. CONCLUSION: Based on these data IgE concentration index to meadow fescue allergens can be used as a prognostic marker to determine the sensitization of patients with different nosology forms of allergy and can help to improve allergic diagnostics.