A method for the treatment of atopic bronchial asthma

 

(57) Abstract:

The invention relates to medicine, in particular to pulmonology and Allergology, and for the treatment of atopic bronchial asthma. For this exercise introduction cause-significant allergen and additional succinic acid orally no more than 0.05 g 2 times a day after meals under the scheme: 3 days reception, 4 days break in a month. The method provides an increase in functional activity of immunocompetent cells and, consequently, reduce the intensity of allergic inflammation. table 1.

The invention relates to medicine, namely to immunology, and can be used in Allergology for the treatment of patients with atopic bronchial asthma (ABA).

The basis for the formation of IgE-dependent allergic inflammation are disorders of immune homeostasis [1]. The most effective treatment and rehabilitation of patients with atopic diseases is specific immunotherapy (SIT) cause significant allergens [1]. The essence of this method is the introduction of the allergen into the body of the patient. In the modified immune response, causing the production of allergen-specific IgG4, IgG1antibodies and slimming sinofile cytokines. This reduces allergen-specific and nonspecific tissue reactivity, increased nonspecific Abina activity of immunoglobulins.

The main disadvantages described above of the method of SIEVES is the presence of frequent side effects, relapses, which in General reduces the effectiveness of the treatment.

The objective of the proposed method is to increase the effectiveness of treatment by eliminating the side effects of relapse.

The invention consists in that in the method of treatment of atopic bronchial asthma, which consists in the introduction into the organism cause significant allergens, impose additional succinic acid per os is not more than 0.05 g 2 times a day after meals for a month under the scheme: 3 days receive a 4-day - break. Patients ABA has a metabolic disorder of blood lymphocytes, which are characterized by low energy supply, primarily due to the decrease in the activity of succinate dehydrogenase (LDH) - a marker enzyme of mitochondria - amid saved compensatory metabolic capabilities of the cell. This fact suggests that it is necessary to replenish the pool of intermediates of the Krebs cycle is ekzohennozelezhnoi on the inner membrane of mitochondria. Moreover, the LDH activity does not depend on the ratio of the concentrations of oxidized and reduced forms of NAD+/NADH+that allows you to save energoaparatura function of mitochondria in hypoxia, which is one of the leading pathophysiological syndromes ABA.

The method is as follows. Enter patient cause significant allergen such as house dust allergen, in the form of injections according to the standard scheme. At the same time appoint reception succinic acid, for example, manufacturing pharmaceutical company LLC “Search-T”, Tomsk according to the following scheme: not more than 0.05 g 2 times a day after meal per os during the month, 3 days receive a 4-day - break.

To assess the effectiveness of treatment of patients ABA conducted an open randomized study. For comparison, we selected two groups of patients. Before and after immunotherapy assess the following indicators: clinical efficacy in points (EC), the index of the variability of the peak exhalation rate in percent (PSV). skin reactivity to house dust allergen in points (KR), the level of IgE antibodies to house dust allergen in ELISA units (IgE D. p.), the activity of LDH in the granules to the cell by the method of R. P. nartsissov. Group I (key concept is ausich treatment without succinic acid. The research results are summarized in the table.

The advantages of the proposed method immunotherapy ABA are:

1. The increase of 1.42 times the clinical efficacy of SIT in patients with ABA (table);

2. Decrease 2 times side effects of SIT in patients with ABA (clinical data).

Clinical example 1. Sick,, N history 23233, was in the Allergy Department of the Regional clinical hospital №1, Krasnoyarsk with a diagnosis of atopic bronchial asthma mild persistent throughout the period of clinical remission.

Upon receipt 08.01.01, indicators of forced expiratory volume in the first second (OFB1and PSV more than 80% of predicted values, the index of variability PSV less than 20% was observed hypersensitivity to household allergens. 09.01.01 was started specific hyposensitization allergen house dust subcutaneous method in combination with succinic acid (per os 0.05 g 2 times a day after meals for a month under the scheme: 3 days receive a 4-day break). When conducting specific immunotherapy of side effects were observed during the entire course of treatment.

Research conducted 2 weeks after the course specific hypotensive normal (proper) indicators of external respiration function, as well as the extinction of sensitization to house dust allergen, as evidenced by the results of the final sample and the level of specific IgE to house dust in the serum.

In the dynamics of observations 12 months after course SIT exacerbation of atopic bronchial asthma was absent, calls for emergency assistance in connection with bronchoobstructive syndrome was not observed. Clinical remission was maintained for 12 months (observation period).

Clinical example 2. Patient D., N history 4187, was in the Allergy Department of the Regional clinical hospital №1, Krasnoyarsk with a diagnosis of atopic bronchial asthma mild persistent throughout the period of clinical remission.

Upon receipt 12.03.01, indicators OFB1and PSV more than 80% of predicted values, the index of the variability of EPS in the range of 10% was observed hypersensitivity to house dust allergen. 13.03.01, assigned specific hyposensitization allergen house dust subcutaneous method for accelerated scheme in combination with succinic acid (a single dose of 0.05 g 2 times a day after meal per os, 3 reception, 4 days break). Systemic and local reactions to the conduct of specific immunotherapy is not NAII in combination with succinic acid has full control of asthma (asthma symptoms were absent) in the patient, indicators of external respiration function had no significant differences with healthy options, decreased hypersensitivity to house dust allergen, reflecting skin tests and specific IgE to house dust in the serum.

In the dynamics of observations 12 months after the course SITH no exacerbations of atopic bronchial asthma hospitalizations due to broncho-obstructive syndrome was not observed. Clinical remission was observed 12 months (observation period).

Clinical example 3. Patient S., N history 6000, was in the Allergy Department of the Regional clinical hospital №1, Krasnoyarsk with a diagnosis of atopic bronchial asthma mild persistent throughout the period of clinical remission.

Upon receipt 12.03.01, indicators OFB1and PSV more than 80% of predicted values, the index of variability PSV 10%. It was noted hypersensitivity to household allergens. 13.03.01, assigned specific hyposensitization allergen house dust subcutaneous method in a more expedient manner. When conducting SIT on the maximum dose of house dust allergen was observed reaction in the form of redness and itching in the place injective after a course SIEVE, showed it to a satisfactory effect of reducing the frequency of asthma, nocturnal asthma symptoms, as well as needs2-agonists short-acting. This remained high sensitivity to house dust allergen.

Dynamic observation set 2.5 months after course SIT exacerbation of atopic bronchial asthma, which proceeded with moderate bouts of bronchoobstructive, and therefore in the treatment added to inhaled corticosteroids (Becotidi 300 mg per day) for 3 months, after which the atopic bronchial asthma stabilized. Currently assigned cromoglycate sodium at a dose of 20 mg/day in 2 doses for a period of 6 months.

Therefore, the task to solve due to the fact that the complex cause-significant allergen is injected succinic acid, which is easily included in the physiological cell metabolism significantly and quickly increase energorashodyi processes in the cell, and therefore increases the functional activity of immunocompetent cells and, as a consequence, the decrease in the intensity of allergic inflammation.

The proposed method can be used in clinical practice for patients method antiallergic treatment//Immunology. - 1997. No. 2. - S. 4-8.

A method for the treatment of atopic bronchial asthma, which consists in the introduction into the organism cause significant allergens, characterized in that it further impose succinic acid per os is not more than 0.05 g 2 times a day after meals for a month under the scheme: 3 days receive a 4-day - break.

 

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