The aim of the study was to investigate the effect of fine suspended particles in the atmospheric air on the formation and course of allergic and non-allergic phenotypes of the T2 endotype of bronchial asthma (BA) using the case-control study. Materials and methods. BA patients were selected in the course of seeking medical help. The groups were formed on the base of matching criteria (gender, age, body mass index, level of education), supplemented by the collection of information about potential cofounders. Based on the data on monitoring the content of fine suspended particles in the atmospheric air of Kazan, the average annual and maximum concentrations of PM2.5 and PM10 fractions were determined in the residential areas. The group of “cases” included forty patients with an allergic phenotype and 42 patients with an eosinophilic non-allergic phenotype of bronchial asthma, the control group included forty eight people. Additionally, sampling of atmospheric air was carried out using an 8-stage impactor to assess the content of bacterial endotoxin, and elemental composition. Results. Higher levels of pollution with fine suspended particles were demonstrated in the areas of residence of BA patients, comparing to the control group. An increase in the average annual concentration of the PM2.5 by 10 µg/m3 increases the odds of the eosinophilic non-allergic BA phenotype in adults by 4.76 times. The odds of the allergic phenotype of bronchial asthma increases in the presence of bacterial endotoxin - 1.32 times per 0.01 EU/m3 of endotoxin in the 3.2-18 µm size fraction. A more severe course of the eosinophilic non-allergic BA phenotype was noted at higher average annual concentrations of the PM2.5. The control of allergic asthma depends on the bacterial contamination of the aerosol. Limitations of the study are related to the use of geospatial approach to assess personalized average annual and maximum annual concentrations. Conclusion. The role of fine suspended particles in the atmospheric air in the development of bronchial asthma in adults has been shown. Various mechanisms were established to be involved in the formation of the clinical picture of the eosinophilic non-allergic and allergic phenotypes of bronchial asthma.

Т оксический эпидермальный некролиз-острое, тяжелое, потенциально опасное для жизни заболевание, клиническим проявлением которого служит распространенное буллезное поражение кожи и слизистых оболочек, приводящее к эпидермальному некролизу более 30% поверхности кожи, в сочетании с выраженной интоксикацией и во многих случаях с полиорганной недостаточностью [1]. Согласно результатам исследований токсический эпидермальный некролиз регистрируется с частотой от 0,93 до 6 случаев на 1 млн населения в год. В 30-50% случаев заболевание заканчивается летальным исходом, риск которого увеличивается у пациентов с почечной недостаточностью, злокачественными новообразованиями, сепсисом, эпилепсией, системными болезнями соединительной ткани [1, 2]. Необходимо © Коллектив авторов, 2020 Адрес для корреспонденции: Хакимова Резеда Фидаиловна-д.м.н., проф. кафедры клинической иммунологии с аллергологией Казанского государственного медицинского университета,

BACKGROUND: It is now well established that allergens induce eosinophilic inflammation in T2 endotype of asthma. However, much less is known about the role of non-specific factors (suspended particles in the atmospheric air-PM). AIMS: To define eosinophilic inflammation on the basis of several biomarkers in T2 endotype of asthma exposed to PM. MATERIALS AND METHODS: We studied 61 patients with T2 endotype of asthma (ages 18-65). Group 1 included 34 patients with allergic asthma and group 2 included 27 patients with non-allergic asthma. Moreover, 30 healthy matched controls without asthma and other allergic diseases were enrolled the study. We performed clinical examination and allergy testing. Additionally, serum levels of IL-33, IL-25, IL-4, IL-5, IL-13, DPP4 (multiplex assay) and periostin (ELISA) were evaluated. The analyses of annual concentration average (Avr) and maximal annual concentration (MaxAvr) average of PM2.5 and PM10 in Kazan were carried out using the database of the Center for Hygiene and Epidemiology in the Republic of Tatarstan for 2014-2020. Statistical analyseswere performedusing the R statistical software (version 4.0.5). The study was funded by RFBR (project number 19-05-50094). RESULTS: We detected increased blood eosinophil count and IL-5 levels in asthma patients. High levels of total IgE (p=0.0001), that correlated with IL-4 levels were observed only in patients with allergic asthma (rS=0.38; р=0.045). Moreover, elevated IL-25 levels were found in patients with allergic asthma (p=0.009). No significant differences in IL-13 levels in patient with asthma were found. Regression analysis revealed that the PM2.5Avr increase by 1 mcg/m3 results in the growth of IL-33 and IL-25 levels, but the PM10Avr increase raises the IL-25 levels only in patients with non-allergic asthma. No significant increase in IL-25 and IL-33 levels under the exposure to PM2.5Avr and PM 10Avr was detected in patients with allergic asthma. CONCLUSIONS: The results of this study indicate the pivotal role of fine suspended particles in the development and maintenance of eosinophilic inflammation in patients with non-allergic asthma.

The article presents an overview of the development of hematology service in the Republic of Tatarstan. The well-known scientist Nikolay Konstantinovich Goryaev (1875-1943), who worked in Kazan for a long time, began to develop this direction and after passing an internship in Germany proposed an improved device for calculating the blood elements known throughout the world. Adherents of Professor Goryaev continued research in the field of hematology, a blood transfusion station was organized. Professor S.I. Sherman proposed new methods of diagnosis and treatment of B12 deficiency anemia. Professor Sh.I. Ratner studied the changes in the blood picture in diseases of the abdominal cavity. The first 15 specialized hematological beds were opened in 1968 in the hospital named “Old Clinic”. The physician who treated such patients was Rakhil Sholomovna Dashevskaya, PhD. At present, hematology service is provided by three hospitals in Kazan, hematological and therapeutical beds in Naberezhnye Chelny and Nizhnekamsk, outpatient hematology service in Zelenodolsk. In recent years, the introduction of stem cell therapy has begun, and modern combined methods of chemotherapy have been introduced.

Introduction. Suspended particles in ambient air of cities increase the risk of developing respiratory and cardiovascular diseases. At the same time, data on the role of suspended particles in the formation and complication of the course of bronchial asthma (BA) are extremely limited. The aim of study was to substantiate the design of a study to study the effect of fine suspended particles in atmospheric air on the development of the T2 endotype of BA. The design of a "case-control" study was developed and implemented, including patients with the T2-endotype of BA and persons in the control group. In order to verify the diagnosis of BA, General clinical methods of examination and specific allergological examination are used. In parallel, the quantitative characteristics and qualitative composition of suspended particles in atmospheric air are studied with the determination of the mass of suspended particles, dispersion, chemical and microbiological (muldi-tof mass spectrometry, PCR analysis) composition. Atmospheric air samples will be collected using a cascade impactor in the area where patients with bronchial asthma and control groups live. For each fraction, the following will be analyzed: suspended particle mass, dispersion, chemical and microbiological (muldi-tof mass spectrometry, PCR analysis) composition. Conclusions. The study will assess the risk of T2-endotype formation of bronchial asthma with various quantitative and qualitative characteristics of suspended microparticles in the atmospheric air.