Objective. To determine the diagnostic significance of methods of allergological diagnostics: skin prick tests (SPT), quantitative determination of specific immunoglobulin E (sIgE) and nasal provocative test (NPT) in children with allergy to house dust mites (HDM) diagnosed with allergic rhinitis (AR) or AR in combination with asthma. Methods. Patients underwent a targeted history taking for possible domestic sensitization, SPT with HDM allergens, NPT with HDM, and sIgE to HDM allergens was determined by the ImmunoCAP method. Results. The statistical processing group included 109 children (67 boys, 42 girls, aged 5 to 17,9 years (mean age 8,9±2,52 years)), in whom sensitization to HDM was confirmed by at least one of the methods used in the study. A higher sensitivity of SPT then of sIgE was determined (96,3% and 81,6%, respectively). According to SPT and sIgE results, sensitization to both types of mites (D. pteronyssinus and D. farinae) is more common than isolated. Coincidence of positive results of SPT and sIgE was obtained in 84 cases (77,1%). Conclusion. SPT can be considered as the first line of investigation. The use of a complex of examination methods is necessary to determine the role of sensitization to HDM, if NPT is taken as the «gold» standard of diagnosis.

Objective. Based on literature data and own research, on the selection of pediatric patients for the treatment of allergen immunotherapy (AIT) with house dust mite (HDM) allergens, to develop an Algorithm for selecting patients for AIT with HDM allergens in children with bronchial asthma (BA) and allergic rhinitis (AR). Methods. Data from our own studies included 420 patients with AR and complaints indicating domestic sensitization (256 boys, 164 girls), aged 5 to 17,.9 years (mean age 8,.44 ± 3.,06), of which 176 have had BA. Patients underwent skin prick tests (SPT) with household allergens, determination of sIgE for HDM allergens by the ImmunoCAP method, and nasal provocative test (NPT) with HDM. If the results were negative, the allergological examination was repeated again in 12-–18 months. Results: The Patient Selection Algorithm was constructed on the basis of the obtained data on the significance of the examination methods used. The primary role of SPT, the possibility of repeating the examination in case of negative results, indications for NPT with HDM allergens were taken into account. The algorithm makes it possible to organize an examination of a patient with HDM allergy in order to develop indications for AIT.

Background. Children with mild bronchial asthma (BA) are prone to poor control of symptoms during seasonal acute respiratory infections (ARIs). Objective. To optimize therapy in children with mild BA to improve disease control during seasonal ARIs. Patients and methods. This single-blind placebo-controlled prospective single-center trial evaluating the efficacy of ammonium glycyrrhizinate (Reglisam, ‘VIFITECH,’ Russia) and lasting 4 months included 63 children with mild BA (21 in the placebo group) aged 5 to 10 years with a disease duration of at least 3 months. We assessed respiratory function, FeNO level, results of the asthma control test, characteristics of BA exacerbations, and the need for betamimetics and budesonide via a nebulizer. We used the Student's t-test and Wilcoxon test to evaluate the differences in mean and median values; the differences were considered significant at р < 0.05. Results. The frequency and mean duration of ARIs were lower in the group of active therapy (1.06 ± 0.35 episodes and 6.52 ± 2.19 days) than in the placebo group (1.77 ± 0.26 episodes and 10.83 ± 3.07 days). The differences were statistically significant (р = 0.036 and р = 0.019, respectively). Patients receiving placebo required longer budesonide administration per one BA exacerbation: 11.72 ± 1.98 days vs 8.65 ± 2.17 days in patients receiving active therapy (р = 0.026). Significant differences in the respiratory function and FeNO level were observed only in the subgroup of patients who had incomplete asthma control upon enrollment. We observed no new adverse events that had not been reported earlier. Conclusion. Our findings suggest high efficacy of ammonium glycyrrhizinate used to enhance basic therapy for mild BA in children, in whom respiratory infections are the most common triggers of BA exacerbations. Key words: ammonium glycyrrhizinate, basic therapy, children, mild bronchial asthma, acute respiratory infections (ARIs)

House dust mites are important cause for allergic rhinitis, and almost half of allergic rhinitis patients is sensitized to them. In patients with house dust mite allergy evidence of sensitivity can not be strictly achieved with medical history and patients complaints, since the cause-effect relationships are not obvious. At the same time incomplete allergological examination can lead to an incorrect definition of the main relevant allergens, and expensive treatment may not give the desired result in this cases. The estimation of the allergens for allergenspecific immunotherapy should be based on the disease history, detection of offending allergens by means of allergological examination in vivo with skin tests, nasal or conjunctival provocational tests, and component diagnostics if necessary. This approach based on use of provocational tests as a part of allergological examination is considered to be one of the ways to personalized therapy.