IMMUNOLOGICAL ASPECTS OF THE EFFECTIVENESS OF ALLERGEN-SPECIFIC IMMUNOTHERAPY. LITERATURE REVIEW.
Introduction: Seasonal allergic diseases are currently a global medical and social problem. To date, the most effective method of treating allergic diseases is allergen-specific immunotherapy. This treatment method affects all pathogenetic links of the allergic process and has a long preventive effect after completion of treatment courses. Objective: To consider the immunological mechanisms of allergen-specific immunotherapy in patients with seasonal allergic diseases according to a literature review. Search strategy: The search for sources was carried out in scientific databases of evidence-based medicine (PubMed, Scopus, Ebscohost, Medline, The Сochrane Library, SpringerLink, Web of Science) and in electronic scientific libraries (Google Academy, websites of medical periodicals of countries CIS, e-library.ru). Depth of search from 2008 to 2020. The database data revealed a large number of literary sources, which selected in accordance with the context of the study. Of the 119 literary sources, 102 publications selected. Inclusion criteria: as an analytical material for this article, reports on randomized and cohort studies were selected; meta-analyzes and systematic reviews; full-text and publicly available publications; Articles in Russian and English with statistically verified conclusions. The exclusion criteria were articles of low methodological quality that did not have evidence. Results: The review analyzed the results of the most important clinical trials and various schemes of allergen-specific immunotherapy. The allergen-specific immunotherapy effect realized through the following main immunological mechanisms: initiation and maintenance of the transition from T-helper 2 to T-helper 1 immunological response, in the development of which regulatory T- cells played the main role, releasing immunosuppressive cytokines interleukin -10 and transforming growth factor, which induce production immunoglobulin G4. The basis of this process is the shift in the balance between immunoglobulin E and immunoglobulin G4 in the direction of enhancing the production of the latter, which considered a fundamentally important condition for successful allergen-specific immunotherapy and provides long-term clinical tolerance. Conclusions: To date, allergen-specific immunotherapy is the most effective and safe method of treating seasonal allergic diseases. Successful studies in the determination of allergen-specific immunotherapy biomarkers provide great prospects for the active prevention of a wide range of allergic diseases and their complications.
Marina R. Izmailovich1, https://orcid.org/0000-0001-8128-4356 Meruert A. Gazalieva1, Natalia E. Glushkova2, https://orcid.org/0000-0003-1400-8436 Olga Yu. Dedova1, Saltanat T. Mendybay1, Anna V. Skvortsova1 1 NPJSC «Medical University of Karaganda», Karaganda, Republic of Kazakhstan; 2 NPJSC «Medical University of Semey», Semey, Republic of Kazakhstan.
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Izmailovich M.R., Gazalieva M.A., Glushkova N.E., Dedova O.Yu., Mendybay S.T., Skvortsova A.V. Immunological aspects of the effectiveness of allergen-specific immunotherapy. Literature review // Nauka i Zdravookhranenie [Science & Healthcare]. 2020, (Vol.22) 2, pp. 38-48. doi:10.34689/SH.2020.22.2.004

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