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The main mechanism for the occurrence of urticaria is the degranulation of mast cells. It has been proven that, regardless of the activation pathway, clinical manifestations will not differ. According to the literature, up to half of cases of chronic spontaneous urticaria are autoimmune in nature, can be combined with autoimmune thyroid disease, SLE, etc., and have a more severe course.In therapy, antihistamines are traditionally used. However, some patients do not respond to the treatment, even with a multiple increase in doses. In the treatment of urticaria resistant to traditional antihistamines, the use of Omalizumab is recommended. The purpose of the study: to determine the profile of patients with chronic urticaria, as well as to evaluate the effectiveness of treatment with Omalizumab in patients with IgE- dependent and IgE-independent chronic urticaria.Eight-one patients with chronic urticaria (60 adults, 21 children) were examined. Patients before the start of therapy had a long history of CU: from 1 to 20 years. Patients before the start of therapy were treated with antihistamines, but no control was obtained. An increase in the level of serum IgE was detected in 51.7% of cases in adults and 42% in children. Concomitant sensitization was determined in 48.3% of adults and 76.2% of children. In children, food, epidermal and pollen sensitization was the most common. Pollen and epidermal sensitization were more common in adults. The level of eosinophilia in the group with IgE-dependent was more pronounced than in other group (p = 0.0097). After 6 months, the group with IgE-dependent showed an improvement in the symptom score (UCT) from 3.1 CI (1.5-4.6) to 12.2 CI (10.8-13.7), (p = 0.0001). In other group, symptoms improved from 0.63 CI (0.36-1.6) to 8.1 CI (5-11.2) after 6 months (no control). After 6 months of genetically engineered biological therapy (GIBT), complete control over the symptoms of CU in group 1 was obtained in 66.7% of patients, partial — in 33.7%. In the second group, in 33.3% of cases, positive treatment results could not be achieved. Thus, genetically engineered biological therapy with Omalizumab increases the control over the course of CU. Treatment outcomes are higher in patients with an IgE-dependent disease profile.

Allergic rhinitis and bronchial asthma are widespread respiratory allergic diseases. In some territories of the Russian Federation, the dominant cause of pollinosis is ragweed. The aim of the study was to evaluate the clinical and immunological efficacy of ASIT with the allergen Ambrosia artemisiifolia in patients sensitized to Ambrosia trifida in the Samara region. Patients with proven sensitization to Ambrosia trifida was held immunotherapy with Ambrosia artemisiifolia allergoid preseason. After treatment, patients had a decrease in the severity of symptoms of allergic rhinitis according to VAS (p = 0.00001), a decrease in the need for medications (p = 0.0003), as well as the need for corticosteroids against the background of therapy from 34.6% to 0% (p = 0.00001). In 8% of cases, the result of treatment was good, in 69% satisfactory, in 23% unsatisfactory. In the control group, there were no changes in the severity of symptoms (p = 0.858). Also, in the control group, the need for medications remained unchanged and 14.3% of patients continued to use corticosteroids.After ASIT, there was a decrease in the level of IL-4 (p = 0.002), and a decrease in the ratio of IL-4/ IL-10 (p = 0.0063); at the same time, changes in the level of other cytokines (IL-10; IFNγ) were statistically insignificant (p > 0.05). Before treatment, the levels of IL-4/ IL-10 in both groups were comparable, and after treatment, the differences became statistically significant (p = 0.031). We did not get a statistically significant change in the level of IgG4 Amb a 1 or IgG4 Amb trifida. There was no correlation between the level of individual cytokines and the results of treatment. As a result of the conducted ASIT, positive clinical and immunological results were obtained. In most patients, the disease has acquired a controlled course. At the same time, the lack of excellent and low number of good results of ASIT is probably due to the intraspecific allergenic properties of ragweed.

The aim of the study was to study the dynamics of clinical and allergic characteristics of patients with allergic rhinitis (AR) in Samara over the past 5 years. Clinical and allergological examination was performed in 1526 patients from 2012 to 2018. For skin prick testing, 16 names of standard allergens were used. In 2018, the most common forms of AR were seasonal – 40.7 % and combined (seasonal and perennial) forms of AR – 39.8 %. Over the past 5 years, there has been a 1.5-fold increase in seasonal forms of AR (pollinosis). The structure of sensitization revealed an increase in pollen allergy from 39.2 % to 50.6 %, and a decrease in the level of hypersensitivity to epidermal allergens from 29.9 % to 14.5 %. Sensitization to weeds remains dominant in patients with pollinosis and ranges from 82.8 % to 75.2 % in 2012 and 2018, respectively. The predominance of polysensitization to different groups of allergens over monosensitization remains: 55.8 % and 44.2 %, respectively.

Objective: to analyze dynamics of sporulation of mold fungi in order to predict the risks of exacerbation of allergic diseases in Samara.Materials and methods. We evaluated the concentration of fungal spores between April 1st and September 30th in 2016–2019 in the air. Mold spores were captured using an impactor trap on slides covered with a mixture of vaseline and wax with subsequent counting of spore number and their identification.Results. The mean vegetative period of mold fungi in Samara city was 164 days. We have identified spores of Cladosporium and Alternaria, which accounted for 34.4 % of the total number of spores in the atmospheric air of Samara. Cladosporium spores were detected during the entire observation period; their proportion was 15.3% from the total number of fungal spores, their maximum concentrations were within the normal limits and did not exceed 960 spores/m3. The proportion of Alternaria spores was 19.1%. In some periods, concentrations of Alternaria spores exceeded threshold values: the concentration between 10 and 100 spores/m3 was observed 4 to 31 days per months; the concentration above 100 spores/m3 was observed 2 to 25 days per month. The highest total monthly concentration of Alternaria spores was detected in July–September, during the period of sagebrush and ragweed pollination, which can potentially hamper the diagnosis and treatment of patients who have exacerbations of their allergic diseases in this period.Conclusion. We have identified the main taxa of mold fungi, analyzed their regional specificity and assessed the risk of allergic diseases in individuals sensitized to Alternaria and Cladosporium species. Our findings will help to optimize the diagnosis, treatment, and prevention of allergic diseases in the region.

The true prevalence of pollinosis in general and of weed susceptibility to pollen in particular (mainly wormwood and ragweed) in Russia and worldwide has not been studied enough. The ragweed is a quarantine weed, which is a native species in Russia. Wormwood is a large genus of herbaceous plants, in Russia the most common bitter and common wormwood. The aim of the study was to study the level of sensitization to ragweed pollen and wormwood in Samara region for 5 years. In the city of Samara revealed the growth of sensitization to ragweed pollen and wormwood from 2012 to 2017, which is consistent with the data on the leading role of ragweed pollen and wormwood as a risk factor for the development of pollinose in the region. Taking into account the data on ragweed distribution in the region is three separate, to avoid cross-reactions between allergens of different types of ragweed and wormwood, and to identify the truth of sensitization in these patients should be conducted component allergy diagnostics.

A complex of organizingmethodical, medical preventive and antiepidemic measures both at the frontier passing points and on the whole Amurskaya Province prior to detection of a SARS case in Blagoveshchensk City and from the moment of the disease registration to prevent further dissemination of this infection is represented.

Antiepidemic measures in Blagoveshchensk City of Amurskaya Province were carried out among persons contacted with a patient suspected to «atypical pneumonia» (further diagnosis was confirmed by laboratory methods). Chinese citizens were isolated at the hotel (at the place of their residing); close relatives of the patient were accommodated in the isolation ward of the Regional infectious hospital. Russians were kept under observation at the place of their residing. The efficiency of the performed measures is marked.

The substantiating of SARS diagnosis in patients (Blagoveshchensk, Amur Region) is presented. The diagnosis was based on the results of clinical picture, epidemiological anamnesis and inquiry, and laboratory study of the patient’s blood and nasopharyngeal washes with the help of ELISA and PCR.

Efficacy of ricobendazole in 10 % solution for injection against the most helminthosis of cattle are studied. Therapeutic dosis of ricobendazole (4 mg/kg) were determined. The drug was showed 98–100% efficacy against dictyocaulosis, gastrointestinal nematodosis, monieziosis. Fasciola hepatica, Trichocephalis ovis were more resistant to action of ricobendazole.

Test of Ricobendazole used for treatment of moniesiosis was conducted in the farm «Krasny Put» in Pestravsk district of Samara region in June-July 2013. 40 lambs sponta- neously infected with Moniesia spp. were selected for testing. By strongilatosis of the gastrointestinal tract Ricobendazole was tested in the same farm in June July 2013 on 26 wedders (gelded rams) in the age of 1-1,5 years spontaneously infected with various spe- cies of Strongylata. By dictyocaulosis and other lung strongilatosis Ricobendazole was tested on 24 spontaneously infected sheep selected after examination of feces according to Berman method. Efficacy of Ricobendazole against various species of Anoplocephala is studied in June-August 2013 in farms of Samara region that are unfavorable in relation to avitellinosis and tisaniesiosis in sheep spontaneously infected with Avitellinae centri- punctata (12 heads) and Thisaniezia giardi (10 heads). By trichocephalosis the medicine is tested on different groups of sheep at the dose of 4, 6 and 8 mg/kg. Anthelmintic effi- cacy of Ricobendazole is studied by main helminthosis in sheep. Ricobendazole at the dose of 4 mg/kg showed 100 % efficacy against Nematodirus spp. and other Strongylata of gastrointestinal tract, Dictyocaulus filaria, 99,9 % - against Moniezia spp., 85,8 % - against Mullerius capillaris, 84,7 % - against Protostrongylus spp., 96,1 % - against Аvitellina centripunctata, 99,2 % - against Th. giardi and 73,9 % - against T. ovis.

Efficacy of the injective anthelmintic drug Ritril produced on the base of Ricobendazole and Triclabendazole used in treatment of different types of helminthosis in cattle has been studied. It was determined that Ritril has a high anthelmintic efficacy when administered at a dose of 0,8 ml/10 kg of body weight. The drug shown a 100% efficacy in treatment of dictyocaulosis and strongylatosis of gastrointestinal tract. Fasciola spp. and Trichocephala spp. were more resistant to the effect of Ritril. Therefore it is recommended to use the drug at a higher dose – 1,6 ml/10 kg of body weight.

Immune-related adverse events (irAEs) occur in up to 50% of patients treated with an anti-CTLA-4 antibody and 30% of patients treated with PD-1/PD-L1 antibodies. Severe forms of toxicity are observed in 3% of patients and require systemic steroid therapy and constant monitoring. One of the considered predictor biomarkers of irAEs development is HLA-genotypes. This research aims to evaluate the diagnostic significance of HLA-DRB1 genotypes and other clinical and laboratory parameters to predict the development of irAEs. The study involved 28 patients with metastatic melanoma taking checkpoint inhibitors therapy [nivo 53.6%, Ipi+nivo 32.1%, other (pembro, prolgo) 14.3%]. The PD-L1 expression and HLA-DRB1 genotype were evaluated. After 2-3 months the development of irAES was assessed. The complications of 3-4 grade or multi-organ damage were termed as severe irAEs. Various IrAEs developed in 57.1% (16/28) of patients, while severe irAEs occurred in 35.7% (10/28). Among all patients, HLA-DRB1 genotypes associated with the risk of autoimmune diseases were found in 78.5% (22/28). The PD-L1 expression was detected in 60.7% (17/28) of individuals. Combination treatment increases the risk of toxicity, p = 0.0028, with a diagnostic sensitivity of 56% and a diagnostic specificity of 100% (RR = 2.71, OR = 31.67). An index based on the parameters studied (HLA-DRB1, absence of PD-L1 expression, and type of treatment) was created. It allows assuming the risk of developing severe irAES (p = 0.0126). When comparing this indicator between irAEs 1-2 and irAEs 3-4, the presence of an index value of more than 2 gives a sensitivity for predicting severe toxicity of 40.00% and a specificity of 83.33%.

We undertook a structural and functional study of blood cell mitochondria in 25 patients with controlled mild bronchial asthma (BA) including evaluation of blood saturation with oxygen, carboxyhemoglobin level in blood and carbon monoxide content in the exhaled air. Membrane potential of leukocyte mitochondria was determined based on the results of flow cytofluorimetry and fatty acid (FA) composition in platelet mitochondrial membranes measured by GLC. It was shown that the absence of clinical symptoms of BA during remission was associated with a reduction of membrane potential and a change of FA composition resulting in the depletion of the basal pool of saturated (12:0, 14:0, 18:0) and polyunsaturated (20:4n-6, 20:5n-3, 22:5n-3, 22:4n-6) FA. These changes in the structural and functional state of blood cell mitochondria in patients with BA are signs of disordered energy-producing activity, membrane permeability and transmembrane transport suggesting the development of mitochondrial dysfunction and cellular hypoxia. A deeper insight into the role of the structural and functional state of blood cell mitochondria in the formation of respiratory disorders will facilitate early detection of the risk and complications of bronchial obstruction.