269 research outputs found
Shadowing Effects on Particle and Transverse Energy Production
The effect of shadowing on the early state of ultrarelativistic heavy ion
collisions and transverse energy production is discussed. Results are presented
for RHIC Au+Au collisions at GeV and LHC Pb+Pb collisions
at TeV.Comment: 4 pgs, 2 figures, presented at Quark Matter '9
Diagram of plastic material transition into brittle state under hydrogen saturation
Major progress made in theoretically describing the behavior of a Β«hydrogen-metalΒ» system still fails to unambiguously explain the phenomenon of hydrogen brittleness in metals. It follows that a phenomenological approach is appropriate to describe the transition of a plastic material into its brittle state with the growth of hydrogen concentration. A diagram for such a transition is plotted on the basis of known experimental data on how hydrogen affects mechanical properties of structural steels. It is intended for the purposes of predicting the behavior of fracture observed in elements of metal structures under peak overloads or normal operation. Β© Published under licence by IOP Publishing Ltd
Phenomenon of embrittlement in titanium shells from hydrogen exposure
Increasing the reliability of equipment used for production, transportation, storage and utilization of hydrogen is directly related to solving the problem of hydrogen embrittlement of metals. Without a fundamental physical theory, it is necessary to predict the bearing capacity of metal structures on the basis of obtained experimental data on the effect which hydrogen have on metal properties. This paper presents a solution (based on the method of discrete orthogonalization proposed by S.K. Godunov) of a physically-nonlinear problem of stress distribution in a titanium shell. Since hydrogen, most notably, reduces plastic properties of metals utilized in structural elements, a critical point was determined where the intensity of shear deformation is maximal. It was found how the intensity changes at a critical point of a shell if the pressure within the device rises to an emergency level. Such a rise of the pressure in the shell could lead to appearance of plastic deformation regions, and hydrogen exposure is manifested in reduced breaking stress and changed fracture pattern. Β© 2019 Published under licence by IOP Publishing Ltd
ΠΠ±ΠΎΡΠ½ΠΎΠ²Π°Π½ΠΈe ΠΊΠΎΠ½ΡΡΡΡΠΊΡΠΈΠΈ Π΄ΠΈΡΠΊΠΎΠ²ΠΎΠ³ΠΎ Π·Π°Π΄Π΅Π»ΡΠ²Π°ΡΡΠ΅Π³ΠΎ ΠΎΡΠ³Π°Π½Π° Π»ΡΠΊΠΎΠΏΠΎΡΠ°Π΄ΠΎΡΠ½ΠΎΠΉ ΠΌΠ°ΡΠΈΠ½Ρ
One of necessary vegetable cultures in agricultural production is onion which production has to satisfy requirements of the population. The most responsible operation at cultivation of bulbous cultures is planting of bulbs as receiving qualitative products requires uniform distribution of bulbs focused by a stem down along a furrow. Covering working elements affect the provision of bulbs in a furrow at their planting. The authors justificated a design of the disk covering elements in onion planter, worked out a design of laboratory installation and a technique for carrying out of researches. Several options of working elements designs were studied: smooth spherical disks; spherical disks with straight soil guides; spherical disks with curvilinear soil guides. The uniformity of distribution and quantity of the down stem bulbs covering with use of curvilinear soil guide disk are bettr than with use of rectilinear ones pochvonapravitel or smooth spherical disks, on average by 2.6 and 1.8 percent respectively, in a speed interval from 0.8 to 1.2 m/s. The quantity of the stem down bulbs covering by the soil makes 95 percent, and uniformity of bulbs distribution equals 93.8 percent when using disk covering working element with curvilinear soil guides at a speed of 1 m/s and the angle of 25 degrees between the horizontal diameter and the direction of disk forward motion.ΠΠ΄Π½Π° ΠΈΠ· Π½Π΅ΠΎΠ±Ρ
ΠΎΠ΄ΠΈΠΌΡΡ
Π² ΡΠ΅Π»ΡΡ
ΠΎΠ·ΠΏΡΠΎΠΈΠ·Π²ΠΎΠ΄ΡΡΠ²Π΅ ΠΎΠ²ΠΎΡΠ½ΡΡ
ΠΊΡΠ»ΡΡΡΡ - ΡΠ΅ΠΏΡΠ°ΡΡΠΉ Π»ΡΠΊ, ΠΏΡΠΎΠΈΠ·Π²ΠΎΠ΄ΡΡΠ²ΠΎ ΠΊΠΎΡΠΎΡΠΎΠ³ΠΎ Π΄ΠΎΠ»ΠΆΠ½ΠΎ ΡΠ΄ΠΎΠ²Π»Π΅ΡΠ²ΠΎΡΡΡΡ ΠΏΠΎΡΡΠ΅Π±Π½ΠΎΡΡΠΈ Π½Π°ΡΠ΅Π»Π΅Π½ΠΈΡ. ΠΠ°ΠΈΠ±ΠΎΠ»Π΅Π΅ ΠΎΡΠ²Π΅ΡΡΡΠ²Π΅Π½Π½ΠΎΠΉ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠ΅ΠΉ ΠΏΡΠΈ Π²ΠΎΠ·Π΄Π΅Π»ΡΠ²Π°Π½ΠΈΠΈ Π»ΡΠΊΠΎΠ²ΠΈΡΠ½ΡΡ
ΠΊΡΠ»ΡΡΡΡ ΡΠ²Π»ΡΠ΅ΡΡΡ ΠΏΠΎΡΠ°Π΄ΠΊΠ° Π»ΡΠΊΠΎΠ²ΠΈΡ, ΡΠ°ΠΊ ΠΊΠ°ΠΊ Π΄Π»Ρ ΠΏΠΎΠ»ΡΡΠ΅Π½ΠΈΡ ΠΊΠ°ΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎΠΉ ΡΠΎΠ²Π°ΡΠ½ΠΎΠΉ ΠΏΡΠΎΠ΄ΡΠΊΡΠΈΠΈ Π½Π΅ΠΎΠ±Ρ
ΠΎΠ΄ΠΈΠΌΠΎ ΡΠΎΠ±Π»ΡΠ΄Π΅Π½ΠΈΠ΅ ΡΠ°Π²Π½ΠΎΠΌΠ΅ΡΠ½ΠΎΠ³ΠΎ ΡΠ°ΡΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΡ Π»ΡΠΊΠΎΠ²ΠΈΡ Π²Π΄ΠΎΠ»Ρ Π±ΠΎΡΠΎΠ·Π΄Ρ, ΠΎΡΠΈΠ΅Π½ΡΠΈΡΠΎΠ²Π°Π½Π½ΡΡ
Π΄ΠΎΠ½ΡΠ΅ΠΌ Π²Π½ΠΈΠ·. ΠΠΎΠ»ΠΎΠΆΠ΅Π½ΠΈΠ΅ Π»ΡΠΊΠΎΠ²ΠΈΡ Π² Π±ΠΎΡΠΎΠ·Π΄Π΅ ΠΏΡΠΈ ΠΈΡ
ΠΏΠΎΡΠ°Π΄ΠΊΠ΅ ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΡΡ Π·Π°Π΄Π΅Π»ΡΠ²Π°ΡΡΠΈΠ΅ ΡΠ°Π±ΠΎΡΠΈΠ΅ ΠΎΡΠ³Π°Π½Ρ. Π ΡΠ²ΡΠ·ΠΈ Ρ ΡΡΠΈΠΌ ΠΏΡΠΎΠ²Π΅Π»ΠΈ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΠΏΠΎ ΠΎΠ±ΠΎΡΠ½ΠΎΠ²Π°Π½ΠΈΡ ΠΊΠΎΠ½ΡΡΡΡΠΊΡΠΈΠΈ Π΄ΠΈΡΠΊΠΎΠ²ΠΎΠ³ΠΎ Π·Π°Π΄Π΅Π»ΡΠ²Π°ΡΡΠ΅Π³ΠΎ ΠΎΡΠ³Π°Π½Π° Π»ΡΠΊΠΎΠΏΠΎΡΠ°Π΄ΠΎΡΠ½ΠΎΠΉ ΠΌΠ°ΡΠΈΠ½Ρ. Π Π°Π·ΡΠ°Π±ΠΎΡΠ°Π»ΠΈ ΠΊΠΎΠ½ΡΡΡΡΠΊΡΠΈΡ Π»Π°Π±ΠΎΡΠ°ΡΠΎΡΠ½ΠΎΠΉ ΡΡΡΠ°Π½ΠΎΠ²ΠΊΠΈ ΠΈ ΠΌΠ΅ΡΠΎΠ΄ΠΈΠΊΡ Π΄Π»Ρ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈΡ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ. ΠΠ·ΡΡΠΈΠ»ΠΈ ΡΠ»Π΅Π΄ΡΡΡΠΈΠ΅ Π²Π°ΡΠΈΠ°Π½ΡΡ ΠΊΠΎΠ½ΡΡΡΡΠΊΡΠΈΠΉ Π·Π°Π΄Π΅Π»ΡΠ²Π°ΡΡΠΈΡ
ΡΠ°Π±ΠΎΡΠΈΡ
ΠΎΡΠ³Π°Π½ΠΎΠ²: Π³Π»Π°Π΄ΠΊΠΈΠ΅ ΡΡΠ΅ΡΠΈΡΠ΅ΡΠΊΠΈΠ΅ Π΄ΠΈΡΠΊΠΈ; ΡΡΠ΅ΡΠΈΡΠ΅ΡΠΊΠΈΠ΅ Π΄ΠΈΡΠΊΠΈ Ρ ΠΏΡΡΠΌΠΎΠ»ΠΈΠ½Π΅ΠΉΠ½ΡΠΌΠΈ ΠΏΠΎΡΠ²ΠΎΠ½Π°ΠΏΡΠ°Π²ΠΈΡΠ΅Π»ΡΠΌΠΈ; ΡΡΠ΅ΡΠΈΡΠ΅ΡΠΊΠΈΠ΅ Π΄ΠΈΡΠΊΠΈ Ρ ΠΊΡΠΈΠ²ΠΎΠ»ΠΈΠ½Π΅ΠΉΠ½ΡΠΌΠΈ ΠΏΠΎΡΠ²ΠΎΠ½Π°ΠΏΡΠ°Π²ΠΈΡΠ΅Π»ΡΠΌΠΈ. Π£ΡΡΠ°Π½ΠΎΠ²ΠΈΠ»ΠΈ, ΡΡΠΎ ΠΊΠΎΠ»ΠΈΡΠ΅ΡΡΠ²ΠΎ Π»ΡΠΊΠΎΠ²ΠΈΡ, Π·Π°Π΄Π΅Π»Π°Π½Π½ΡΡ
ΠΏΠΎΡΠ²ΠΎΠΉ Π΄ΠΎΠ½ΡΠ΅ΠΌ Π²Π½ΠΈΠ·, ΠΈ ΡΠ°Π²Π½ΠΎΠΌΠ΅ΡΠ½ΠΎΡΡΡ ΠΈΡ
ΡΠ°ΡΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΡ Π²Π΄ΠΎΠ»Ρ ΡΡΠ΄ΠΊΠ° Ρ Π΄ΠΈΡΠΊΠΎΠ²ΠΎΠ³ΠΎ Π·Π°Π΄Π΅Π»ΡΠ²Π°ΡΡΠ΅Π³ΠΎ ΠΎΡΠ³Π°Π½Π° Ρ ΠΊΡΠΈΠ²ΠΎΠ»ΠΈΠ½Π΅ΠΉΠ½ΡΠΌΠΈ ΠΏΠΎΡΠ²ΠΎΠ½Π°ΠΏΡΠ°Π²ΠΈΡΠ΅Π»ΡΠΌΠΈ Π²ΡΡΠ΅, ΡΠ΅ΠΌ Ρ Π΄ΠΈΡΠΊΠΎΠ²ΠΎΠ³ΠΎ Π·Π°Π΄Π΅Π»ΡΠ²Π°ΡΡΠ΅Π³ΠΎ ΠΎΡΠ³Π°Π½Π° Ρ ΠΏΡΡΠΌΠΎΠ»ΠΈΠ½Π΅ΠΉΠ½ΡΠΌΠΈ ΠΏΠΎΡΠ²ΠΎΠ½Π°ΠΏΡΠ°Π²ΠΈΡΠ΅Π»ΡΠΌΠΈ ΠΈ Ρ Π³Π»Π°Π΄ΠΊΠΈΡ
ΡΡΠ΅ΡΠΈΡΠ΅ΡΠΊΠΈΡ
Π΄ΠΈΡΠΊΠΎΠ², Π² ΡΡΠ΅Π΄Π½Π΅ΠΌ Π½Π° 2,6 ΠΈ 1,8 ΠΏΡΠΎΡΠ΅Π½ΡΠ° ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²Π΅Π½Π½ΠΎ, Π² ΡΠΊΠΎΡΠΎΡΡΠ½ΠΎΠΌ ΠΈΠ½ΡΠ΅ΡΠ²Π°Π»Π΅ ΠΎΡ 0,8 Π΄ΠΎ 1,2 ΠΌ/Ρ. ΠΠΏΡΠ΅Π΄Π΅Π»ΠΈΠ»ΠΈ, ΡΡΠΎ ΠΏΡΠΈ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠΈ Π΄ΠΈΡΠΊΠΎΠ²ΠΎΠ³ΠΎ Π·Π°Π΄Π΅Π»ΡΠ²Π°ΡΡΠ΅Π³ΠΎ ΠΎΡΠ³Π°Π½Π° Ρ ΠΊΡΠΈΠ²ΠΎΠ»ΠΈΠ½Π΅ΠΉΠ½ΡΠΌΠΈ ΠΏΠΎΡΠ²ΠΎΠ½Π°ΠΏΡΠ°Π²ΠΈΡΠ΅Π»ΡΠΌΠΈ ΠΏΡΠΈ ΡΠΊΠΎΡΠΎΡΡΠΈ 1 ΠΌ/Ρ ΠΈ ΡΠ³Π»Π΅ ΠΌΠ΅ΠΆΠ΄Ρ Π³ΠΎΡΠΈΠ·ΠΎΠ½ΡΠ°Π»ΡΠ½ΡΠΌ Π΄ΠΈΠ°ΠΌΠ΅ΡΡΠΎΠΌ ΠΈ Π½Π°ΠΏΡΠ°Π²Π»Π΅Π½ΠΈΠ΅ΠΌ ΠΏΠΎΡΡΡΠΏΠ°ΡΠ΅Π»ΡΠ½ΠΎΠ³ΠΎ Π΄Π²ΠΈΠΆΠ΅Π½ΠΈΡ Π΄ΠΈΡΠΊΠ° 25 Π³ΡΠ°Π΄ΡΡΠΎΠ² ΠΊΠΎΠ»ΠΈΡΠ΅ΡΡΠ²ΠΎ Π»ΡΠΊΠΎΠ²ΠΈΡ, Π·Π°Π΄Π΅Π»Π°Π½Π½ΡΡ
ΠΏΠΎΡΠ²ΠΎΠΉ Π΄ΠΎΠ½ΡΠ΅ΠΌ Π²Π½ΠΈΠ·, ΡΠΎΡΡΠ°Π²Π»ΡΠ΅Ρ 95 ΠΏΡΠΎΡΠ΅Π½ΡΠΎΠ², Π° ΡΠ°Π²Π½ΠΎΠΌΠ΅ΡΠ½ΠΎΡΡΡ ΡΠ°ΡΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΡ Π»ΡΠΊΠΎΠ²ΠΈΡ - 93,8 ΠΏΡΠΎΡΠ΅Π½ΡΠ°
ΠΠΈΠΎΠΌΠ°ΡΠΊΠ΅ΡΡ Π²ΠΎΡΠΏΠ°Π»Π΅Π½ΠΈΡ Π΄ΡΡ Π°ΡΠ΅Π»ΡΠ½ΡΡ ΠΏΡΡΠ΅ΠΉ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΡΡΠΆΠ΅Π»ΠΎΠΉ Π±ΡΠΎΠ½Ρ ΠΈΠ°Π»ΡΠ½ΠΎΠΉ Π°ΡΡΠΌΠΎΠΉ Π² ΡΠ΅Π°Π»ΡΠ½ΠΎΠΉ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΏΡΠ°ΠΊΡΠΈΠΊΠ΅
Severe asthma is a heterogeneous disease consisting of several endotypes and phenotypes diagnosed due to different biomarkers. Frequency of different endotypes and phenotypes in real clinical practice needs further investigation.The aim of this study was to assess biomarkers of T2-inflammation in patients with severe asthma in a single secondary care center.Methods. We examined 96 adult outpatients (34% male) with severe asthma. Data collected included demographics, smoking history, asthma exacerbations during previous 12 months, medication use, comorbidities. Lung function tests were assessed by using the Spirograph 2120 (Vitalograph, Great Britain). Blood eosinophils (Eos) were measured by automatic haemoanalyser. Atopic status was determined by positive skin prick-test (> 3 mm) and/or serum specific IgE to common inhalant allergens. Serum total IgE levels were assessed by immunofluorescence assay. FeNO was measured by a chemiluminescence analyzer (Model LR4000; Logan Research, Rochester, UK). Presence of allergy, need for regular oral steroid use, blood Eos β₯ 150 cell/ΞΌl and FeNO β₯ 20 ppb were considered as markers of T2-driven inflammation. Asthma control and quality of life were assessed by using Russian versions of ACQ-5 and St. George's Respiratory Questionnaire (SGRQ). Statistical analyses were performed with Statistica Ver. 10.0 (StatSoft, Inc., USA).Results. The majority of patients with severe asthma (93%) have at least one or more elevated markers (presence of allergy, need for regular oral steroid use, Eos β₯ 150 cell/ΞΌl or FeNO β₯ 20 ppb) of T2-inflammation. Biomarkers levels did not differ in non-steroid-dependent and steroid-dependent patients. The most frequent markers were allergy and blood Eos β₯ 150 cell/ΞΌl. Two or more elevated biomarkers were revealed in 72% of patients.Conclusion. The majority of patients with severe asthma in real clinical practice have signs of T2-inflammation. It seems that many severe asthmatics have indications for prescription of biological and can be treated by more than one of monoclonal antibodies against major cytokines of T2-inflammation.Π’ΡΠΆΠ΅Π»Π°Ρ Π±ΡΠΎΠ½Ρ
ΠΈΠ°Π»ΡΠ½Π°Ρ Π°ΡΡΠΌΠ° (ΠΠ) ΡΠ²Π»ΡΠ΅ΡΡΡ Π³Π΅ΡΠ΅ΡΠΎΠ³Π΅Π½Π½ΡΠΌ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠ΅ΠΌ, ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½Π½ΡΠΌ ΡΠ°Π·Π½ΡΠΌΠΈ ΡΠ΅Π½ΠΎΡΠΈΠΏΠ°ΠΌΠΈ ΠΈ ΡΠ½Π΄ΠΎΡΠΈΠΏΠ°ΠΌΠΈ, Π΄Π»Ρ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ ΠΊΠΎΡΠΎΡΡΡ
ΠΈΡΠΏΠΎΠ»ΡΠ·ΡΡΡΡΡ ΡΠ°Π·Π»ΠΈΡΠ½ΡΠ΅ Π±ΠΈΠΎΠΌΠ°ΡΠΊΠ΅ΡΡ. Π§Π°ΡΡΠΎΡΠ° ΡΠ΅Π½ΠΎΡΠΈΠΏΠΎΠ² ΠΈ ΡΠ½Π΄ΠΎΡΠΈΠΏΠΎΠ² ΡΡΠΆΠ΅Π»ΠΎΠΉ ΠΠ Π² ΡΠ΅Π°Π»ΡΠ½ΠΎΠΉ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΏΡΠ°ΠΊΡΠΈΠΊΠ΅ ΠΈΠ·ΡΡΠ΅Π½Π° Π½Π΅Π΄ΠΎΡΡΠ°ΡΠΎΡΠ½ΠΎ.Π¦Π΅Π»ΡΡ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΡΠ²ΠΈΠ»Π°ΡΡ ΠΎΡΠ΅Π½ΠΊΠ° Π±ΠΈΠΎΠΌΠ°ΡΠΊΠ΅ΡΠΎΠ² Π’2-Π²ΠΎΡΠΏΠ°Π»Π΅Π½ΠΈΡ Π΄ΡΡ
Π°ΡΠ΅Π»ΡΠ½ΡΡ
ΠΏΡΡΠ΅ΠΉ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΡΡΠΆΠ΅Π»ΠΎΠΉ ΠΠ.ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. ΠΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½Ρ Π²Π·ΡΠΎΡΠ»ΡΠ΅ Π°ΠΌΠ±ΡΠ»Π°ΡΠΎΡΠ½ΡΠ΅ ΠΏΠ°ΡΠΈΠ΅Π½ΡΡ (n = 96; 34 % β ΠΌΡΠΆΡΠΈΠ½Ρ; Π²ΠΎΠ·ΡΠ°ΡΡ β 18β78 Π»Π΅Ρ) Ρ ΡΡΠΆΠ΅Π»ΠΎΠΉ ΠΠ. ΠΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ ΡΡΠ½ΠΊΡΠΈΠΈ Π»Π΅Π³ΠΊΠΈΡ
Π²ΡΠΏΠΎΠ»Π½ΡΠ»ΠΎΡΡ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠΌ ΡΠΏΠΈΡΠΎΠΌΠ΅ΡΡΠΈΠΈ (ΡΠΏΠΈΡΠΎΠ³ΡΠ°Ρ 2120, Vitalograph, ΠΠ΅Π»ΠΈΠΊΠΎΠ±ΡΠΈΡΠ°Π½ΠΈΡ) Ρ ΠΎΡΠ΅Π½ΠΊΠΎΠΉ ΠΎΠ±ΡΠ°ΡΠΈΠΌΠΎΡΡΠΈ ΠΎΠ±ΡΡΡΡΠΊΡΠΈΠΈ. ΠΡΠ΅Π½ΠΊΠ° ΡΡΠ²ΡΡΠ²ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΠΈ ΠΊ ΠΎΡΠ½ΠΎΠ²Π½ΡΠΌ ΠΈΠ½Π³Π°Π»ΡΡΠΈΠΎΠ½Π½ΡΠΌ Π°Π»Π»Π΅ΡΠ³Π΅Π½Π°ΠΌ ΠΎΡΡΡΠ΅ΡΡΠ²Π»ΡΠ»Π°ΡΡ Ρ ΠΏΠΎΠΌΠΎΡΡΡ ΠΊΠΎΠΆΠ½ΡΡ
ΠΏΡΠΎΠ± ΠΈ / ΠΈΠ»ΠΈ ΡΡΠΎΠ²Π½Π΅ΠΉ ΡΠΏΠ΅ΡΠΈΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΈΠΌΠΌΡΠ½ΠΎΠ³Π»ΠΎΠ±ΡΠ»ΠΈΠ½Π° (Ig) E Π² ΡΡΠ²ΠΎΡΠΎΡΠΊΠ΅ ΠΊΡΠΎΠ²ΠΈ. Π‘ΠΎΠ΄Π΅ΡΠΆΠ°Π½ΠΈΠ΅ ΡΠΎΠ·ΠΈΠ½ΠΎΡΠΈΠ»ΠΎΠ² Π² ΠΏΠ΅ΡΠΈΡΠ΅ΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΊΡΠΎΠ²ΠΈ ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΠ»ΠΎΡΡ ΠΈΠΌΠΏΠ΅Π΄Π°Π½ΡΠ½ΡΠΌ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠΌ Π½Π° Π°Π²ΡΠΎΠΌΠ°ΡΠΈΡΠ΅ΡΠΊΠΎΠΌ Π³Π΅ΠΌΠΎΠ°Π½Π°Π»ΠΈΠ·Π°ΡΠΎΡΠ΅. Π£ΡΠΎΠ²Π΅Π½Ρ ΠΎΠΊΡΠΈΠ΄Π° Π°Π·ΠΎΡΠ° Π²ΡΠ΄ΡΡ
Π°Π΅ΠΌΠΎΠ³ΠΎ Π²ΠΎΠ·Π΄ΡΡ
Π° (FeNO) ΠΈΠ·ΠΌΠ΅ΡΡΠ»ΡΡ ΠΏΡΠΈ ΠΏΠΎΠΌΠΎΡΠΈ Ρ
Π΅ΠΌΠΈΠ»ΡΠΌΠΈΠ½ΠΈΡΡΠ΅Π½ΡΠ½ΠΎΠ³ΠΎ Π³Π°Π·ΠΎΠ°Π½Π°Π»ΠΈΠ·Π°ΡΠΎΡΠ° (Logan 4100, ΠΠ΅Π»ΠΈΠΊΠΎΠ±ΡΠΈΡΠ°Π½ΠΈΡ), ΡΡΠΎΠ²Π΅Π½Ρ ΠΎΠ±ΡΠ΅Π³ΠΎ IgE ΡΡΠ²ΠΎΡΠΎΡΠΊΠΈ ΠΊΡΠΎΠ²ΠΈ ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΠ»ΡΡ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠΌ ΠΈΠΌΠΌΡΠ½ΠΎΡΠ»ΡΠΎΡΠ΅ΡΡΠ΅Π½ΡΠ½ΠΎΠ³ΠΎ Π°Π½Π°Π»ΠΈΠ·Π°. ΠΠΎΠ½ΡΡΠΎΠ»Ρ Π½Π°Π΄ ΠΠ ΠΈ ΠΊΠ°ΡΠ΅ΡΡΠ²ΠΎ ΠΆΠΈΠ·Π½ΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΠΎΡΠ΅Π½ΠΈΠ²Π°Π»ΠΈΡΡ ΠΏΡΠΈ ΠΏΠΎΠΌΠΎΡΠΈ ΡΡΡΡΠΊΠΎΡΠ·ΡΡΠ½ΡΡ
Π²Π΅ΡΡΠΈΠΉ ΠΠΏΡΠΎΡΠ½ΠΈΠΊΠ° ΠΏΠΎ ΠΊΠΎΠ½ΡΡΠΎΠ»Ρ Π½Π°Π΄ ΠΠ (Asthma Control Questionnaire β ACQ-5) ΠΈ ΡΠ΅ΡΠΏΠΈΡΠ°ΡΠΎΡΠ½ΠΎΠ³ΠΎ Π²ΠΎΠΏΡΠΎΡΠ½ΠΈΠΊΠ° ΠΠΎΡΠΏΠΈΡΠ°Π»Ρ Π‘Π²ΡΡΠΎΠ³ΠΎ ΠΠ΅ΠΎΡΠ³ΠΈΡ (St. George's Respiratory Questionnaire β SGRQ). Π‘ΡΠ°ΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠΈΠΉ Π°Π½Π°Π»ΠΈΠ· ΠΏΡΠΎΠ²ΠΎΠ΄ΠΈΠ»ΡΡ Ρ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ ΠΏΠ°ΡΠ°ΠΌΠ΅ΡΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΈ Π½Π΅ - ΠΏΠ°ΡΠ°ΠΌΠ΅ΡΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΌΠ΅ΡΠΎΠ΄ΠΎΠ² ΠΏΠ°ΠΊΠ΅ΡΠ° ΠΏΡΠΈΠΊΠ»Π°Π΄Π½ΡΡ
ΠΏΡΠΎΠ³ΡΠ°ΠΌΠΌ Statistica 10.Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. Π£ ΠΏΠΎΠ΄Π°Π²Π»ΡΡΡΠ΅Π³ΠΎ Π±ΠΎΠ»ΡΡΠΈΠ½ΡΡΠ²Π° (93 %) ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΡΡ - ΠΆΠ΅Π»ΠΎΠΉ ΠΠ Π²ΡΡΠ²Π»Π΅Π½ Ρ
ΠΎΡΡ Π±Ρ ΠΎΠ΄ΠΈΠ½ ΠΈΠ· ΠΊΡΠΈΡΠ΅ΡΠΈΠ΅Π² Π’2-Π²ΠΎΡΠΏΠ°Π»Π΅Π½ΠΈΡ Π΄ΡΡ
Π°ΡΠ΅Π»ΡΠ½ΡΡ
ΠΏΡΡΠ΅ΠΉ (ΡΡΠΎΠ²Π΅Π½Ρ ΡΠΎΠ·ΠΈΠ½ΠΎΡΠΈΠ»ΠΎΠ² β₯ 150 ΠΊΠ». / ΠΌΠΊΠ» ΠΈ / ΠΈΠ»ΠΈ FeNO β₯ 20 ppb, ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈ Π·Π½Π°ΡΠΈΠΌΠ°Ρ Π³ΠΈΠΏΠ΅ΡΡΡΠ²ΡΡΠ²ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΡ ΠΊ Π°Π»Π»Π΅ΡΠ³Π΅Π½Π°ΠΌ ΠΈΠ»ΠΈ ΠΏΠΎΡΡΠ΅Π±Π½ΠΎΡΡΡ Π² ΡΠ΅Π³ΡΠ»ΡΡΠ½ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΡΠΈΡΡΠ΅ΠΌΠ½ΡΠΌΠΈ Π³Π»ΡΠΊΠΎΠΊΠΎΡΡΠΈΠΊΠΎΡΡΠ΅ΡΠΎΠΈΠ΄Π°ΠΌΠΈ. Π£ΡΠΎΠ²Π½ΠΈ Π±ΠΈΠΎΠΌΠ°ΡΠΊΠ΅ΡΠΎΠ² Π·Π½Π°ΡΠΈΠΌΠΎ Π½Π΅ ΡΠ°Π·Π»ΠΈΡΠ°Π»ΠΈΡΡ ΠΏΡΠΈ Π½Π°Π»ΠΈΡΠΈΠΈ Π³ΠΎΡΠΌΠΎΠ½Π°Π»ΡΠ½ΠΎΠΉ Π·Π°Π²ΠΈΡΠΈΠΌΠΎΡΡΠΈ ΠΈ Π΅Π΅ ΠΎΡΡΡΡΡΡΠ²ΠΈΠΈ. Π‘ΡΠ΅Π΄ΠΈ ΠΌΠ°ΡΠΊΠ΅ΡΠΎΠ² Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ ΡΠ°ΡΡΠΎ ΠΎΡΠΌΠ΅ΡΠ°Π»ΠΈΡΡ Π°Π»Π»Π΅ΡΠ³ΠΈΡ ΠΈ ΡΡΠΎΠ²Π΅Π½Ρ ΡΠΎΠ·ΠΈΠ½ΠΎΡΠΈΠ»ΠΎΠ² β₯ 150 ΠΊΠ» / ΠΌΠΊΠ». Π£ 72 % Π±ΠΎΠ»ΡΠ½ΡΡ
Π²ΡΡΠ²Π»Π΅Π½ΠΎ ΠΎΠ΄Π½ΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΠ΅ ΠΏΠΎΠ²ΡΡΠ΅Π½ΠΈΠ΅ ΡΡΠΎΠ²Π½Ρ Π½Π΅ΡΠΊΠΎΠ»ΡΠΊΠΈΡ
Π±ΠΈΠΎΠΌΠ°ΡΠΊΠ΅ΡΠΎΠ².ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. Π Π±ΠΎΠ»ΡΡΠΈΠ½ΡΡΠ²Π΅ ΡΠ»ΡΡΠ°Π΅Π² ΡΡΠΆΠ΅Π»ΠΎΠΉ ΠΠ Π² ΡΠ΅Π°Π»ΡΠ½ΠΎΠΉ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΏΡΠ°ΠΊΡΠΈΠΊΠ΅ ΠΎΡΠΌΠ΅ΡΠ°Π΅ΡΡΡ Π’2-ΡΠ½Π΄ΠΎΡΠΈΠΏ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ, ΠΏΡΠΈ Π²ΡΡΠ²Π»Π΅Π½ΠΈΠΈ ΠΊΠΎΡΠΎΡΠΎΠ³ΠΎ Π½Π°Π·Π½Π°ΡΠ°Π΅ΡΡΡ Π±ΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠ°Ρ ΡΠ΅ΡΠ°ΠΏΠΈΡ. ΠΠΎΠ»Π΅Π΅ ΡΠ΅ΠΌ Ρ ΠΏΠΎΠ»ΠΎΠ²ΠΈΠ½Ρ Π±ΠΎΠ»ΡΠ½ΡΡ
ΡΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½ ΠΏΠ΅ΡΠ΅ΠΊΡΠ΅ΡΡ ΠΏΠΎΠΊΠ°Π·Π°Π½ΠΈΠΉ Π΄Π»Ρ Π½Π°Π·Π½Π°ΡΠ΅Π½ΠΈΡ ΡΠ°Π·Π½ΡΡ
ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠΎΠ² ΠΌΠΎΠ½ΠΎΠΊΠ»ΠΎΠ½Π°Π»ΡΠ½ΡΡ
Π°Π½ΡΠΈΡΠ΅Π» ΠΊ ΠΎΡΠ½ΠΎΠ²Π½ΡΠΌ ΡΠΈΡΠΎΠΊΠΈΠ½Π°ΠΌ Π’2-Π²ΠΎΡΠΏΠ°Π»Π΅Π½ΠΈΡ
Π Π΅ΡΠ»ΠΈΠ·ΡΠΌΠ°Π± Π² Π»Π΅ΡΠ΅Π½ΠΈΠΈ Π±ΠΎΠ»ΡΠ½ΡΡ ΡΡΠΆΠ΅Π»ΠΎΠΉ Π±ΡΠΎΠ½Ρ ΠΈΠ°Π»ΡΠ½ΠΎΠΉ Π°ΡΡΠΌΠΎΠΉ ΡΠΎΠ·ΠΈΠ½ΠΎΡΠΈΠ»ΡΠ½ΠΎΠ³ΠΎ ΡΠ΅Π½ΠΎΡΠΈΠΏΠ°
It is known that patients with severe asthma often fail to achieve disease control. Excessive airways eosinophilic inflammation is one of the key causes of severe uncontrolled asthma in this case. The occurrence of eosinophilic phenotype of inflammation is quite high in severe uncontrolled asthma. Thus, about 55% of patients have eosinophil level in induced sputum β₯ 3%. Eosinophilic phenotype of asthma is associated with greater severity of symptoms, presence of atopy, late onset of the disease, and lack of response to inhaled glucocorticosteroids. Numerous studies confirmed the relationship between elevated eosinophils in the airways and more frequent and severe asthma exacerbations, as well as reduced lung function, increased administration of steroids and other medications, and more frequent use of healthcare services. Severe eosinophilic asthma is characterized mainly by late onset of the disease, persistent eosinophilia in the airways and peripheral blood. It is associated with frequent exacerbations, chronic or intermittent need to the use of systemic corticosteroids to achieve better control of the disease, and unfavorable prognosis of the natural course. Predominantly eosinophilic type of airway inflammation is a characteristic manifestation of T2 endotype of asthma, that is implemented due to the domination of Th2-lymphocyte response (allergic asthma) and/or due to high activity of type 2 innate lymphoid cells (ILC2) involved in the development of both non-allergic and allergic asthma. Th2 and ILC2 cells increase IL-5 level, which plays an important role in the formation of uncontrolled eosinophilic inflammation in the airways in patients suffering from T2 endotype of severe asthma, by stimulating eosinophil precursor maturation in the bone marrow, mobilization of eosinophils and precursors from the bone marrow, accumulation of eosinophils in the blood, eosinophilic infiltration of lung tissue, and eosinophil migration in the area of inflammation. The novel medication reslizumab (Cinqair) is the first anti-IL-5 immunological biologic drug registered in Russia for the treatment of severe asthma with eosinophilic airway inflammation. As a humanized monoclonal antibody (IgG4k) with high affinity for IL-5, reslizumab specifically binds to IL-5 and inhibits its interaction with IL-5 receptor on the cell surface, thus disrupting the underlying pathophysiology of bronchial inflammation in asthma, including maturation and survival of eosinophils, inflammation and remodeling of the airways. Clinical effects of reslizumab are manifested as decreased asthma exacerbation rate, improved lung function, and disease control.ΠΠ·Π²Π΅ΡΡΠ½ΠΎ, ΡΡΠΎ Ρ Π±ΠΎΠ»ΡΠ½ΡΡ
ΡΡΠΆΠ΅Π»ΠΎΠΉ Π±ΡΠΎΠ½Ρ
ΠΈΠ°Π»ΡΠ½ΠΎΠΉ Π°ΡΡΠΌΠΎΠΉ (ΠΠ) ΡΠ°ΡΡΠΎ Π½Π΅ Π΄ΠΎΡΡΠΈΠ³Π°Π΅ΡΡΡ ΠΊΠΎΠ½ΡΡΠΎΠ»Ρ Π½Π°Π΄ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠ΅ΠΌ. ΠΡΠΈ ΡΡΠΎΠΌ ΠΈΠ·Π±ΡΡΠΎΡΠ½ΠΎΠ΅ ΡΠΎΠ·ΠΈΠ½ΠΎΡΠΈΠ»ΡΠ½ΠΎΠ΅ Π²ΠΎΡΠΏΠ°Π»Π΅Π½ΠΈΠ΅ Π΄ΡΡ
Π°ΡΠ΅Π»ΡΠ½ΡΡ
ΠΏΡΡΠ΅ΠΉ ΡΠ²Π»ΡΠ΅ΡΡΡ ΠΎΠ΄Π½ΠΎΠΉ ΠΈΠ· ΠΊΠ»ΡΡΠ΅Π²ΡΡ
ΠΏΡΠΈΡΠΈΠ½ ΡΡΠΆΠ΅Π»ΠΎΠ³ΠΎ Π½Π΅ΠΊΠΎΠ½ΡΡΠΎΠ»ΠΈΡΡΠ΅ΠΌΠΎΠ³ΠΎ ΡΠ΅ΡΠ΅Π½ΠΈΡ ΠΠ. Π ΡΡΡΡΠΊΡΡΡΠ΅ ΡΡΠΆΠ΅Π»ΠΎΠΉ Π½Π΅ΠΊΠΎΠ½ΡΡΠΎΠ»ΠΈΡΡΠ΅ΠΌΠΎΠΉ ΠΠ ΡΠ°ΡΡΠΎΡΠ° ΡΠΎΠ·ΠΈΠ½ΠΎΡΠΈΠ»ΡΠ½ΠΎΠ³ΠΎ ΡΠ΅Π½ΠΎΡΠΈΠΏΠ° Π²ΠΎΡΠΏΠ°Π»Π΅Π½ΠΈΡ Π΄ΠΎΡΡΠ°ΡΠΎΡΠ½ΠΎ Π²ΡΡΠΎΠΊΠ°. Π’Π°ΠΊ, ΠΎΠΊΠΎΠ»ΠΎ 55 % ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΠ·ΡΡΡΡΡ ΡΡΠΎΠ²Π½Π΅ΠΌ ΡΠΎΠ·ΠΈΠ½ΠΎΡΠΈΠ»ΠΎΠ² Π² ΠΈΠ½Π΄ΡΡΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠΉ ΠΌΠΎΠΊΡΠΎΡΠ΅ β₯ 3 %. ΠΠΎΠ·ΠΈΠ½ΠΎΡΠΈΠ»ΡΠ½ΡΠΉ ΡΠ΅Π½ΠΎΡΠΈΠΏ ΠΠ Π°ΡΡΠΎΡΠΈΠΈΡΡΠ΅ΡΡΡ Ρ Π±ΠΎΠ»ΡΡΠ΅ΠΉ Π²ΡΡΠ°ΠΆΠ΅Π½Π½ΠΎΡΡΡΡ ΡΠΈΠΌΠΏΡΠΎΠΌΠΎΠ², Π°Π»Π»Π΅ΡΠ³ΠΈΠ΅ΠΉ, Π½Π΅ΡΠ΅Π΄ΠΊΠΎ Ρ ΠΏΠΎΠ·Π΄Π½ΠΈΠΌ ΡΠ°Π·Π²ΠΈΡΠΈΠ΅ΠΌ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ ΠΈ Π½Π΅ΠΏΠΎΠ»Π½ΡΠΌ ΠΎΡΠ²Π΅ΡΠΎΠΌ Π½Π° Π»Π΅ΡΠ΅Π½ΠΈΠ΅ ΠΈΠ½Π³Π°Π»ΡΡΠΈΠΎΠ½Π½ΡΠΌΠΈ Π³Π»ΡΠΊΠΎΠΊΠΎΡΡΠΈΠΊΠΎΡΡΠ΅ΡΠΎΠΈΠ΄Π°ΠΌΠΈ (ΠΈΠΠΠ‘). Π ΠΌΠ½ΠΎΠ³ΠΎΡΠΈΡΠ»Π΅Π½Π½ΡΡ
ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡΡ
ΠΏΠΎΠ΄ΡΠ²Π΅ΡΠΆΠ΄Π΅Π½Π° ΡΠ²ΡΠ·Ρ ΠΌΠ΅ΠΆΠ΄Ρ ΠΏΠΎΠ²ΡΡΠ΅Π½Π½ΡΠΌ ΡΡΠΎΠ²Π½Π΅ΠΌ ΡΠΎΠ·ΠΈΠ½ΠΎΡΠΈΠ»ΠΎΠ² Π² Π΄ΡΡ
Π°ΡΠ΅Π»ΡΠ½ΡΡ
ΠΏΡΡΡΡ
ΠΈ Π±ΠΎΠ»Π΅Π΅ ΡΠ°ΡΡΡΠΌΠΈ ΠΈ ΡΡΠΆΠ΅Π»ΡΠΌΠΈ ΠΎΠ±ΠΎΡΡΡΠ΅Π½ΠΈΡΠΌΠΈ ΠΠ, Π° ΡΠ°ΠΊΠΆΠ΅ ΡΠ½ΠΈΠΆΠ΅Π½Π½ΠΎΠΉ ΡΡΠ½ΠΊΡΠΈΠ΅ΠΉ Π»Π΅Π³ΠΊΠΈΡ
, ΠΏΠΎΠ²ΡΡΠ΅Π½Π½ΡΠΌ ΠΏΡΠΈΠ΅ΠΌΠΎΠΌ ΠΠΠ‘ ΠΈ Π΄ΡΡΠ³ΠΈΡ
Π»Π΅ΠΊΠ°ΡΡΡΠ²Π΅Π½Π½ΡΡ
ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠΎΠ², Π±ΠΎΠ»Π΅Π΅ ΡΠ°ΡΡΡΠΌ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ ΡΡΠ»ΡΠ³ Π·Π΄ΡΠ°Π²ΠΎΠΎΡ
ΡΠ°Π½Π΅Π½ΠΈΡ. Π’ΡΠΆΠ΅Π»Π°Ρ ΡΠΎΠ·ΠΈΠ½ΠΎΡΠΈΠ»ΡΠ½Π°Ρ ΠΠ Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΠ·ΡΠ΅ΡΡΡ ΠΏΡΠ΅ΠΈΠΌΡΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎ ΠΏΠΎΠ·Π΄Π½ΠΈΠΌ Π½Π°ΡΠ°Π»ΠΎΠΌ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ, ΠΏΠ΅ΡΡΠΈΡΡΠΈΡΡΡΡΠ΅ΠΉ ΡΠΎΠ·ΠΈΠ½ΠΎΡΠΈΠ»ΠΈΠ΅ΠΉ Π² Π΄ΡΡ
Π°ΡΠ΅Π»ΡΠ½ΡΡ
ΠΏΡΡΡΡ
ΠΈ ΠΏΠ΅ΡΠΈΡΠ΅ΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΊΡΠΎΠ²ΠΈ. ΠΠΉ ΡΠ²ΠΎΠΉΡΡΠ²Π΅Π½Π½Ρ ΡΠ°ΡΡΡΠ΅ ΠΎΠ±ΠΎΡΡΡΠ΅Π½ΠΈΡ, ΠΏΠΎΡΡΠΎΡΠ½Π½Π°Ρ ΠΈΠ»ΠΈ ΡΠΏΠΈΠ·ΠΎΠ΄ΠΈΡΠ΅ΡΠΊΠ°Ρ Π·Π°Π²ΠΈΡΠΈΠΌΠΎΡΡΡ ΠΎΡ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡ ΡΠΈΡΡΠ΅ΠΌΠ½ΡΡ
ΠΠΠ‘ Π΄Π»Ρ Π΄ΠΎΡΡΠΈΠΆΠ΅Π½ΠΈΡ Π»ΡΡΡΠ΅Π³ΠΎ ΠΊΠΎΠ½ΡΡΠΎΠ»Ρ Π½Π°Π΄ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠ΅ΠΌ, Π° ΡΠ°ΠΊΠΆΠ΅ Π½Π΅Π±Π»Π°Π³ΠΎΠΏΡΠΈΡΡΠ½ΡΠΉ ΠΏΡΠΎΠ³Π½ΠΎΠ· Π΅ΡΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎΠ³ΠΎ ΡΠ΅ΡΠ΅Π½ΠΈΡ. ΠΡΠ΅ΠΈΠΌΡΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎ ΡΠΎΠ·ΠΈΠ½ΠΎΡΠΈΠ»ΡΠ½ΡΠΉ ΡΠΈΠΏ Π²ΠΎΡΠΏΠ°Π»Π΅Π½ΠΈΡ Π΄ΡΡ
Π°ΡΠ΅Π»ΡΠ½ΡΡ
ΠΏΡΡΠ΅ΠΉ ΡΠ²Π»ΡΠ΅ΡΡΡ Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠ½ΡΠΌ ΠΏΡΠΎΡΠ²Π»Π΅Π½ΠΈΠ΅ΠΌ Π’2-ΡΠ½Π΄ΠΎΡΠΈΠΏΠ° ΠΠ, ΠΊΠΎΡΠΎΡΡΠΉ ΡΠ΅Π°Π»ΠΈΠ·ΡΠ΅ΡΡΡ Π·Π° ΡΡΠ΅Ρ Π΄ΠΎΠΌΠΈΠ½ΠΈΡΠΎΠ²Π°Π½ΠΈΡ Th2-Π»ΠΈΠΌΡΠΎΡΠΈΡΠ°ΡΠ½ΠΎΠ³ΠΎ ΠΎΡΠ²Π΅ΡΠ° (Π°Π»Π»Π΅ΡΠ³ΠΈΡΠ΅ΡΠΊΠ°Ρ ΠΠ) ΠΈ / ΠΈΠ»ΠΈ Π²ΡΡΠΎΠΊΠΎΠΉ Π°ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ Π²ΡΠΎΠΆΠ΄Π΅Π½Π½ΡΡ
Π»ΠΈΠΌΡΠΎΠΈΠ΄Π½ΡΡ
ΠΊΠ»Π΅ΡΠΎΠΊ 2-Π³ΠΎ ΡΠΈΠΏΠ° β ILC2-ΠΊΠ»Π΅ΡΠΎΠΊ, ΡΡΠ°ΡΡΠ²ΡΡΡΠΈΡ
Π² ΡΠ°Π·Π²ΠΈΡΠΈΠΈ ΠΊΠ°ΠΊ Π½Π΅Π°Π»Π»Π΅ΡΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ, ΡΠ°ΠΊ ΠΈ Π°Π»Π»Π΅ΡΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΠ. ΠΠ°ΠΊ Th2-, ΡΠ°ΠΊ ΠΈ ILC2-ΠΊΠ»Π΅ΡΠΊΠΈ ΡΠ²Π΅Π»ΠΈΡΠΈΠ²Π°ΡΡ ΡΡΠΎΠ²Π½ΠΈ ΠΈΠ½ΡΠ΅ΡΠ»Π΅ΠΉΠΊΠΈΠ½Π°-5 (IL-5), ΠΊΠΎΡΠΎΡΡΠΉ ΠΈΠ³ΡΠ°Π΅Ρ Π²Π°ΠΆΠ½ΡΡ ΡΠΎΠ»Ρ Π² ΡΠΎΡΠΌΠΈΡΠΎΠ²Π°Π½ΠΈΠΈ Π½Π΅ΠΊΠΎΠ½ΡΡΠΎΠ»ΠΈΡΡΠ΅ΠΌΠΎΠ³ΠΎ ΡΠΎΠ·ΠΈΠ½ΠΎΡΠΈΠ»ΡΠ½ΠΎΠ³ΠΎ Π²ΠΎΡΠΏΠ°Π»Π΅Π½ΠΈΡ Π² Π±ΡΠΎΠ½Ρ
ΠΎΠ»Π΅Π³ΠΎΡΠ½ΠΎΠΌ ΡΠ΅Π³ΠΈΠΎΠ½Π΅ Ρ Π±ΠΎΠ»ΡΠ½ΡΡ
, ΡΡΡΠ°Π΄Π°ΡΡΠΈΡ
Π’2-ΡΠ½Π΄ΠΎΡΠΈΠΏΠΎΠΌ ΡΡΠΆΠ΅Π»ΠΎΠΉ ΠΠ, ΡΡΠΈΠΌΡΠ»ΠΈΡΡΡ ΡΠΎΠ·ΡΠ΅Π²Π°Π½ΠΈΠ΅ ΠΏΡΠ΅Π΄ΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΈΠΊΠΎΠ² ΡΠΎΠ·ΠΈΠ½ΠΎΡΠΈΠ»ΠΎΠ² Π² ΠΊΠΎΡΡΠ½ΠΎΠΌ ΠΌΠΎΠ·Π³Π΅, ΠΌΠΎΠ±ΠΈΠ»ΠΈΠ·Π°ΡΠΈΡ ΡΠΎΠ·ΠΈΠ½ΠΎΡΠΈΠ»ΠΎΠ² ΠΈ ΠΏΡΠ΅Π΄ΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΈΠΊΠΎΠ² ΠΈΠ· ΠΊΠΎΡΡΠ½ΠΎΠ³ΠΎ ΠΌΠΎΠ·Π³Π°, Π½Π°ΠΊΠΎΠΏΠ»Π΅Π½ΠΈΠ΅ ΡΠΎΠ·ΠΈΠ½ΠΎΡΠΈΠ»ΠΎΠ² Π² ΠΊΡΠΎΠ²ΠΈ, ΡΠΎΠ·ΠΈΠ½ΠΎΡΠΈΠ»ΡΠ½ΡΡ ΠΈΠ½ΡΠΈΠ»ΡΡΡΠ°ΡΠΈΡ ΡΠΊΠ°Π½ΠΈ Π»Π΅Π³ΠΊΠΈΡ
ΠΈ ΠΌΠΈΠ³ΡΠ°ΡΠΈΡ ΡΠΎΠ·ΠΈΠ½ΠΎΡΠΈΠ»ΠΎΠ² Π² ΠΎΡΠ°Π³ Π²ΠΎΡΠΏΠ°Π»Π΅Π½ΠΈΡ. ΠΠΎΠ²ΡΠΉ ΠΏΡΠ΅ΠΏΠ°ΡΠ°Ρ Π Π΅ΡΠ»ΠΈΠ·ΡΠΌΠ°Π± (Π‘ΠΈΠ½ΠΊΠ΅ΠΉΡΠΎ) ΡΠ²Π»ΡΠ΅ΡΡΡ ΠΏΠ΅ΡΠ²ΡΠΌ Π·Π°ΡΠ΅Π³ΠΈΡΡΡΠΈΡΠΎΠ²Π°Π½Π½ΡΠΌ Π² Π ΠΎΡΡΠΈΠΈ Π°Π½ΡΠΈ-IL-5 ΠΈΠΌΠΌΡΠ½ΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠΌ Π±ΠΈΠΎΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠΎΠΌ Π΄Π»Ρ Π»Π΅ΡΠ΅Π½ΠΈΡ ΡΡΠΆΠ΅Π»ΠΎΠΉ ΠΠ Ρ ΡΠΎΠ·ΠΈΠ½ΠΎΡΠΈΠ»ΡΠ½ΡΠΌ ΡΠΈΠΏΠΎΠΌ Π²ΠΎΡΠΏΠ°Π»Π΅Π½ΠΈΡ Π΄ΡΡ
Π°ΡΠ΅Π»ΡΠ½ΡΡ
ΠΏΡΡΠ΅ΠΉ. ΠΠ°ΠΊ Π³ΡΠΌΠ°Π½ΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠ΅ ΠΌΠΎΠ½ΠΎΠΊΠ»ΠΎΠ½Π°Π»ΡΠ½ΠΎΠ΅ Π°Π½ΡΠΈΡΠ΅Π»ΠΎ (IgG4k), Π²ΡΡΠΎΠΊΠΎΠ°ΡΠΈΠ½Π½ΠΎΠ΅ ΠΊ IL-5, Π Π΅ΡΠ»ΠΈΠ·ΡΠΌΠ°Π± ΡΠΏΠ΅ΡΠΈΡΠΈΡΠ΅ΡΠΊΠΈ ΡΠ²ΡΠ·ΡΠ²Π°Π΅ΡΡΡ Ρ Π½ΠΈΠΌ ΠΈ ΠΏΡΠ΅ΠΏΡΡΡΡΠ²ΡΠ΅Ρ Π²Π·Π°ΠΈΠΌΠΎΠ΄Π΅ΠΉΡΡΠ²ΠΈΡ IL-5 Ρ Π΅Π³ΠΎ ΡΠ΅ΡΠ΅ΠΏΡΠΎΡΠΎΠΌ Π½Π° ΠΏΠΎΠ²Π΅ΡΡ
Π½ΠΎΡΡΠΈ ΠΊΠ»Π΅ΡΠΎΠΊ, Π½Π°ΡΡΡΠ°Ρ ΠΏΡΠΎΡΠ΅ΡΡ, Π»Π΅ΠΆΠ°ΡΠΈΠΉ Π² ΠΎΡΠ½ΠΎΠ²Π΅ ΠΏΠ°ΡΠΎΡΠΈΠ·ΠΈΠΎΠ»ΠΎΠ³ΠΈΠΈ Π±ΡΠΎΠ½Ρ
ΠΈΠ°Π»ΡΠ½ΠΎΠ³ΠΎ Π²ΠΎΡΠΏΠ°Π»Π΅Π½ΠΈΡ ΠΏΡΠΈ ΠΠ, Π²ΠΊΠ»ΡΡΠ°Ρ ΡΠΎΠ·ΡΠ΅Π²Π°Π½ΠΈΠ΅ ΠΈ Π²ΡΠΆΠΈΠ²Π°Π΅ΠΌΠΎΡΡΡ ΡΠΎΠ·ΠΈΠ½ΠΎΡΠΈΠ»ΠΎΠ², Π²ΠΎΡΠΏΠ°Π»Π΅Π½ΠΈΠ΅ ΠΈ ΡΠ΅ΠΌΠΎΠ΄Π΅Π»ΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ Π΄ΡΡ
Π°ΡΠ΅Π»ΡΠ½ΡΡ
ΠΏΡΡΠ΅ΠΉ. ΠΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΡΡΡΠ΅ΠΊΡΡ Π Π΅ΡΠ»ΠΈΠ·ΡΠΌΠ°Π±Π° ΠΏΡΠΎΡΠ²Π»ΡΡΡΡΡ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠ΅ΠΌ ΡΠ°ΡΡΠΎΡΡ ΠΎΠ±ΠΎΡΡΡΠ΅Π½ΠΈΠΉ ΠΠ, ΡΠ»ΡΡΡΠ΅Π½ΠΈΠ΅ΠΌ ΡΡΠ½ΠΊΡΠΈΠΈ Π»Π΅Π³ΠΊΠΈΡ
ΠΈ ΠΊΠΎΠ½ΡΡΠΎΠ»Ρ Π½Π°Π΄ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠ΅ΠΌ
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