medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2021-12-101-108medsovet-6336Research ArticleПУЛЬМОНОЛОГИЯ, ЛОРBRONCHOPULMONOLOGY, OTORHINOLARYNGOLOGYОсобенности применения современных антигистаминных препаратов в лечении аллергического ринитаFeatures of the modern antihistamines use in the treatment of allergic rhinitishttps://orcid.org/0000-0002-6047-4924КривопаловА. А.KrivopalovA. A.

д.м.н., старший научный сотрудник,

190013, Санкт-Петербург, ул. Бронницкая, д. 9 

Dr. Sci. (Med.), Senior Researcher, 

9, Bronnitskaya St., St Petersburg, 190013

krivopalov@list.ruhttps://orcid.org/0000-0003-0451-8635РеброваС. А.RebrovaS. A.

врач-аллерголог,

190013, Санкт-Петербург, ул. Бронницкая, д. 9 

Allergist, 

9, Bronnitskaya St., St Petersburg, 190013

svetlanrebrov@yandex.ruhttps://orcid.org/0000-0003-4595-365XШамкинаП. А.ShamkinaP. A.

аспирант,

190013, Санкт-Петербург, ул. Бронницкая, д. 9 

Postgraduate Student, 

9, Bronnitskaya St., St Petersburg, 190013

p.s.ent@bk.ruСанкт-Петербургский научно-исследовательский институт уха, горла, носа и речиРоссияSaint Petersburg Research Institute of Ear, Throat, Nose and SpeechRussian Federation202114092021012101108Copyright © Кривопалов А.А., Реброва С.А., Шамкина П.А., 20212021Кривопалов А.А., Реброва С.А., Шамкина П.А.Krivopalov A.A., Rebrova S.A., Shamkina P.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/6336

Аллергический ринит остается одной из наиболее актуальных проблем современной оториноларингологии. Широкое распространение, поздняя диагностика, недооценка возможных рисков прогрессирования болезни, развитие осложнений побуждает разрабатывать и совершенствовать новые варианты терапии аллергического ринита. Аллергический ринит – гетерогенное заболевание, которое представлено различными клиническими фенотипами, в  связи с  чем выраженность назальных симптомов может варьировать от легкого недомогания до тяжелого течения заболевания. На сегодняшний день наиболее часто применяемой тактикой лечения пациентов с аллергическим ринитом остается фармакотерапия. При назначении терапии врач разрабатывает индивидуальный план лечения на  основе принципов персонализированной медицины с  учетом доминирующей симптоматики, данных анамнеза о ранее проводимой терапии и эффекте лечения, типа воспаления (Th2-тип, смешанное воспаление), сопутствующих заболеваний (конъюнктивит, астма и др.), предпочтений пациента. К развитию симптоматики в ходе заболевания приводят тканевые эффекты медиатора гистамина, что обуславливает широкое применение антигистаминных лекарственных препаратов в лечении ринита. Антигистаминные препараты II поколения лишены седативных эффектов, обладают продолжительным эффектом и хорошим профилем безопасности. Одним из современных антигистаминных препаратов II поколения является биластин. Результаты исследований доказали высокую антигистаминную активность биластина 20 мг in vitro и in vivo, отсутствие сердечных побочных и седативных эффектов на центральную нервную систему, возможность устранять носовые и глазные симптомы заболевания и улучшать качество жизни пациентов с аллергическим ринитом. Таким образом, препарат биластин полностью соответствует современным критериям EAACI/WAO ARIA для лекарственных средств, используемых для лечения АР. В работе представлен клинический случай пациента с хроническим персистирующим аллергическим ринитом, бытовой сенсибилизацией с легким неконтролируемым течением. Добавление к интраназальным глюкокортикостероидам перорального антигистаминного препарата биластин позволило купировать симптомы заболевания, стабилизировать состояние и подготовить пациента к последующей аллергенспецифической иммунотерапии. 

Allergic rhinitis remains one of the most relevant problems of modern otorhinolaryngology. The widespread prevalence, late diagnosis, underestimation of the possible risks of disease progression, the development of complications (including asthma) prompts the development and improvement of new treatment options for allergic rhinitis. Allergic rhinitis is a heterogeneous disease that presents with various clinical phenotypes, and therefore the severity of nasal symptoms can vary from mild malaise to severe disease.. Today, pharmacotherapy remains the most frequently used treatment tactic for patients with allergic rhinitis. While prescribing therapy the doctor develops an individual treatment plan based on the principles of personalized medicine, considering: the dominant symptoms, anamnesis data on previous therapy and the effect of treatment, the type of inflammation (Th2-type, mixed inflammation), concomitant diseases (conjunctivitis, asthma, etc.) etc.) and patient preferences. The tissue effects of the histamine mediator lead to the development of symptoms during the course of the disease, which determines the wide-spread use of antihistamines in the treatment of rhinitis. Antihistamines of the second generation are devoid of sedative effects, have a long-lasting effect and a good safety profile. One of the modern II generation antihistamines is bilastine. The research results proved the high antihistaminic activity of bilastine 20 mg in vitro and in vivo, the absence of cardiac and sedative side effects on the central nervous system, the ability to eliminate the nasal and ocular symptoms of disease and improve the quality of life of patients with allergic rhinitis. Thus, bilastine fully complies with current EAACI / WAO ARIA requirements for drugs used to treat AR. The paper presents a clinical case of a patient with chronic persistent allergic rhinitis, household sensitization with a slight uncontrolled course. The oral antihistamine bilastine was added to intranasal glucocorticosteroids, which help to relieve symptoms of the disease, stabilize the condition and prepare the patient for subsequent allergen-specific immunotherapy. 

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The authors declare that there are no conflicts of interest present.