Гетерогенность и перспективные направления персонализации терапии аллергического ринита в детском возрасте

Аллергический ринит — одно из самых распространенных хронических заболеваний детского возраста. Ранняя манифестация симптомов, поздняя диагностика и нерациональная (или недостаточно эффективная) фармакотерапия повышают риск полисенсибилизации и способствуют развитию других заболеваний дыхательной системы и ЛОР-органов. Патогенетическая и клиническая гетерогенность аллергического ринита, а также сложности в достижении комплаенса являются основными причинами высокой вариабельности ответа на проводимое лечение. Результаты исследований последних лет, посвященные изучению фенотипических различий пациентов с аллергическим ринитом, открывают перспективы по разработке новых эффективных персонализированных алгоритмов оказания медицинской помощи. Обзор современных исследований по проблеме гетерогенности (генетической, микробиомной и мультиморбидной) детского аллергического ринита и связанной с ней различной эффективности фармакотерапии был выполнен с использованием данных научных электронных библиотек eLibrary и PubMed. Актуальные результаты научных исследований могут стать основой для разработки фенотип-ориентированных подходов к лечению аллергического ринита у детей — как за счет повышения эффективности использования традиционных лекарственных средств и их комбинаций (антигистаминных препаратов, интраназальных глюкокортикоидов, антилейкотриеновых препаратов), так и путем возможного воздействия на новые фармакотерапевтические мишени.

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