Introduction. Tryptase, a mast cell-derived protease, plays a significant role in the diagnosis and pathogenesis of allergic and inflammatory diseases. The baseline serum tryptase level is used as a biomarker for the diagnosis of conditions associated with mast cell activation, which may be accompanied by severe allergic reactions and anaphylaxis. Studying tryptase isoforms, along with their structural and functional variations, aids in understanding genetic predisposition and the mechanisms underlying inflammatory diseases such as bronchial asthma and chronic inflammation.

Materials and Methods. A detailed investigation of the structure and function of various tryptase isoforms was conducted. Biochemical properties human tryptase isoforms were examined. The analysis included the study of the genes TPSAB1, TPSB2, TPSG1, and TPSD1, which encode different forms of tryptase, and the assessment of their activity. Tryptase secretion has been investigated, along with various factors influencing its release.

Results. Tryptase, a mast cell-derived enzyme, is represented by four major isoforms—_α, _β, _γ, and _δ. Among the secreted isoforms, α- and _β-tryptases are the most prominent, _β-tryptase exhibits the highest catalytic activity, whereas _α-tryptase demonstrates limited enzymatic function. The tryptase genes are located on chromosome 16 and show a high degree of homology. Key genes TPSAB1 and TPSB2 encode active forms of tryptase, and an increased number of TPSAB1 copies leads to elevated baseline tryptase levels, heightening the risk of allergic reactions. Tryptase plays a role in inflammatory and allergic processes, including mast cell degranulation, affecting vascular permeability and leukocyte recruitment.

Conclusion. The collected data on the secretion and functions of tryptase produced by mast cells suggest that it can be regarded as a multifunctional mediator, acting through specific molecular and cellular mechanisms. Tryptase is critically involved in the pathogenesis of inflammatory processes and allergic responses across multiple organs and systems, including the respiratory tract and the skin. Understanding the biochemical characteristics and genetic features of tryptase isoforms opens new opportunities for the development of diagnostic and therapeutic approaches for high-impact allergic diseases.

Relevance. In recent decades, there has been an increase in a number of non-communicable chronic diseases and treated as a global health priority. There is an increase in the prevalence of allergic diseases, including allergic rhinitis (AR), and obesity in the pediatric population. In this regard, the study of AR in children with comorbid obesity is of particular interest.

The aim of the review is to summarize current data on the immunological and clinical-epidemiological features of AR in children with comorbid obesity.

Content. The review presents current information on the role of individual cytokines and adipokines in the development of chronic systemic inflammation in children with AR and obesity. An analysis of literature data on the significance of obesity as a possible risk factor for the development of AR in childhood is conducted. Clinical and epidemiological features are discussed, and individual studies are presented on some aspects of AR therapy in obese patients.

Conclusions. The analysis showed that the currently available data on the relationship between AR and overweight/obesity in children are contradictory and require further research.

Introduction. Contact allergic dermatitis (CAD) is known to be one of the most prevalent allergic diseases of skin, so its research is of a high interest. Besides clarification of modern approaches to the treatment of contact allergic dermatitis is undoubtedly of current interest. The increase in the growth of contact allergic dermatitis in children explains the relevance of solving the problem of treating the disease in this age group.

Purpose of the lecture. The purpose of this lecture is to review modern approaches to the treatment of contact allergic dermatitis taking into account current clinical guidelines with an emphasis on childhood.

Materials and Methods. This lecture presents consideration of modern principles of treatment of contact allergic dermatitis taking into account the specific features of pediatric practice. A non-systematic literature review was conducted. Pharmacological mechanisms of main medications used are discussed. Focus is based on rational skin therapy. Besides information is given about topical glucocorticosteroids and principles in choosing of concrete group and formulation of them. Also characteristics of topical calcineurin inhibitors are given, and their role in treatment of contact allergic dermatitis is explained. In addition, mechanism of the “vicious circle” during secondary infection and treatment tactics are described.

Results. Increased prevalence of contact allergic dermatitis in children depends primarily on household contact with chemicals and metals, as well as on the use of topical medications. This should be taken into account in prescription of elimination regime. Choice of the class and the formulation of topical corticosteroids should be made differentially taking into account the age, structural features of the child’s skin, its sensitivity in different areas and the stage of the inflammatory process. Based on indications topical calcineurin inhibitors might be used in treatment of contact allergic dermatitis especially in pediatric practice. They are characterized by the absence of those side effects which are common during use of topical corticosteroids. Secondary infection which is quite often observed in CAD in childhood requires timely administration of antiseptics and combined topical medications containing corticosteroids, antibiotics and antifungal components.

Conclusion. Contact allergic dermatitis has good prognosis in case of implementation of elimination measures, adherence to treatment algorithm in accordance with clinical guidelines and age-based characteristics.

Over the past decades, the proportion of obese children has increased 4-fold. At the same time, there is an increase in allergic pathology in the children’s population.

The aim is to present modern data on the relationship between childhood obesity and allergic diseases.

Materials and methods. A search was conducted for domestic and foreign literature on the relationship between various links in the pathogenesis of allergic pathology and obesity using the databases Scopus, Web of Science, PubMed, Google Scholar, eLibrary, Cyberleninka. The review includes studies published from January 2016 to January 2025.

Results. Data on the mechanical and inflammatory effects of obesity in relation to atopy in children are described. In addition, obesity is associated with increased production of inflammatory cytokines and adipokines, which supports low-activity systemic inflammation and increases the risk of exacerbations of allergic diseases. Allergic rhinitis, atopic dermatitis, food allergies, and chronic urticaria also appear to be associated with the chronic systemic low-activity inflammation characteristic of obesity. Vitamin D deficiency, characteristic of obesity, appears to play a role in the development of bronchial asthma and allergic rhinitis, while dyslipidemia and skin barrier defects may explain the link between obesity and atopic dermatitis.

Conclusion. Further research on the relationship between obesity and atopy is needed, confirming the role of adipose tissue in the development of allergic diseases, in order to develop new therapeutic strategies.

Introduction. Bronchial asthma (BA) in combination with obesity is a complex phenotype, an important pathogenetic factor in the formation of which is low-intensity systemic inflammation accompanied by the secretion of a spectrum of proinflammatory cytokines, including interleukin-18 (IL-18). However, the effect of IL-18 on the formation of bronchial obstruction syndrome in children and adolescents with BA obesity cannot be considered established.

Objective: to study the content of IL-18 in blood serum in children and adolescents with asthma and its relationship with the body mass index of patients, taking into account obstructive disorders.

Materials and methods. A single-center observational cross-sectional pilot study was conducted. 85 patients with asthma aged from 8 to 17 years were examined. Anthropometric and spirometric parameters were measured, and serum IL-18 levels were assessed. The study participants were divided into 2 groups: 1 — patients with low and normal body weight, 2 — overweight and obese.

Results. A direct statistically significant correlation was established between the level of IL-18 in blood serum and zBMI, R = 0.30, p = 0.008. In the general group and in patients with obstructive disorders, the level of IL-18 was statistically significantly higher in group 2 compared with group 1, 247.0 [207.0; 334.5] against 208.0 [134.0; 293.0] pg/ml, p = 0.012 and 349.0 [176.0; 452.0] versus 212.0 [148.0; 250.0] pg/ml, p = 0.02, respectively. In the absence of obstructive disorders, the level of IL-18 was comparable in children of these groups, 242.0 [194.5; 313.0] and 204.0 [134.0; 304.0] pg/ml, p = 0.282.

In patients of the second group and in the general group, the level of IL-18 was statistically significantly higher in the presence of obstructive disorders, 227.5 [171.0; 352.5] versus 223.0 [163.0; 307.0] pg/ml, p = 0.048 and 349.0 [176.0; 452.0] versus 242.0 [194.5; 313.0] pg/ml, p = 0.046.

Conclusion. In patients with asthma and overweight or obesity, the presence of bronchial obstruction is characterized by a statistically significantly higher level of IL-18 in blood serum compared with patients without bronchial patency disorders. This may indicate the inclusion of this interleukin in the genesis of bronchial obstruction in overweight and obese patients.

Introduction. In the period from October to December 2024, there was an increase in cases of community-acquired pneumonia in children caused by Mycoplasma pneumoniae in the Republic of Bashkortostan, which has important epidemiological and clinical consequences. Mycoplasma infections have a cyclical pattern of epidemics, frequent outbreaks in organized groups, and a significant seasonal pattern, which makes children particularly vulnerable. In children with bronchial asthma, mycoplasma infection can worsen the course of the disease, contributing to bronchial hyperreactivity and complications such as spontaneous mediastinal emphysema. Objective. The aim is to perform a clinical and pathogenetic analysis of the course of community-acquired pneumonia caused by Mycoplasma pneumoniae in a child with bronchial asthma complicated by spontaneous mediastinal emphysema.

Presentation of the clinical case. The case of a 15-year-old boy with bronchial asthma and polyvalent sensitization, who developed community-acquired pneumonia of mycoplasmic etiology with a complication in the form of spontaneous mediastinal emphysema, is presented. The clinical picture of the disease included a dry cough, chest pain, difficulty breathing, and fever. The laboratory confirmed the diagnosis of mycoplasma pneumonia with a positive PCR result for Mycoplasma pneumoniae. X-ray examination revealed signs of inflammation and emphysema. Complex therapy included antibiotics, anti-inflammatory drugs and inhalation therapy, which contributed to the positive dynamics and improvement of the patient’s condition.

Conclusion. The presented clinical case illustrates the specific course of community-acquired pneumonia of Mycoplasma etiology in a child with bronchial asthma complicated by spontaneous mediastinal emphysema. The combination of chronic airway inflammation and atypical bacterial infection contributed to the development of a severe complication. Timely diagnosis, including pathogen identification, comprehensive antibacterial and anti-inflammatory therapy, as well as maintenance of baseline asthma treatment, ensured a favorable clinical outcome and prevented adverse events.