The common cold, which is mostly caused by respiratory viruses and clinically represented by the symptoms of acute respiratory viral infections (ARVI) with mainly upper respiratory tract involvement, is an important problem in pediatric practice. Due to the high prevalence, socio-economic burden, and lack of effective prevention measures (except for influenza and, partially, RSV infection), ARVI require strong medical attention. The purpose of this descriptive literature review was to analyze the current practical approaches to the treatment of ARVI to facilitate the choice of therapy in routine practice. This descriptive overview includes information on the causative agents of ARVI. Special attention is paid to the role of interferon gamma as a cytokine with antiviral and immunomodulatory effects on the pathogenesis of ARVI. Modern approaches to the treatment of ARVI, including antiviral, pathogenesis-directed and symptomatic therapy are presented. The emphasis is on the use of antibody-based drugs in the immunoprophylaxis and immunotherapy of ARVI. The data presented in this review allow us to conclude that a modern, balanced and evidence-based approach to the choice of ARVI treatment in children should be used in clinical practice. The published results of clinical trials and systematic reviews with meta-analyses of ARVI in children allow us to conclude that it is possible and expedient to use broad-spectrum antiviral drugs in complex therapy. This approach can provide an adequate response of the child’s immune system to the virus without limiting the clinical possibilities of using only symptomatic therapy.

Under the auspices of the Russian Association of Allergists and Clinical Immunologists and the Russian Pediatric Respiratory Society, an expert meeting on Leukotriene receptor antagonists in the treatment of bronchial asthma was held. Asthma is a common noncommunicable chronic disorder of the airways, characterized by variable and recurring symptoms, airflow obstruction, bronchial hyper-responsiveness, and underlying inflammation. The creation and widespread use of inhaled corticosteroids and other innovative classes of drugs for treating bronchial asthma have remarkably affected the ability to achieve control over the course of the disease. Regardless, in most European countries, more than half of patients with bronchial asthma have suboptimal disease control. Recently, a class of leukotriene receptor blockers that contribute to the suppression of chronic allergic inflammation in patients with asthma has been actively studied. The majority of studies confirmed the usefulness of montelukast as monotherapy and as an add-on therapy to inhaled corticosteroids in mild to moderate asthma across all age groups. However, experts noted that in practical medicine, healthcare providers continuously inquire about the effectiveness and safety of this class of medicines in patients with bronchial asthma. In this consensus document, the experts considered the importance of providing an answer to several topical questions regarding the use of antileukotriene therapy in clinical practice.

This literature review aims to provide an update on the problem of coronavirus infection in children. It covers specific features of the pathogens and ways of their transmission in children and focuses on the nuances of the clinical course. It also describes the approaches to diagnosis, treatment, and prevention of seasonal coronavirus infections and COVID-19. Particular attention is paid to treatment and prevention of acute respiratory viral infections (ARVIs), including seasonal coronavirus infections, during the ongoing COVID-19 pandemic using Anaferon for children, a drug with an immune-mediated antiviral effect. The article provides the data on experimental and clinical evaluation of Anaferon efficacy in children with coronavirus infections. Experimental in vitro studies of Anaferon for children demonstrated its antiviral efficacy against highly pathogenic MERS-CoV. Clinical trials, including double-blind placebo-controlled RCTs, showed that the inclusion of Anaferon for children in the comprehensive therapy of seasonal coronavirus infections reduced the disease duration, mitigated symptoms, and decreased the incidence of nosocomial infections. These effects were associated with the modulating activity of Anaferon for children affecting both cellular and humoral immunity. The analysis of studies evaluating Anaferon for children allows us to recommend this drug for widespread use in the treatment and prevention of seasonal ARVIs, including those caused by coronaviruses during the ongoing COVID-19 pandemic. Key words: Anaferon for children, treatment, coronavirus infection, prevention, COVID-19

С целью оптимизации выбора противовирусных средств у детей в рутинной практике лечения ОРВИ было проведено двухцентровое проспективное открытое рандомизированное исследование эффективности и переносимости схем терапии с применением Эргоферона, Кагоцела, Арбидола у детей в возрасте старше 3 лет на протяжении двух эпидсезонов (осень 2012 — весна 2014 гг.). 152 ребенка с симптомами ОРВИ, продолжительностью не более 48 часов, были рандомизированы в 3 группы, в которых для лечения ОРВИ применялись Эргоферон (группа Э, 67 пациентов), Кагоцел (группа К, 40 пациентов), Арбидол (группа А, 45 пациентов). На 2-м и 3-м визитах оценивалась доля пациентов с нормализацией температуры тела (первичный критерий), выраженность интоксикационного и катарального синдромов. На 3-м визите регистрировались: индекс эффективности (оценка врачом эффективности и переносимости терапии по шкале CGI) и оценки эффективности и переносимости исследуемого препарата со слов родителей/представителей ребенка; анализировалась частота назначения медикаментов — общее число назначений в группе, частота и продолжительность применения отдельных групп препаратов. Для анализа и оценки полученных данных применялись стандартные методы параметрической и непараметрической статистики. Группы К и А не имели статистически значимых различий в исходных характеристиках и в динамике оцениваемых критериев эффективности и для дальнейшего анализа из них была сформирована новая группа 2 (85 пациентов). На 2-м визите отмечалась нормализация утренней и вечерней температуры тела в 76 и 79% соответственно, в 1-й группе, против 73 и 79% — во 2-й группе (2, p > 0,05). 100% пациентов из 1-й группы и 98% пациентов — из 2-й группы не имели признаков интоксикации или ранговый показатель синдрома интоксикации был не выше 1 (слабо выражен). Доля пациентов с выраженностью катарального синдрома на уровне 2-3 рангов в 1-й группе по сравнению с исходными данными сократилась с 15 до 3%, во 2-й группе — с 18 до 8%. На 3-м визите 94% пациентов в 1-й группе и 95% во — 2-й группе не имели клинических проявлений интоксикации, практически, каждый третий ребенок из обеих групп полностью избавился от катаральных явлений к окончанию лечения, в 70 и в 65% случаев в 1-й и 2-й группах выраженность катарального синдрома не превышала 1 ранга (2, p > 0,05). В ходе проведения исследования не было зарегистрировано побочных эффектов, связанных с приемом тех или иных компонентов исследуемых схем терапии. Оценка эффективности и переносимости, данная врачами по шкале CGI в 1-й группе составила 3,37 ± 0,65 (M ± SD, 95%CI 3,22—3,53), против 3,23 ± 0,77 (M ± SD, 95%CI 3,08-3,39) во 2-й группе (Т-критерий, p = 0,38). В 1-й группе максимальную оценку (4 балла) врачи поставили в 46%, а минимальную (2 балла) — в 9%, в то время, как во 2-й группе аналогичные доли составили 40 и 16% соответственно (p = 0,44 для максимальной оценки и p = 0,17 для минимальной оценки). Оценка эффективности терапии родителями в 1-й группе составила 3,73 ± 0,57 (M ± SD, 95%CI 3,59-3,87) против 3,35 ± ± 0,72 (M ± SD, 95%CI 3,20—3,50) в 2-й группе; Т-критерий, p = 0,04. По данным частотного анализа балльных оценок, положительные оценки (4—5 баллов) чаще ставили родители детей из 1-й группы: 71% против 44% (2-я группа), критерий 2, p = = 0,001, минимальные оценки (2 балла) реже встречались во 1-й группе: 1,5% против 12% (2-я группа), критерий 2, p = 0,02. Оценка переносимости терапии, данная родителями в 1-й группе (4,04...

Atopic diseases remain one of the most common childhood diseases. At the beginning of life, atopic dermatitis (AD) occurs, and only then bronchial asthma (BA). This staged development of sensitization and transformation of clinical manifestations is called the atopic march. Are the genetic factors of predisposition to AD the same for BA? There is still no definite answer to this question. Mutations in the filaggrin gene (FLG) are known to impair skin barrier function. Filaggrin is expressed not only in the skin, but also in the respiratory organs of the nasal mucosa, lungs, and bronchi. Filaggrin defects lead not only to disruption of the skin barrier, but also to an increase in the Th2 response and increased production of IgE, typical of bronchial asthma. Therefore, mutations in the FLG gene can be a risk factor for the development of not only AD, but also BA.The aimof this study was to compare the values of the association of mutations in the FLG gene with AD and BA in the Russian sample.Material and methods.Case-control study design. We used 265 blood samples from children. 4 mutations in the filaggrin gene were identified by real-time PCR. The association of mutations with disease was assessed by odds ratio.Results.We showed a strongly pronounced association of the deletion of 4 nucleotides (2282del4) with AD, but not with BA, although for patients with atopic BA the indicator of the association of this mutation with the disease was higher than for the group with symptoms of bronchial asthma identified by the ISAAC questionnaire. These results lead to the conclusion that the role of the filaggrin gene for BA is much less significant than for AD.

Study Goals.Assessment of the efficacy and safety of the Pentanedioic Acid Imidazolyl Ethanamide (IPA) in the treatment of influenza and other acute respiratory viral infections (ARVI) in children aged 3–6 years.Children Characteristics and Study Methods.The randomized double-blind placebo-controlled multicenter clinical study involving 190patients aged 3–6 years was carried out as follows: 95 patients received IPA at 30 mg/day dose once for 5 days and 95 patients – placebo using the same pattern. The therapy efficacy was assessed by the body temperature, dynamics of the individual symptoms of thedisease as per the Severity Scale for the patients with influenza and other acute respiratory viral infections (Scale) and the incidencerate of complications of the acute respiratory viral infections. The primary endpoint is the period of the score reduction on the Scale to 2points, providing that there is not more than 1 score on the individual subscales with the body temperature normalization from the startof treatment. The safety analysis was carried out using the assessment of the nature and incidence rate of the adverse events.Results.The IPA use at 30 mg/day dose significantly promotes the achievement of goals for the primary endpoint – the averagevalue in the IPA group is 91.79 h (95% confidence interval – CI from 87.45 to 96.13), in the placebo group – 100.12 h (95% CIfrom 96.73 to 103.51). In the IPA group, the body temperature returned to normal by 18.56 h faster in average compared with theplacebo. The regression of the catarrhal and intoxication symptoms was significantly promoted with the IPA use as follows: by the3rd day of the therapy, the average score on the Scale was 5.22 points for IPA, and it was statistically significantly lower than thatin the placebo group – 6.21 points. The comparative analysis of the incidence rate of adverse events did not reveal the statisticallysignificant differences between IPA and placebo. None of the adverse events recorded was clinically significant, and none caused thecancellation or change in the dosage of the study drug.Conclusions.IPA broad-spectrum antiviral drug at 30 mg/day dose has demonstrated the high efficacy in the treatment of the acute respiratory viral infections of various etiologies in children aged 3–6 years. The IPA use compared with the placebo causes the significant reduction of the fever period, accelerates the relief of the intoxication and catarrhal symptoms, and decreases the recoverytime. The IPA is characterized by high tolerability and high safety, which allows to recommend the drug for the treatment of influenzaand ARVI (acute respiratory viral infections) in children from 3 years of age.