Bronchial asthma is a heterogeneous disease that requires identification of its phenotype and a personalized approach to therapy. At the same time, despite a wide range of therapeutic options, many patients with asthma cannot achieve control over the disease.Methodology. The target audience of these clinical recommendations are general practitioners, therapists, pediatricians, allergologists-immunologists, pulmonologists, and functional diagnostics doctors. Each thesis-recommendation about diagnostic and therapeutic procedures has been scored according to the scales of classes of recommendations from 1 to 5 and A, B, C scale of the levels of evidence. The clinical recommendations also contain comments and explanations to the theses, algorithms for the diagnosis and treatment of bronchial asthma, and reference materials.Conclusion. The presented clinical guidelines cover current information about the etiology and pathogenesis, classification, clinical manifestations, diagnosis, treatment, and prevention of bronchial asthma. These guidelines were approved by the Scientific and Practical Council of the Ministry of Health of the Russian Federation in 2021.

The increase in the frequency and unfavorable outcomes of anaphylactic shock in recent decades determines the need for the development of clear and clear definitions, diagnosis and treatment of both shock and prevention of possible complications associated with it. The article provides options for the course of anaphylactic shock, algorithms for diagnosis and treatment.

The PRIMA Consensus document developed by leading Russian experts reviews the principles of outpatient immunotherapy in children with frequent acute respiratory viral infections.

The clinical guidelines for asthma provide a systematic approach to the diagnosis and treatment of this chronic inflammatory disease of the respiratory tract. The article provides a detailed description of current diagnostic methods, including history taking, physical examination, pulmonary function tests, and inflammation measurements. The focus is on individualizing therapy based on the severity and control of the disease, as well as the presence of comorbidities. The authors emphasize the importance of using inhaled corticosteroids as the foundation for long-term control and the use of fast-acting bronchodilators for symptomatic relief. The guidelines also cover non-pharmacological measures, such as avoiding allergens, lifestyle changes, and teaching patients how to properly use inhalers and monitor their symptoms. An important aspect of the guidelines is the “supportive therapy” strategy and the plan of action for exacerbations, which helps to respond promptly and reduce the risk of severe conditions. The guidelines emphasize the need for regular monitoring of treatment effectiveness and the adjustment of therapy based on the progression of the disease. The goal of these clinical guidelines is to improve the quality of care for patients with asthma, reduce the frequency of exacerbations, and enhance their quality of life through the implementation of evidencebased diagnostic and treatment methods.

In many countries of the world and in Russia, in particular, the pharmacological use of antagonists of cysteinyl receptors LT1 (CysLTR) is a long-proven and well-proven pharmacotherapy of bronchial asthma (BA) and allergic rhinitis (AR) in adults and children. Among antileukotriene drugs the most commonly used medication for the treatment of these diseases is the original montelukast, which is considered a safe drug associated with the appearance of only a few adverse reactions, usually not differing in type and frequency from those that occur with placebo. Currently, there are a large number of generics of montelukast, therefore, practitioners have many questions regarding the benefits and risks of montelukast therapy for patients with BA and AR. In 2020 FDA (Food and Drug Administration USA) analyzed the risk of adverse events during Montelukast treatment and indicated them on the packaging of the drug (original montelukast and its generics). This contributed to the creation of an expert commission to study this issue and form an expert opinion, which is demonstrated in our publication.

Significant progress has been made over the past decade in the treatment of allergic diseases such as atopic dermatitis and bronchial asthma. Dupilumab, which targets interleukin IL-4 and IL-13, has become an innovative targeted therapy. Immunobiologic therapy with the interleukin inhibitor is indicated for patients with moderate to severe uncontrolled atopic dermatitis, moderate to severe eosinophilic phenotype of uncontrolled Bronchial asthma and patients with poorly controlled severe chronic polyposis rhinosinusitis. A clinical case and recent data on the use of dupilumab for the treatment of type 2 inflammatory disease and prospects for its use are discussed.