CC BY
5
УДК 61
Shakirova A.T., Zamirbekova K.Z., Okombaeva P.N.,
Patyidin K., Inzhas A.
I.K. Akhunbaev KSMA, S. Tentishev AzMI, Bishkek, Kyrgyz Republic
RELATIONSHIP BETWEEN ALLERGIC DERMATOSES AND GIARDIASIS
Abstract
Parasitic intestinal infestations (helminthiasis, giardiasis) play a significant role in the pathogenesis of allergic dermatoses and are a trigger for immunopathological changes in the skin. This problem still remains poorly understood; the role of many individual representatives of parasitosis pathogens in the development of allergic dermatoses is unknown.
Key words:
eczema, parasitosis, giardiasis, allergy, course.
Parasitic diseases are widespread among the population of all countries and, according to WHO, occupy 3rd-4th place among all diseases of infectious and parasitic nature. About 500 species of helminths that parasitize humans have been registered in the world, and the prevalence of helminth-protozoal infections is quite high.
Helminthiases and giardiasis make up the majority of all parasitic morbidity in the Republic. The pathogenic effect of helminths on humans consists of sensitization of the body with the subsequent development of an allergic reaction, toxic action, mechanical damage to tissues and blood vessels, absorption of blood and certain nutrients, in particular vitamins, as well as the introduction of microbial flora.
It has been proven that disruption of the barrier function of the intestinal mucosa during dysbiosis can be the cause of hematogenous and lymphogenous spread of intestinal microflora in the body, the development of sensitization by opportunistic intestinal microbes, leading to autoallergic reactions, which are the cause of relapses and transition to the chronic form of the disease [1, 2].
In recent years, data have been obtained on the significant role of parasitic intestinal infestations (helminthiasis, giardiasis, ascariasis) in the pathogenesis of skin diseases, which are the triggering mechanism for immunopathological changes in the skin and support its chronic course [2,3,4]. However, this problem still remains poorly understood; the role of many individual representatives of parasitosis pathogens in the development of this pathology is unknown.
Clinical forms of giardiasis with a predominance of allergic manifestations are described: indomitable skin itching, urticaria, erythema of the skin, bronchial asthma and asthmatic bronchitis, rhinitis, arthralgia, arthritis, conjunctivitis, persistent blepharitis, etc., which disappeared immediately or some time after specific treatment.
Giardiasis is a common infectious disease caused by microorganisms of the protozoan group - Giardia (Lamblia intestinalis). These parasites live in the duodenum and small intestine and cause disruption of the gastrointestinal tract. The pathogens were first identified in 1681 by A. Leeuwenhoek, but only 200 years later D. Lamble studied their structure and role in the development of the disease in detail.
The urgency of the problem is explained by the fact that giardiasis occurs 3 times more often in children than in adults. More than 20% of the child population is diagnosed with Giardia infestation. A child's stay in a children's group significantly increases the risk of infection with this microorganism.
Giardiasis infestation is the cause of allergic manifestations. According to the authors, 69% of patients with allergic dermatosis have Giardia, 16% have enterobiasis, and 3% have ascariasis [5]. The dermatological manifestations of giardiasis are peculiar: urticaria, Quincke's edema, keratosis pilaris, uneven skin coloration, cheilitis, xerosis, isolated lesions of the palms and soles [7], but there is little data on the effect of giardia on the
course of eczema in children.
Today, the problem of dermatitis and eczema is becoming more and more urgent; it accounts for 30-40% of the structure of skin diseases. Eczema and dermatitis significantly affect quality of life and are clinically diverse. These are acute or chronic diseases, prone to relapse, characterized by an inflammatory response to exogenous or endogenous factors, manifested by polymorphic rashes and severe itching.
Among the exogenous causes are bacterial and fungal agents, chemicals, physical factors, drugs, food products, etc., endogenous - antigenic determinants of microorganisms from foci of chronic infection. Pathology of the gastrointestinal tract and hepatobiliary system, accompanied by enzymopathies, dyskinesias, intestinal dysbiosis, and impaired membrane digestion and absorption, have an important pathogenetic significance in the development of allergic dermatoses. Failure of the intestinal barrier, most typical for young children, leads to the absorption of insufficiently digested products into the blood, including undigested protein [2,8].
Genetic predisposition plays an important role: if one of the parents (mostly the mother) is ill, the chance of developing the disease in the child is approximately 40%, and if both parents are ill, it is 50-60% [1,4]. The affected lesions are symmetrical with unclear boundaries, the skin on them is hyperemic and swollen, with microvesicles and areas of weeping in the form of wells. Yellow-brown crusts, scales or papules are present. Initially, the process is localized on the face (cheeks, forehead, while the nasolabial triangle is not involved), then it spreads to the scalp, neck, ears, extensor surfaces of the limbs, torso and buttocks [3,6].
Parasitoses contribute to the more frequent occurrence of somatic diseases and the exacerbation of chronic diseases, having a multifaceted effect on the host's body, including its immune system.
Allergic dermatoses with parasitic invasion are characterized by a more severe course, high levels of blood eosinophils and total immunoglobulin E, a decrease in the sensitivity of skin tests, and the development of predominantly food sensitization.
Features of parasitic allergies are a torpid course, a tendency to relapse, and resistance to antiallergic therapy. Timely diagnosis and etiotropic therapy of parasitosis leads to the elimination of symptoms of allergic dermatoses.
The etiological connection of allergic dermatoses with giardiasis is confirmed by the significantly higher frequency of giardiasis in individuals with allergic dermatoses than among the healthy population, as well as the effect of antiparasitic treatment on the relief of allergy symptoms in more than 50% of those infected [8]. Among the pathogenetic mechanisms of allergic manifestations in giardiasis, in addition to the direct allergenic effect of pathogen antigens, they suggest an increase in the permeability of the small intestinal mucosa to food and bacterial allergens, caused by parasitic antigens [4,5,8]. Bibliography
1. Avdyukhina T.I., Konstantinova T.N., Kucherya T.V., Gorbunova Yu.P. Giardiasis / Manual for doctors. - M., 2003. - 30 p.
2. Apenchenko Yu.S. Giardiasis in children. - Tver, 2007. - 157 p.
3. Novikova V.P., Kalinina E.Yu., Shabalov A.M., Osmalovskaya E.A. Giardiasis / Textbook for doctors. - St. Petersburg: InformMed, 2010. - 120 p.
4. Sergiev V.P., Lobzin Yu.V., Kozlov S.S. Human parasitic diseases (protozoa and helminthiasis). - St. Petersburg, 2006. - 592 p.
5. Terletskaia-Ladwig E., Eggers M. Enders M., Regnath T. Epidemiological aspects of gastrointestinal infections // Dtsch Med Wochenschr. - 2011; 136 (3): 69-75.
6. Fayzullina R.A. Giardiasis in children: modern clinical features, diagnosis and treatment // Doctor.Ru. - 2014; 3 (91): 23-30.
7. Centers for Disease Control and Prevention. Giardia. - 2015.
8. Shakirova A.T., Buranchieva A.A. The influence of parasites on the course of childhood eczema "Trends in the development of science and education," No. 60, April 2020, part 8, pp. 37-43, Samara.
© Shakirova A.T., Zamirbekova K.Z., Okombaeva P.N., Patyidin K., Inzhas A., 2023
