ssmuБюллетень сибирской медициныBulletin of Siberian Medicine1682-03631819-3684Siberian State Medical University, the Ministry of Healthcare of the Russian Federation10.20538/1682-0363-2021-4-180-192ssmu-4595Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEW AND LECTURESТранскутанная сенсибилизация. Все ли мы знаем?Epicutaneous sensitization. what do we know?https://orcid.org/0000-0002-7571-5460НовикГ. А.NovikG. A.

д-р мед. наук, профессор, зав. кафедрой педиатрии им. проф. И.М. Воронцова, 

194100, г. Санкт-Петербург, ул. Литовская, 2

2, Litovskaya Str., St.Petersburg, 194100

ga_novik@mail.ruЖдановаМ. В.ZhdanovaM. V.

канд. мед. наук, доцент, кафедра педиатрии им. профессора И.М. Воронцова, зав. учебнойчастью, 

194100, г. Санкт-Петербург, ул. Литовская, 2

2, Litovskaya Str., St.Petersburg, 194100

https://orcid.org/0000-0002-9184-1803ДемидоваА. С.DemidovaA. S.

ассистент, кафедра педиатрии им. профессора И.М. Воронцова, 

194100, г. Санкт-Петербург, ул. Литовская, 2

2, Litovskaya Str., St.Petersburg, 194100

Санкт-Петербургский государственный педиатрический медицинский университет (СПбГПМУ)РоссияSaint-Petersburg State Pediatric Medical UniversityRussian Federation202104012022204180192Copyright © Новик Г.А., Жданова М.В., Демидова А.С., 20222022Новик Г.А., Жданова М.В., Демидова А.С.Novik G.A., Zhdanova M.V., Demidova A.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://bulletin.ssmu.ru/jour/article/view/4595

Согласно существующей в настоящее время гипотезе, транскутанная сенсибилизация является одним из ведущих механизмов формирования пищевой аллергии.

Цель: анализ иммунологических механизмов формирования транскутанной сенсибилизации и роли дефекта кожного барьера.

Для написания обзора был проведен поиск полнотекстовых публикаций на английском языке в базах данных PubMed, UpToDate, Web of Science, Scopus по ключевым словам: epicutaneous sensitization, atopic dermatitis, skin barrier defect, food allergy. Статьи должны были находиться в свободном доступе и представлять наиболее актуальную информацию по теме. Исследования отбирались по принципу наибольшей выборки и индекса цитирования. После первичного отбора публикаций авторы изучили их на предмет соответствия информации тематике исследования. В обзор включена 101 публикация за период 1998–2020 гг.

Рассмотрены данные экспериментальных исследований, изложены современные представления о гипотезе двойного воздействия аллергена, приведены данные исследований, доказывающих клиническую значимость транскутанной сенсибилизации в формировании пищевой аллергии. Знание механизмов развития транскутанной сенсибилизации необходимо для выработки стратегий профилактики пищевой аллергии. Одним из перспективных направлений профилактики пищевой аллергии является использование эмолиентов, которые восстанавливают кожный ответ, однако исследования, посвященные профилактическому приему эмолиентов, в настоящее время не дают однозначного ответа.

В настоящее время накоплено недостаточно данных ни «за», ни «против» существования механизма транскутанной сенсибилизации как обязательного условия для формирования пищевой аллергии. Требуется дальнейшее проведение исследований в данном направлении. 

Background. According to the currently existing hypothesis, epicutaneous sensitization is one of the leading mechanisms in the development of food allergy.

The aim of this review was to analyze immune mechanisms in epicutaneous sensitization and the role of skin barrier impairment.

We performed a literature search using PubMed, UpToDate, Web of Science, and Scopus databases by the key words: epicutaneous sensitization, atopic dermatitis, skin barrier impairment, food allergy. Articles were to be in open access and present the most relevant information on the topic. Studies were selected by the largest sample size and the highest citation index. Once publications were identified, they were reviewed by all the authors to select the studies that specifically addressed the theme of the review. A total of 101 publications from 1998–2000 were included in the study.

This review article discusses the data of experimental studies, sets out modern ideas about the hypothesis of a double exposure to an allergen, and presents research data proving the clinical significance of epicutaneous sensitization in relation to food allergy. Knowledge about the mechanisms of epicutaneous sensitization development is necessary to elaborate strategies for prevention of food allergy. One of the modern trends in prevention is the use of emollients, which are supposed to restore the skin response. However, studies on preventive intake of emollients do not present a similar viewpoint.

There is not enough evidence for or against the mechanism of epicutaneous sensitization as an indispensable condition for the formation of food allergies. Further research in this area is required. 

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The authors declare that there are no conflicts of interest present.