Environmentdependent microcirculatory and autonomic neurovascular changes in the children with allergic rhinitis

Abstract

Recently, the studies of environmental effects upon public health of children become quite relevant [1, 12, 20]. Over last decades, there is a rapid increase in allergic diseases, including allergic rhinitis, among the child population. A large number of studies connect this increment in pediatric allergies with influence of environment, technogenic development and urbanization [4]. Allergic rhinitis (AR) is one of the most pressing problems in allergology and immunology [2], being among the most common chronic disorders in children [6, 21]. Thus, it was found that the pathogenesis of AR is a complex mechanism that is not limited to a purely allergic reaction and inflammation in the nasal region. It includes complex mechanisms of neurogenic inflammation under participation of the main neuropeptides and neurotransmitters, which are closely related to the individual condition of endocrine and immune systems, being largely determined by the state of mucous membranes of the nasal cavity and respiratory tract in general. The pathogenesis of AR is primarily influenced by the state of microvasculature of the mucous membrane, as well as dictinct qualitative and quantitative characteristics of microbiocenosis of the nasal cavity, nasopharynx and oropharynx, upper and lower respiratory tract. All these parameters are directly determined by neurovegetative mechanisms [5, 7, 9, 16]. An important place in the pathogenesis of the development of allergic diseases belongs to changes of the microcirculation system which is involved into all the clinical manifestations observed. The microcirculation disorders play an important initial triggering role in pathogenesis of allergic rhinitis. Likewise, the autonomic nervous system is responsible for setting links between the body, ambient and internal environment via regulation of metabolism, functioning of organs and tissues based on changes in this environment; it also provides integration of all organs into a single entity, acting as one of the main adaptive systems in human body [13]. Therefore, the autonomic nervous system regulates the body and homeostasis by unifying the separate pathogenetic links of disease progression and setting basis for structural and functional unity [3, 19]. This regulatory mechanism is implemented via nerves and reflexes by different neurohumoral factors. Their nature has been established under experimental conditions and is beyond doubt to date [8].