G.A. Tikchonova – Ph.D.(Med.), Senior Research Scientist, State Scientific Center of the Russian Federation – Institute of Medicobiological Problems of the RAS
A.G. Goncharova – Dr. Sc. (Med.), Leader Research Scientist, State Scientific Center of the Russian Federation – Institute of Medicobiological Problems of the RAS
A.A. Markin – Ph.D. (Med.), Associate Professor, Head of Laboratory of medical biochemistry and neuroendocrinology, Russian Federation State Scientific Centre – Institute for Biomedical Problems of the RAS (Moscow)
The widespread and steady growth of allergic diseases and pseudo-allergic reactions of the human body to various stimuli is a prerequisite for regulating the rules for the selection of cosmonauts and persons involved in model studies, as well as for the development of uniform diagnostic approaches. The world medical community possesses reliable algorithms that allow determining the diagnostic set, life prognosis and professional commitment to this category of subjects with a sufficient degree of reliability and validity. The presence of a clear correlation between the clinical picture and the results of skin tests is still considered as the main diagnostic marker. At the same time, in clinical laboratory diagnostics, due to the variety of physiological manifestations of allergic and pseudo-allergic reactions, as well as the different diagnostic value of currently used allergological testing kits, the use of prick-tests seems to be the most significant. Under conditions of high probability of an allergic disease presence, provocative tests and a test on inhibition of natural lymphocytes emigration in vivo can be applied in case of drug allergy verification. When diagnosing food allergies, oral food provocation methods with double-blind placebo control should be implemented. In vitro tests are undoubtedly the predominant diagnostic criterion that has repeatedly proved highly informative and safe. They are of particular value when it is impossible to cancel antihistamines, if there is polyvalent sensitization, or if it is not possible to carry out in vivo testing at once with all the suspected allergens in a limited time and with questionable results of skin testing. In this regard, molecular diagnostic methods are of the greatest interest. The level of total immunoglobulin E can be considered as an exclusively additional criterion for allergic diagnosis only at the stage of final clinical conclusion. The leading criteria for laboratory diagnosis, in our opinion, should be considered methods confirming the presence of allergen-specific IgE in the body or positive provocative tests. Given the complexity and dynamism of the problem under consideration, the issue of diagnosing certain types of allergies, as well as determining suitability for participation in space flights and long-term model studies in the case of verified allergic reactions requires further study, as well as the development of uniform regulatory standards within the existing rules for the selection of this category of subjects.
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