Оральный аллергический синдром и ангиоотеки в ротовой полости у пациентов с сенсибилизацией к березе: есть ли повышенные риски?

Abstract

Aim: to study the sensitization profile in patients with sensitivity to Bet v1 allergen who have clinically significant respiratory symptoms of pollinosis during the birch flowering season, oral allergy syndrome (OAS), and angioedema to nuts and stone fruits. Patients and Methods: a prospective open-label study included 40 children (average age 7.52±0.64), 26 (65%) boys and 14 (35%) girls. All children had sensitization to the birch major allergen (Bet v1), symptoms of respiratory allergy during the birch flowering season, manifestations of OAS with angioedema in combination with hives or without it after eating fruits of Rosaceae family/nuts/peanuts. Children underwent general clinical and allergy researches, determination of total IgE and eosinophil cationic protein. By the method of component-resolved diagnosis of allergy (ISAC-112, ImmunoCAP), a comprehensive allergology examination for 112 allergen molecules was performed for each child. Results: the children of the study group were found to have increased values of total IgE (256.66±40.45 IU/mL) and eosinophil cationic protein (67.22±8.67 ng/mL). It was found that 57.5% of children were sensitized to tree nut storage proteins (rJug r1, rJug r2, NCoR a9, rAna o2, rBer e1), and some patients (27.5%) had increased specific IgE to non-specific lipid-transfer proteins (npLTPs) (rPru p3, NCoR a8, rAra h9, rJug r3). Antibodies to peanut storage proteins (rAra h1, rAra h2, rAra h3, rAra h6) were in 22.5% of children in the study group. Conclusion: the component-resolved diagnosis of allergy allows to determine the sensitization profile of patients. Sensitization detection to storage proteins and/or nsLTPs of nuts, peanuts and fruits is a predictor of possible severe allergic reactions. The exclusion of these products, both raw and heat-treated, reduces the number of severe acute allergic reactions in patients and prevents possible fatal outcomes. KEYWORDS: oral allergy syndrome, angioedema, children, birch, sensitization to Bet v1 allergen, storage proteins, nsLTPs. FOR CITATION: Lepeshkova T.S., Beltyukov E.K., Tsarkova S.A., Naumova V.V. Oral allergy syndrome and angioedema in patients with birch allergen sensitization: are there any high risks? Russian Medical Inquiry. 2021;5(1):21–24. DOI: 10.32364/2587-6821-2021-5-1-21-24.