Оценка иммунного статуса у беременных женщин с отягощенным аллергологическим анамнезом

Abstract

Most researchers emphasize that in the structure of diseases of infants, there is a predominance of pathological conditions that occur precisely in the perinatal period, which indicate the correlation of these diseases with the health of the mother and the course of her pregnancy. Objective. Assessment of the immune status and effectiveness of diet therapy in pregnant women with burdened allergic history. Patients and methods. The observation groups consisted of 118 pregnant women. The first group included 83 pregnant women who received a hypoallergenic diet with the exclusion of main allergens, with the replacement of cow's milk with goat's milk, or the exclusion of dairy products as a causally significant allergen. The second group consisted of 35 pregnant women who followed the usual dietary recommendations offered in women's consultations, with the inclusion of cow's milk in the diet. The content of total IgE and allergen-specific IgE antibodies to food proteins in blood serum was determined by the immunoblot method using PROTIA Allergy-Q diagnostic panels. Results. 71.1% of pregnant women of the first group and 40% of women of the second group had the history of allergic diseases. According to skin scarification tests, these women had polyvalent sensitization. When studying the immunological status of pregnant women, attention was drawn to the fact that high levels of total serum IgE were in patients with allergies, with diseases of the gastrointestinal tract, as well as with a combination of these pathologies. 37.3% of the observed pregnant women of the first group, both with and without allergies, had high levels of total serum IgE. At the same time, the level of total IgE was higher in pregnant women suffering from allergic diseases. In addition, IgE sensitization to milk proteins was found in women with normal and high levels of total IgE in the blood. The concentration of allergen-specific IgE antibodies to cow's milk proteins was higher in women with IgE-mediated allergies. The use of a hypoallergenic diet in pregnant women caused the most pronounced decrease in the total IgE content in the blood compared with the indicators before treatment. The majority of the observed women showed a positive trend towards a decrease in IgE sensitization to milk proteins against the background of dietary therapy. Conclusion. All pregnant women with allergic diseases had food sensitization. Gastrointestinal pathology was observed in 34.7% of pregnant women, and its frequency in women with clinically confirmed allergies was 2.3 times higher than in women without allergies. A highly sensitive method for diagnosing food sensitization using PROTIA Allergy-Q panels has made it possible to most accurately identify causally significant allergen products, develop and effectively use personalized hypoallergenic diets for pregnant women. Considering the concept of food programming, the use of hypoallergenic diets in the diet of pregnant women with allergic diseases is one of the options for the prevention of allergic diseases in the future in children born to such mothers. Key words: pregnant women, allergy, food IgE sensitization, diet therapy