Abstract
Bronchial asthma is a chronic disease characterized by reversible airway obstruction with clinical manifestations of recurrent wheezing episodes, airway inflammation, and their hyperreactivity. Timely diagnosis of bronchial asthma in early childhood will allow adequate prescribing therapy and controlled management of patients, which in the future will reduce the risk of serious complications and improve the quality of life of patients.The aim of the study – to identify the influencing factors on the manifestations of atopic reactivity in children with bronchial asthma, depending on the content of IgE specific to house dust antigens in the blood serum, in order to optimize the management of the disease.Material and methods. A comprehensive clinical and paraclinical examination of 79 school-age children with atopic bronchial asthma was carried out in the Regional Children's Clinical Hospital and the City Children's Polyclinic in Chernivtsi. According to the concentration of specific IgE to the house dust allergen, the patients were divided into two clinical groups. The first (I) clinical group included 55 children in whom the concentration of these antibodies in the blood exceeded 3.5 kU / l, the second group (II) consisted of 24 patients in which the level of specific IgE was below this value. According to the main clinical signs, the comparison groups were compared.Results. It was found that the proportion of patients in the first group who had contact with tobacco smoking of their parents was higher than in the comparison group. Constant contact with tobacco smoke, when both parents have this bad habit in the family, increases the likelihood of developing hypersensitivity to house dust in children with asthma by almost 9 times. At the same time, bronchial asthma was more often combined with atopic dermatitis in these patients, while low concentration of specific IgE to house dust was associated with comorbidity of asthma with allergic rhinitis. The risk of moderate to severe bronchial asthma in patients with low IgE levels increases significantly. The probability of developing the phenotypes of late-onset asthma and exercise-induced asthma in children with low concentrations of specific IgE to house dust increases by 3 and 2 times, respectively. The number of schoolchildren with an extremely high concentration of IgE (more than 100 kU/l) to D. Pteronyssinus antigens was twice as high as in the comparison group, and every second patient also had very high levels of antibodies to D. Farinae tick.Conclusion. Children with atopic hypersensitivity to house dust allergens have an increased chance of comorbid bronchial asthma and atopic dermatitis, late-onset asthma and physical exertion, asthma is much more severe, which must be taken into account when personalizing specific therapy.
Highlights
В то же время, у данных больных бронхиальная астма чаще всего сочеталась с атопическим дерматитом, тогда как низкая концентрация специфического IgE к домашней пыли сопровождалась коморбидным течением бронхиальной астмы и аллергического ринита
The aim of the study – to identify the influencing factors on the manifestations of atopic reactivity in children with bronchial asthma, depending on the content of IgE specific to house dust antigens in the blood serum, in order to optimize the management of the disease
According to the concentration of specific IgE to the house dust allergen, the patients were divided into two clinical groups
Summary
Ключові слова: бронхіальна астма, атопія, алергени, IgE, діти. Буковинський медичний вісник. 2021. Мета дослідження – виявити впливові чинники на прояви атопічної реактивності у дітей, хворих на бронхіальну астму залежно від вмісту специфічних до антигенів домашнього пилу IgE в сироватці крові, для оптимізації менеджменту захворювання. За концентрацією специфічного IgE до алергену домашнього пилу пацієнтів було розподілено на дві клінічні групи. Водночас у даних хворих бронхіальна астма частіше поєднувалась із атопічним дерматитом, натомість, низька концентрація специфічного IgE до домашнього пилу асоціювалася з коморбідністю астми з алергічним ринітом. Імовірність розвитку фенотипів астми пізнього початку та астми фізичної напруги у дітей із низькою концентрацією специфічного IgE до домашнього пилу зростає у 3 та 2 рази відповідно. У дітей із атопічною гіперчутливістю до алергенів домашнього пилу зростають шанси коморбідного перебігу бронхіальної астми та атопічного дерматиту, розвитку астми пізнього початку та фізичної напруги, перебіг астми значно тяжчий, що необхідно враховувати при персоналізації специфічної терапії захворювання
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