Features of patients with the multiple sensitization diagnostics before allergen specific immunotherapy will be set and the assessment of the therapy results with the laboratory methods

Abstract

Due to the wide expansion of atopy, its early beginning, variety of forms, difficulty of specific pathogenetic treatment, and also high cost of in vitro researches there is a need of diagnostic test systems development and optimization. To make the assessment of atopy diagnostics efficiency in children with a multiple allergy and the analysis of specific immunotherapy (ASIT) influence on immune markers level in serum for a choice of the most significant predictive indicator. 457 children (mean age 8,9 ± 4,3 years) with pollinosis symptoms that prevalence in spring period were tested with birch pollen allergens extract by detecting allergen-specific immunoglobulin E (sIgE) levels. Than patient witch showed positive sIgE level (243 children) were tested with expanded set of plant allergens (birch, alder, hazel, oak pollen, allergens of Rosaceae family and carrot) and set of birch pollen allergocomponents (Bet v1, Bet v2, Bet v4, Bet v6). From them 32 patients were treated with allergen-specific immunotherapy. Immunological assays were performed by indirect immunofluorescent method on ImmunoCAP250 (Sweden). It was shown that birch allergens sIgE antibodies detection in patients with pollinosis allows to estimate sensitization degree to allergens of related trees and could predict their quantitative values. The oak allergens sIgE level is a good predictive marker of sIgE level to food plant derived allergens. And apple allergens sIgE concentration is closely assotiated with sIgE to fruit allergens of Rosacea family. Detection of sensitization to minor allergens in patient influences on therapy efficacy prognosis. sIgE detection to limited number of allergens (birch-oak-apple) is effective to sIgE value assessment in patient with allergy to plant causing allergens cross reactivity. Component-divided in vitro diagnostics directed on reveal of sensitization caused by minor allergens, is actual at the answer a question about ASIT validity and its efficiency. Component-divided in vitro diagnostics directed on reveal of sensitization caused by minor allergens, is actual at the answer a question about ASIT validity and its efficiency. Significant results of the therapy are shown after double course ASIT that also allows to reduce considerably production of sIgE antibodies to significant allergens, and cross reacting plant food allergens.