ROLE OF MOLECULAR INVESTIGATIONS IN DIAGNOSTICS OF PATIENTS WITH POLLEN ALLERGY

Abstract

Introduction. Allergic diseases are one of the frequent disorders of children’s and adults’ health worldwide. Pollen allergy is among the most common allergic diseases. According to the data of epidemiological investigations, 5 to 34% of the population in developed countries is susceptible to this disease. Besides, most patients are young individuals of working age. By unfavorable prognoses of scientists, the spread of this pathology is expected among 50% of European population in 2025. However, knowledge in the area of allergopathy diagnostics is constantly improving. Contemporary approach is based on allergen components or component diagnostics. Component diagnostics enables to identify causative allergen and thus choose therapeutic tactics with the prognosis of its efficacy for each patient, as well as to suggest personified diet, elimination measures, warnings on lifestyle and avoidance of life-threatening conditions, etc.

Aim. To demonstrate practical reasoning of the choice of effective therapeutic tactics based on component investigations in patients with pollen allergy.

Materials and methods. Patients with allergic rhinitis / conjunctivitis have been randomly selected after their primary visit in the first week of August in the current year. General laboratory and instrumental investigations, SPT with allergen extracts (Diater, Spain), determination of total serum and specific IgE by immunoenzymatic assay using test systems “Euroimmun” were performed. Immunofluorescence method ImmunoCAP (Thermo Scientific, Uppsala, Sweden) was used for the detection of species-specific allergen components. The material of investigation was blood serum.

Results. According to the results of skin prick-test, 50% of patients could receive AIT with two different allergen extracts “Mixture of weeds” and “Mixture of herbs”. Based on molecular investigations, it was revealed that such combination was appropriate for none of the patients (20% of individuals had genuine sensitization to allergens of herb pollen, including the marker of cross-reactive molecules, 30% of individuals were sensitive to genuine allergens of Artemisia and/or Ambrosia).

Conclusions. Based on skin prick-test and molecular diagnostics, the doctor makes a completely different decision concerning the choice of extracts for AIT conduction. Component detection of sensitizing profile and high sensitivity of this method enable to reveal a genuine protein, which is the initial cause of allergy appearance and to prescribe etiotropic allergen-specific immunotherapy with this allergen, to which sensitization was found. In the treatment of patients, it is important to use allergens, standardized by activity, which are monitored for the presence of major components that allows reaching the highest effect of treatment.