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© Igor P Kaidashev, Nelya Kutsenko УДК 616-056:577.27
THE ALLERGEN-SPECIFIC IGE REACTIVITY PATTERN OF UKRAINIAN ALLERGIC PATIENTS
Igor P Kaidashev, Nelya Kutsenko
Research Institute for genetic and Immunological Grounds of Pathology Ukrainian Medical Stomatological Academy, Poltava Ukraine
Цель исследования проанализировать уровни специфических IgE у больных аллергическими заболеваниями Полтавской области к наиболее распространенным причинным аллергенам (молоко, арахис, белок куриного яйца, желток куриного яйца, картошка, морковка, рыба треска, яблоко, соя, пшеничная мука, пыльца бородавчатой берёзы, луговая тимофеевка, пыльца полыни, клещ D.pteronyssinus, клещ D.farinae, эпидермис собаки, эпидермис кошки, эпидермис лошади, грибок Asp.fumigatus и Cladosp. herbarum). Определяя уровни специфических IgE с помощью системы "Ро1у^еск"(Германия), повышенные уровни выявлены у 55% всех обследуемых нами людей. Дерматофагоидные клещи и эпидермальные аллергены были доминирующими в определении причинных аллергенов среди детей, и были выявлены у 40% обследуемых. Группа пыльцевых аллергенов была наиболее актуальной в определении специфических IgE среди обследуемого взрослого населения. На втором месте у взрослых выявляли специфические IgE к эпителию кошки (практически у 15%). Таким образом, дерматофагоидные клещи и эпидермальные аллергены основные причинные аллергены в развитии аллергических заболеваний на территории центральной Украины. Поэтому одним из профилактических методов должно быть снижение концентрации аллергенов путём санации помещений.
Ключевые слова: специфический IgE, аллергические заболевания, причинные аллергены. During the last few decades, a number of studies
have identified a high prevalence of asthma and allergy in different regions of the world [1, 2]. Allergy is regarded as an altered immune response that is characterized by an increased production of immunoglobuline E (IgE) in response to environmental antigens and allergens. This increased IgE circulates in the blood and enters the tissues, including the airway mucosa and skin, where it is mostly bound to the high-affinity receptors on the surface of mast cells and basophils and the low-affinity receptors on eosinophils, macrophages and platelets [3]. Major allergens and prevalence of sensitization in atopic patients vary in different populations [4, 5]. In Ukraine, the measurement of sensitization to allergens is a common clinical practice in patients with severe symptoms of allergic disorders. The data on the less common tests of individual allergens (like specific IgE measurement) have not been systematically collected nor published in international journals and they are not accessible to scientists and physicians (allergists, pediatricians etc).
Methods
We therefore estimated the specificity and intensity of sensitization to 20 different allergens (food, epithelial, molds and airborn) in patients with atopic bronchial asthma and rhinitis from Poltava city in the center of Ukraine. Participants were enrolled in the study on the basis of medical history of atopic asthma and rhinitis from clinical departments. The groups were comprised by 57 children aged 0,5-18 and 58 adults aged 18-40 years. Clinical specialists verified the diagnoses according to the GINA and ARIA protocol. The Local Ethical Committee of Ukrainian Medical Stomatological Academy approved this study.
Blood samples were collected in March 2008 to March 2009. Specific IgE was measured by the in vitro test system Polycheck Allergy Diagnostic (BIOCHECK GmbH, Munster, Germany), according to manufacturer's instructions. The groups were compared by MannWhitney U-test.
Results
The major allergen and important allergen were defined as those to which more than 50% and 30% of patients in groups were sensitized, respectively.
The t03 - Birch pollen, g06 - Timothy grass pollen and e01 - Cat epithelia allergens were found to be the major allergens with 50% of Ukrainian adult allergic patients sensitized to this allergen (Fig. A). Other important allergens were d01 - D.pteronyssinus, d02 - D.farinae, e02 - Dog epithelia, with more than 30% of adult atopics sensitized.
The nothing allergens were found to be the major allergens with 50% of Ukrainian allergic children (Fig. B). d01 - D.pteronyssinus, d02 - D.farinae, e02 - Dog epithelia, e01 - Cat epithelia allergens were found to be the important allergens with more than 40% of Ukrai-
nian allergic children sensitized to this allergen (Fig. B). To our mind, the f49 - apple is one of the most important allergen in allergic children with the prevalence more then 28%.
In adult patient the high reactivity to outdoor allergens has been observed (birch and timothy pollens), while sensitization to indoor allergens were limited by e01 cat epithelia allergen (moulds and plant-origin allergens have been very low <15%). In allergic children the indoor allergens (d01 - D.pteronyssinus, d02 - D.farinae, e02 -Dog epithelia, e01 - Cat epithelia) have been observed mainly. However, the f49 - apple allergen were observed more than 28% and 23% of adults and children, respectively (P<0.05). So, there were significant differences between the reactivity pattern of adults and children (P<0.05).
A
II
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fl3 102 £01 175 135 131 103 £14 104 t03 g06 w06 dOl d02 e02 eOl e03 m03 m02
D 0,35 - 3,5 kU/1, m 3,5 - 17,5 kU/1, G 17,5-50kU/l, | 50-100 kU/1 and higher.
Fig. A Adult patients
f13 - Peanut, f02 - Milk, f01 - Eggwhite, f75 - Eggyolk, f35 - Potato, f31 - Carrot, f03 - Codfish, f49 - Apple, f14 -Soya, f04 - Wheat flour, t03 - Birch pollen, g06 - Timothy grass pollen, w06 - Mugwort pollen, d01 - D.pteronyssinus, d02 - D.farinae, e02 - Dog epithelia, e01 - Cat epithelia, e03 - Horse epithelia, m03 - Asp.fumigatus, m02 - Cla-dosp.herbarum.
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50
45
40
35
30
25
20
15
10
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1
1
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— —
n n n n ■ n n
fl3 f02 fOl f75 0 5 Ol 1D3 f49 fl4 1D4 t03 g06 w06 dOl d02 e02 eOl e03 m03 m02
G 0,35 - 3,5 kU/1, G 3,5 - 17,5 kU/1, G 17,5-50kU/l, | 50-100 kU/1 and higher.
Fig. B Children
0,35 - 3,5 kU/l, 3,5 - 17,5 kU/l, 17,5 - 50 kU/l, 50 -100 kU/l and higher.
f13 - Peanut, f02 - Milk, f01 - Eggwhite, f75 - Eggyolk, f35 - Potato, f31 - Carrot, f03 - Codfish, f49 - Apple, f14 -Soya, f04 - Wheat flour, t03 - Birch pollen, g06 - Timothy grass pollen, w06 - Mugwort pollen, d01 - D.pteronyssinus, d02 - D.farinae, e02 - Dog epithelia, e01 - Cat epithelia, e03 - Horse epithelia, m03 - Asp.fumigatus, m02 - Cla-dosp.herbarum.
To our mind, the quit frost winter in the central part of Ukraine with a long winter period and strong winds prevents accumulation of pollen and mould spore allergens in the air and decreases the possibility of sensitization to outdoor antigens in children. In this situation the indoor antigens become the important or main allergens. Cats and dogs are present in many of the Ukrainian houses. Moreover, the transportability of cat and dog allergens on clothing facilitates sensitization of allergic patients irrespective of pet-keeping at home directly. Poor ventilation of homes and high humidity due to interval between indoor and outdoor temperature may also contribute to accumulation of mite allergens in beddings and upholstered furniture, triggering sensitization. So, we can observer the evolution of allergy from indoor allergy in children to outdoor allergy in adults in the population of atopic peoples.
Thus, very high reactivity to indoor allergens of in allergic patients from central Ukraine seems to be a man-made problem and could be partly avoided by reducing risk allergen concentration at homes by sanitation of houses.
This is the first international report on allergic sensitization in allergic patients from central Ukraine. It shows the importance of indoor and outdoor allergens (birch,
timothy, cat, dog and dust mite allergens) in maintaining the manifestations of allergy (asthma and rhinitis). Our data can serve as a baseline for future studies of risk factors in atopic allergy development in Ukraine as a ground for the development of test systems according to the specific reactivity pattern.
This work was supported by Ukrainian Ministry of Health Public Service.
References
1. Linneberg A, Jargenssen T, Nielsen NH, Madsen F, Fra-lund L, Dirksen A. The prevalence of skin-test positive allergic rhinoconjunctivitis in Danish adults: two cross-sectionsl surveys 8 years apart. The Copengagen Allergy Study. Allergy 2000; 55: 767-72.
2. Compalaty E, Penagos M, Henley K, Canonica GW, Allergy prevalence survey by the world allergy organization. Allergy Clin Immunol Int - J World Allergy Org 2007; 19(3): 82-90.
3. Bradding P, Holgate ST. Immunopathology and human mast cell cytokines. Crit Rev Oncol/Hematol 1999; 31(2): 119-33.
4. Zhang C, Gjesing B, Spangfort MD, Xu J, Zhong N. The allergen-specific IgE reactivity pattern of Chinese house dust mite allergic patients. Allergy 2008; 63(12):1640-1.
5. Gusareva ES, Bragina EJ, Deeva EV, Kazakevich NV, Puzyrev VP, Ogorodova LM, Lipoldova M. Cat is a major allergen in patients with asthma from west Siberia, Russia. Allergy 2006; 61(4):509-10.
Summary
THE ALLERGEN-SPECIFIC IGE REACTIVITY PATTERN OF UKRAINIAN ALLERGIC PATIENTS
Igor P Kaidashev, Prof., M.D.; Nelya Kutsenko, Ph.D
Key words: specific IGE, allergic disorders, individual allergens.
In Ukraine, the measurement of sensitization to allergens is a common clinical practice in patients with severe symptoms of allergic disorders. The data on the less common tests of individual allergens (like specific IgE measurement) have not been systematically collected nor published in international journals and they are not accessible to scientists and physicians. We therefore estimated the specificity and intensity of sensitization to 20 different allergens (food, epithelial, molds and airborn) in patients with atopic asthma and rhinitis from Poltava city in the center of Ukraine. The groups were comprised by 57 children aged 0,5-18 and 58 adults aged 18-40 years.
d01 - D. pteronyssinus, d02 - D. farinae, e02 - Dog epithelia, e01 - Cat epithelia allergens were found to be the important allergens with more than 40% of Ukrainian allergic children sensitized to this allergen. To our mind, the f49 -apple allergen is one of the most important allergen in allergic children with the prevalence more then 25%. In adult patient the high reactivity to outdoor allergens has been observed (birch and timothy pollens), while sensitization to indoor allergens were limited by e01 cat epithelia allergen (moulds and plant-origin allergens have been very low <15%). Thus, very high reactivity to indoor allergens of in allergic patients from central Ukraine seems to be a man-made problem and could be partly avoided by reducing risk allergen concentration at homes by sanitation of houses. Ukrainian Ministry of Health Public Service, Ukrainian Medical Stomatological Academy
Mamepian nadiurnoB do pedaKqit 18.09.09
