Molecular analysis of sensitization by aeroallergens in adult patients with allergic bronchial asthma

Introduction. Bronchial asthma is an inflammatory disease manifested by various phenotypes. The most studied phenotype of asthma is allergic. Molecular allergodiagnostics of allergic diseases using microchips makes it possible to determine the molecular profiles of sensitization of patients with allergic asthma, to identify priority molecules for personalized allergen-specific immunotherapy. Objective: to conduct a molecular analysis of the sensitization of adult patients with allergic bronchial asthma with aeroallergens in the Rostov region of southern Russia Methods. In a multicenter, retrospective, non-randomized cohort study, data from Allergy Explorer 2 (ALEX2) allergy chips were analyzed in 166 adult patients with an allergic phenotype of bronchial asthma. Statistical processing of the results was carried out using the Microsoft Office Excel 2010 and Statistica 10.0 for Windows software package. Results. Molecular analysis of sensitization showed that pollen sensitization with a predominance of IgE-mediated reaction to ragweed pollen was most common in the studied cohort of patients – an increase in the level of IgE to the main allergen component Amb a 1 (pectate lyase) was registered in 73 (43.98%) patients, sensitization to the allergen of wormwood pollen Art v 1 (defensin) was noted 39 (23.49%). Sensitization to allergens of mold and yeast fungi was recorded, with a predominance to mold fungi – the main molecule Alternaria alternata (Alt a 1) in 27 (16.27%), less often the enolase protein family (Alt a 6) in 2 (1.20%), the molecule Cladosporium herbarum (Cla h 8) in 1.20% (n=2), rarely to Aspergillus fumigatus, a molecule of the superoxide dismutase family (Asp f 6) in 5 (3.01%) of the examined patients. Among yeast fungi, sensitization was rarely found to the allergens Malassezia sympodialis: molecules (Mala s 5) and (Mala s 6) in 1 (0.60%) of the examined adult asthma, respectively. Conclusion. The method of molecular allergodiagnostics used made it possible to establish not only the spectrum and level of sensitization, but also to identify allergocomponents that play a causally significant role in the development of the allergic phenotype of asthma in adult patients. The simultaneous period of flowering of herbs and sporulation of fungi in the region increases the antigenic load, which contributes to an increase in sensitization in adult patients with asthma in the Rostov region of southern Russia, the transformation of asthma into more severe forms, the expansion of causally significant allergens and mixed sensitization.