Russian Journal of AllergyRussian Journal of AllergyРоссийский Аллергологический Журнал1810-88302686-682XPublishing House ABV Press153410.36691/RJA1534Original studiesОригинальные исследованияResearch ArticleSuppression spontaneous and induced expression of CD203c basophils after subcutaneous immunotherapy with ragweed and mugwort allergensСнижение спонтанной и индуцированной экспрессии СD203c базофилов после подкожной иммунотерапии аллергенами амброзии и полыниhttps://orcid.org/0000-0002-4069-05668946-3393BarychevaLiudmila Yu.БарычеваЛюдмила Юрьевна
Russian Federation

MD, Dr. Sci. (Med.), Professor

д.м.н., профессор

for_ludmila@inbox.ruhttps://orcid.org/0000-0001-5806-972X3599-5095DushinaLiudmila V.ДушинаЛюдмила Валентиновна
Russian Federation

MD, Cand. Sci. (Med.)

к.м.н.

dushina.stv@gmail.comhttps://orcid.org/0000-0002-2048-57091709-2182MasalskiySergey S.МасальскийСергей Сергеевич
Russian Federation

MD, Cand. Sci. (Med.)

к.м.н.

masalsky85@gmail.comhttps://orcid.org/0000-0001-7876-62587068-4939SmolkinYuri S.СмолкинЮрий Соломонович
Russian Federation

MD, Dr. Sci. (Med.)

д.м.н.

smolking@df.ruhttps://orcid.org/0000-0003-0971-53475236-9634KozmovaNatalia A.КозьмоваНаталья Александровна
Russian Federation
kozmova@mail.ruhttps://orcid.org/0000-0001-5764-64412065-9023KuropatnikovaElena A.КуропатниковаЕлена Андрияновна
Russian Federation
Lenysionok@mail.ruStavropol State Medical UniversityСтавропольский государственный медицинский университетStavropol Regional Clinical Consultative and Diagnostic CenterСтавропольский краевой клинический консультативно-диагностический центрAssociation Pediatric Allergist and Immunologist RussiaАссоциация детских аллергологов и иммунологов РоссииScientific-Clinical Consultative Center of Allergology and ImmunologyНаучно-клинический консультативный центр аллергологии и иммунологииAcademy of Postgraduate Education of the Federal Research and Clinical Center of Specialized Medical Care and Medical TechnologiesАкадемия постдипломного образования Федерального научно-клинического центра специализированных видов медицинской помощи и медицинских технологий28072022081020221932993162504202221062022Copyright ©; 2022, Pharmarus Print MediaCopyright ©; 2022, Фармарус Принт Медиа2022Pharmarus Print MediaФармарус Принт Медиаhttps://rusalljournal.ru/raj/article/view/1534

BACKGROUND: The basophil activation test (BAT) reflects the presence of immunoglobulin E on the cell surface and can be a tool for monitoring the effectiveness of allergen-specific immunotherapy. Spontaneous and allergen-induced BAT levels may likely change after effective subcutaneous immunotherapy, and this is of clinical importance.

AIMS: To determine the basophil activation markers in patients sensitized to weed pollen during subcutaneous immunotherapy

MATERIALS AND METHODS: This clinical study of 2 years included 60 patients with allergic rhinitis who underwent subcutaneous immunotherapy with weed allergens for two seasons. The proportion of basophil-expressing CD203c, spontaneously and after exposure to a trigger allergen, was determined. BAT was performed before treatment and after the first and second courses of preseason subcutaneous immunotherapy (0, 3, and 15 months of treatment). The effectiveness of subcutaneous immunotherapy was assessed by the dynamics of the symptom scale (Rhinoconjunctivitis total symptom score [RTSS]) and the drug assessment (Daily medical score [DMS]).

RESULTS: Subcutaneous immunotherapy with water–salt extracts was effective. The median RTSS in patients after two courses decreased from 13.0 [10.0; 15.0] to 4.5 [3.00; 7.25] points (p <0.001) and DMS score from 2.0 [2.0; 2.0] to 1.0 [1.0; 2.0] points (p <0.001). Spontaneous BAT remained unchanged after the first course of allergen-specific immunotherapy. The mean BAT values before therapy and after the first course of subcutaneous immunotherapy did not differ (8.15% [6.10; 11.9] vs. 9.0% [6.30; 12.0]). The spontaneous BAT decreased after the second course of treatment (8.15% [6.10; 11.9] vs. 6.20% [4.27; 9.00], χ2=15.5, p <0.001). Allergen-induced BAT significantly decreased from the first year of treatment. The overall change in the total group for BAT with ragweed after the first course of subcutaneous immunotherapy was 11.25% (95% confidence interval [CI]: 7.10–15.10, p <0.001). The overall difference in the induced ВAT test at the end of therapy reached 8.63% (95% CI: 5.30–12.05, p <0.001). The indices of induced BAT decreased by 12.0% after the first course of therapy with mugwort allergens (95% CI: 6.95–17.90, p <0.001), and the difference from the initial values after the second course was 9.67% (95% CI: 6.85–15.90, p <0.001).

CONCLUSIONS: Subcutaneous immunotherapy with ragweed and mugwort allergens was effective. The change in spontaneous and induced BAT is associated with a positive effect of allergen-specific immunotherapy.

Обоснование. Тест активации базофилов (basophil activation test, BAT) отражает представленность IgE на поверхности клетки и может быть инструментом мониторинга эффективности аллергенспецифической иммунотерапии. Вероятно, уровень спонтанного и индуцированного аллергеном BAT может изменяться после эффективной подкожной иммунотерапии, что имеет клиническое значение.

Цель ― определение маркеров активации базофилов у пациентов, сенсибилизированных к пыльце сорных трав, при проведении подкожной иммунотерапии.

Материалы и методы. Исследование в реальной клинической практике (2 года, 60 пациентов с аллергическим ринитом, которым проводилась подкожная иммунотерапия аллергенами сорных трав в течение двух сезонов). Определяли долю базофилов, экспрессирующих CD203c, спонтанно и после экспозиции с триггерным аллергеном. BAT выполняли до лечения, после первого и второго курсов предсезонной подкожной иммунотерапии (0, 3, 15-й мес лечения). Эффективность подкожной иммунотерапии оценивалась по динамике шкалы симптомов RTSS (Rhinoconjunctivitis total symptom score) и медикаментозной оценки DMS (Daily medical score).

Результаты. Подкожная иммунотерапия водно-солевыми экстрактами была эффективна: медианы RTSS у пациентов после двух курсов снизились с 13,0 [10,0; 15,0] до 4,5 [3,00; 7,25] баллов (p <0,001), оценка DMS ― с 2,0 [2,0; 2,0] до 1,0 [1,0; 2,0] балла (p <0,001). Спонтанный BAT оставался неизменным после первого курса аллергенспецифической иммунотерапии. Средние показатели ВАТ до терапии и после первого курса подкожной иммунотерапии не различались (8,15% [6,10; 11,9] и 9,0% [6,30; 12,0]). После второго курса лечения спонтанный BAT уменьшился (8,15% [6,10; 11,9] и 6,20% [4,27; 9,00], χ2=15,5, p <0,001). BAT, индуцированные аллергенами, достоверно снижались уже после первого курса лечения. Суммарное изменение в общей группе составило для BAT с амброзией после первого курса подкожной иммунотерапии 11,25% (CI 95% 7,10; 15,10), p <0,001. Суммарная разница в тесте индуцированного ВАТ к окончанию терапии достигла 8,63% (CI 95 5,30; 12,05), p <0,001. После первого курса терапии аллергенами полыни показатели индуцированного BAT снизились на 12,0% (CI 95% 6,95; 17,90), p <0,001, разница с первоначальными значениями после второго курса составила 9,67% (CI 95% 6,85; 15,90), p <0,001.

Заключение. Подкожная иммунотерапия аллергенами амброзии и полыни была эффективна. Изменение спонтанного и индуцированного BAT связано с положительным эффектом от аллергенспецифической иммунотерапии.

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