Russian Journal of AllergyRussian Journal of AllergyРоссийский Аллергологический Журнал1810-88302686-682XPublishing House ABV Press1599410.36691/RJA15994Original study articlesОригинальные исследованияResearch ArticleAnalysis of the sensitization spectrum in patients with severe allergic diseases using the ImmunoCAP ISAC methodОценка спектра сенсибилизации у пациентов с тяжёлым течением аллергических заболеваний методом ImmunoCAP ISAChttps://orcid.org/0000-0002-5083-6637FominaDaria S.ФоминаДарья Сергеевна
Russian Federation

MD, Cand. Sci. (Med.), Associate Professor

канд. мед. наук, доцент

daria_fomina@mail.ruhttps://orcid.org/0000-0002-9545-4720LebedkinaMarina S.ЛебедкинаМарина Сергеевна
Russian Federation
marina.ivanova0808@yandex.ruhttps://orcid.org/0000-0002-0865-8355NikitinaEkaterina A.НикитинаЕкатерина Андреевнаkatrin88866@gmail.comhttps://orcid.org/0000-0002-8013-5276DushkinAlexander D.ДушкинАлександр Дмитриевич
Russian Federation

MD, Cand. Sci. (Med.)

канд. мед. наук

alex@drdushkin.ruhttps://orcid.org/0000-0001-6209-387XChernovAnton A.ЧерновАнтон Александрович
Russian Federation

MD, Cand. Sci. (Med.)

канд. мед. наук

sbornaya1med@yandex.ruhttps://orcid.org/0000-0002-0928-2054YukhnovskayaYulia D.ЮхновскаяЮлия Дмитриевна
Russian Federation
yukhyuliya@yandex.ruhttps://orcid.org/0000-0001-6010-7975LysenkoMariana A.ЛысенкоМарьяна Анатольевна
Russian Federation

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

д-р мед. наук, профессор

gkb52@zdrav.mos.ruhttps://orcid.org/0000-0002-1930-5424KaraulovAlexander V.КарауловАлександр Викторович
Russian Federation

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

д-р мед. наук, профессор

drkaraulov@mail.ruMoscow City Hospital 52Городская клиническая больница № 52The First Sechenov Moscow State Medical University (Sechenov University)Первый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)Astana Medical UniversityМедицинский университет АстанаMoscow Cancer HospitalМосковская городская клиническая онкологическая больница № 62The Russian National Research Medical University named after N.I. PirogovРоссийский национальный исследовательский медицинский университет имени Н.И. Пирогова010420241504202421155732909202319032024Copyright ©; 2024, Pharmarus Print MediaCopyright ©; 2024, Фармарус Принт Медиа2024Pharmarus Print MediaФармарус Принт Медиаhttps://creativecommons.org/licenses/by-nc-nd/4.0/https://rusalljournal.ru/raj/article/view/15994

BACKGROUND: An important advance in modern allergology has been made by the introduction of allergenic molecules/components, including their detection by the ImmunoCAP ISAC method. This method is useful in patients with a complex spectrum of sensitization and severe forms of allergic diseases, where various predictors of severe course are actively searched for.

AIM: To evaluate the informativeness of component resolved diagnostic by ISAC ImmunoCAP method in patients with severe bronchial asthma and severe atopic dermatitis.

MATERIALS AND METHODS: A single-center retrospective study was conducted from January to August 2023. 100 patients who were candidates for biologicals for severe bronchial asthma (group 1; 63 patients), severe atopic dermatitis (group 2; 20 patients), or their combination (group 3; 17 patients) were included. Component restlved diagnostic was performed by ImmunoCAP ISAC method.

RESULTS: Polysensitization and high occurrence of food and fungal allergens were more frequently detected in the groups of patients with severe atopic dermatitis. When analyzing the pollen sensitization spectrum in groups 2 and 3, Bet v 1 and PR-10 family cross-linked molecules (Mal d 1, Pru p 1, Ara h 8, Gly m 4, Cor a 1.04), as well as Ole e 9, Cyn d 1, Ph p 1 and Par j 2 were the most common. Epidermal allergens were common in all three groups. Lipocains (Can f 1, Can f 4, Can f 6, Ecu q 1, Mus m 1), kallikreins (Can f 5), and albumin (Fel d 2) dominated among them. The presence of sensitization to household allergens was detected only in group 2 and only to the molecule Der p 23. Among fungal allergens, the allergen Asp f 6 was predominant in the groups with severe atopic dermatitis, and the component Alt a 1 in patients with severe bronchial asthma. Among food allergens, one of the most common allergens was the molecule Gad c 1, Gal d 1, Gal d 2, Gal d 5 and Bos d 6.

CONCLUSION: Component resolved diagnostic is an accurate assay suitable for determining the spectrum of sensitization in patients; its result can serve as a distinct biomarker for severe allergic diseases.

Обоснование. Инновационным направлением в современной аллергологии стало изучение и внедрение диагностических методов, определяющих спектр сенсибилизации с расшифровкой по аллергенным молекулам/компонентам, в том числе их определение методом ImmunoCAP ISAC. Данный метод полезен у пациентов со сложным спектром сенсибилизации и многоформными клиническими проявлениями, в том числе при тяжёлых вариантах аллергических заболеваний, где активно ведётся внедрение подходов персонализированной медицины с целью стратификации на отдельные фенотипы заболевания.

Цель ― оценить информативность аллергокомпонентной молекулярной диагностики методом ISAC ImmunoCAP у пациентов с тяжёлыми формами бронхиальной астмы и атопического дерматита.

Материалы и методы. В одноцентровое ретроспективное исследование включено 100 пациентов-кандидатов на проведение генно-инженерной биологической терапии по поводу тяжёлой бронхиальной астмы (группа 1; n=63), тяжёлого атопического дерматита (группа 2; n=20) или их сочетания (группа 3; n=17). Аллергодиагностика проводилась методом ImmunoCAP ISAC.

Результаты. В группе пациентов с тяжёлым атопическим дерматитом чаще выявлялась полисенсибилизация, а также высокая встречаемость пищевых и грибковых аллергенов. При анализе спектра пыльцевой сенсибилизации выявлено, что в группах 2 и 3 наиболее распространены молекула Bet v 1 и перекрёстные молекулы PR-10 семейства (Mal d 1, Pru p 1, Ara h 8, Gly m 4, Cor a 1.04), а также Ole e 9, Cyn d 1, Ph p 1 и Par j 2. Сенсибилизация к эпидермальным аллергенам распространена во всех трёх группах. Среди них доминировали липокаины (Can f 1, Can f 4, Can f 6, Ecu q 1, Mus m 1), калликреин (Can f 5), альбумин (Fel d 2). Наличие сенсибилизации к бытовым аллергенам выявлено только в группе 2 и только к молекуле Der p 23. Cреди грибковых аллергенов в группах с тяжёлым атопическим дерматитом преобладал аллерген Asp f 6, а компонент Alt a 1 ― у пациентов с тяжёлой бронхиальной астмой. Среди пищевых аллергенов одними из самых распространённых являются молекулы Gad c 1, Gal d 1, Gal d 2, Gal d 5 и Bos d 6.

Заключение. Аллергокомпонентная диагностика является точным анализом, подходящим для определения спектра сенсибилизации у конкретного пациента, результат которого может служить отдельным биомаркером при тяжёлых формах аллергических заболеваний.

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