CLINICAL AND ANAMNESTIC PATTERN AND SENSITIZATION TO AEROALLERGENS IN CHILDREN WITH ATOPIC BRONCHIAL ASTHMA

R.M. Fayzullina, R.R. Gafurova, V.V. Viktorov

Department of Faculty Pediatrics with Courses in Pediatrics, Neonatology and Simulation Center IDPO, Bashkir State Medical University, Ufa, Republic of Bashkortostan, Russian Federation

Objective: To analyze the profile of sensitization to airborne allergens in children with atopic bronchial asthma (BA) residing in Ufa referring to the main anamnestic and clinical data.

Methods: The study was carried out in two phases and included general clinical examination along with specific allergy tests. In the 1st phase, allergy screening of 121 BA patients aged from 6 years to 17 years 11 months 29 days using a panel of respiratory allergens for detection of serum specific IgE was conducted. In the 2nd phase of the study, 114 children with a verified diagnosis of atopic BA with were selected based on sensitization to the respiratory allergens, while the remaining 7 patients were excluded from the study based on the exclusion criteria. In the 2nd phase of the study, allergen sensitization was evaluated by serum specific IgE levels determined by indirect immunofluorescence on a three-dimensional porous solid phase (ImmunoCAP® 250, Phadia). The obtained data were used for subsequent assessment of respiratory allergens sensitization profiles in children with atopic BA.

Results: Manifestations of atopy and concomitant pathology at an early age were revealed in 89 patients (78%). In 73 children (64%) anamnestic data analysis revealed a family history of allergic diseases and BA, which was more often on the mother’s side (46 children, 63%); among them, the most common was a family history of BA (21 children, 46%). All 114 patients had clinical manifestations of bronchial obstruction and hyperreactivity as a result of the allergen exposure, and the influence of adverse environmental triggers and ecological microenvironment. The results of the allergen screening in the 1st phase of the study showed that more commonly Class III sensitization (increased level) was determined in the patients enrolled (40 children, 35%). The data from the 2nd phase of the study revealed polyvalent sensitization in 81 patients (71%). Among the pollen allergens, most commonly children with atopic BA showed sensitization to warty birch (Betula verrucosa) (t3).

Conclusion: Modern diagnostic facilities allow to search and identify allergen sensitization in children with atopic BA, effectively and timely determining causal and exogenous factors for every patient, choosing rationale and most differentiated pharmacotherapy with a response and course prediction, optimization of diagnostics, prevention, and rehabilitation.

Keywords: Bronchial asthma, children, sensitization, atopic phenotype, respiratory allergens, inhaled glucocorticoids.

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