Naumova O. Increasing the quality of the diagnostics and prognosis of the treatment efficacy in patients with the seasonal allergic rhinitis with the use of molecular allergy-based diagnostic techniques

This dissertation is aimed at increasing the quality of diagnosis and treatment efficacy the seasonal allergic rhinitis (SAR) with the cross food allergy with the use of molecular allergy-based diagnostic techniques in 217 patients with SAR and sensibilization to tree pollen and with/without cross food allergy. We determined that SAR in patients with cross food allergy is accompanied by severe symptoms on a number of clinical characteristics (i.e. constant interruption of nose breathing, inability to sense the smells and the presence of itchiness in the nose cavity); the persistence of the SAR symptoms at the end of the tree pollination season- in 80% of the patients; increase in the food allergy reaction to the fruits during the tree blooming season - in 43,48%; presence of the oral symptoms - in 95,65%, rhinoconjunctivitis - in 61,74%, chronic hives - in 18,26%, abdominal pains - in 17,39%, skin rash - in 13,04% of the patients upon the consumption of the allergy-causing food allergens. With the help of new methods in allergy diagnostics, a subgroup of patients has been identified, out of a population of SAR+cross food allergy patients. This subgroup showed sensibilization to the lipid transport proteins (LTPs), which caused severe anaphylactic reactions. The rate of such sensibilization in patients with SAR that also have sensibilization to the tree pollen and cross food allergy is 11,5%, while the sensibilization to the thermolabile fruit protein (Prup1-PR10) was identified in 80,7% of these patients. It was also shown that sensibilization to the major (rBetv1) and minor allergens (rBetv2-4) from tree pollen does not depend on the presence of cross food allergy. We identified a strong correlation between the stage of sensibilization to the birch tree allergen rBetv 1 and peach allergen rPrup1-PR10 (correlation coefficient of r=0.88 with p<0.05). No correlation was found between the level of specific IgE to rPrup-PR10 and minor (rBetv2-4_ component of the birch tree allergen (coefficient correlation of r=0.16 with p<0.05). Next, we determined that the level of diaminoxidase worsened the progression of the allergic rhinitis. In addition, for the first time, we showed that decreased levels of blood diaminoxidase were more commonly found in patients with SARs and cross food allergy (10,4% against 1%with р<0,05). Finally, we suggested the algorithm for the diagnostics of the severity of cross food allergy in SAR patients, which allowed for improvement of the timely identification of the food allergy and for the prediction of the progression severity upon the fruit consumption.