Zubchenko S. Allergic diseases and chronic Epstein-Barr virus infection: pathogenesis, diagnostic approaches and therapeutic tactics of patient management

This thesis presents a solution to a current scientific problem in immunology and allergology – research into Epstein-Barr virus impact on immune and immune-dependent mechanisms of allergic diseases, diagnostic and therapeutic approach optimization of patients with allergic diseases and chronic EBV-infection. 89,6% out of 365 patients with allergic diseases were diagnosed with EBV- infection, 48,9% of whom were in active phase. Patients with allergic diseases and the active phase of EBV-infection were diagnosed with secondary immune disorders and had more intense clinical and diagnostic signs of hyper-reactivity. Regional features of allergen sensitizing profile and molecular endotypes of different allergic diseases nosologies were identified in patients with allergic diseases living in the Western regions of Ukraine and molecular prognostic models of personalized risk formation of persistent AR, intermittent AR and BA with the active phase of EBV-infection were created. It has been proved that conducting skin prick tests with highly standardized extracts is an accurate method for diagnosing sensitization to respiratory allergens with sensitivity of 95.4% and specificity of 98.8% in relation to multicomponent studies. The influence of EBV in immune and immune-dependent mechanisms of ARi and BA has been proven, which was more intense in patients with active phase of chronic EBV- infection by cytokine imbalance of IL-1β, IL-33, IL-17, IL-12, IL-10 and was confirmed by correlation of IL-12 with miR-146a; IL-33 with miR-155; AGEs with IL-33, IL-17; miR-BART-13 with FEV1, FeNO, of total IgE. A high efficiency of immune-modulatory antiviral therapy course in patients with ARi and BA with the active phase of chronic EBV-infection prior to ASIT was demonstrated, which proved the effectiveness of the latter regardless of the method of allergy vaccine. Subjective and immunological markers for monitoring the effectiveness of ASIT have been proposed. An algorithm for managing patients with ARi and BA with chronic EBV-infection has been developed.