Slyuzar Z. Efficacy of allergen-specific immunotherapy for bronchial asthma in school-age children, sensitized to house dust mites

Objects: bronchial asthma in school-age children; frequency of detection of tick sensitization in school-age children with bronchial asthma, based on the analysis of skin allergy testing and determination of specific IgE to major and minor components of allergens of house dust mites; allergen-specific immunotherapy, dynamics under the influence of treatment of clinical symptoms, spirometric parameters, quality of life, level of IL-13, IFγ in blood serum; goal: to increase the effectiveness of treatment of bronchial asthma in school-age children sensitized to house dust mites with the use of various methods of ASIT; methods: general clinical (history taking, physical examination, filling out individual observation cards of patients); instrumental (computer spirometry involving a test for reversibility of bronchial obstruction); enzyme-linked immunosorbent assays (determination of IL-13 and IFγ levels); allergological (skin allergy testing, molecular diagnosis of allergies with determination of specific IgE to major and minor components of Dermatophagoides pteronyssinus); acarological (research of samples of house dust); questionnaires (quality of life assessment and Asthma - Control - Test (ACT)); statistical methods (parametric and non-parametric methods, correlation, logistics, variance and cluster analyses, calculation of odds ratio, diagnostic value, measures of statistical agreement, testing the hypothesis of frequency equality); results: based on a retrospective analysis of the results of allergy testing in 904 children in Lviv aged 6–17, patients with bronchial asthma. It was found that the structure of their sensitization (p <0.05) is dominated significantly by household allergies (73.23%), in particular, sensitization to allergens of house dust mites Dermatophagoides pteronyssinus, which was found in 94.1% of children with household allergies. An acarological study of house dust was carried out in the premises of Lviv, where schoolchildren with bronchial asthma live. A high concentration of mites was found in 64% of homes, and the numerical and species predominance of Dermatophagoides pteronyssinus was established. Updated scientific data on the possibilities of molecular diagnosis of allergy, based on the increase of specific IgE over 0.35 kU / L to major components of allergens Der p1 and Der p2, confirmed the leading role of allergens Dermatophagoides pteronyssinus in the development of tick allergy in schoolchildren with bronchial asthma. On the basis of a significant increase in the controllability of bronchial asthma, quality of life of patients, speed parameters of respiratory function and reduction of basic treatment, the feasibility of using ASIT in schoolchildren with bronchial asthma has been scientifically substantiated. Scientific data on the possibilities of immunological monitoring of the effectiveness of ASIT has been expanded, a significant increase in IFγ in the case of sublingual ASIT has been established, which can be regarded as an activation of the process of switching the immune response from Th-2 to Th-1 indirectly, which illustrates the positive effect of such treatment. The latter has been introduced to health care institutions and universities in the field of pediatrics.