Lykova M. Hypersensitivity to dog allergens in patients with bronchial asthma and allergic rhinitis: prevalence, specific diagnosis and treatment

The dissertation work was completed at the department of phthisiology and pulmonology of the Shupyk National Healthcare University of Ukraine, in the clinic "Immunology and Allergology Forpost " LLC, Kyiv. The dissertation was devoted to solving the current problem of modern allergology - studying the prevalence of hypersensitivity (HS) to dog allergens among patients with respiratory allergic diseases (RA), determining the spectrum of sensitization to individual dog allergen proteins, developing a diagnostic algorithm for dog allergen proteins and evaluating the effectiveness of allergen-specific immunotherapy (AIT) in persons with allergic rhinitis (AR) and/or bronchial asthma (BA) with HS to dog allergens. At the first stage of the study, a retrospective analysis of sensitization profiles to allergenic proteins, including animals, among patients who applied to the clinic of allergology and immunology with signs of possible respiratory allergy pathology was carried out. The results of the ISAC multiplex test were analyzed in 553 people, who were divided by age into 3 groups: children aged 0-6 years, children aged 7-18 years and adult aged 19 years and older. Among patients with confirmed sensitization to dog allergens, the dependence of clinical symptoms on the profile of sensitization to individual allergenic proteins was established. At the second stage of the study, a prospective analysis of the spectrum of sensitization to individual dog allergenic proteins was performed among 102 patients with BA and/or AR and HS to dog allergens, confirmed by a skin prick test (SPT), and establishing the correspondence of the severity of BA and/or AR symptoms from the spectrum of sensitization to individual allergenic proteins of the dog. At the third stage of the study, an analysis of the 11 effectiveness of AIT with standardized dog allergens was performed in 23 people with BA and/or AR after the 1st year of treatment by evaluating the dynamics of clinical data and the level of specific IgG4 (sIgG4) to dog extract before treatment and one year after its initiation. The vast majority of patients with respiratory allergic diseases (73.3%) were sensitized to more than 3 allergenic proteins, 26.7% of people with sensitization from 1 to 3 components, and 59.3% - to more than 5 allergenic proteins. At the same time, the majority (63.4%) of the examinees were simultaneously sensitized to inhalation and food allergens.