Halushko B. House dust mite sensitisation in children with persistent allergic rhinitis and the effectiveness of anti-mite allergen-specific immunotherapy

This thesis is devoted to allergic rhinitis in children sensitised to house dust mite allergens. Allergic rhinitis (AR) is an important medical and social problem because of its high prevalence and negative impact on the quality of life of children, as well as a significant economic burden on the health care system. House dust mites (HDM) are the most important allergens, ahead of mould and pet allergens, in terms of their involvement in respiratory allergy. Given the impossibility of complete eradication of house dust mites from the environment, achieving long-term remission of the disease in such patients requires a comprehensive evidence-based approach using basic symptomatic pharmacotherapy and allergen-specific immunotherapy based on modern capabilities of accurate molecular allergy diagnostics. The aim of the study is to optimise the treatment of persistent allergic rhinitis in children by determining the exact sensitisation to individual molecules of HDM allergens, establishing the features of the clinical course and differentiated use of basic therapy and anti-HDM allergen-specific immunotherapy. Objectives of the study: 1. To investigate the spectrum of HDM sensitisation in children of different ages with allergic pathology and persistent allergic rhinitis based on the results of accurate molecular allergy diagnostics. 2. To determine the features of the clinical course and the spectrum of sensitisation to house dust mite allergens by means of accurate molecular allergy diagnostics, taking into account the severity of persistent AR in children. 3. To evaluate serum total and specific immunoglobulin E to HDM allergens in children with persistent AR and its combination with bronchial asthma, taking into account the age and severity of AR. 4. To monitor the level of nitric oxide in exhaled air in children with persistent allergic rhinitis and sensitisation to certain molecules of house dust mite allergens, taking into account the severity of AR. 5. To evaluate the effectiveness of treatment and three-year history in children with persistent allergic rhinitis caused by sensitisation to house dust mite allergens using basic and allergen-specific immunotherapy with allergoids.