Analysis of the sensitization spectrum in patients with severe allergic diseases using the ImmunoCAP ISAC method

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Abstract

BACKGROUND: An important advance in modern allergology has been made by the introduction of allergenic molecules/components, including their detection by the ImmunoCAP ISAC method. This method is useful in patients with a complex spectrum of sensitization and severe forms of allergic diseases, where various predictors of severe course are actively searched for.

AIM: To evaluate the informativeness of component resolved diagnostic by ISAC ImmunoCAP method in patients with severe bronchial asthma and severe atopic dermatitis.

MATERIALS AND METHODS: A single-center retrospective study was conducted from January to August 2023. 100 patients who were candidates for biologicals for severe bronchial asthma (group 1; 63 patients), severe atopic dermatitis (group 2; 20 patients), or their combination (group 3; 17 patients) were included. Component restlved diagnostic was performed by ImmunoCAP ISAC method.

RESULTS: Polysensitization and high occurrence of food and fungal allergens were more frequently detected in the groups of patients with severe atopic dermatitis. When analyzing the pollen sensitization spectrum in groups 2 and 3, Bet v 1 and PR-10 family cross-linked molecules (Mal d 1, Pru p 1, Ara h 8, Gly m 4, Cor a 1.04), as well as Ole e 9, Cyn d 1, Ph p 1 and Par j 2 were the most common. Epidermal allergens were common in all three groups. Lipocains (Can f 1, Can f 4, Can f 6, Ecu q 1, Mus m 1), kallikreins (Can f 5), and albumin (Fel d 2) dominated among them. The presence of sensitization to household allergens was detected only in group 2 and only to the molecule Der p 23. Among fungal allergens, the allergen Asp f 6 was predominant in the groups with severe atopic dermatitis, and the component Alt a 1 in patients with severe bronchial asthma. Among food allergens, one of the most common allergens was the molecule Gad c 1, Gal d 1, Gal d 2, Gal d 5 and Bos d 6.

CONCLUSION: Component resolved diagnostic is an accurate assay suitable for determining the spectrum of sensitization in patients; its result can serve as a distinct biomarker for severe allergic diseases.

About the authors

Daria S. Fomina

Moscow City Hospital 52; The First Sechenov Moscow State Medical University (Sechenov University); Astana Medical University

Email: daria_fomina@mail.ru
ORCID iD: 0000-0002-5083-6637

MD, Cand. Sci. (Med.), Associate Professor

Russian Federation, Moscow; Moscow; Astana, Republic of Kazakhstan

Marina S. Lebedkina

Moscow City Hospital 52

Author for correspondence.
Email: marina.ivanova0808@yandex.ru
ORCID iD: 0000-0002-9545-4720
Russian Federation, Moscow

Ekaterina A. Nikitina

Moscow City Hospital 52; The First Sechenov Moscow State Medical University (Sechenov University)

Email: katrin88866@gmail.com
ORCID iD: 0000-0002-0865-8355
Moscow; Moscow

Alexander D. Dushkin

The First Sechenov Moscow State Medical University (Sechenov University); Moscow Cancer Hospital

Email: alex@drdushkin.ru
ORCID iD: 0000-0002-8013-5276

MD, Cand. Sci. (Med.)

Russian Federation, Moscow; Moscow

Anton A. Chernov

Moscow City Hospital 52

Email: sbornaya1med@yandex.ru
ORCID iD: 0000-0001-6209-387X

MD, Cand. Sci. (Med.)

Russian Federation, Moscow

Yulia D. Yukhnovskaya

The First Sechenov Moscow State Medical University (Sechenov University)

Email: yukhyuliya@yandex.ru
ORCID iD: 0000-0002-0928-2054
Russian Federation, Moscow

Mariana A. Lysenko

Moscow City Hospital 52; The Russian National Research Medical University named after N.I. Pirogov

Email: gkb52@zdrav.mos.ru
ORCID iD: 0000-0001-6010-7975

MD, Dr. Sci. (Med.), Professor

Russian Federation, Moscow; Moscow

Alexander V. Karaulov

The First Sechenov Moscow State Medical University (Sechenov University)

Email: drkaraulov@mail.ru
ORCID iD: 0000-0002-1930-5424

MD, Dr. Sci. (Med.), Professor

Russian Federation, Moscow

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2. Fig. 1. Prevalence of sensitization to pollen allergy components in each group. Note. тАтД ― severe atopic dermatitis; тБА ― severe bronchial asthma.

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3. Fig. 2. Prevalence of sensitization to epidermal allergy components in each group. Note. тАтД ― severe atopic dermatitis; тБА ― severe bronchial asthma.

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4. Fig. 3. Prevalence of sensitization to food allergy components in each group. Note. тАтД ― severe atopic dermatitis; тБА ― severe bronchial asthma.

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5. Fig. 4. Level of significance of allergy components from the ISAC ImmunoCAP panel.

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6. Fig. 5. Prevalence of molecules in the group of patients with a combination of allergic rhinoconjunctivitis, bronchial asthma and atopic dermatitis.

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7. Fig. 6. Level of significance of allergic components from the ISAC panel in patients with a combination of allergic rhinoconjunctivitis, bronchial asthma and atopic dermatitis.

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8. Fig. 7. Correlation analysis of clinical and epidemiologic data in group 1. Note. тБА ― severe bronchial asthma; БА ― bronchial asthma; ОФВ1 ― forced expiratory volume in 1 second; ИМТ ― body mass index; ГЭРБ ― gastroesophageal reflux disease; ХОБЛ ― chronic obstructive pulmonary disease; АРК ― allergic rhinoconjunctivitis; ХПРС ― chronic polyposis rhinosinusitis; ХСК ― chronic spontaneous urticaria; ХИК ― chronic induced urticaria; ИПА/ППА ― true/cross food allergy; Комбо АтД ― comorbid atopic dermatitis; Неперенос НПВС ― intolerance to non-steroidal anti-inflammatory drugs; БытА ― household allergens; ЭА ― epidermal allergens; ГА ― fungal allergens; ПА ― food allergens; ПыльцА ― pollen allergens.

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9. Fig. 8. Correlation analysis of clinical and epidemiologic data in group 2. Note. тАтД ― severe atopic dermatitis; АД ― atopic dermatitis; БА ― bronchial asthma; ОФВ1 ― forced expiratory volume in 1 second; ИМТ ― body mass index; ГЭРБ ― gastroesophageal reflux disease; ХОБЛ ― chronic obstructive pulmonary disease; АРК ― allergic rhinoconjunctivitis; ХПРС ― chronic polyposis rhinosinusitis; ХСК ― chronic spontaneous urticaria; ХИК ― chronic induced urticaria; ИПА/ППА ― true/cross food allergy; Комбо АтД ― comorbid atopic dermatitis; Неперенос НПВС ― intolerance to non-steroidal anti-inflammatory drugs; БытА ― household allergens; ЭА ― epidermal allergens; ГА ― fungal allergens; ПА ― food allergens; ПыльцА ― pollen allergens.

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10. Fig. 9. Correlation analysis of clinical and epidemiologic data in group 3. Note. тАтД ― severe atopic dermatitis; тБА ― severe bronchial asthma; БА ― bronchial asthma; ОФВ1 ― forced expiratory volume in 1 second; ИМТ ― body mass index; ГЭРБ ― gastroesophageal reflux disease; ХОБЛ ― chronic obstructive pulmonary disease; АРК ― allergic rhinoconjunctivitis; ХПРС ― chronic polyposis rhinosinusitis; ХСК ― chronic spontaneous urticaria; ХИК ― chronic induced urticaria; ИПА/ППА ― true/ cross food allergy; Комбо АтД ― comorbid atopic dermatitis; Неперенос НПВС ― intolerance to non-steroidal anti-inflammatory drugs; БытА ― household allergens; ЭА ― epidermal allergens; ГА ― fungal allergens; ПА ― food allergens; ПыльцА ― pollen allergens.

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