The purpose - to determine the profile of sensitization to house dust mite (HDM) in children of Ukraine with various allergic diseases and to analyze its age and regional characteristics. Materials and methods. 5430 children aged from the first year to 18 years from different regions of Ukraine with allergic diseases (allergic rhinitis, bronchial asthma, atopic dermatitis alone or in combination) were examined. The diagnosis of allergic diseases was established according to the criteria of GINA 2019a, ARIA 2019, EAACI Atopic dermatitis guidelines. Patients were examined by molecular component enzyme-linked immunosorbent assay of venous blood with the ALEX2 test system (Macro Array Diagnostics GmbH, Austria). Levels of specific IgE above 0.3 kUA/L to allergenic molecules of HDM were determined: Der f 1, Der f 2, Der p 1, Der p 2, Der p 5, Der p 7, Der p 10, Der p 11, Der p 23, Der p 20 and Der p 21. Results. Among 5430 subjects, sensitization to HDM allergens was detected in 1705 (31.4%) children. Sensitization to HDM allergens was most often observed in school-age children (34.3-40.0% of cases; p<0.001). Sensitization to allergens of HDM was significantly more often found in children of the western region compared to the northern (χ²=171.2; p=0.001), southern (χ²=32.4; p=0.001), eastern (χ²=65.9; p=0.001) and the central (χ²=16.62; p<0.002) region of residence. The most common sensitization to Der f 1 (58.4%), Der f 2 (73.7%), Der p 1 (58.4%), Der p 2 (75.2%), Der p 23 (56.2%), and there was a high level of sensitization to the molecules Der p 5 (32.4%) and Der p 7 (22.3%). Conclusions. Currently, the level of sensitization to allergens of HDM among children with allergy in Ukraine is on average 31.4%. Sensitization to HDM allergens was more frequent (p<0.001) in school-age children compared to preschool children - 37.0% and 24.2%, respectively. Sensitization to HDM allergens predominates among children with allergopathology living in the western regions of Ukraine (42.5% of patients) compared to the eastern, southern, central and northern regions (26.8-35.4% of children). The frequency of sensitization to major molecules of HDM in children with allergy in Ukraine is: to Der f 1 - 58.4%, to Der f 2 - 73.7%, to Der p 1 - 58.4%, to Der p 2 - 75.2%, to Der p 23 - 56.2%. For the first time, the level of sensitization to new HDM molecules in children with allergopathology in Ukraine was established: to Der p 20 - 8.2%, to Der p 21 - 27.2%. The study was conducted in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local Ethics Committee for all participants. Informed consent of patients (parents of children or their guardians) was obtained for the research. No conflict of interests was declared by the authors.
Relevance. In recent years, there has been a significant increase in the number of allergic diseases among the population. In patients with allergic conditions in the presence of indications, allergists are increasingly prescribing allergen-specific immunotherapy. This necessitates the search for new accurate tools and markers for forecasting and evaluating its effectiveness. At present, methods of monitoring the effectiveness of allergen-specific immunotherapy are largely based on the assessment of the clinical condition of patients through questionnaires and provocative trials. Promising in this direction is the study of the role of IgG4 in the development of tolerance to allergens, and the mechanisms by which this protective function is realized. Particularly important are pathological reactions to food, which can be mediated not only by IgE, but also by IgG-associated circulating immune complexes. Therefore, it is important to study the role of IgG in the development of food intolerance and the possibility of using an elimination diet based on the identification of specific IgG to food in such patients. Objective: to summarize the literature and the results of own studies of IgG antibodies in the diagnosis of allergic conditions and control of allergen-specific immunotherapy. Methods. Search in international scientometric databases PubMed, Scopus, etc. by keywords. Search depth - 10 years (2011-2021). IgG determination was performed by FOX test (Food Xplorer Macro Array Diagnostics GmbH, Austria), enzyme linked immunosorbent assay (ELISA). Results. A review of the literature revealed studies that found an association between increases in IgG4 levels and a decrease in allergy in patients receiving allergen-specific therapy. Also, a significant number of studies attribute the important role of IgG in the development of food intolerance, in which a high-efficiency elimination diet based on excluded products to which specific IgG is detected. Conclusions. IgG is an antibody with unique biological properties, which plays an important role in the mechanisms of occurrence and course of a number of diseases, including those related to allergies. As a result, IgGs have great diagnostic potential. The existing problem of lack of objective diagnostic methods that would assess the effectiveness of allergen-specific immunotherapy in the early stages and predict the patient's condition in the future, could be solved by introducing the determination of IgG4 levels in general clinical practice. It is also important to determine food-specific IgG in patients with food intolerance, the content of which we determined using the FOX test. Various studies have established the effectiveness of a diet based on the elimination from the diet of foods to which specific IgG has been detected. Compared to the uncontrolled intake of symptomatic drugs and various unjustified dietary restrictions, this diet has significant therapeutic and economic benefits.
The annual increase in the number of allergic diseases among children and adults determines the search for safe and effective medicine for the treatment of allergies. Today, cetirizine is one of the most well-known antihistamines, which is the «gold standard» in the symptomatic treatment of allergies. It quickly relieves allergy symptoms by entering into a competitive blockade with histamine in 20 minutes after ingestion due to high selectivity for H1$receptors. The most effective is the use of this medicine in allergic manifestations such as sneezing, rhinorrhea, tearing, skin rash. One of the main advantages of cetirizine is high safety, which allows the use it in pediatric practice from 6 months age, and numerous studies confirm this. No conflict of interest was declared by the authors. Key words: Cetirizine, antihistamines, allergy, H1-receptors, allergic rhinitis, urticaria.
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