Evaluation of the spectrum of sensitization in children with bronchial asthma in Moscow and Moscow region

Abstract

Introduction. Chronic allergic respiratory inflammation triggered by contact with cause-significant allergens is the pathogenetic characteristic of atopic bronchial asthma. Identification of sensitization is essential for successful therapy of bronchial asthma.Aim. To study age-related changes in the spectrum of sensitization to allergens in children with bronchial asthma followed up in healthcare facilities of Moscow and Moscow region.Materials and methods. A total of 970 children aged 0 to 17 years 11 months residing in Moscow and Moscow region were include in the retrospective, cross-sectional, population-based study of the spectrum of allergic sensitization of bronchial asthma based on their medical records.Results. Total IgE was only assessed in 37.11% (n = 360) of patients from the study cohort of children with bronchial asthma, of which an elevated IgE level was identified in 81% of cases (292 children), suggesting the prevalence of the atopic bronchial asthma phenotype over non-atopic asthma phenotype. The analysis showed the changing patterns of allergen sensitization by age group. Most of the patients, irrespective of their age, showed sensitization to household allergens. In addition to household allergen sensitization, food sensitization was also reported in 36% in children under 4 years of age, which was the highest rate as compared to other age periods. Sensitization to household and pollen allergens was found to increase significantly as children age (p < 0.05). Cross-sensitization (to pollens produced from wind-pollinated plants) to food allergens was low, but increased from an early age up to 15-18 years. Allergic rhinitis (AR) is a very common comorbidity of asthma and accounts for 18% with a gradual increase in indicators by the age of 18. Children with concurrent asthma have almost the same incidence of developing atopic dermatitis up to age 18.Conclusions. The prevalence of sensitization to food allergens has been established in children with asthma residing in Moscow and Moscow region under 4 years old, and the prevalence of sensitization to household, pollen and epidermal allergens — over 5 years old, which should be taken into account when managing these patients.