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Keywords:

  • asthmatic patients;
  • cat, dog and mite allergens;
  • Russia;
  • sensitization;
  • specific IgE

Asthma is the most severe allergic disease. The majority of cases are associated with atopy, which is characterized by hyperproduction of total and specific immunoglobulin E (IgE) against common environmental allergens (1, 2). Major allergens and prevalence of sensitization in atopic patients vary in different populations, providing cues about the pathogenic effects of environment and lifestyle. In Russia, measurement of sensitization to allergen mixtures is a common clinical practice in patients with severe symptoms of allergic disorders. The data on the less common tests of individual allergens have not been systematically collected nor published in international journals and they are not accessible to scientists and clinical allergologists.

We therefore estimated the specificity and intensity of sensitization to 20 different airborne allergens in patients with atopic bronchial asthma from Tomsk (n = 67) and Thumen (n = 43), cities in west Siberia, Russia.

Participants were enrolled from databases of Tomsk and Thumen clinics. Nine (13.4%) and six (13.9%) patients from Tomsk and Thumen, respectively, refused to participate in the study for different reasons. Individuals aged 4–18 years were enrolled in the study on the basis of medical history of atopic bronchial asthma. Clinical specialists verified the diagnoses according to the Global Initiative for Asthma (GINA) protocol. A structured interview was performed with each participant (or his/her guardians), and a questionnaire about the clinical symptoms of asthma, nature of disorder manifestation and smoking habits was completed. The spirometric indexes were also taken into account when performing the diagnostics. All patients were noncognate and were not exposed to any intentional selection. The study was approved by the local Ethical Committee.

Blood samples were collected in April to May and in November to December of 2004 and in March 2005. Specific IgE was measured by the in vitro test system EUROLINE (EUROIMMUN, Medizinische Labordiagnostika GmbH, Lübeck, Germany), according to manufacturer's instructions. The groups were compared by Mann–Whitney U-test. The major allergen and important allergen were defined as those to which more than 50% and 30% of patients in a group were sensitized, respectively. The IgE distribution profiles and the level of sensitization were not significantly different in Tomsk and Thumen groups (P = 0.22–0.29); therefore, patients have been pooled in one group (n = 110).

Cat allergen (e1) was found to be the major allergen with 57.3% of Russian asthmatic patients sensitized to this allergen (Fig. 1). Other important allergens were Dermatophagoides pteronyssinus (d1), D. farinae (d2) and dog allergen (e2), with more than 30% of asthmatics sensitized.

image

Figure 1. Proportion (%) of Tomsk and Thumen (n = 110) asthmatic patients sensitized to airborne allergens in relation to the level of circulating IgE. Sensitization to moulds (m6 –Alternaria alternata, m3 –Aspergillus fumigatus, m2 –Cladosporium herbatum, m1 –Penicillium notatum), animals (e3 – horse, e2 – dog, e1 – cat), mites (d2 –Dermatophagoides farinae, d1 –D. pteronyssinus), weeds (w9 –Plantago lanceolata, w6 –Artemisia vulgaris, w1 –Ambrosia elatior), trees (t7 –Quercus alba, t4 –Corylus avellana, t3 –Bettula verrucosa, t2 –Alnus incana), and grass (g12 –Secale cereale, g6 –Phleum pratense, g3 –Dactylis glomerata, g1 –Anthoxantum odoratum) is shown. □ 0.35–3.5 kU/l, bsl00023 3.5–17.5 kU/l, ░ 17.5–50 kU/l, bsl00001 50–100 kU/l

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Very high reactivity to indoor allergens has been observed, while sensitization to outdoor allergens (moulds and plant-origin allergens) has been very low. The inclement climate of Siberia with a long winter period and low air moisture prevents accumulation of pollen and mould spore allergens in the air and decreases the possibility of sensitization. Cats and dogs are present in many of the Russian houses. Moreover, the transportability of cat and dog allergens on clothing (3) facilitates sensitization of asthmatics irrespective of pet-keeping at home directly (P > 0.05). Poor ventilation of homes may also contribute to accumulation of mite allergens in beddings and upholstered furniture, triggering atopic sensitization (4). Thus, very high reactivity to indoor allergens of asthmatic patients from west Siberia (Russia) seems to be a man-made problem and could be partly avoided by reducing risk allergen concentration at homes by frequent ventilation and cleaning of flats.

This is the first report on allergic sensitization in asthmatic patients from Russia. It shows the importance of cat, dog and dust mite allergens in maintaining the manifestations of asthma. Our data can serve as a baseline for future studies of risk factors in asthma development in Russia.

This work was supported by grants GACR 310/03/H147 and AVOZ50520514.

References

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