Molecular Approach to Optimal Choice of Specific Immunotherapy for Patients with Sensitization to Weed Pollen Allergens

Abstract

Abstract Introduction: The problem of pollen allergy, particularly pollen of weeds is urgent for the population of Western Ukraine, including Lviv region. Aim: To compare possibility of SPT and component diagnostics for the selection of appropriate specific immunotherapy. Materials and Methods: Forty eight patients of both sexes, aged 23.0±2.7 years, residents of Lviv region with seasonal allergic rhinitis / conjunctivitis, were selected according to primary stay in the first week of August of the current year. SPT to extracts of pollen allergens from local sources was performed, including a mixture of weeds, grasses and extracts of mugwort, ragweed, timothy ("Immunologist", Ukraine). Immuno CAP (Thermo Scientific, Uppsala, Sweden) was used for molecular investigations of sIgE. Results: Positive SPT to weed mixture, extracts of ambrosia, ragweed and grass mixtures was found in 50% of patients. This indicated co-sensitization to various sources of allergens; 29.2% of patients had monosensitization to weed pollen, and 20.8% – monosensitization to grass pollen. However, simultaneous sensitization to pollen of mugwort, ragweed and timothy was not proven by molecular investigations. Instead, it was found that 20.8% of patients had sensitization to ragweed and mugwort, 29.2% of individuals – monosensitization to ragweed, and 20.8% – monosensitization to mugwort. Most (70.8%) patients with monosensitization to weed pollen had specific IgE to Art v1 and/or Art v3, and / or Amb a1. False positive results of SPT indicated that co-sensitization to grasses and weeds can be explained by the presence of sIgE for cross-reactive markers of profilin Phl p 12 and polcalcin – Phl p 7. Conclusion: Based on SPT and molecular investigations the doctor makes a fundamentally different decision on the selection of extracts for specific allergen immunotherapy. Optimal allergic immunotherapy is based on identification of primary sensitizer and cross-reactivity markers.