STUDY OF THE EFFICIENCY OF ALLERGEN IMMUNOTHERAPY IN PATIENTS WITH ALLERGIC RHINITIS

Allergen immunotherapy is one of the effective treatments for many allergic diseases. The principle of allergen immunotherapy is to achieve tolerance to causative allergens. The effectiveness of allergen immunotherapy depends on the correct diagnostic approach, the quality of the vaccine and patient compliance. This article presents the analysis of the effectiveness of the allergen immunotherapy using sublingual and subcutaneous methods of administration in patients with allergic rhinitis. The study group consisted of 236 patients with allergic rhinitis, 126 (53.4%) female and 110 (46.6%) male individuals aged 32.6 ± 2.4 years. Clinical and laboratory data collection, instrumental, cytological, specific allergological studies (total IgG4, skin prick-tests, molecular studies ALEX) were carried out. The efficacy of the аllergen immunotherapy was assessed by a combined symptom medication score. According to the results of skin prick-tests, it was determined that 163 (69.0%) people had polysensitization, 61 (25.8%) individuals had monosensitization, and 12 (5.2%) had negative skin prick-tests. ALEX component studies were performed for 52 people. The most common major components found were Phl p 1, 69.2%, Lol p 1, 57.7%, Der f 2, 48.1%, Der p 2, 42.3%, Bet v 1, 34.6 %. Minor components Phl p 7, Phl p 12 were detected in 9 (17.3%) patients. According to molecular studies, the prognostic efficiency of the аllergen immunotherapy was defined as high in 41 people and as average in 9 people; 86 patients with allergic rhinitis took the allergen immunotherapy: 37 people by sublingual route, and 49 people by subcutaneous methods. There was a significant decrease in the overall assessment of symptoms, medication needs, and a comprehensive assessment that did not depend on the method of administration of the allergy vaccine. Comparative analysis of total IgG4 levels before and in the third year of the allergen immunotherapy showed only a tendency to increase (p = 0.492). The component-resolved diagnosis plays an important role in choosing a treatment strategy for patients with allergy and predicting the efficacy of the allergen immunotherapy. Allergen immunotherapy, regardless of the methods of its introduction, shows high clinical efficacy in patients with allergic rhinitis that was confirmed by the criteria of combined evaluation. Assessment of total IgG4 levels has not had a reliable diagnostic value as a biomarker of the immunological response to the allergen immunotherapy.