Sensitization to cat allergens in children with bronchial asthma

Abstract

Asthma is a global medical and social problem of pediatrics, which is due to its significant impact on the quality of life of patients and economic losses. Most children have an atopic asthma phenotype, with early clinical manifestations, atopic background, family atopic history, sensitization to aeroallergens, eosinophilic inflammation, and bronchial hyperreactivity. In each case of asthma in a child, it is important to predict the clinical course of the disease and the effectiveness of its therapy. In the era of precision medicine, endotypes of asthma have been characterized, which make it possible to personalize more effective therapeutic approaches. Thus, determining the molecular profile of sensitization plays a key role in predicting clinical symptoms and severity of asthma, as well as developing recommendations for preventing allergens and optimizing therapy. It is the allergy to cats that is the main trigger of asthma all over the world and ranks second among all aeroallergens. To date, a large number of cat allergens have been studied. Among them, first of all, the following main clinically significant major and minor allergens are distinguished as Fel d 1 (uteroglobin), Fel d 2 (serum albumin) and Fel d 4 (lipocalin). The main sources of allergens in cats are saliva, dander and perianal glands. Dry saliva and dander from cat hair spreads as small airborne particles into the environment and can cause sensitization. All cats produce enough allergens to be considered clinically significant. The profile of sensitization to molecular allergens in cats is individual; however, its relationship with the development of asthma in children is still insufficiently studied. Although it would be most advisable to avoid contact with the animal, this is not possible often. In addition, the indirect effect of animal allergens occurs in areas where animals do not live. Allergen-specific immunotherapy is a potential solution to this problem, although further evidence for its effectiveness in children is needed.

Keywords

• cat allergens, asthma, children, molecular diagnosis of allergy, review