Local manifestations of cross food allergy in children with clinical symptoms of respiratory allergy to birch pollen: solutions

Abstract

Introduction. According to modern data, Oral Allergy Syndrome (OAS) is most often formed by patients sensitized to the birch family: up to 73% of patients allergic to birch experienced OAS. 86% of them experience their oral symptoms year-round, which significantly affects the quality of life of these patients. The effectiveness of AIT in the treatment of respiratory allergy symptoms is beyond doubt, while the effect on the manifestations of cross-food allergies requires additional study.Objective. To study the clinical effectiveness of the formation of oral tolerance to fruits and vegetables under the influence of allergen-specific immunotherapy (ASIT) with the allergen Staloral® “Birch pollen allergen” (Stallergenes Greer, France).Material and methods. The study (prospective open comparative longitudinal) included 184 patients with respiratory allergy to birch pollen aged 5 to 16 years with confirmed sensitization to the major molecule (Bet v 1). Children of the main group (n = 134, 7.0 [5.0; 9.0] years) had OAS. Children from the comparison group (n = 50, 7.0 [6.0; 10.0] years) did not have OAS. A clinical examination, general clinical and allergological examinations were carried out for each child. Component allergy diagnostics was performed using a multiplex panel (ISAC-112, ImmunoCAP) for children with OAS (n = 40) who had multiple manifestations of cross-food allergies. Patients of both groups (n = 184) received a three-year course of AIT with the allergen Staloral® “Birch pollen allergen”.Results. In patients with OAS, it was possible to achieve the formation of oral tolerance (total or partial) to fresh vegetables and fruits in 88.81% (n = 119, p = 0.000). There was a decrease in the intensity and duration of respiratory allergy symptoms during the pollination season, and the need for pharmacotherapy after a three-year course of AIT Staloral® “Birch pollen allergen” in children of both groups.Conclusions: three-year AIT with the allergen Staloral® “Birch pollen allergen” is able to form oral tolerance in children with cross food allergies to PR-10 proteins of vegetables and fruits.

Keywords

• children
• oral allergy syndrome
• allergen-specific immunotherapy