RESUMEN
Background: Fungi are known for their ability to cause allergies, but data on individual sensitization to them are insufficient. The purpose of the study was to carry out a comprehensive analysis of the fungal allergens' sensitization profile in the Ukrainian population and to determine both population and individual sensitivity to these allergens. Methods: We utilized a set of ALEX allergy test data from 20,033 inhabitants of 17 regions of Ukraine from 1 to 89 years conducted in 2020-2022. A complex of programs in the Python language was developed and Bayesian network analysis was applied to determine the sensitivity combinations in individual patients to various fungal components. Results: Sensitivity to Alt a 1 dominated and was observed in 79.39% of patients, and 62.17% of them were sensitive solely to Alt a 1. Exclusive sensitivity to Mala s 6 was second in individual patient profiles with a frequency of 4.06%. Combined sensitivity to Alt a 1 - Asp f 3 was third with a share of 3.28%. Pen ch and Cla h extracts stimulated the production of the lowest median sIgE levels. The highest median sIgE levels were for Alt a 1, Mala s 11 and Asp f 6, respectively. Median sIgE levels increased in adults compared to children for all components of Aspergillus fumigatus, as well as for Mala s 5 and Mala s 11. In the rest of the cases, they decreased in adults compared to children. The sensitization rates to fungi in general and specifically to Alternaria were lower in the western parts of Ukraine, especially in the Carpathian region, situated within the Broad-leaved Forest zone. The results of Bayesian modeling revealed that in the case of Alt a 1, the simultaneous absence of sensitivity to Cla h 8, Mala s 11, Mala s 5 and Mala s 6 molecules could condition the presence of sensitization to the major Alternaria allergen with a probability of 92.42%. In all other cases, there was a high probability of absence of sensitivity to particular allergen against the background of absence of sensitivity to other ones, which may indicate the independent development of sensitization to different fungal allergens. Conclusions: Sensitivity to Alt a 1 dominated in the studied population with a lower rate in the western regions. The highest median sIgE levels were induced by Alt a 1, Mala s 11 and Asp f 6. Bayesian Analysis suggest a high probability of the independent development of sensitization to different fungal allergens. The idea that sensitization to one allergen may be protective against sensitization to another one(s) requires further clinical study.
RESUMEN
BACKGROUND: The allergenicity of pollen of Poaceae family members is a well-known and confirmed fact. Using the data of component-resolved molecular diagnostics of allergy, we set a goal to establish the population and individual characteristics of sensitization to grass pollen and assess the patterns of its development. METHODS: Multiplex allergy Alex2 test results of 20,033 patients were used. In addition to descriptive statistics to uncover traits of the sensitized population, statistical inference was utilized to establish the conditional probability of sensitisation, the nature of links between allergens, and the most frequent combinations of allergens in individual patient profiles. RESULTS: Sensitivity to grass pollen comprised 30.79% of the studied sample. Children accounted for 62.21%, adults-37.79%. Sensitisation to Phl p 1, Lol p 1, and Cyn d 1 was the most frequent in all age groups. Among them, Phl p 1 and Lol p 1 were the major ones. Phl p 2, Phl p 5.0101, and Phl p 6 were also responsible for primary sensitization; Phl p 5.0101 promoted the highest sIgE levels. A combination "Lol p 1-Phl p 1", where Lol p 1 might play a leading role, was most frequent in individual profiles. Monosensitization to Phl p 2 was the second most frequent and Bayesian Network suggested its independent development. Monosensitization to Cyn d 1, especially among children, may indicate the impact of climate change, promoting the spread of the subtropical grasses to the temperate region. CONCLUSIONS: Descriptive statistics and known clinical data coincide well with statistical inference results and can provide for new clinical insights.
RESUMEN
House dust mite (HDM) allergens are considered to be one of the most common causes of asthma and allergic rhinitis in the world. Cysteine proteases Der p 1 and Der f 1 (group 1) and also NPC 2 family proteins Der p 2 and Der f 2 (group 2) of D. pteronyssinus and D. farinae respectively are considered the main allergens of HDMs. The difference in the sensitivity of the population to these and other allergy causing components of HDM determines the treatment strategy. Thus, the purpose of this work was to determine the pattern of sensitization of the Ukrainian population to individual allergy causing molecular components of HDM in order to improve treatment strategies for the HDM allergy in various regions of Ukraine. To determine the molecular profile of sensitization to HDM, the data of multiplex allergy test Alex2 have been obtained from 10,651 patients. The sample included 57.86% children under the age of 18 and 42.14% adults. A Python language-based statistical analysis was performed, in order to group patients by sensitization to individual molecules and their combinations, regarding the age and geographical location of the patients. Simultaneous sensitization to Der f 2 and Der p 2 allergens was the most common among the entire group Simultaneous sensitization to 5 molecules-of group 1 (Der p 1 and Der f 1), group 2 (Der f 2 and Der p 2), and Der p 23-was the second most common for entire dataset and for the children group. This pattern differed in adults, where monosensitization to Der p 23 occupied the second position, suggesting that this molecule is an important factor of HDM allergy in Ukraine. Of the 16 analyzed regions, sensitization to Der p 23 prevailed in 2 Western regions of Ukraine. In the rest of the regions combination of Der p 2 and Der f 2 was the most prevalent. The established character of population sensitization to HDM in Ukraine is a good prognostic marker of allergen immunotherapy (AIT) efficacy.