RELATIONSHIP OF ALLERGIC DISEASES, POLLEN EXPOSURE AND COVID-19 IN GEORGIA.

Allergic diseases have been recognized as one of the global health issues and affect about a third of the worldwide population. COVID-19 pandemic has raised concerns about the risk of infection and the severity of COVID-19 infection in patients with asthma and allergic rhinitis. The aim of our study was to define the relationships between pollen exposures and SARS-CoV-2 infection rates in Georgia, as well as to characterize the Covid-19 autoimmune and antiviral responses in Georgian allergic patients with different sensitization patterns. Data on daily COVID-19 positivity rates, case fatality rates, and pollen concentrations from February 2020 to November 2022 were collected in Tbilisi, Kutaisi, and Batumi. Diagnostic parameters, including total IgE, specific IgE, eosinophil counts, anti-nuclear antibodies, and Covid-19 antibodies, were assessed in 181 atopic patients and 24 healthy controls with confirmed SARS-CoV-2 infection. Laboratory findings revealed significant variations in eosinophil counts and total IgE levels among the groups. ANA positivity did not exhibit substantial differences between atopic patients and healthy controls. Individuals with indoor allergies displayed lower SARS-CoV-2-specific antibody levels, potentially explained by variations in adaptive immune responses. There was no correlation between pollen concentration and COVID-19 epidemiological characteristics, indicating that pollen had no effect on virus epidemiology.

EVALUATION OF ANTINUCLEAR ANTIBODIES IN GEORGIAN ALLERGIC PATIENTS POLYSENSITIZED WITH CROSS REACTIVE ALLERGENS.

Western countries have been challenged with an "allergy epidemic" during the last three to four decades. Interestingly, there has been a parallel increase in the incidence rates of several autoimmune disorders.The aim of our study was to evaluate antinuclear antibodies (ANA) in Georgian allergic patientspolysensitized with cross reactive allergens, in order to establish connection between allergic and autoimmune diseases in our population. Two groups of patients were included in the study: patients with atopy (group 1, n=97) and without (group 2, n=42).ImmunoCAPPhadiatop and ISAC assay platforms were used for atopy screening and polysensitization patterns evaluation. Screening for ANAs was performed by IIFA (Indirect Immunofluorescence assay) on HEp-2 cells. In general 67(69.1%) allergic patients were sensitized to at least one of the cross reactive allergen. Among allergic patients 26 (26.8%) tested positive for the presence of auto-antibodies; for non-allergic patient this value was only 1(2.4%). 18(26.9%) patients sensitized to cross reactive allergens showed positive results for ANA testing and 8(26.7%) allergic patient without cross allergen sensitization were positive for ANA. The AC-2 was only one detected pattern among non-atopic individuals (1/2.4%) and the most frequent pattern in allergic patients (19/73%). In the ANA positive group of allergic patients the atopic dermatitis (13/50%) and asthma (6/23.1%) were most frequently diagnosed. The occurrence of antinuclear antibodies is more frequent in atopic patients and associate mostly with asthma and atopic dermatitis phenotypes of allergic diseases. The most frequent coexisting ANA pattern is dense fine speckled pattern (AC-2).The occurrence of ANA antibody in atopic patients and its role in allergy remains the subject for future research.

CYPRESS POLLEN SESITIZATION IN GEORGIA: CLINICAL AND MOLECULAR CHARACTERISTICS.

Cypress pollen allergy is a widely distributed, highly prevalent and severe winter pollinosis that may be caused by several Cupresaceae species around the Mediterranean basin, in North America and Asia. Exposure to cypress pollen has increased steadily over the last few decades and the prevalence of allergy to cypress pollen has also dramatically increased from 0.6% to 9.8% in the general population and from 9% to 35% in allergic patients, probably because of the allergen load has become more intense. The objective of the study was to evaluate cypress pollen allergy in Georgia and describe clinical characteristics and the molecular profile of sensitization. Patients attended to allergy clinic with suspected cypress pollen allergy (n=492) were included in the study. Diagnostic workup was performed according to local guidelines, specific IgE antibody against cypress allergen was performed using ImmunoCAP and ISAC assay platform. The airborne pollen monitoring was performed with a Burkard Seven Day Volumetric Spore-trap (Burkard Manufacturing Co Ltd, UK) during the seasons of 2019-2020, following the recommendations of European Aerobiology Society. 37.2% of studied cases were positive to cypress diagnostic test. From cypress positive 183 patients only 17 patients (9.2%) had no symptoms during the cypress season. The most frequent symptoms were sneezing and ocular itching (82.9% of patients for both symptoms), rhinorrhea was reported in 77.7% of cases and dry cough and shortness of breath - only in 22.3% (each symptoms). More than half of frequent symptoms were reported as severe. The cypress positive patients were mostly co-sensitized to plant allergen components: grasses (nCyn d1- 61.5% of ISAC positive cases, rPhl p 1 -72.5%, rPhl p 5 - 46.8%), trees (rBet v 1 - 27.5%, nCry j 1 - 78.9%, nPla a 2 - 32.1%) and weeds (nAmb a 1 - 48.6%, nArt v 1 - 20.2%). Our data show that in Georgia, the prevalence of sensitization to cypress pollen in patients attending the allergy clinic is high (every third patient). The clinical symptoms predominantly associated with allergic rhinitis and atopic conjunctivitis, in most cases which are expressing by acute sneezing and ocular itching during the pollen season and all patients are poly-sensitized. This was the first study to give a detailed description of the clinical characteristics of cypress pollen allergic patients in Georgia.

2020 ARIA CARE PATHWAYS FOR ALLERGIC RHINITIS - GEORGIA.

Allergic rhinitis is the most common chronic disease worldwide. Treatment guidelines have improved the knowledge on rhinitis and have had a significant impact on AR management. In 20 years, ARIA has considerably evolved from the first multi-morbidity guideline in respiratory diseases to the digital transformation of health and care. Allergic rhinitis in Georgia, Next-generation ARIA-GRADE guidelines and ARIA, 2020 care pathways for Allergen Immunotherapy have been discussed in this review.