Estudio epidemiológico observacional para la determinación del perfil de sensibilización molecular a alérgenos perennes y estacionales en pacientes alérgicos (adultos y niños) de Mallorca

Abstract

Introduction: The mucosal surface of the airways and more specifically the nasal fossa, represents the first line of defence against different environmental agents. It should present an effective and appropriate response, as an imbalance at this level could be the origin of allergic rhinitis. The overall immune system is highly complex. An inappropriate and disproportionate response, caused by an allergen, triggers a hypersensitivity reaction, giving rise to allergy symptoms. The principal allergens are: dust mites, pollens and fungal spores. The current incidence rate of allergic rhinitis in our environment is approximately 23% of the population and is increasing. The limited information existing in relation to this pathology in Mallorca warrants the development of the present doctoral thesis. In conjunction with the clinical history, the diagnosis is based on the Prick Test (SPT) and/or the measurement of specific IgE levels, both in relation to the total allergen extract. Recently, the component resolved diagnosis has been incorporated into the test panel in order to determine the molecular profile of patients. Objectives: The study objective is to determine the allergic patients’ molecular profile, in relation to both seasonal and perennial allergens. A study was also undertaken of the correlation between the molecular profile and the type and severity of the allergic disease, the impact of panallergens, the risk factors associated with the most prevalent sensitisations and the degree of association between the different allergens. Material and methods: An epidemiological, cross-sectional study has been conducted with principal variables collected prospectively. Samples from 101 patients between the ages of 7 and 60 years have been analysed. All patients included in the study had respiratory allergy symptoms and a positive Prick Test. A study was undertaken of each patient’s molecular profile, determining the specific IgE in relation to the allergen panel included in the study. All statistical analyses were conducted using SAS® 9.3 software. Results: Determination of the molecular profile shows that the most prevalent sensitisations were Der p 2 (53.5 %), Der f 2 (52.5%), Der p 1 (44.4%), Der f 1 (41.4%), Lep d 2 (21.2%), Ole e 1 (44.3%) and Phl p 1 (34.3%). Conclusions: Molecular diagnosis reduces the number of patients sensitised to a specific allergen, which has very relevant therapeutic implications, especially in polysensitised patients. The discordant results between both diagnostic methods leads us to suspect that the results obtained by skin tests do not correspond with the actual sensitisation in these patients.