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Allergic rhinitis and bronchial asthma are widespread respiratory allergic diseases. In some territories of the Russian Federation, the dominant cause of pollinosis is ragweed. The aim of the study was to evaluate the clinical and immunological efficacy of ASIT with the allergen Ambrosia artemisiifolia in patients sensitized to Ambrosia trifida in the Samara region. Patients with proven sensitization to Ambrosia trifida was held immunotherapy with Ambrosia artemisiifolia allergoid preseason. After treatment, patients had a decrease in the severity of symptoms of allergic rhinitis according to VAS (p = 0.00001), a decrease in the need for medications (p = 0.0003), as well as the need for corticosteroids against the background of therapy from 34.6% to 0% (p = 0.00001). In 8% of cases, the result of treatment was good, in 69% satisfactory, in 23% unsatisfactory. In the control group, there were no changes in the severity of symptoms (p = 0.858). Also, in the control group, the need for medications remained unchanged and 14.3% of patients continued to use corticosteroids.After ASIT, there was a decrease in the level of IL-4 (p = 0.002), and a decrease in the ratio of IL-4/ IL-10 (p = 0.0063); at the same time, changes in the level of other cytokines (IL-10; IFNγ) were statistically insignificant (p > 0.05). Before treatment, the levels of IL-4/ IL-10 in both groups were comparable, and after treatment, the differences became statistically significant (p = 0.031). We did not get a statistically significant change in the level of IgG4 Amb a 1 or IgG4 Amb trifida. There was no correlation between the level of individual cytokines and the results of treatment. As a result of the conducted ASIT, positive clinical and immunological results were obtained. In most patients, the disease has acquired a controlled course. At the same time, the lack of excellent and low number of good results of ASIT is probably due to the intraspecific allergenic properties of ragweed.

Aim: to assess the dynamics of mold sporulation in Samara to predict the risk of allergy development and exacerbation. Patients and Methods: mold spore samples were collected from April 1 to September 30 in 2016–2019 using trap impactor and placed on slides coated with Vaseline-wax mixture. Mold spores were calculated and referred to various taxa. Allergy risks were predicted. Thresholds for evoking asthma are estimated to be 100 spores/m3 for Alternaria and 3,000 spores/m3 for Cladosporium. Results: in Samara, average mold vegetative period was 164 days. Cladosporium and Alternaria spores were identified. Their spores were estimated as 34.4% of total atmospheric spores in Samara. Cladosporium spores estimated as 15.3% of total fungal spores were identified during the whole observation period. Maximum concentration was less than 960 spores/m3 having been within the average range. Alternaria spores were estimated as 19.1%. The proportion of days exceeding the threshold value of 100 spores/m3 was 6% to 81% having been the highest in July-September. Conclusion: prerequisites for the development of fungal sensitization were revealed. Regional specificity of sporulation in Samara was illustrated. Major mold taxa were identified. Allergy risks in Alternaria and Cladosporium sensitization were assessed. The highest total average monthly amount of Alternaria spores was during Artemisia and Ambrosia pollination season. This could be challenging for the diagnosis and treatment of patients suffering from allergic symptom exacerbations during this period. Our findings will improve the diagnosis, treatment, and prevention of allergic disorders in Samara. KEYWORDS: aerobiological monitoring, allergy, mold spores, Cladosporium, Alternaria, fungal sensitization. FOR CITATION: Mazokha K.S., Manzhos M.V., Khabibulina L.R. et al. Important issues of fungal sensitization: aerobiological aspects. Russian Medical Inquiry. 2021;5(1):4–9. DOI: 10.32364/2587-6821-2021-5-1-4-9.

It is considered that Ambrosia trifida is not widespread in Russia, thereby avoiding its threatening effects to populational health. However, there are some areas in Russia where more than half of land area is covered by Ambrosia trifida. Many such foci are found in the Samara, Orenburg regions, Tatarstan and Bashkiria. Ambrosia trifida is distributed in Central Russia, the North Caucasus region and Siberia. The objective of the study was to examine specific IgE-profile in ragweed sensitized patients in the Samara region. A clinical and allergy examination of 969 patients with allergic rhinitis was performed. Allergic diagnostics was performed by using skin testing (prick-test) with standard set of pollen, household, and epidermal allergens. The data of skin tests in patients co-sensitized with ragweed and Artemisia allowed to analyze IgE-antibodies specific to the major Ambrosia (Amb a 1, Аmb. trifida) and Artemisia (Art v 1) allergens. Patients with negative skin test for the Amdrosia artemisiifolia and clinical manifestations of seasonal allergy were assessed for level of sIgE-antibodies nAmb a 1 and Amb trif. Skin test data demonstrated that seasonal and combined forms of allergic rhinitis dominated in patients examined. In particular, positive skin test data for pollen allergens dominated (50.6%) among all allergen groups so that more than half of them belonged to weed pollen allergens. Patients challenged with skin tests for Artemisia and ragweed allergens more likely displayed positive reaction to the Artemisia allergen (71.27%) and Ambrosia artemisiifolia (50.88%). Co-sensitization (to Artemisia and ragweed) prevailed in this geographic region featured with equal rate of simultaneously detected sIgE specific to the two types of ragweed and artemisia (nAmb a 1 + nArt v 1 + Amb trif) as well as Ambrosia trifida and Artemisia (Amb trif + nArt v 1). Almost half of the patients with negative Ambrosia art. prick-test were found to bear sIgE specific to Amb trif. Further investigation will help to better understand this phenomenon and take a fresh look at diagnostics and treatment of ragweed allergy in relevant geographic area.

Background. Pollinosis (hay fever) is a widespread disease in Russia. Often the cause of pollinosis is allergens of weeds, among which ragweed (Ambrosia artemisiifolia, Ambrosia trifida) and wormwood predominate. The purpose of the study was to evaluate the spectrum of sensitization to different types of ragweed in Samara, as well as the effectiveness of allergen immunotherapy, depending on the patient’s IgE profile. Materials and methods. Sensitisation to weeds was evaluated retrospectively based on the results of skin prick-tests. The determination of allergocomponents (Amb a 1 and Аmb.trifida) was carried out using the ImmunoCAP ISAC diagnostic test system (Sweden). Patients with confirmed sensitization to ragweed tridividual and lack of IgE to Amb a 1 were treated with allergen immunotherapy with ragweed allergoid preseason. Results. More than half of the patients suffering from pollinosis in Samara are sensitized to ragweed. In case of negative CP with the allergen Ambrosia artemisiifolia, positive IgE-AT to ambrosia are detected in 79.5 % of cases. Against the background of allergen immunotherapy during the ragweed flowering season, most patients noted an improvement in their condition. At the same time, there were no excellent results of allergen immunotherapy. Conclusions. A comprehensive examination for different types of ragweed, a study of IgE-AT to Ambrosia trifida for the diagnosis of ragweed pollinosis is necessary. When conducting allergen immunotherapy with the ragweed allergen, the patient’s IgE profile and the effect of different types of ragweed on the results of immunotherapy should be taken into account.

Aim. To determine the regional characteristics of the pollen spectrum of the air environment by the end of the five-year monitoring; to create the pollen calendar of allergenic plants in Samara, Russia. Materials and methods. Pollen was sampled using the volumetric method with a self-engineered pollen impactor into glass slides, covered with a mixture of petrolatum and wax. The pollen grains were counted and classified according to the systematic groups. Results. IIn 2013 the Samara urban air basin contained pollen of 21 taxa (12 woody taxa and 9 herbaceous taxa); in 2014 - 20 taxa (13 woody and 7 herbaceous); in 2015 - 20 taxa (12 woody and 8 herbaceous); in 2016 - 21 taxa (13 woody and 8 herbaceous); in 2017 - 18 taxa (10 woody and 8 herbaceous). During the five-year survey the dominant taxa were ragweed (24.3%), poplar (12,0%), birch (11.5%), pine (7.5%), maple (6.3%), elm (6.3%), nettle (5.8%), willow (4.8%), Gramineae (4.7%), and wormwood (3.7%). 10 dominant taxa were determined, which formed from 90% to 95% of the annual pollen volume. The prevailing taxa varied considerably from year to year by specific weight. Only three pollen species were present in the spectrum annually in the amount of more than 4% of the annual amount: poplar, birch and ambrosia pollen grains. Conclusion. Regional features of aeropalynological situation was revealed and pollen calendar of allergenic plants in Samara was created.

Background. Purpose - to study the dynamics of anthesisin two parts of the city with different plants structure, the selection of the dominant taxa, calendaring of anthesising plants for Samara city. Methods. Pollen was captured by the gravimetric method, on glass slides, covered with a special mixture. In the obtained preparations pollen grains were counted and identified their belonging to different systematic groups. Results. In 2013 there were registered 21 taxons - 12 wood and 9 herbaceous, in 2014 - 20 taxa - 13 wood and 7 herbaceous in the air basin of Samara city. Birch pollen (16%), ambrosia (15%), poplar (11%), maple (10%), cereals (9%), pine (8%), willow (8%), nettle (6%), Artemisia (4%), Chenopodiaceae (4%),were dominated representing 90% of the pollen spectrum. Conclusion. Regional features of palinological spectrum in Samara city was revealed.

Background. The objective was to study the taxonomic diversity of the concentration of pollen, its changes and peculiarities of the course of seasonal allergic rhinitis in Samara city. Methods. Pollen was located with gravimetric method on the glass, covered with a special mixture. Clinical and allergological examination conducted among 775 children aged from 5 to 18 years and 692 adults with symptoms of rhinitis. Results. Registered three periods of increase of concentration of pollen: spring period, summer period and summer-autumn period. The major taxa in the spring was pollen Populus - 49% and Betula - 27% during this period. In the summer period dominated pollen was Pinus - 37%, Poaceae - 28% and Betula - 22%. In summer-autumn period prevailed pollen grains Ambrosia - 63% and Artemisia - 10%, of the total number of pollen grains for this period. Clinical and allergological studies have shown that the proportion of patients with seasonal allergic rhinitis is 78% among the total number of patients with allergic rhinitis. Isolated form of seasonal allergic rhinitis was diagnosed in 22% of children and in 20% of adults. Patients of this group are allergic to pollen, weeds and compositae revealed in 68%, trees - 20%, cereals - 12% of cases. Conclusion. Qualitative and quantitative composition of aeropalynologic spectrum was established and showed the peculiarities of the course of seasonal allergic rhinitis in Samara city.

The basic results of clinical researches on efficacy and safety studying sublingual allergenspecific immunotherapy (slASIT) are presented in the review. The results of SUBLINGUAL application of allergens in Russian Federation are presented.

Background. The purpose of this study was to investigate the prevalence and incidence of allergic rhinitis (AR) and bronchial asthma (BA) among different groups of population of Samara region during 2001—2010. Methods. Material for analysis was taken from the statistic forms of municipality hospitals of Samara and the Samara region (form No. 12) during 2001—2010 in comparison with the corresponding indicators of Volga federal region (PFO) and the Russian Federation. Results. Prevalence of BAin all groups of patients in the Samara region in 2009 was revealed. These indicators were more than such indicators in Russian Federation — among children on 25%, in teenagers on 38%, in adult on 50%. Prevalence of AR among children and teenagers exceeded indicators in Russian Federation — among children on 44%, teenagers — on 68%. The incidence of asthma in adults is 2,5 times higher than the incidence of AR (95,8—30,5 per 100 thousand). Conclusion. High prevalence of AR and asthma in the Samara region with a tendency to increase, the discrepancy indices studied data from epidemiological studies that require further implementation of international recommendations for diagnosis, treatment and prevention of AR among general practitioners.

Background. The purpose of the work was to investigate remote and preventive results of sublingual allergenspecific immunotherapy (SLiT) at pollinosis patients. Methods. 25 patients at the age from 19 till 50 years old with an allergic rhinitis and asthma (35%) sensitized to artemisia were under the supervision. SLiT was administered in the period since September 2003 till May 2006 with pollen allergen («Sevapharma», Czech Republik). The average total dose of the allergen per one patient at the end of the third year was 189999 PNU. Clinical efficiency was estimated annually and in 30 months after discontinuation of SLiT. Frequency and intensity of symptoms during the pollen season, requirement for medicines, FEV1 parameters and results of prick tests were considered. Results. good and excellent results after three courses of immunotherapy demonstrated 23 patients (92%), satisfactory - 2 patients (8%). The results were remained at 22 patients (88%) within the next 30 months. at 3 patients (12%) increase of rhinoconjunctivitis symptoms was noted, and 3 (12%) showed expansion of a sensibilisation spectrum. Further increase of intensity and frequency of asthma symptoms, decrease in indicators FEV1 was not registered. Conclusion. SLiT is a highly effective method of treatment for patients with seasonal rhinitis and leads to the clinical results remaining more than 2 years at the majority of patients.

The aim of the Study. The aim of the study was to investigate the prevalence of bronchial asthma (BA) in various age groups among the urban and rural population of Penza region. Materials and Methods. A questionnaire-based screening was performed among 4212 schoolchildren aged between 7 and 14 and 2150 adults aged between 20 and 60 in Penza. Respectively, 2195 and 3193 patients of the same age groups were tested in rural settlements. Allergic diagnostics was carried out by means of the skintesting method applying the standard set of allergens (household, pollen and epidermal). Results. The prevalence of AR among the juveniles aged 7 and 13 was respectively 2,7 and 5,9 % in Penza; 2,3 and 4,3% in rural settlements. The prevalence among the adults was 5,7-3,6%, which several times outnumbers the indexes of the official statistics. The atypical form of BA prevailed. The sub-diagnosis of the disease was conditioned by the light form of BA with weak symptomatic manifestations prevailing among the patients under study. Conclusion. It is necessary to improve the measures on primary diagnosis and treatment of BA, which shall considerably increase the efficacy of the therapy employed and improve the prognosis of the disease.

Background. To study the influence of sublingual allergen-specific immunotherapy (slASIT) on dynamics of immunologic parameters in patients with pollinosis. Materials and methods. 40 healthy persons and 25 pollinosis patients received slASIT course with mixt of autumn grasses allergen. IgA, IgM, IgG, IgE antibodies, slgA, albumin in saliva and IgA, IgM, IgG, IgE antibodies, total IgE, IFN-γ, IL-4 in serum were investigated. Results. Patients with pollinosis have infringements of both local and general immunity. SlASIT changes a profile of cytokines aside Th-1, stimulates formation of the secretory allergen-specific antibodies, reduces IgE antibodies in saliva. Conclusion. SlASIT is a highly effective method of allergic diseases treatment and it induces B-cellular and T-cellular tolerance.