Sensitization to epidermal allergens in children with allergic disorders: a 30-year follow-up study

Aim: to analyze changes in sensitization to common epidermal allergens over time in children with allergic diseases in a metropolitan area. Patients and Methods: summary and analysis of 26,343 skin prick test protocols of children aged 4–18 years who were examined and treated between 1989 and 2019 were performed. A standard skin scarification test was used to determine an individual's sensitivity to common epidermal allergens, including feline, canine, sheep, and equine hair/epidermis, pillow feathers, and human hair, using a drop of water-salt allergen extract. To calculate the average exponents, i.e., the annual level and severity of sensitization, visual scoring (+1, +2, +3, +4) was used. This was done by calculating the percentage ratio of the number of patients with hypersensitivity to the allergen to the total number of patients examined for this allergen during a particular year. The proportion of low (1-2) and high (3-4) scores were also compared. Results: the cohort of allergic children was followed up for 30 years, during which there was a constant increase in IgE-hypersensitivity to epidermal allergens. Specifically, there was an 8.5-fold increase in sensitivity to feline hair/epidermis, with a 27.5-fold increase in the proportion of children scoring 3–4 points. Sensitivity to canine hair/epidermis increased by 5.2 times, while sensitivity to horse dander increased by 24%, sheep's hair by 23.7%, pillow feather by 2.7 times, and human hair by 2.8 times. Meanwhile, a retrospective analysis has shown a slowdown in the rate of increase in the number of sensitized patients and a decrease in the severity of specific hypersensitivity, mainly in the range of 1–2 points, over the last 15 years. Conclusion: the retrospective analysis indicates a progressive increase in epidermal sensitization to all studied allergens, with a general increase in the severity of hypersensitivity. This suggests an increase in close direct and indirect contacts with animals, as well as the potential effect of aggressive urban ecology on the immune balance of a growing child and the transformation of immunogenicity of animal allergens themselves. Given this, it is important to consider the efficacy of elimination measures and the choice of effective methods for preventing epidermal allergy. This includes the formation of immune tolerance to ensure reliable and long-term protection. KEYWORDS: animal allergens, epidermal allergy, children, sensitization monitoring, increased hypersensitivity; perspectives. FOR CITATION: Bardenikova S.I., Lokshina E.E., Dovgun O.B., Shavlokhova L.A., Bogdanova N.A., Serebrovskaya N.B., Mstislavskaya S.A., Kuznetsov G.B. Sensitization to epidermal allergens in children with allergic disorders: a 30-year follow-up study. Russian Medical Inquiry. 2024;8(3):118–123 (in Russ.). DOI: 10.32364/2587-6821-2024-8-3-1.