Журнал «Здоровье ребенка» 7 (58) 2014

Summary. The article represents the dynamical analysis of sensitivity to pollen at children for the past 21 year based on the results of specific skin tests on allergy. It had shown the reasonable changes in qualitative and quantitative composition of pollen sensitization spectrum. In recent years the structure of pollen sensitization of children in Lviv region with seasonal allergies had shown the significant increase of number of registrations of sensitization to specific allergen pollen of trees (birch, maple, alder, hazel, acacia, walnut, oak), herbs and grasses (corn, sunflower, hemp, foxtail, fenugreek) and weeds (dandelion, wormwood, quinoa, ragweed, tsykloheny).

Actuality. In recent decades, the prevalence of allergic diseases in children has been steadily increasing. In particular, it was recorded a large number of seasonal diseases that developed as a result of sensitization of the organism to pollen (hay fever). Today it is proved that the etiological structure of pollen sensitization can be characterized by significant regional differences. However, in the late years many studies, devoted to the study of sensitization of the population to spores have appeared. The latest researches have proven that the recourse to medical facilities on seasonal exacerbations of asthma had been often caused by increasing concentrations of spores than pollen.

Object. To study the dynamics of the etiological structure of seasonal allergies in children of Lviv region during the past 21 years (1990-2010 years) on the basis of specific skin allergy tests.     

Materials and methods. Research was conducted at the Lviv city Children's Allergy Center and two policlinic departments of the city. We have analyzed the results of allergy survey for 3107 children aged 5 to 18 years. Allergic survey included the collection of historical information and conducting specific allergy testing of pollen allergens of Russian ( “Allergen”, Stavropol) and of native (“Imunolog”, Vinnitsa) origins. To analyze, pollen allergens were divided into three groups, depending on the period of their peak flowering. The first group included trees - flowering which occur in spring. The second group included plants that bloom in summer, such as grass and cereal representatives. The third group consisted of weeds that pollen in autumn. We had analyzed the results only of extremely high rates of sensitization (hyper sensitization with 3 or 4 plus). For this research the children were divided into three age groups: 5-8 years, 9-12 years and 13-18 years.

Results. Among the children surveyed were 1930 (62 %) boys and 1177 (38 %) girls. In the trees group we analyzed results allergy skin test with such allergens: hazel, oak, birch, ash, alder, maple, poplar, walnut, willow, pine, chestnut, linden, elder, spruce, bird-cherry tree, hornbeam. The group of herbs and grasses has included the following allergens: rye, corn, hryastytsya, hemp, fescue, sunflower, foxtail, ryegrass, bent, pazhytnytsya, timothy, buckwheat, plantain. And the analysis of third group was based on such weeds as wormwood, dandelion, couch, cyklohena, stokolos, weeds, ragweed, bluegrass, nettles, sorrel.

The conducted studies revealed that the range of pollen sensitization during the observation period has significantly changed. In particular, the levels of hyper sensitization have increased to such plants such as corn, birch, maple, dandelion, sunflower, hemlock, hemp, quinoa, ragweed, alder, hazel, foxtail, acacia, fenugreek, walnut, oak, cyklohena, timothy. It was also noticed that the sensitivity of children to wheatgrass, hryastytsya, rye, bluegrass, ryegrass, fescue, ash had significantly reduced. In terms of the group the hypersensitivity increased to a group of trees and weeds, while hyper sensitization to grasses and cereals kept high throughout the period of observation. The threshold of sensitivity to rump, buckwheat and plantain remained relatively unchanged. However, this dynamic hypersensitivity was not linear because of the overall trends in individual sensitivity observed maximum and minimum peaks of hyper sensitization. It should be highlighted that the panel of pollen allergens during 21 years of research had slightly changed, so we used the data of a specific testing to allergens that were present in almost all the study period duration.

We studied the fungal sensitization only in 2009 and 2010. The structure of the allergens consisted of such fungi: Aspergillus, Cladosporium, Alternaria, Botrytis, Monilia, Renicilium. Among the various species of fungi in the context of seasonal allergies, most attention was paid to taxa of Cladosporium, Alternaria, as they occupied the largest share of atmospheric bio spray, and thus often cause exacerbation of seasonal allergic disease. The level of hypersensitivity to these fungal species for 2009 and 2010 remained high (30-20 %). Also, during this period significantly has increased susceptibility to the fungus Aspergillus, which is enlisted in the major Central European allergen range (from 16.46 % to 21.77 %).

Conclusions:

The etiologic factors of seasonal allergies in our region is pollen and fungal spores;

It was found the qualitative and quantitative changes in the structure of pollen sensitization of children within 21 years period of observation. Especially, significantly increased the frequency of registration of sensitization to pollen of trees: birch, maple, alder, hazel, acacia, walnut, oak, grasses and cereals: corn, sunflower, hemp, foxtail, fenugreek; weeds: dandelion, wormwood, quinoa, ragweed, cyklohena. At the same time, there is a tendency of reduce of the sensitivity to the pollen of certain trees (ash), herbs and grasses (hryastytsya, rye, ryegrass, fescue), weeds (couch, Tonkonog). In terms of group performance the hypersensitivity increased to a group of trees and weeds, while to grasses and cereals kept high throughout the period of observation;

During the 2009 and 2010 in the spectrum of fungal sensitization at high points we ​​recorded hypersensitivity to Cladosporium, Alternaria.