Erythrocyte antigens as immunogenetic markers of respiratory atopic diseases in Georgians.

The aim of this study was to investigate the role of erythrocyte antigens of several systems (ABO, Rh, MNSs, P, Duffy, Kell) in the predisposition to and development of respiratory atopic disease (RAD) in the Georgian population. Two hundred and ninety-three patients with RAD, 83 patients with intrinsic bronchial asthma (IBA) and 215 healthy subjects were included. Associations between blood groups and RAD (atopic bronchial asthma [ABA] and pollinosis), the severity of the disease and the type of sensitization were established, involving the ABO, MNSs and Duffy systems. The groups at higher risk for the development of RAD were carriers of phenotypes O(I), MN, O(I)MN, MNFya(-), O(I)Fya(-) and O(I)MNFya(-). Resistance to RAD was associated with phenotypes A(II), AB(IV), N, Fya(+) and B(III)N. Markers for ABA and pollinosis were also revealed. Allergy to house dust allergen was associated with phenotype MN, whereas pollen sensitization was associated with the M group of MNSs. The risk for the development of severe ABA was higher in patients with B(III), M and B(III)M phenotypes. For the patients with groups O(I) and MN, a mild to moderate degree of severity of ABA was more characteristic. In healthy Georgians, erythrocyte polymorphism was not associated with immune status. In cases of house dust allergy, erythrocyte antigen P1 was associated with high levels of IgE. In patients with RAD higher B-lymphocyte counts were associated with O(I) and lower counts with A(II).

Local humoral immunity in patients with pollen allergy.

All classes of immunoglobulins and albumin have been studied in different phases of disease, both in blood and in the nasal secretions of 75 patients with pollen allergy. There were 20 healthy persons in the test group. Total correlational analysis was done to determine interdependence of the researched indexes. The percentage of local synthesis of immunoglobulins in the nasal secretion was calculated with the help of Donovan's formula. The results obtained allowed us to find out that the local origin was responsible for 74% of total IgE, 97% of IgA and 10% of IgG in the nasal secretion in patients with pollen allergy. While comparing the results of skin tests with RAST, both in blood and in the nasal secretion, a positive coincidence was found considering the results of skin tests and RAST in serum in 93.8% cases, and in the nasal secretion in 91% of the cases. Coincidence between negative skin tests and the results of RAST in serum was as high as 89% of the cases. In some cases with negative skin test, specific IgE to the corresponding pollen allergens was found in the nasal secretion. In most of the cases there was correlation between allergen specific IgE in blood and in the nasal secretion in the phase of remission (88% of cases) and in the phase of exacerbation (100%). Total and allergen specific IgE in the nasal secretion can be widely used to diagnose allergy "in vitro".

Comparative estimation of general and local humoral immunity indicators in connection with local immunotherapeutic treatment.

All classes of immunoglobulins in blood and in the nasal secretions of 75 patients were studied in different phases of disease. There were 20 healthy persons in the control group. Forty patients were treated by preseasonal local immunotherapy through the application of water-salt extracts of pollen allergens intranasally, with the help of drops and aerosol during 2 years. It was found that the patients had a high level of total IgE in the nasal secretion, both in the phase of remission and especially in the phase of exacerbation, though the concentration of IgE in the nasal secretion, on the whole, was several times lower than in serum. Quantification of the level of IgE in the nasal secretion can be recommended to diagnosis allergy, "in vitro". The level of sIgA in the nasal secretion of the patients with pollen allergy was lower in comparison with the test group of healthy persons, being most remarkable in the phase of exacerbation. Patients with pollen allergy had a heightened level of IgD in blood with a marked reliability in the exacerbation phase. IgD was not detected in the nasal secretion. Local immunotherapy was found to have a high effectiveness of 80% after one course of treatment, and nearly 95% success with two courses. Therefore, we consider that local immunotherapy should be widely used. With the background of the local immunotherapy there were changes in the concentration of immunoglobulins, mainly in the nasal secretion of the immunoglobulins. IgE in the nasal secretion was lowered to a great extent after two courses of treatment. sIgA after local immunotherapy had a tendency to increase considerably after two courses of treatment. The increase of sIgA level and the lowering of IgE in the nasal secretion can be considered as immunologic criteria of local immunotherapy effectiveness.

[Study of the HLA and IgE systems in healthy persons and in patients with allergies of the respiratory tract]. / Issledovanie sistemy HLA i IgE u zdorovykh lits i bol'nykh allergozami dykhatel'nykh putei.

The purpose of the paper is to study the association of HLA-antigens and serum levels of IgE in healthy persons and patients with allergic diseases of the respiratory tracts in Georgian population. Research showed the association of the HLA-system and genes controlling serum levels of IgE. The association of comparatively low levels of IgE with antigens HLA-A11, B35, Cw4, and of a raised level with B7 and Cw2 antigens was established in healthy subjects. Healthy persons carrying antigen B7 and residents of the endemic zone of ragweed spreading formed a group at high risk of developing hyper-IgE response and ragweed pollinosis. Production of specific IgE antibodies was clearly correlated with certain HLA-antigens whereas the association of the HLA-system with total IgE levels was less marked and was revealed at comparatively low (less than 213.55 kU/l) or at significantly raised (over 433.41 kU/l) levels of total IgE. Development of hyper-IgE response (over 1000 kU/l) was associated with HLA-A3 (RR = 2.2; delta = 0.21).