medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2025-498medsovet-9655Research ArticleАЛЛЕРГОЛОГИЯ И ИММУНОЛОГИЯALLERGOLOGY AND IMMUNOLOGYСовременные возможности оценки IgE-опосредованной сенсибилизации и прогноза формирования десенсибилизации к белкам коровьего молокаModern possibilities for assessing IgE-mediated sensitization and predicting the formation of desensitization to cow’s milk proteinshttps://orcid.org/0000-0002-0716-3529ЛепешковаТ. С.LepeshkovaT. S.

Лепешкова Татьяна Сергеевна, д.м.н., доцент кафедры поликлинической педиатрии

620028, Екатеринбург, ул. Репина, д. 3

Tatiana S. Lepeshkova, Dr. Sci. (Med.), Associate Professor of the Department of Outpatient Pediatrics

3, Repin St., Ekaterinburg, 620028

levlpa@mail.ruhttps://orcid.org/0000-0001-5944-3365ВалентаР.ValentaR.

Валента Рудольф, д.м.н., профессор, иностранный член РАН, профессор Центра патофизиологии, инфектологии и иммунологии Института патофизиологии и аллергологии, Венский медицинский университет; 1профессор лаборатории иммунопатологии кафедры клинической иммунологии и аллергологии, Первый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)

1090, Австрия, Вена, ул. Шпитальгассе, д. 23; 119991, Москва, ул. Трубецкая, д. 8, стр. 2

Rudolf Valenta, Dr. Sci. (Med.), Professor, Foreign Corr. Member RAS, Professor of the Center for Pathophysiology, Infectiology and Immunology, Institute of Pathophysiology and Allergy Research, Medical University of Vienna; Laboratory of Immunopathology, Department of Clinical Immunology and Allergy, Sechenov First Moscow State Medical University (Sechenov University)

23, Spitalgasse St., Vienna, 1090, Austria; 8, Bldg. 2, Trubetskaya St., Moscow, 119991, Russia

rudolf.valenta@meduniwien.ac.athttps://orcid.org/0000-0003-3855-217XГарибВ. Ф.GaribV. F.

Гариб Виктория Фирузовна, д.м.н., профессор, научный сотрудник Центра патофизиологии, инфектологии и иммунологии Института патофизиологии и аллергологии, Венский медицинский университет; руководитель проекта, Международный центр молекулярной аллергологии, Министерство инновационного развития, Узбекистан

1090, Австрия, Вена, ул. Шпитальгассе, д. 23; 100174, Узбекистан, Ташкент, 2-я ул.Ташми, д. 2

Victoria F. Garib, Dr. Sci. (Med.), Professor, Research Fellow, Center for Pathophysiology, Infectiology and Immunology, Institute of Pathophysiology and Allergy Research, Medical University of Vienna; Project Manager, International Center of Molecular Allergology, Ministry of Innovation Development

23, Spitalgasse St., Vienna, 1090, Austria; 2, 2nd St. Tashmi Tashkent,100174, Uzbekistan

viktoriya.garib@meduniwien.ac.athttps://orcid.org/0000-0002-1930-5424КарауловА. В.KaraulovA. V.

Караулов Александр Викторович, академик РАН, д.м.н., профессор, заведующий кафедрой клинической иммунологии и аллергологии и заведующий лабораторией иммунопатологии

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Alexander V. Karaulov, Acad. RAS, Dr. Sci. (Med.), Professor, Head of the Department of Clinical Immunology and Allergy, Laboratory of Immunopathology

8, Bldg. 2, Trubetskaya St., Moscow, 119991

drkaraulov@mail.ruhttps://orcid.org/0000-0002-5250-7351КовтунО. П.KovtunO. P.

Ковтун Ольга Петровна, академик РАН, д.м.н., профессор, ректор 

620028, Екатеринбург, ул. Репина, д. 3

Olga P. Kovtun, Corr. Member RAS, Dr. Sci. (Med.), Professor, Rector

3, Repin St., Ekaterinburg, 620028

usma@usma.ruhttps://orcid.org/0000-0003-2485-2243БельтюковЕ. К.BeltyukovE. K.

Бельтюков Евгений Кронидович, чл.корр. РАН, д.м.н., профессор, профессор кафедры факультетской терапии, эндокринологии, аллергологии и иммунологии 

620028, Екатеринбург, ул. Репина, д. 3

Evgeny K. Beltyukov, Corr. Member RAS, Dr. Sci. (Med.), Professor, Professor of the Department of Faculty Therapy, Endocrinology, Allergology and Immunology

3, Repin St., Ekaterinburg, 620028

asthma@mail.ruhttps://orcid.org/0000-0002-3028-2657НаумоваВ. В.NaumovaV. V.

Наумова Вероника Викторовна, к.м.н., доцент, доцент кафедры факультетской терапии, эндокринологии, аллергологии и иммунологии

620028, Екатеринбург, ул. Репина, д. 3

Veronika V. Naumova, Cand. Sci. (Med.), Associate Professor of the Department of Faculty Therapy, Endocrinology, Allergology and Immunology

3, Repin St., Ekaterinburg, 620028

nika.naumova@gmail.comhttps://orcid.org/0009-0006-8510-0239ЗюзеваН. А.ZyuzevaN. A.

Зюзева Наталья Анатольевна, к.м.н., заместитель главного врача амбулаторно-поликлинической работы

620028, Екатеринбург, ул. Нагорная, д. 48

Natalia A. Zyuzeva, Cand. Sci. (Med.), Deputy Chief Physician for Outpatient Work

48, Nagornaya St., Ekaterinburg, 620028

natanat1308@yandex.ruУральский государственный медицинский университетРоссияUrals State Medical UniversityRussian FederationВенский медицинский университет; Первый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)АвстрияMedical University of Vienna; Sechenov First Moscow State Medical University (Sechenov University)AustriaВенский медицинский университет; Международный центр молекулярной аллергологии при Министерстве инновационного развитияАвстрияMedical University of Vienna; International Center for Molecular AllergologyAustriaПервый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)РоссияSechenov First Moscow State Medical University (Sechenov University)Russian FederationДетская городская клиническая больница №11 города ЕкатеринбургаРоссияChildren’s City Clinical Hospital No. 11Russian Federation202512122025020118129Copyright © Лепешкова Т.С., Валента Р., Гариб В.Ф., Караулов А.В., Ковтун О.П., Бельтюков Е.К., Наумова В.В., Зюзева Н.А., 20252025Лепешкова Т.С., Валента Р., Гариб В.Ф., Караулов А.В., Ковтун О.П., Бельтюков Е.К., Наумова В.В., Зюзева Н.А.Lepeshkova T.S., Valenta R., Garib V.F., Karaulov A.V., Kovtun O.P., Beltyukov E.K., Naumova V.V., Zyuzeva N.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/9655Введение

Введение. Белки коровьего молока (БКМ) при IgE-опосредованной пищевой аллергии нередко становятся причиной тяжелых анафилактических реакций. Для установления атопической природы симптомов требуется сбор клинико-анамнестических данных и проведение аллергологического исследования, которое сможет дать информацию о прогнозировании сроков формирования десенсибилизации и рисках повторных системных реакций.

Цель

Цель. Установить молекулярный спектр и уровень IgE-сенсибилизации к молочным протеинам и их пептидам на микрочипе Milk Allergen Micro-Array (MAMA) ImmunoCAP ISAC у детей, страдающих аллергией к БКМ (АБКМ); провести мониторинг показателей после продолжительной элиминационной диеты.

Материалы и методы

Материалы и методы. В проспективное когортное открытое исследование включены дети (n = 41, 31 мальчик и 10 девочек): 1-я группа – пациенты с персистирующей АБКМ, имевшие анафилаксию на БКМ в анамнезе (n = 20); 2-я группа – дети с АБКМ (n = 21) без системных реакций. Средний возраст 4,17 ± 2,14 лет. Проведены: сбор анамнеза, клинический осмотр, обследование на панели MAMA. Повторное измерение sIgE у двенадцати человек проведено через 18 мес. безмолочной элиминационной диеты. Результаты. На панели МАМА определен спектр и уровень sIgE к БКМ (n = 41): суммарные значения sIgE у детей с анафилаксией были достоверно выше (от 2,0 до 346,0 ISU-E), чем у детей без системных реакций (от 0,3 до 11,4 ISU-E) (р = 0,000). Высокая сенсибилизация хотя бы к одному основному протеину регистрировалась у детей с анафилаксией. Повторное исследование выявило пациентов с десенсибилизацией, которым можно вводить молочные белки.

Выводы

Выводы. Мультиплексная панель Milk Allergen Micro-Array (MAMA) ImmunoCAP ISAC может быть полезной в диагностике и мониторинге спектра и уровня сенсибилизации при IgE-зависимых формах АБКМ с момента постановки диагноза до формирования десенсибилизации и признаков клинической толерантности.

Introduction

Introduction. Cow’s milk proteins (CMP) often cause severe anaphylactic reactions in IgE-mediated food allergies. To establish the atopic nature of symptoms, it is necessary to collect clinical and anamnestic data and conduct an allergological study. Determining spectrum and levels of IgE sensitization can provide information in predicting timing of desensitization and risks of repeated systemic reactions.

Aim

Aim. Еstablish molecular spectrum and level of IgE sensitization to milk proteins and their peptides on Milk Allergen MicroArray (MAMA) ImmunoCAP ISAC microchip in children suffering from allergy to CMP; to monitor indicators after a long-term elimination diet.

Materials and methods

Materials and methods. Prospective cohort open study included children (n = 41, 31 boys and 10 girls): group 1 – with persistent CMP allergy, who had a history of anaphylaxis to CMP (n = 20); group 2 – children with CMP allergy (n = 21) without systemic reactions. Average age – 4.17 ± 2.14 years. Anamnesis collection, clinical examination and on MAMA panel examination were performed. Repeated measurement of sIgE in twelve people was carried out after 18 months of a dairy-free elimination diet.

Results

Results. Spectrum and level of sIgE to CMP were determined on MAMA panel (n = 41): sIgE values in children with anaphylaxis were significantly higher (from 2.0 to 346.0 ISU-E) than in children without systemic reactions (from 0.3 to 11.4 ISU-E) (p = 0.000). High sensitization to at least one major protein was recorded in children with anaphylaxis. A repeat study identified patients with desensitization who can be administered milk proteins.

Conclusions

Conclusions. Milk Allergen Micro-Array (MAMA) ImmunoCAP ISAC multiplex panel can be useful in diagnosing and monitoring of spectrum and level of sensitization in IgE-dependent forms of CMP allergy from moment of diagnosis until formation of desensitization and signs of clinical tolerance.

детипищевая аллергияпищевая анафилаксияаллергия к белкам коровьего молокааллергочип Milk Allergen Micro-Arraychildrenfood allergyfood anaphylaxiscow’s milk protein allergyMilk Allergen Micro-Array allergic chipДанное исследование финансировалось компанией HVD Biotech (Вена, Австрия), Медицинским университетом Вены (Австрия); грантом научного фонда Российской Федерации (№23-75-30016: «Оценка профилей аллергической сенсибилизации в Российской Федерации на основе микрочипов аллергенов как основа персонализированного лечения и профилактики аллергии (AllergochipRUS)» (Россия).This study was funded by HVD Biotech (Vienna, Austria), Medical University of Vienna (Austria); a grant from the Scientific Foundation of the Russian Federation (No. 23-75-30016: “Evaluation of allergic sensitization profiles in the Russian Federation based on allergen microarrays as a basis for personalized treatment and prevention of allergies (AllergochipRUS)” (Russia).ReferencesBertuzzi Z, Coco RR, Muraro A, Nowak-Węgrzyn A. 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The authors declare that there are no conflicts of interest present.