Biomarkers of oral fluid after oral-pharyngeal provocative test with allergen for the diagnosis of atopic bronchial asthma
Vitebsk State Medical University, Vitebsk, Belarus
Aim of study: Determination of changes in the enzymatic activity of the oral fluid under the influence of an allergen through an oral-pharyngeal test with the allergen mite Dermatophagoides pteronyssinus for the diagnosis of allergy. Material and methods. The study included 27 patients with allergic asthma and 15 healthy patients without allergy pathology. Oral-pharyngeal challenge test with the allergen mite Dermatophagoides pt was performed on all study participants. In the oral fluid taken after 30 minutes and 24 hours, the level of tryptase, eosinophilic cationic protein, myeloperoxidase and neutrophilic elastase were determined byELISA.
Results. The level of tryptase increased in patients with allergic asthma after 30 minutes to 7 .98 ng / ml and returned to normal after 24 hours. The diagnostic criterion for level of tryptase 7,87 ng / ml. An increase in the level of eosinophilic cationic protein (ÅÑÐ) was detected in 23 (86%) patients after 30 minutes. Before provocation, the level ofECP was 678.9 [580.2; 777.6] pg / ml, and after provocation 829.6 [697.9; 961.2] pg / ml, ð 0.003. The level of myeloperoxidase in patients with asthma was significantly higher than in healthy ones and amounted to 112.5 [91.5; 133.4] ng / ml and 100.2 [88.7; 109.4] ng / ml, respectively (ð = 0.04). The diagnostic criterion for level of myeloperoxidase after 30 minutes is 99 ng / ml and after 24 hours- 97 .3 ng / ml. The determination of the increase in the level of neutrophil elastase after conducting à oralpharyngeal provocative test with an allergen has à diagnostic value only after 24 hours and the criterion according to the calculations ofROC analysis is 34.15 ng / ml. In patients with atopic bronchial asthma, the mean level ofK + in the oral fluid before provocation was 65.8 ± 2.37 mg / 1, and after - 76.5 ± 1.92 mg / l. The diagnostic criterion for level of Ê+ after 30 minutes was 72 mg / 1.
Conclusion: The determination level of enzymes in the oral fluid after à provocative oral-pharyngeal test is à non-invasive àïd informative method for diagnosiïg allergic diseases of the upper respiratory tract. The increase in blomarkers indicates à specific hypersensitivity of COPR to the allergen.