Identification of allergen-specific B-lymphocytes in patients with allergic diseases in the absence of specific IgE antibodies; [Определение аллерген-специфических В-лимфоцитов у пациентов с аллергическими заболеваниями при отсутствии специфических IgE-антител]

Introduction. Allergy diagnostics are based on patient history, skin and provocation tests, and the determination of specific IgE levels in serum. However, there are cases where patients exhibit symptoms of an allergic disease without detectable specific IgE to allergens, such as in local allergic rhinitis (LAR). Studying allergen-specific B-lymphocytes in such patients may help to accurately diagnose hypersensitivity. The aim of the study is to develop and optimize a method for detecting allergen-specific IgE+-B-cells in the blood of allergic patients. Material and methods. The study included 6 adult patients with birch pollen allergy, 1 patient with LAR and 5 healthy adult volunteers without allergic diseases. Enzyme-linked immunosorbent assay, basophil activation test (BAT), flow cytometry, and special protocols for staining and analyzing B-lymphocytes were used to develop and optimize the detection method. Results. It was found that patients with birch pollen allergy have detectable allergen-specific IgE+-B-lymphocytes during the pollen season. The patient with LAR also had identifiable specific B-lymphocytes, suggesting the potential involvement of these cells in the development of allergic reactions even in the absence of specific IgE in serum and basophil activation by Bet v 1 allergen in blood samples. Conclusion. The developed methods and approaches allow for more accurate diagnosis of allergic reactions, including cases where routine allergological examination methods do not detect specific IgE antibodies. Identifying allergen-specific IgE+-B-cells in patients’ blood opens new possibilities for studying the pathogenetic mechanisms of development and diagnosis of allergic diseases. © Коллектив авторов, 2024.