D2.30 - Combined sensitization among patients with allergic rhinitis and bronchial asthma: changes during the war in Ukraine

The purpose of the present study was to investigate the characteristics of combined sensitization to allergens of various origin in patients with allergic diseases under wartime conditions.

   An analysis of multicomponent allergy diagnostics test was conducted among patients with allergic rhinitis and bronchial asthma. The sensitization profiles of 1,742 patients before the onset of the war in Ukraine and 1,010 patients after the start of military actions (2023–2024) were examined. Special attention was paid to determining the prevalence of co-sensitization to fungal allergens, as Ukrainian studies have shown that rocket explosions increase the concentration of Alternaria alternata spores in the air.

Overall, among the population of patients with allergic diseases, sensitization to the following groups of allergens was recorded: pollen – 91.4% of patients (95% CI: 90.2%–92.6%, p<0.001), household allergens – 85% (95% CI: 83.4%–86.6%, p<0.001), food allergens – 81.8% (95% CI: 80.1%–83.5%, p < 0.001), epidermal allergens – 81.8% (95% CI: 80.1%–83.5%, p<0.001), and fungal allergens – 75% (95% CI: 73.0%–77.0%, p < 0.001). After the start of military actions, an increase in the number of patients sensitized to mold (Alternaria alternata) was observed. Among 37% of patients sensitized to tree and grass pollen, sensitization to the mold was simultaneously detected (95% CI: 34.4%–39.6%, p<0.05 ).

The prevalence of co-sensitization to fungal allergens increased among patients sensitized to:

● Weed allergens (most notably in patients sensitized to ragweed allergen Amb a 1, from 52% [95% CI: 48.5%–55.5%, p<0.001] to 75% [95% CI: 72.1%–77.9%, p<0.001] before and during the war).

● Epidermal allergens (most notably in patients sensitized to cat allergen Fel d 1, from 36% [95% CI: 33.0%–39.2%, p<0.001] to 48.1% [95% CI: 45.2%–51.0%, p<0.001]).

● Food allergens (most notably in patients sensitized to melon allergen Cuc m 2, from 20% [95% CI: 17.1%–22.9%, p<0.05] to 26.9% [95% CI: 23.5%–29.8%, p<0.05]).

Compared to pre-war data, the prevalence of co-sensitization to fungal allergens (Alternaria alternata) has increased during the wartime period in Ukraine. These findings underscore the necessity of comprehensive diagnostics of allergic diseases using multicomponent testing to develop effective preventive and therapeutic strategies, including hypoallergenic diets to prevent cross-allergic reactions.