| Abstract | Alergije ili atopijske bolesti spadaju u tip I preosjetljivosti koja se naziva neposredna (ili anafilaktička), a prouzročena je specifičnim IgE protutijelima koja su specifična za antigene iz okoliša. Atopijski dermatitis dio je atopijske trijade (atopijski dermatitis. alergijski rinitis i astma), ali može se pojaviti i samostalno. To je čest kožni poremećaj koji može biti prouzročen reakcijom kasne faze na alergen u koži. Astma je upalna bolest prouzročena ponavljajućom reakcijom neposredne preosjetljivosti i alergijskom reakcijom kasne faze u plućima koja prouzročuju razvoj kliničko patološke trijade koju čine povremena i reverzibilna opstrukcija dišnih puto,·a, kronična upala bronha s infiltracijom eozinofilima te hipertrofija glatkih mišićnih stanica bronha s pojačanom reakcijom na bronhokonstriktore. Danas je određivanje koncentracije ukupnog lgE, kao jednostavna i automatizirana metoda, sastavni dio postupka probira za osobe s atopijom. Nakon toga slijedi postupak identifikacije alergena koji su pokrenu) i alergijsku reakciju određivanjem specifičnog lgE u odnosu na moguće uzročne alergene na što su uputili SPT, anamneza i klinička slika pacijenta. Veoma je bitno bilo utvrditi imaju li osobe s astmom i AD-om veću učestalost alergijskih bolesti, odnosno imaju li veće koncentracije ukupnoga i specifičnog lgE u odnosu na osobe bez tih dijagnoza, a koncentracije ukupnoga i specifičnog IgE koreliraju s alergijskim bolestima Potvrđena je nulta hipoteza - utvrđeno je kako pacijenti s atopijskim dermatitisom ili astmom imaju više serumske koncentracije antitijela ukupnoga i specifičnog IgE u odnosu na kontrolnu skupinu ispitanika. Analizirajući rezultate u osobe s astmom i AD-om zajedno, kao i odvojeno, vidljivo je da imaju veće koncentracije ukupnoga i specifičnog IgE u odnosu na osobe bez navedenih dijagnoza. Značenje ovih rezultata u neposrednoj je vezi s činjenicom da su alergijske bolesti češće u osoba s AD-om i astmom nego u ostatku populacije. U usporedbi 234 pacijenta s astmom ili AD-om s istim brojem kontrolnih pacijenata, medijan za koncentraciju tigE bio je 1 1 7 (87,2 - 1 53,9), a za kontrolnu skupinu 44,35 (12,4- 133,0), dok je P < 0,000 1 . Kod 152 pacijenta s astmom medijan za koncentraciju tigE bio je 130,5 (97,4 - 177,3), a za kontrolnu skupinu istog broja pacijenata 49,4 (31,6- 68,4), dok je u usporedbi P<0,0001. U skupini od 82 pacijenta s AD-om medijan za koncentraciju tlgE bio je 80,5 ( 1 5 , l - 649,0), a za isti broj kontrolnih pacijenata 38,35 (9,0 - 134,0), dok je P = 0,0229. |
| Abstract (english) | Allergies or atopic diseases belong to type I hypersensitivity which is called immediate (or anaphylactic) and is caused by lgE antibodies that are specific for antigens from the environment. Atopic dermatitis, eczema, (AD) is a member of the atopic triad (atopic dermatitis, allergic rhinitis and asthma), but it can also occur alone. It is a frequent skin disorder that may be due to the late phase reaction to an allergen in the skin. Asthma is an inflammatory disease caused by repeated immediate hypersensitivity reaction and late-phase allergic reaction in the lungs that give rise to the development of clinico-pathological triad consisting of occasional and reversible airway obstruction, chronic inflammation of the bronchial tubes with eosinophil infiltration and hypertrophy of the bronchial smooth muscle cells with enhanced reaction to bronchoconstrictor agents. As a simple and automated method, determination of total IgE (tlgE) concentration is currently a component of screening in individuals with atopia. It is followed by identifying allergens that have initiated allergic reaction, which is done by determining a specific lgE in relation to potential causative allergens indicated by SPT, medica! history and patient's clinical data. It has been highly important to ascertain if individuals with asthma and AD have an increased frequency of allergic reactions, i.e. whether they have higher totaJ - and specific IgE levels when compared to
individuals without such diagnoses since totaJ and specific lgE concentrations are correlated with allergic diseases. Zero hypothesis has been confirmed: it has been established that patients with atopic dermatitis or asthma have higher serum total - and specific IgE antibody concentrations as compared to the control group. On analyzing results in individuals with asthma and AD or one of these diseases, it was evident that they have higher total- and specific IgE levels in relation to individuals without those diagnoses. The importance of these results is directly associated with the fact that allergic diseases are more frequent in individuals with AD and asthma than in the rest of population. On comparison of 234 asthma or AD patients with the same number of control subjects, the median obtained for tlgE concentration was 1 17 (87.2-153.9) in the patient group and 44.35 (12.4 - 1 33.0) for the control group, while P<0.0001 . In 152 asthma patients, the tlgE concentration median was 1 30.5 (97.4-177.3), and in the same number of control subjects it was 49.4 (31 .6-68.4 ), P<0.0001 . In the group of 82 AD patients, the tlgE concentration median was 80.5 (15.1 -649.0), and it was 38.35 (9.0-134.0) for the same number of control subjects, with P=0.0229. |
