perinatologyРоссийский вестник перинатологии и педиатрииRossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics)1027-40652500-2228Ltd. “The National Academy of Pediatric Science and Innovation”10.21508/1027-4065-2025-70-1-5-10perinatology-2132Research ArticleПЕРЕДОВАЯEDITORIALДостижения и перспективы молекулярной аллергодиагностики в педиатрииAchievements and future prospects of molecular allergy diagnostics in pediatricshttps://orcid.org/0000-0001-5039-8473ПампураА. Н.PampuraA. N.

Пампура Александр Николаевич - д.м.н., проф., зав. отделением аллергологии и клинической иммунологии; л. внештатный детский специалист - аллерголог-иммунолог ДЗМ, врач-аллерголог-иммунолог

Москва

Moscow

https://orcid.org/0000-0002-4908-6146ЖукалинаЕ. Ф.ZhukalinaE. F.

Жукалина Евгения Федоровна - к.м.н., ст. науч. сотр. отделения аллергологии и клинической иммунологии

125412 Москва, ул. Талдомская, д. 2

Moscow

https://orcid.org/0000-0001-9553-3560МоренкоМ. А.MorenkoM. A.

Моренко Марина Алексеевна - д.м.н., проф., зав. кафедрой детских болезней с курсами аллергологии, иммунологии, гематологии и эндокринологии; гл. детский иммунолог ОУЗ г. Нур-Султан

Астана

Moscow

https://orcid.org/0000-0002-5874-1624УсеноваО. П.UssenovaO. P.

Усенова Оксана Полатовна - врач-аллерголог-иммунолог, педиатр, магистр медицины, асс. кафедры детских болезней с курсами аллергологии, иммунологии, гематологии и эндокринологии

010000 Астана, ул. Бейбитшилик, д. 49/A

Astana

ОСП «Научно-исследовательский клинический институт педиатрии и детской хирургии им. академика Ю.Е. Вельтищева» (Институт Вельтищева) ФГАОУ ВО РНИМУ им. Н.И. Пирогова Минздрава России; ГБУЗ «Морозовская детская городская клиническая больница ДЗМ»РоссияVeltischev Research and Clinical Institute for pediatrics and pediatric surgery at the Pirogov Russian National Research Medical University; Morozov Children’s City HospitalRussian FederationОСП «Научно-исследовательский клинический институт педиатрии и детской хирургии им. академика Ю.Е. Вельтищева» (Институт Вельтищева) ФГАОУ ВО РНИМУ им. Н.И. Пирогова Минздрава РоссииРоссияVeltischev Research and Clinical Institute for pediatrics and pediatric surgery at the Pirogov Russian National Research Medical UniversityRussian FederationНАО «Медицинский университет Астана»КазахстанMorozov Children’s City HospitalKazakhstanНАО «Медицинский университет Астана»КазахстанAstana medical universityKazakhstan202505032025701510Copyright © Ltd. “The National Academy of Pediatric Science and Innovation”, 20252025Ltd. “The National Academy of Pediatric Science and Innovation”Ltd. “The National Academy of Pediatric Science and Innovation”https://www.ped-perinatology.ru/jour/about/submissions#copyrightNoticehttps://www.ped-perinatology.ru/jour/article/view/2132

Совершенствование клинических подходов и инновационные технологические решения в области молекулярной аллергодиагностики принципиально изменили тактику и стратегию ведения детей с аллергическими заболеваниями. В частности, молекулярная аллергодиагностика используется для принятия решений при подозрении на пищевую аллергию, оценки рисков развития жизнеугрожающих реакций, оптимизации элиминационной диеты, выявления перекрестной гиперчувствительности, диагностики ингаляционной аллергии и ее клинической значимости, назначения оптимальных рекомендаций по снижению экспозиции ингаляционных аллергенов, рационального выбора фармакотерапии и аллергенспецифической иммунотерапии, определения прогноза течения аллергического заболевания, в том числе формирования атопического марша. Кроме того, молекулярная аллергодиагностика является основой формирования системы профилактики аллергических заболеваний. В статье авторы попытались обозначить основные достижения и перспективы применения молекулярной аллергодиагностики в педиатрической практике.

Improvements in clinical approaches and innovative technological solutions in the field of molecular allergy diagnostics have fundamentally changed the tactics and strategy for managing children with allergic diseases. In particular, molecular allergy diagnostics is used to make decisions in cases of suspected food allergy; to assess the risks of life-threatening reactions; to optimize the elimination diet; to identify cross-reactivity; to diagnose inhalant allergies and determine their clinical significance;to provide optimal recommendations for reducing the exposure to inhalation allergens; to rationally select pharmacotherapy and allergen-specific immunotherapy; to predict the course of allergic disease, including the development of the atopic march. In addition, molecular allergy diagnostics is the foundation for establishing a system for preventing allergic diseases. In this article, we have tried to outline the main achievements and prospects of molecular allergy diagnostics application in pediatric practice.

детиаллергические заболеванияаллергеныспецифические IgEмолекулярная аллергодиагностикаchildrenallergic diseasesallergensspecific IgEmolecular allergy diagnosticsИсследование и публикация осуществлены при поддержке гранта Правительства Москвы на реализацию научно-практического проекта в медицине № 0408–1.The research work and the publication of its results had been carried out with the financial support from the Moscow City Government Grant for the Implementation of a Scientific and Practical Project in Medicine No. 0408–1.ReferencesValenta R., Karaulov A., Niederberger V., Gattinger P., van Hage M., Flicker S., et al. Molecular aspects of allergens and allergy. Adv Immunol 2018; 138: 195–256. DOI: 10.1016/bs.ai.2018.03.002Valenta R., Karaulov A., Niederberger V., Gattinger P., van Hage M., Flicker S., et al. Molecular aspects of allergens and allergy. Adv Immunol 2018; 138: 195–256. DOI: 10.1016/bs.ai.2018.03.002Valenta R., Lidholm J., Niederberger V., Hayek B., Kraft D., Grönlund H. The recombinant allergen-based concept of component-resolved diagnostics and immunotherapy (CRD and CRIT). Clin Exp Allergy 1999; 29(7): 896–904. DOI: 10.1046/j.1365–2222.1999.00653.xValenta R., Lidholm J., Niederberger V., Hayek B., Kraft D., Grönlund H. The recombinant allergen-based concept of component-resolved diagnostics and immunotherapy (CRD and CRIT). Clin Exp Allergy 1999; 29(7): 896–904. DOI: 10.1046/j.1365–2222.1999.00653.xJakob T., Forstenlechner P., Matricardi P., Kleine-Tebbe J. Molecular allergy diagnostics using multiplex assays: methodological and practical considerations for use in research and clinical routine: Part 21 of the Series Molecular Allergology. Allergo J Int 2015; 24: 320–332. DOI: 10.1007/s40629–015–0087–8Jakob T., Forstenlechner P., Matricardi P., Kleine-Tebbe J. Molecular allergy diagnostics using multiplex assays: methodological and practical considerations for use in research and clinical routine: Part 21 of the Series Molecular Allergology. Allergo J Int 2015; 24: 320–332. DOI: 10.1007/s40629–015–0087–8Ansotegui I.J., Melioli G., Canonica G.W., Caraballo L., Villa E., Ebisawa M. IgE allergy diagnostics and other relevant tests in allergy, a World Allergy Organization position paper. World Allergy Organ J 2020; 13(2): 100080. DOI: 10.1016/j.waojou.2019.100080Ansotegui I.J., Melioli G., Canonica G.W., Caraballo L., Villa E., Ebisawa M. IgE allergy diagnostics and other relevant tests in allergy, a World Allergy Organization position paper. World Allergy Organ J 2020; 13(2): 100080. DOI: 10.1016/j.waojou.2019.100080Garib V., Trifonova D., Freidl R., Linhart B., Schlederer T., Douladiris N. et al. Milk Allergen Micro-Array (MAMA) for Refined Detection of Cow’s-Milk-Specific IgE Sensitization. Nutrients 2023; 15(10): 2401. DOI: 10.3390/nu15102401Garib V., Trifonova D., Freidl R., Linhart B., Schlederer T., Douladiris N. et al. Milk Allergen Micro-Array (MAMA) for Refined Detection of Cow’s-Milk-Specific IgE Sensitization. Nutrients 2023; 15(10): 2401. DOI: 10.3390/nu15102401Dramburg S., Hilger C., Santos A.F., de Las Vecillas L., Aalberse R.C., Acevedo N., et al. EAACI Molecular Allergology User’s Guide 2.0. Pediatr Allergy Immunol 2023; 34 Suppl 28: e13854. DOI: 10.1111/pai.13854. PMID: 37186333Dramburg S., Hilger C., Santos A.F., de Las Vecillas L., Aalberse R.C., Acevedo N., et al. EAACI Molecular Allergology User’s Guide 2.0. Pediatr Allergy Immunol 2023; 34 Suppl 28: e13854. DOI: 10.1111/pai.13854. PMID: 37186333Riggioni C., Ricci C., Moya B., Wong D., van Goor E., Bartha I. et al. Systematic review and meta-analyses on the accuracy of diagnostic tests for IgE-mediated food allergy. Allergy 2024; 79(2): 324–352. DOI: 10.1111/all.15939Riggioni C., Ricci C., Moya B., Wong D., van Goor E., Bartha I. et al. Systematic review and meta-analyses on the accuracy of diagnostic tests for IgE-mediated food allergy. Allergy 2024; 79(2): 324–352. DOI: 10.1111/all.15939Пампура А.Н., Есакова Н.В. Анафилаксия у детей. М.: Медпрактика-М, 2020; 368. [Pampura A.N., Esakova N.V. Anaphylaxis in children. Moscow: Medpraktika, 2020; 368. (in Russ.)Пампура А.Н., Есакова Н.В. Анафилаксия у детей. М.: Медпрактика-М, 2020; 368. [Pampura A.N., Esakova N.V. Anaphylaxis in children. Moscow: Medpraktika, 2020; 368. (in Russ.)Golden D.B.K., Wang J., Waserman S., Akin C., Campbell R.L., Ellis A.K. et al. Anaphylaxis: A 2023 practice parameter update. Ann Allergy Asthma Immunol 2024; 132(2): 124–176. DOI: 10.1016/j.anai.2023.09.015Golden D.B.K., Wang J., Waserman S., Akin C., Campbell R.L., Ellis A.K. et al. Anaphylaxis: A 2023 practice parameter update. Ann Allergy Asthma Immunol 2024; 132(2): 124–176. DOI: 10.1016/j.anai.2023.09.015Tosca M.A., Schiavetti I., Olcese R., Trincianti C., Ciprandi G. Molecular Allergy Diagnostics in Children with Cow’s Milk Allergy: Prediction of Oral Food Challenge Response in Clinical Practice. J Immunol Res 2023; 2023: 1129449. DOI: 10.1155/2023/1129449Tosca M.A., Schiavetti I., Olcese R., Trincianti C., Ciprandi G. Molecular Allergy Diagnostics in Children with Cow’s Milk Allergy: Prediction of Oral Food Challenge Response in Clinical Practice. J Immunol Res 2023; 2023: 1129449. DOI: 10.1155/2023/1129449Есакова Н.В., Пампура А.Н. Особенности пищевой анафилаксии у детей, возникающей при альтернативных путях поступления аллергена. Педиатрия. Журнал им. Г.Н. Сперанского 2021; 100(2): 57–63.Esakova N.V., Pampura A.N. Features of food anaphylaxis in children arising from alternative routes of allergen intake. Pediatrija. Zhurnal im. G.N. Speranskogo. 2021; 100(2): 57–63. (in Russ.) DOI: 10.24110/0031–403X-2021–100–2–57–63Fiocchi A., Bognanni A., Brożek J., Ebisawa M., Schünemann H. WAO DRACMA guideline group. World Allergy Organization (WAO) Diagnosis and Rationale for Action against Cow’s Milk Allergy (DRACMA) Guidelines update — I — Plan and definitions. World Allergy Organ J 2022; 15(1): 100609. DOI: 10.1016/j.waojou.2021.100609Fiocchi A., Bognanni A., Brożek J., Ebisawa M., Schünemann H. WAO DRACMA guideline group. World Allergy Organization (WAO) Diagnosis and Rationale for Action against Cow’s Milk Allergy (DRACMA) Guidelines update — I — Plan and definitions. World Allergy Organ J 2022; 15(1): 100609. DOI: 10.1016/j.waojou.2021.100609Пампура А.Н., Жукалина Е.Ф., Моренко М.А., Усенова О.П. Современные подходы к диагностике и ведению детей раннего возраста с аллергией на белки коровьего молока. Рос вестн перинатол и педиатр 2023; 68:(2): 39–46.Pampura A.N., Zhukalina E.F., Morenko M.A., Ussenova O.P. Modern approaches to the diagnosis and management of children with allergy to cow’s milk proteins. Ros vestn perinatol i pediatr 2023; 68:(2): 39–46. (in Russ.). DOI: 10.21508/1027– 4065–2023–68–2–39–46Gómez T.E., Gratacós G.A.R., González J.O.M., Joyanes R.J.B., Palacios C.A, García R.R. Profilins and Food-Dependent Exercise-Induced Anaphylaxis. J Investig Allergol Clin Immunol 2021; 31(4): 349–350. DOI: 10.18176/jiaci.0650Gómez T.E., Gratacós G.A.R., González J.O.M., Joyanes R.J.B., Palacios C.A, García R.R. Profilins and Food-Dependent Exercise-Induced Anaphylaxis. J Investig Allergol Clin Immunol 2021; 31(4): 349–350. DOI: 10.18176/jiaci.0650Santos A.F., Riggioni C., Agache I., Akdis C.A., Akdis M., Alvarez-Perea A. et al. EAACI guidelines on the diagnosis of IgE-mediated food allergy. Allergy 2023; 78(12): 3057–3076. DOI: 10.1111/all.15902Santos A.F., Riggioni C., Agache I., Akdis C.A., Akdis M., Alvarez-Perea A. et al. EAACI guidelines on the diagnosis of IgE-mediated food allergy. Allergy 2023; 78(12): 3057–3076. DOI: 10.1111/all.15902Tedner S.G., Asarnoj A., Thulin H., Westman M., Konradsen J.R., Nilsson C. Food allergy and hypersensitivity reactions in children and adults-A review. J Intern Med 2022; 291(3): 283–302. DOI: 10.1111/joim.13422Tedner S.G., Asarnoj A., Thulin H., Westman M., Konradsen J.R., Nilsson C. Food allergy and hypersensitivity reactions in children and adults-A review. J Intern Med 2022; 291(3): 283–302. DOI: 10.1111/joim.13422Skypala I.J., Bartra J., Ebo D.G., Antje Faber M., Fernandez-Rivas M., Gomez F., et al. The diagnosis and management of allergic reactions in patients sensitized to non-specific lipid transfer proteins. Allergy 2021; 76: 2433–2446. DOI: 10.1111/all.14797Skypala I.J., Bartra J., Ebo D.G., Antje Faber M., Fernandez-Rivas M., Gomez F., et al. The diagnosis and management of allergic reactions in patients sensitized to non-specific lipid transfer proteins. Allergy 2021; 76: 2433–2446. DOI: 10.1111/all.14797Bublin M., Breiteneder H. Cross-reactivities of non-homologous allergens. Allergy 2020; 75: 1019–1022. DOI: 10.1111/all.14120Bublin M., Breiteneder H. Cross-reactivities of non-homologous allergens. Allergy 2020; 75: 1019–1022. DOI: 10.1111/all.14120Candreva A.M., Smaldini P.L., Cauerhff A., Petruccelli S., Docena G.H. A novel approach to ameliorate experimental milk allergy based on the oral administration of a short soy cross-reactive peptide. Food Chem 2021; 346: 128926. DOI: 10.1016/j.foodchem.2020.128926Candreva A.M., Smaldini P.L., Cauerhff A., Petruccelli S., Docena G.H. A novel approach to ameliorate experimental milk allergy based on the oral administration of a short soy cross-reactive peptide. Food Chem 2021; 346: 128926. DOI: 10.1016/j.foodchem.2020.128926Warm K., Lindberg A., Lundbäck B., Rönmark E. Increase in sensitization to common airborne allergens among adults — two population-based studies 15 years apart. Allergy Asthma Clin Immunol 2013; 9(1): 20. DOI: 10.1186/1710–1492–9–20Warm K., Lindberg A., Lundbäck B., Rönmark E. Increase in sensitization to common airborne allergens among adults — two population-based studies 15 years apart. Allergy Asthma Clin Immunol 2013; 9(1): 20. DOI: 10.1186/1710–1492–9–20Sarzsinszky E., Lupinek C., Vrtala S., Huang H.J., Hofer G., Keller W. et al. Expression in Escherichia coli and Purification of Folded rDer p 20, the Arginine Kinase From Dermatophagoides pteronyssinus: A Possible Biomarker for Allergic Asthma. Allergy Asthma Immunol Res 2021; 13(1): 154–163. DOI: 10.4168/aair.2021.13.1.154Sarzsinszky E., Lupinek C., Vrtala S., Huang H.J., Hofer G., Keller W. et al. Expression in Escherichia coli and Purification of Folded rDer p 20, the Arginine Kinase From Dermatophagoides pteronyssinus: A Possible Biomarker for Allergic Asthma. Allergy Asthma Immunol Res 2021; 13(1): 154–163. DOI: 10.4168/aair.2021.13.1.154Жукалина Е.Ф., Пампура А.Н., Суровенко Т.Н., Медведева А.Д. Профили молекулярной сенсибилизации к аллергенам пушных животных у пациентов Российской Фе- дерации. Педиатрия 2024; 103(2): 17–26.Zhukalina E.F., Pampura A.N., Surovenko T.N., Medvedeva A.D. Profiles of molecular sensitization to fur animal allergens in patients of the Russian Federation. Pediatrija 2024; 103(2): 17–26. (in Russ.) DOI:10.24110/0031–403X-2024–103–2–17–26Alvaro-Lozano M., Akdis C.A., Akdis M., Alviani C., Angier E., Arasi S. et al. EAACI Allergen Immunotherapy User’s Guide. Pediatr Allergy Immunol 2020; 31 25(25): 1–101. DOI: 10.1111/pai.13189Alvaro-Lozano M., Akdis C.A., Akdis M., Alviani C., Angier E., Arasi S. et al. EAACI Allergen Immunotherapy User’s Guide. Pediatr Allergy Immunol 2020; 31 25(25): 1–101. DOI: 10.1111/pai.13189Wickman M., Lupinek C., Andersson N., Belgrave D., Asarnoj A., Benet M. et al. Detection of IgE Reactivity to a Handful of Allergen Molecules in Early Childhood Predicts Respiratory Allergy in Adolescence. EBioMedicine 2017; 26: 91–99. DOI: 10.1016/j.ebiom.2017.11.009Wickman M., Lupinek C., Andersson N., Belgrave D., Asarnoj A., Benet M. et al. Detection of IgE Reactivity to a Handful of Allergen Molecules in Early Childhood Predicts Respiratory Allergy in Adolescence. EBioMedicine 2017; 26: 91–99. DOI: 10.1016/j.ebiom.2017.11.009Grönlund H., Saarne T., Gafvelin G., van Hage M. The major cat allergen, Fel d 1, in diagnosis and therapy. Int Arch Allergy Immunol. 2010;151(4): 265–274. DOI: 10.1159/000250435Grönlund H., Saarne T., Gafvelin G., van Hage M. The major cat allergen, Fel d 1, in diagnosis and therapy. Int Arch Allergy Immunol. 2010;151(4): 265–274. DOI: 10.1159/000250435Bjerg A., Winberg A., Berthold M., Mattsson L., Borres M.P., Rönmark E. A population-based study of animal component sensitization, asthma, and rhinitis in schoolchildren. Pediatr Allergy Immunol 2015; 26(6): 557–563. DOI: 10.1111/pai.12422Bjerg A., Winberg A., Berthold M., Mattsson L., Borres M.P., Rönmark E. A population-based study of animal component sensitization, asthma, and rhinitis in schoolchildren. Pediatr Allergy Immunol 2015; 26(6): 557–563. DOI: 10.1111/pai.12422Hatzler L., Panetta V., Lau S., Wagner P., Bergmann R.L., Illi S. et al. Molecular spreading and predictive value of preclinical IgE response to Phleum pratense in children with hay fever. J Allergy Clin Immunol 2012; 130(4): 894–901.e5. DOI: 10.1016/j.jaci.2012.05.053Hatzler L., Panetta V., Lau S., Wagner P., Bergmann R.L., Illi S. et al. Molecular spreading and predictive value of preclinical IgE response to Phleum pratense in children with hay fever. J Allergy Clin Immunol 2012; 130(4): 894–901.e5. DOI: 10.1016/j.jaci.2012.05.053Jensen-Jarolim E., Pacios L.F., Bianchini R., Hofstetter G., Roth-Walter F. Structural similarities of human and mammalian lipocalins, and their function in innate immunity and allergy. Allergy 2016; 71(3): 286–94. DOI: 10.1111/все.12797Jensen-Jarolim E., Pacios L.F., Bianchini R., Hofstetter G., Roth-Walter F. Structural similarities of human and mammalian lipocalins, and their function in innate immunity and allergy. Allergy 2016; 71(3): 286–94. DOI: 10.1111/все.12797Schoos A.M., Kattan J.D., Gimenez G., Sampson H.A. Sensitization phenotypes based on protein groups and associations to allergic diseases in children. J Allergy Clin Immunol 2016; 137(4): 1277–1280. DOI: 10.1016/j.jaci.2015.09.035Schoos A.M., Kattan J.D., Gimenez G., Sampson H.A. Sensitization phenotypes based on protein groups and associations to allergic diseases in children. J Allergy Clin Immunol 2016; 137(4): 1277–1280. DOI: 10.1016/j.jaci.2015.09.035Steering Committee Authors; Review Panel Members. A WAO — ARIA — GA2LEN consensus document on molecular-based allergy diagnosis (PAMD@): Update 2020. World Allergy Organ J 2020; 13(2): 100091. DOI: 10.1016/j.waojou.2019.100091Steering Committee Authors; Review Panel Members. A WAO — ARIA — GA2LEN consensus document on molecular-based allergy diagnosis (PAMD@): Update 2020. World Allergy Organ J 2020; 13(2): 100091. DOI: 10.1016/j.waojou.2019.100091

The authors declare that there are no conflicts of interest present.