The role of sensitization to birch polen allergens in the development of acute atopic dermatitis in patients living in Moscow and the Moscow region

Atopic dermatitis (AD) is a chronic inflammatory skin disease, its pathogenesis is associated with immunological disorders and genetically determined defects of the epidermal barrier. Exposure to aeroallergens, including pollen, plays a crucial role in the exacerbations and progression of AD. When individuals sensitized to pollen allergens come into contact with these allergens, a T2 immune response is activated, characterized by the release of cytokines IL-4, IL-13, and IL-31, which stimulate the production of IgE. This leads to enhanced inflammation, improved penetration of allergens through the compromised epidermal barrier, and activation of keratinocytes and dendritic cells, further impairing the skin barrier function and exacerbating AD symptoms. Previous studies have shown that pollen allergens can directly affect the epidermal barrier by activating proteolytic enzymes that break down intercellular connections in the epidermis, increasing its permeability to allergens and pathogens. This study analyzes the impact of sensitization to birch pollen allergens on the AD exacerbation in adult patients living in Moscow and the Moscow region. Birch pollen is a significant allergen capable of triggering exacerbations of allergic diseases, especially in the Northern Hemisphere countries where birch is widely spread. The study included 30 adult AD patients sensitized to birch pollen, and the SCORAD index was used to assess the severity of the disease, combining both objective skin condition indicators and subjective patient complaints (itching, sleep disturbance). Allergological examination was conducted using the ISAC ImmunoCAP allergochip, allowing for the determination of specific IgE levels to more than 100 allergens, including the main birch pollen allergen – Bet v 1. The analysis showed that most patients experienced a significant increase in AD symptoms during the birch flowering period, correlating with the levels of specific IgE to Bet v 1. The study highlights the clinical significance of sensitization to birch pollen as a trigger factor for AD exacerbation, confirming the need to analyze sensitization to pollen allergens to develop personalized approaches to the diagnosis and treatment of AD patients.

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