HETEROGENEITY OF FACTORS INFLUENCING THE DEVELOPMENT OF ALLERGIC DISEASES

Liakhovska N. V, Sakevich V. D, Tumchuk L. Yu, Liakhovskiy V. I.

LITERATURE REVIEWS

Scentific article

Abstract. Аllergic diseases, that including аsthma, allergic rhinitis and dermatitis, are common diseases that often manifest early in life and persist into adulthood. The pathophysiology and expression of these diseases are influenced by interactions between susceptibility genes and exposure to environmental factors such as aeroallergens, secondhand smoke, and infections. Isolated use of traditional markers, such as lung function parameters and skin prick testing, level of serum IgE and clinical symptoms to diagnose specific subtypes and manage asthma and allergic diseases have been shown to be inadequate because of the heterogenous underlying pathophysiology of disease phenotypes. Сomplex of external factors that an individual is exposed to throughout their lifetime is termed the exposome. The exposome spans multiple domains from population to molecular levels and, in combination with genetic factors, holds the key to understanding the phenotypic diversity seen in allergic patients. Exposomal domains are categorized into nonspecific (human and natural factors affecting populations), specific (humidity, ultraviolet radiation, diet, pollution, allergens, water hardness) and internal (cutaneous and gut microbiota and host cell interaction) exposures. A separate, extremely relevant link in the development of allergic diseases is the psychoemotional part of patients. Many studies have shown the encouraging effects of psychological interventions on clinical outcome in allergic diseases. Although evidence suggests that these interventions result in restoring a more normal Th1/Th2 balance, further research is warranted to prove a direct link between clinical improvement and immune changes following psychological interventions in allergic diseases. The combined approach to the treatment of allergic inflammation will improve the quality of life of patients and improve the effectiveness of pharmacological treatment of this polymorbid pathology.

allergy, exposome, psychosomatic manifestations.

1. Wild CP. Complementing the genome with an “exposome”: the outstanding challenge of environmental exposure measurement in molecular epidemiology. Cancer Epidemiol Biomarkers Prev. 2005;14(8):1847-50. doi: 10.1158/1055-9965.EPI-05-0456.
2. Miller GW, Jones DP. The nature of nurture: refining the definition of the exposome. Toxicol Sci. 2014;137(1):1-2. doi: 10.1093/toxsci/ kft251.
3. Wild CP. The exposome: from concept to utility. Intertanational Journal of Epidemiol. 2012;41(1):24-32. Available from: https://doi. org/10.1093/ije/dyr236
4. Agache I, Miller R, Gern JE, Hellings PW, Jutel M, Muraro A, Phipatanakul W, Quirce S, Peden D. Emerging concepts and challenges in implementing the exposome paradigm in allergic diseases and asthma: a Practall document. Allergy. 2019;74(3):449-463. doi: 10.1111/ all.13690.
5. Stefanovic N, Flohr C, Irvine D. The exposome in atopic dermatitis. Allergy. 2020;75(1):63-74. doi: 10.1111/all.13946 
6. Winckelmans E, Nawrot TS, Tsamou M, Hond ED, Baeyens W, Kleinjans J, et al. Transcriptome-wide analyses indicate mitochondrial responses to particulate air pollution exposure. Environmental Health. 2017 Aug 18;16(1):87. doi: 10.1186/s12940-017-0292-7.
7. Jiang C, Wang X, Li X, Inlora J, Wang T, Liu Q, Snyder M. Dynamic human environmental exposome revealed by longitudinal personal monitoring. Cell. 2018 Sep 20;175(1):277-291. doi: 10.1016/j.cell.2018.08.060.
8. Kaidashev I, Morokhovets H, Rodinkova V, DuBuske L, Bousquet J. Assessment of Google Trends terms reporting allergies and the grass pollen season in Ukraine. World Allergy Organ Jour. 2020 Sep 30; 13(10):100465. doi: 10.1016/j.waojou.2020.100465.
9. Vriejheid M. The exposome: a new paradigm to study the impact of environment on health. Thorax. 2014;69(9):876-8. doi:
10. 1136/ thoraxjnl-2013-204949. 10.Aschard H, Tobin MD, Hancock DB, Skurnik D, Sood A, James Al, et al. Evidence for large-scale gene-by-smoking interaction effects on pulmonary function. Int J Epidemiol. 2017 Jun 1;46(3):894-904. doi: 10.1093/ije/dyw318.
11. Gref A, Merid SK, Gruzieva O, Ballereau S, Becker A, Bellander T, et al. Genome-wide interaction analysis of air pollution exposure and childhood asthma with functional follow-up. Am J Respir Crit Care Med. 2017 May 15;195(10):1373-1383. doi: 10.1164/rccm.201605- 1026OC.
12. Forno E, Sordillo J, Brehm J, Chen W, Benos T, Yan Q, et al. Genome-wide interaction study of dust mite allergen on lung function in children with asthma. The Journal of Allergy and Clinical Immunology 2017;140(4):996-1003. doi: 10.1016/j.jaci.2016.12.967.
13. Liakhovska NV, Izmailova OV, Shlykova OA, Kaidashev IP. Rol` polimorfizmiv heniv Toll-podibnykh retseptoriv 2, 4 ta bilka klityn Klara v rozvytku bronkhialnoi astmy u doroslykh. Problemy ekolohii ta medytsyny. 2013;17(5-6):71-5. [in Ukrainian].
14. Ibrahim NK, Alghamdi AA, Almehmadi MM, Alzahrani AA, Turkistani AK, Alghamdi K. Allergy and related clinical symptoms among medical students and interns. Pakistan Journal of Medical Science. 2019;35(4):1060-1065. doi:10.12669/pjms.35.4.1281
15. Heinroth JCA. Lehrbuch der Störungen des Seelenlebens oder der Seelen-störungen und ihrer Behandlung: Zwey Theile. Leipzig: Vogel; 1818. 396 p.
16. Lipowski ZJ. What does the word “psychosomatic” really mean? A historical and semantic inquiry. Psychosomatic Medicine. 1984 Mar 9;46(2):153-171. doi: 10.1097/00006842-198403000-00007
17. Malkina-Pyh IG. Psihosomatika: Uchebnik. Moskva, Berlin: Direkt-Media; 2019. 423 p. [in Russian].
18. Tat’yanchikov AO. Osnovi psihosomatiki ta psihogenetiki: navchal’no-metodichnі rekomendacіi. Odesa: Fenіks 2020; 36 p. [in Ukrainian].
19. Henningsen P. Management of somatic symptom disorder. Dialogues in Clin Neuroscience. 2018;20(1):23-31. doi: 10.31887/ DCNS.2018.20.1/phenningsen.
20. Micoulaud-Franchi JA, Lemogne C, Quilès C. Definition of somatoform disorders: somatic symptoms or mental symptoms? Rev Prat. 2019;69(2):197-204.
21. Bekhuis E, Gol J, Burton C, Rosmalen J. Patients’ descriptions of the relation between physical symptoms and negative emotions: a qualitative analysis of primary care consultations. Br J Gen Pract. 2020 Jan 30;70(691):78-85. doi: 10.3399/bjgp19X707369.
22. Beilharz JE, Paterson M, Fatt S, Wilson C, Burton A, Cvejic E, et al. The impact of childhood trauma on psychosocial functioning and physical health in a non-clinical community sample of young adults. Australian and New Zealand J Psychiatry. 2020;54(2):185-194. doi: 10.1177/0004867419881206.
23. Wang LX, Yang ZC, Kang ZP, Di LL, Tan Y, Peng XB, et al. Improvement in Psychological Condition of Patients With Persistent Moderate– Severe Allergic Rhinitis by Drug Therapy Combined With Psychological Intervention. Ear, Nose & Throat Journal. 2020;2(99):1-7. doi: 10.1177/0145561320902859.
24. Xi L, Han DM, Lü XF, Zhang L. Psychological characteristics in patients with allergic rhinitis and its associated factors analysis. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2009;44(12):982-5.
25. Stauder A, Kovacs M Anxiety symptoms in allergic patients: identification and risk factors. Psychosom Med. 2003;65(5):816–823.
26. Sansone, RA, Sansone, LA. Allergic rhinitis: relationships with anxiety and mood syndromes. Innov Clin Neurosci. 2011;8(7):12–17.
27. Huang HY, Zhang LZ, Znang QX, Peng L, Xu B, Jiang GF, et al. Analysis of mental state of allergic rhinitis patients in Chengdu city by symptom check list 90 (SCL-90) scale. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2019 Aug 7;54(8):576-583.
28. Yang ZC, Tang BJ, Yu Y, Xin XH. Efficacy analysis of psychological intervention on the basis of medication for the treatment of moderatesevere persistent allergic rhinitis. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2017;31(21):1642-1645. doi:10.13201/j.issn.1001- 1781.2017.21.005.
29. Serrano J, Plaza V, Sureda B, De Pablo J, Picado C, Bardagí S, et al. Alexithymia: A relevant psychological variable in near-fatal asthma. Eur Respir J. 2006;28:296-302. doi: 10.1183/09031936.50008105.
30. Sivak R, Wiater A. Alexitimia, la Dificultad para Verbalizar Afectos. Teoría y Clínica. Buenos Aires: Paidós SAICF. 1997. Chapter 2, Teoría y clínica de la alexitimia; p. 17-33.
31. Taylor G, Bagby R, Parker J, Grotstein J. Disorders of Affect Regulation: Alexithymia in Medical and Psychiatric Illness. Cambridge: Cambridge University Press; 1997. Chapter 2, Affect dysregulation and alexithymia; p. 26-45. doi:10.1017/CBO9780511526831.005
32. Pasini A, Chiaie RD, Seripa S, Ciani N. Alexithymia as related to sex, age and educational level: results of the Toronto Alexithymia Scale in 417 normal subjects. Comprehensive Psychiatry. 1992;33(1):42-6.
33. Kauhanen J, Kaplan GA, Julkunen J, Wilson TW, Salonen JT. Social factors in alexithymia. Comprehensive Psychiatry 1993;34(5):330-5.
34. Kokkonen P, Karvonen JT, Veijola J, Läksy K, Jokelainen J, Järvelin MR, et al. Prevalence and sociodemographic correlates of alexithymia in a population sample of young adults. Comprehensive Psychiatry. 2001;42(6):471-6.
35. Walters P, Schofield P, Howard L, Ashworth M, Tylee A. The relationship between asthma and depression in primary care patients: a historical cohort and nested case control study. PLoS One. 2011;6(6):e20750. doi: 10.1371/journal. pone.0020750.
36. Hasler G, Gergen PJ, Kleinbaum DG, Ajdacic V, Gamma A, Eich D, et al. Asthma and panic in young adults: a 20-year prospective community study. American Journal of Respirit Crit Care Med. 2005 Jun 1;171(11):1224-30. doi: 10.1164/rccm.200412-1669OC.
37. Pichot P, Berner P, Wolf R, Thau K, editors. Psychiatry the State of the Art. New York: Plenum Press; 1985. Chapter 17, Environmental Stress Factors and Bronchial Asthma; p. 415-421. Available from: https://doi.org/10.1007/978-1-4684-4697-5_70
38. Faith RE, Murgo AJ, Good RA, Plotnikoff NP, editors. Cytokines: Stress and Immunity. 2nd ed. Boca Raton: Taylor & Francis Group; 2007. Chapter 2, Psychological stress and its relationship to cytokines and inflammatory diseases; p. 22-9.
39. Jafferany M. Psychodermatology: a guide to understanding common psychocutaneous disorders. Primary Care Companion to The Journal Clinical Psychiatry. 2007;9(3):203-13. doi: 10.4088/pcc.v09n0306.
40. Latremoliere A, Woolf CJ. Central sensitization: a generator of the pain hypersensitivity by central neural plasticity. The Journ of Pain. 2009;10(9):895-926. doi: 10.1016/j.jpain.2009.06.012.
41. Yamamoto Y, Yamazaki S, Hayashino Y, Takahashi O, Tokuda Y, Shimbo T, et al. Association between frequency of pruritic symptoms and perceived psychological stress: a Japanese population-based study. Archives of Dermatol. 2009;145(12):1384-8. doi: 10.1001/ archdermatol.2009.290.
42. Elenkov IJ. Glucocorticoids and the Th1/Th2 balance. Ann N Y Acad Sci. 2004;1024:138-46. doi: 10.1196/annals.1321.010.
43. Tang YY, Ma Y, Fan Y, Feng H, Wang J, Feng S, et al. Central and autonomic nervous system interaction is altered by short-term meditation. Proc of the National Academy of Sciences of USA. 2009 Jun 2;106(22):8865-70. doi: 10.1073/pnas.0904031106.
44. Lotti T, Bianchi B, Panconesi E. Neuropeptides and skin disorders. The new frontiers of neuro-endocrine-cutaneous immunology. International Journal of Dermatology. 1999;38(9):673-5. doi: 10.1046/j.1365-4362.1999.00767.x.
45. Buddenkotte J, Steinhoff M. Pathophysiology and therapy of pruritus in allergic and atopic diseases. Allergy. 2010;65(7):805-21. doi: 10.1111/j.1398-9995.2010.01995.x.
46. Xiao-Hong L. Study of psychological intervention mode for surgical patients and its effect. Chin J Nurs. 2006:ID76057996.
47. Ganasen KA, Ipser JC, Stein DJ. Augmentation of cognitive behavioral therapy with pharmacotherapy. Psychiatr Clin North Am. 2010;33(3):687-99. doi: 10.1016/j.psc.2010.04.008.
48. Sharma HP. Asthma education: pitfalls and solutions. Adolesc Med State Art Rev. 2010;21(1):72-85.
49. Tzeng LF, Chiang LC, Hsueh KCh, Ma WF, Fu LS. A preliminary study to evaluate a patient-centred asthma education programme on parental control of home environment and asthma signs and symptoms in children with moderate-to-severe asthma. Journal of the Clinical Nursing. 2010;19(9-10):1424-33. doi: 10.1111/j.1365-2702.2009.03021.x.
50. Beresnevaite M. Exploring the benefits of group psychotherapy in reducing alexithymia in coronary heart disease patients: a preliminary study. Psychother Psychosom. 2000;69(3):117-22. doi: 10.1159/000012378.
51. Bell MC, Busse WW. Severe Asthma: An Expanding and Mounting Clinical Challenge. The Journal of Allergy and Clinical Immunol Pract. 2013;1(2):110-22. doi: 10.1016/j.jaip.2013.01.005.
52. França K, Castillo D, Roccia MG, Lotti T, Wollina U, Fioranelli M. Psychoneurocutaneous medicine: past, present and future. Wiener Medizinische Wochenschrift. 2017;167(1):31-36. doi: 10.1007/s10354-017-0573-3.

«Bulletin of problems biology and medicine» Issue 1 (159), 2021 year, 292-297 pages, index UDK 616.5-002.2:675

10.29254/2077-4214-2021-1-159-292-297