Dose-dependence of hypersensitivity and hyperreactivity
These two stages of allergy are related by the dose-dependent effect of
allergens and non-specific inducers. However, hyperreactivity is
completely dependent on the degree, intensity of hypersensitivity,
therefore, the dose of an allergen or inducer determines only the degree
of specific or nonspecific hypersensitivity. The need for high doses of
inducers for nonspecific types of allergy is due to the relatively low
concentration, expression of cell receptors or activating molecules of
humoral factors that respond to them (for example, complement).
Hypersensitivity of cells is easily detected in vitro by their
release of mediators, cytokines and enzymes. All leukocytes, if they are
sensitized actively (lymphocytes) or passively (with antibodies –
granulocytes, platelets) respond to the allergen by the release of these
substances and degranulation to low doses of allergens, as well as by
change in phenotype, expression of receptors and CD antigens. In some
patients, nonspecific inducers, for example drugs with nonspecific
hypersensitivity to them, also provoke such a response [12, 13].
The in vivo response to allergens and nonspecific inducers is
assessed by the level of hyperreactivity: by the degree of skin reaction
(hyperemia, edema, etc.), or reaction of bronchi (bronchospasm), as well
as by the clinical symptoms of allergy that it causes (urticaria,
rhinorrhea, etc.) It was possible to evaluate hypersensitivity in
vivo without hyperreactivity and clinical symptoms after developing in
our clinic [7, 8, 9] low-dose allergen-specific nasal and
oral-pharyngeal tests that do not cause clinical symptoms, but are
recorded by an increase in the level of allergy biomarkers in nasal
secretions and oral fluid. Doses of allergens in these tests were
reduced by 20-200 times compared with those used in conventional
provocative tests, which induce clinical symptoms.