The region-specific landscape of sensitization to respiratory allergens in the population of Kazakhstan accord based on molecular diagnostics

Introduction. Allergic diseases still remain one of the most common and widespread chronic pathologies of our time, affecting up to 40% of the population. Due to its unique environment, which presents a combination of steppe, desert and mountain ecosystems, the Republic of Kazakhstan is of particular interest for studying regional sensitization features. The use of molecular diagnostic methods, such as ImmunoCAP ISAC, makes it possible to detect sensitization at the level of individual allergenic components and form personalized therapy strategies.
Aim: Evaluate epidemiological and regional features of sensitization to respiratory allergens in Kazakhstan for the period 2021-2024 using component allergy diagnostics.
Materials and methods: The study embraces 4,745 patients with clinical manifestations of allergic diseases (allergic rhinitis, bronchial asthma, atopic dermatitis) who were tested against the ISAC panel (21 inhaled allergens). Descriptive statistics, Pearson's χ2 criterion, Monte Carlo simulation, and Fisher's exact criterion were used.
Outcomes/Results: During the observation period, the median number of sensitizations increased more than sixfold (from 18.0 in 2021 to 113.0 in 2024), indicating an increase in allergic load. The most frequently detected components were rFel d 1 (34.7%), rPhl p 1 (23.0%), nArt v1 (22.8%) and rBet v1 (21.5%).
Significant regional differences were identified (p = 0.001): weeds (Ambrosia, Artemisia) prevailed in the southern regions, tree allergens (Betula, Alnus) prevailed in the northern regions, polysensitization prevailed in the central and eastern regions, and a combination of steppe and household allergens prevailed in the western regions. Gender differences did not demonstrate any statistical significance (p > 0.05).
Conclusion: The study revealed a substantial increase in sensitization in Kazakhstan and a confirmed geographical stratification of the allergenic spectrum. The results obtained emphasize the need for introduction of regionally adapted diagnostic panels, development of personalized allergen-specific immunotherapy (ASIT) regimens and system monitoring of molecular profile of sensitization for realization of personalized medicine principles.