Heterogeneity of sensitization profiles and clinical phenotypes among patients with seasonal allergic rhinitis in Southern European countries-The @IT.2020 multicenter study.
IgE
allergic rhinitis
component-resolved diagnostics
phenotypes
pollen allergy
sensitization
Journal
Allergy
ISSN: 1398-9995
Titre abrégé: Allergy
Pays: Denmark
ID NLM: 7804028
Informations de publication
Date de publication:
05 Feb 2024
05 Feb 2024
Historique:
revised:
30
11
2023
received:
15
05
2023
accepted:
04
12
2023
medline:
5
2
2024
pubmed:
5
2
2024
entrez:
5
2
2024
Statut:
aheadofprint
Résumé
Pollen allergy poses a significant health and economic burden in Europe. Disease patterns are relatively homogeneous within Central and Northern European countries. However, no study broadly assessed the features of seasonal allergic rhinitis (SAR) across different Southern European countries with a standardized approach. To describe sensitization profiles and clinical phenotypes of pollen allergic patients in nine Southern European cities with a uniform methodological approach. Within the @IT.2020 multicenter observational study, pediatric and adult patients suffering from SAR were recruited in nine urban study centers located in seven countries. Clinical questionnaires, skin prick tests (SPT) and specific IgE (sIgE) tests with a customized multiplex assay (Euroimmun Labordiagnostika, Lübeck, Germany) were performed. Three hundred forty-eight children (mean age 13.1 years, SD: 2.4 years) and 467 adults (mean age 35.7 years SD: 10.0 years) with a predominantly moderate to severe, persistent phenotype of SAR were recruited. Grass pollen major allergenic molecules (Phl p 1 and/or Phl p 5) ranged among the top three sensitizers in all study centers. Sensitization profiles were very heterogeneous, considering that patients in Rome were highly poly-sensitized (sIgE to 3.8 major allergenic molecules per patient), while mono-sensitization was prominent and heterogeneous in other cities, such as Marseille (sIgE to Cup a 1: n = 55/80, 68.8%) and Messina (sIgE to Par j 2: n = 47/82, 57.3%). Co-sensitization to perennial allergens, as well as allergic comorbidities also broadly varied between study centers. In Southern European countries, pollen allergy is heterogeneous in terms of sensitization profiles and clinical manifestations. Despite the complexity, a unique molecular, multiplex, and customized in-vitro IgE test detected relevant sensitization in all study centers. Nevertheless, this geographical diversity in pollen allergic patients imposes localized clinical guidelines and study protocols for clinical trials of SAR in this climatically complex region.
Sections du résumé
BACKGROUND
BACKGROUND
Pollen allergy poses a significant health and economic burden in Europe. Disease patterns are relatively homogeneous within Central and Northern European countries. However, no study broadly assessed the features of seasonal allergic rhinitis (SAR) across different Southern European countries with a standardized approach.
OBJECTIVE
OBJECTIVE
To describe sensitization profiles and clinical phenotypes of pollen allergic patients in nine Southern European cities with a uniform methodological approach.
METHODS
METHODS
Within the @IT.2020 multicenter observational study, pediatric and adult patients suffering from SAR were recruited in nine urban study centers located in seven countries. Clinical questionnaires, skin prick tests (SPT) and specific IgE (sIgE) tests with a customized multiplex assay (Euroimmun Labordiagnostika, Lübeck, Germany) were performed.
RESULTS
RESULTS
Three hundred forty-eight children (mean age 13.1 years, SD: 2.4 years) and 467 adults (mean age 35.7 years SD: 10.0 years) with a predominantly moderate to severe, persistent phenotype of SAR were recruited. Grass pollen major allergenic molecules (Phl p 1 and/or Phl p 5) ranged among the top three sensitizers in all study centers. Sensitization profiles were very heterogeneous, considering that patients in Rome were highly poly-sensitized (sIgE to 3.8 major allergenic molecules per patient), while mono-sensitization was prominent and heterogeneous in other cities, such as Marseille (sIgE to Cup a 1: n = 55/80, 68.8%) and Messina (sIgE to Par j 2: n = 47/82, 57.3%). Co-sensitization to perennial allergens, as well as allergic comorbidities also broadly varied between study centers.
CONCLUSIONS
CONCLUSIONS
In Southern European countries, pollen allergy is heterogeneous in terms of sensitization profiles and clinical manifestations. Despite the complexity, a unique molecular, multiplex, and customized in-vitro IgE test detected relevant sensitization in all study centers. Nevertheless, this geographical diversity in pollen allergic patients imposes localized clinical guidelines and study protocols for clinical trials of SAR in this climatically complex region.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : Euroimmun
Informations de copyright
© 2024 The Authors. Allergy published by European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.
Références
Asher MI, Montefort S, Bjorksten B, et al. Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC phases one and three repeat multicountry cross-sectional surveys. Lancet. 2006;368(9537):733-743.
Bousquet PJ, Leynaert B, Neukirch F, et al. Geographical distribution of atopic rhinitis in the European Community Respiratory Health Survey I. Allergy. 2008;63(10):1301-1309.
Canonica GW, Bousquet J, Mullol J, Scadding GK, Virchow JC. A survey of the burden of allergic rhinitis in Europe. Allergy. 2007;62(Suppl 85):17-25.
Vandenplas O, Suarthana E, Rifflart C, Lemiere C, Le Moual N, Bousquet J. The impact of work-related rhinitis on quality of life and work productivity: a general workforce-based survey. J Allergy Clin Immunol Pract. 2020;8(5):1583-1591 e1585.
Zuberbier T, Lotvall J, Simoens S, Subramanian SV, Church MK. Economic burden of inadequate management of allergic diseases in the European Union: a GA(2) LEN review. Allergy. 2014;69(10):1275-1279.
Shamji MH, Sharif H, Layhadi JA, Zhu R, Kishore U, Renz H. Diverse immune mechanisms of allergen immunotherapy for allergic rhinitis with and without asthma. J Allergy Clin Immunol. 2022;149(3):791-801.
Muraro A, Roberts G, Halken S, et al. EAACI guidelines on allergen immunotherapy: executive statement. Allergy. 2018;73(4):739-743.
European Environment Agency. Observed climate zones in the period 1975-1995 (left) and 1996-2016 (right). 2019 http://www.eea.europa.eu/data-and-maps/figures/observed-climate-zones-in-the/observed-climate-zones-in-the
Hoffmann TM, Acar Sahin A, Aggelidis X, et al. "Whole" vs. "fragmented" approach to EAACI pollen season definitions: a multicenter study in six Southern European Cities. Allergy. 2020;75(7):1659-1671.
Burbach GJ, Heinzerling LM, Edenharter G, et al. GA(2)LEN skin test study II: clinical relevance of inhalant allergen sensitizations in Europe. Allergy. 2009;64(10):1507-1515.
Tripodi S, Frediani T, Lucarelli S, et al. Molecular profiles of IgE to Phleum pratense in children with grass pollen allergy: implications for specific immunotherapy. J Allergy Clin Immunol. 2012;129(3):834-839.e838.
Almeida E, Caeiro E, Todo-Bom A, Duarte A, Gazarini L. Sensitization to grass allergens: Phl p1, Phl p5 and Phl p7 Phl p12 in adult and children patients in Beja (southern Portugal). Allergol Immunopathol (Madr). 2019;47(6):579-584.
Yavuz ST, Oksel Karakus C, Custovic A, Kalayci Ö. Four subtypes of childhood allergic rhinitis identified by latent class analysis. Pediatr Allergy Immunol. 2021;32(8):1691-1699.
Katotomichelakis M, Danielides G, Iliou T, et al. Allergic sensitization prevalence in a children and adolescent population of northeastern Greece region. Int J Pediatr Otorhinolaryngol. 2016;89:33-37.
Sánchez Mesa JA, Brandao R, Lopes L, Galan C. Correlation between pollen counts and symptoms in two different areas of the Iberian Peninsula: Cordoba (Spain) and Evora (Portugal). J Investig Allergol Clin Immunol. 2005;15(2):112-116.
Somoza ML, Pérez-Sánchez N, Torres-Rojas I, et al. Sensitisation to pollen allergens in children and adolescents of different ancestry born and living in the same area. J Asthma Allergy. 2022;15:1359-1367.
Zemmer F, Cenk E, Dahl Å, Galán C, Ozkaragoz F. A multidisciplinary approach of outdoor aeroallergen selection for skin prick testing in the geographical area of Greater Istanbul. Eur Ann Allergy Clin Immunol. 2022;54(1):34-42.
Caimmi D, Raschetti R, Pons P, et al. Epidemiology of cypress pollen allergy in Montpellier. J Investig Allergol Clin Immunol. 2012;22(4):280-285.
Charpin D, Pichot C, Belmonte J, et al. Cypress pollinosis: from tree to clinic. Clin Rev Allergy Immunol. 2019;56(2):174-195.
Castillo Marchuet MJ, Luengo O, Cardona V. Cypress pollen allergy in a Mediterranean area. J Investig Allergol Clin Immunol. 2020;30(1):67.
Sin AZ, Ersoy R, Gulbahar O, Ardeniz O, Gokmen NM, Kokuludag A. Prevalence of cypress pollen sensitization and its clinical importance in Izmir, Turkey, with cypress allergy assessed by nasal provocation. J Investig Allergol Clin Immunol. 2008;18(1):46-51.
Ciprandi G, Comite P, Mussap M, et al. Profiles of birch sensitization (bet v 1, bet v 2, and bet v 4) and oral allergy syndrome across Italy. J Investig Allergol Clin Immunol. 2016;26(4):244-248.
Nuñez-Borque E, Betancor D, Fernández-Bravo S, et al. Allergen profile of London plane tree pollen: clinical and molecular pattern in central Spain. J Investig Allergol Clin Immunol. 2022;32(5):367-374.
Vrinceanu D, Berghi ON, Cergan R, et al. Urban allergy review: allergic rhinitis and asthma with plane tree sensitization (review). Exp Ther Med. 2021;21(3):275.
Pahus L, Gouitaa M, Sofalvi T, et al. Cypress pollen allergy is responsible for two distinct phenotypes of allergic rhinitis different from other pollinosis. Eur Ann Allergy Clin Immunol. 2018;50(1):28-35.
Lipp T, Acar Sahin A, Aggelidis X, et al. Heterogeneity of pollen food allergy syndrome in seven southern European countries: the @IT.2020 multicenter study. Allergy. 2021;76(10):3041-3052.
Acevedo N, Zakzuk J, Caraballo L. House dust mite allergy under changing environments. Allergy, Asthma Immunol Res. 2019;11(4):450-469.
Matricardi PM. 99th Dahlem conference on infection, inflammation and chronic inflammatory disorders: controversial aspects of the 'hygiene hypothesis'. Clin Exp Immunol. 2010;160(1):98-105.
Di Fraia M, Arasi S, Castelli S, et al. A new molecular multiplex IgE assay for the diagnosis of pollen allergy in Mediterranean countries: a validation study. Clin Exp Allergy. 2019;49(3):341-349.