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Background: Studies have linked daily pollen counts to respiratory allergic health outcomes, but few have considered allergen levels., Objective: We sought to assess associations of grass pollen counts and grass allergen levels (Phl p 5) with respiratory allergic health symptoms in a panel of 93 adults with moderate-severe allergic rhinitis and daily asthma hospital admissions in London, United Kingdom., Methods: Daily symptom and medication scores were collected from adult participants in an allergy clinical trial. Daily counts of asthma hospital admissions in the London general population were obtained from Hospital Episode Statistics data. Daily grass pollen counts were measured using a volumetric air sampler, and novel Phl p 5 levels were measured using a ChemVol High Volume Cascade Impactor and ELISA analyses (May through August). Associations between the 2 pollen variables and daily health scores (dichotomized based on within-person 75th percentiles) were assessed using generalized estimating equation logistic models and with asthma hospital admissions using Poisson regression models., Results: Daily pollen counts and Phl p 5 levels were each positively associated with reporting a high combined symptom and medication health score in separate models. However, in mutually adjusted models including terms for both pollen counts and Phl p 5 levels, associations remained for Phl p 5 levels (odds ratio [95% CI]: 1.18 [1.12, 1.24]), but were heavily attenuated for pollen counts (odds ratio [95% CI]: 1.00 [0.93, 1.07]). Similar trends were not observed for asthma hospital admissions in London., Conclusions: Grass allergen (Phl p 5) levels are more consistently associated with allergic respiratory symptoms than grass pollen counts., Competing Interests: Disclosure statement The PollenLITE trial was awarded by the Efficacy and Mechanism Evaluation Programme, is funded by the Medical Research Council (MRC) and managed by the National Institute for Health Research (NIHR) on behalf of the MRC-NIHR partnership, and is jointly sponsored by King’s College London and Guy’s and St Thomas’ NHS Foundation Trust. Additional funding was provided by the King’s Health Partners Research and Development Challenge Fund. This work was also supported by the NIHR Biomedical Research Centre at Guy’s and St Thomas’ NHS Foundation Trust and King’s College London. The work of the UK Small Area Health Statistics Unit is overseen by the UK Health Security Agency and partly funded by the MRC Centre for Environment and Health (grant no. MR/L01341X/1), the NIHR through its Health Protection Units at Imperial College London in Environmental Exposures and Health and in Chemical and Radiation Threats and Hazards, Health Data Research UK, and infrastructure support to the Department of Epidemiology and Biostatistics provided by the NIHR Imperial Biomedical Research Centre. This paper does not necessarily reflect the views of the UK Health Security Agency, the NIHR, or the Department of Health and Social Care. E.F. is supported by the Imperial College Research Fellowship. J.T.M.B. was supported by a Higher Education Funding Council for England Clinical Senior Lectureship Award during the period the PollenLITE study was conducted. The funding sources had no role in the study design, collection, analysis and interpretation of data, writing of the report, and decision to submit the paper for publication. Disclosure of potential conflict of interest: The authors declare that they have no relevant conflicts of interest., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Clinically complex phenotypes require more and more sophisticated and comprehensive diagnostic approaches, able to discriminate genuine sensitizations from cross-reactivity. Interpretative complexity of multiplex diagnostic arrays has somewhat limited their diffusion. This study compares two currently available methods, namely ISAC ® test and ALEX2 ® test., Methods: In total, 140 allergic individuals, with a history of atopic dermatitis, adverse food reactions, allergic rhinitis and/or bronchial asthma were studied by Allergy Explorer-ALEX2 ® macroarray and ImmunoCAP ISAC112 ® . Lin's concordance correlation coefficient, intraclass correlation coefficient and Bland-Altman plots were used to verify the agreement between continuous values. Cohen's kappa coefficient (k) was assessed for the molecules available in both tests. The degree of relationship was analysed using Spearman's correlation (quantitative variables) and Pearson's χ 2 or Fisher's exact test (categorical variables)., Results: A substantial agreement (κ = 0.795) was observed between the two methods with 94,3% concordant results when results were dichotomized as negative or positive, but if double-negative results were discarded, the agreement dropped to 71%. Conversely, little or no concordance was observed comparing raw data. Considering the 102 molecules shared by both systems, 28/102 (27%) showed an almost perfect agreement (k > 0.81), and concordance was good (k > 0.61) in a further 32 (31%) cases. A perfect to substantial agreement was observed by comparing species-specific aeroallergens. Heterogeneous results emerged comparing panallergens (co-recognition ranging from 30% for tropomyosin/serum albumins to 70% for PR-10/profilin). The correlation among LTP, profilin and PR-10 assayed with ISAC ® was better than ALEX2 ® , but the latter identified more positive cases due to the wider number of molecules available. The CCD blocker provided by ALEX ® test abolishes the carbohydrate determinants signal in 60% of the 33 cases reactive to MUXF3 on the ISAC ® test., Conclusion: Despite the excellent concordance of the species-specific markers, the analysis of the panallergens provided in both methods suggests a better performance of the ISAC ® test on those components, while the ALEX2 ® test, which includes a larger number of allergens, allowing a broader molecular detection., (© 2021 John Wiley & Sons Ltd.)

Background: The so-called "thunderstorm asthma" (TA) is an uncommon but dramatic outbreak of asthma attacks occurring during a thunderstorm in the pollen and moulds season. Mechanisms which make the pollen able to enter the deeper airways and provoke severe asthma symptoms are still unclear., Objective: To test the hypothesis that sub-pollen particles (SPPs) originated from the rupture by an osmotic shock of pollen associated with TA contain allergens., Methods: After hydration, SPPs released from pollen grains of grass, pellitory, olive, cypress, ragweed and birch were isolated and determined by microscopy. Allergens were determined by in vitro ELISA inhibition tests indirectly using the sera from 10 polyreactive patients. An inhibition <50% was considered as negative, 50%-75% moderate and > 75% complete., Results: The inhibition experiments showed that the SPPs from birch and cypress were unable to inhibit serum IgE reactivity to Bet v 1 and Cup a 1, respectively. Ragweed SPPs inhibited ragweed pollen extract and Amb a 1 by 75.8 ± 0.11% and 81.2 ± 0.15%, respectively. Olive and pellitory SPPs retained almost the whole IgE-binding capability in all cases tested. Grass SPPs inhibited 32 ± 0.06% of Lolium perenne Lol p 1 and 65% of Phleum pratense extracts, but results were highly variable for individual allergens (97.5%-0.03% for Phl p 2, 45.3 ± 0.12% for Phl p 5, 24.7 ± 0.22% for Phl p 6, and 38.3 ± 0.2% for Phl p 1)., Conclusions: Inhibition experiments confirm the hypothesis that SSPs obtained after the osmotic shock of pollen involved in TA, namely grass, pellitory and olive tree pollen, contain allergens and therefore they can induce severe asthma attacks during thunderstorms., (© 2021 John Wiley & Sons Ltd.)

An increasing number of studies on allergenic molecules have been published during the past 20 years, and the number of proteins reported as allergens is close to 1500 (http://www.allergome.org). Collecting, organizing, and displaying data reported in the scientific literature is becoming the major commitment of Web-based databases that organize this knowledge in heterogeneous ways. This heterogeneity prevents the databases from being connected to each other, something that has been done in several other biomedical fields. This review reports on the current status of allergen databases and available tools to study the allergenicity of new compounds. An analysis of what has been done by applying bioinformatics in other medical fields is presented. Suggestions on how to create a common platform in which experimental, clinical, and epidemiologic data could be merged are offered. The model of the Allergome platform and its modules and tools (eg, InterAll, ReTiME, RefArray, and AllergomeBlaster) are used to exemplify interconnectivity and data integration.

[Display omitted] Cyclophilins are ubiquitous panallergens whose epidemiologic, diagnostic, and clinical relevance is largely unknown and whose sensitization is rarely examined in routine allergy practice. We investigated the epidemiologic, diagnostic, and clinical relevance of cyclophilins in seasonal allergic rhinitis and its comorbidities. We examined a random sample of 253 (25%) of 1263 Italian children with seasonal allergic rhinitis from the Panallergens in Pediatrics (PAN-PED) cohort with characterized disease phenotypes. Nested studies of sensitization prevalence, correlation, and allergen extract inhibition were performed in patients sensitized to birch pollen extract but lacking IgE to Bet v 1/2/4 (74/1263) or with highest serum level of IgE to Bet v 1 (26/1263); and in patients with sensitization to various extracts (ragweed, mugwort, pellitory, Plantago , and plane tree), but not to their respective major allergenic molecule, profilins, and polcalcins. IgE to cyclophilin was detected with recombinant Bet v 7, and extract inhibition tests were performed with the same rBet v 7. IgE to rBet v 7 was detected in 43 (17%) of 253 patients. It was associated with asthma (P <.028) and oral allergy syndrome (P <.017) in univariate but not multivariate analysis adjusted for IgE to profilins (Phl p 12), PR-10s (Bet v 1), and lipid transfer proteins (Pru p 3). IgE to rBet v 7 was also highly prevalent (47/74, 63%) among patients with unexplained sensitization to birch pollen extract. In patients with unexplained sensitization to ragweed, mugwort, pellitory, Plantago and plane tree pollen, the levels of IgE to those extracts correlated with the levels of IgE to rBet v 7, and they were also significantly inhibited by rBet v 7 (inhibition range 45%-74%). IgE sensitization to cyclophilin is frequent in pollen-allergic patients living in temperate areas and can produce "false" positive outcomes in skin prick and IgE tests to pollen extracts. Molecular diagnostic guidelines should include this panallergen family. [ABSTRACT FROM AUTHOR]

Background: Management of hundreds of analytes obtained from the molecular multiplex techniques currently available may represent a challenge for clinicians in daily clinical practice. Objectives: The aim of the study was to describe a comprehensive and simple approach to assess such complex molecular results, to display relevant disease-specific signatures at a glance, and to facilitate their interpretation. Method: A total of 6,332 consecutive allergic patients, categorized based on clinical symptoms reported at the time of the first visit before IgE testing, were evaluated through ImmunoCAP ISAC112®. Results and Conclusions: The occurrence of bronchial asthma is associated with polcalcin, serum albumin, or lipocalin reactivity. Higher risk of severe reaction to food is linked to tropomyosin or nonspecific lipid transfer protein reactivity (in the absence of plant pathogenesis-related proteins [PR-10] or profilin sensitization). We used radar graphic display to highlight, at a glance, the molecular reactivity profiles associated with relevant disease-specific patterns. [ABSTRACT FROM AUTHOR]

Background: Atopic dermatitis (AD) represents a chronic skin disorder seriously affecting patients' QoL and is often associated with immunological imbalance, disorders of the skin barrier function and environmental factors. Objective: We extensively studied the proteomic IgE sensitization profile in a large AD Mediterranean cohort. Methods: A total of 588 individuals with moderate‐severe (70.6%) or mild and/or history of (29.4%) AD were evaluated in comparison to 1285 unselected atopic controls (AC) with a history of adverse reactions to foods, allergic rhinitis and/or bronchial asthma by means of ImmunoCAP ISAC112® and Allergy Explorer‐ALEX® microarray analysis. Results: The olive tree pollen β‐1,3‐glucanase rOle e 9 and the manganese superoxide dismutase from Aspergillus rAsp f 6 were the molecules most significantly associated with AD occurrence and allowed to discriminate among the moderate and severe forms of disease. An IgE hyper‐reactivity to cypress, grasses, olive tree, house dust mites (including rDer p 11), and to all cross‐reactive components except profilin and polcalcin was observed. About 60% of adults with severe AD were sensitized to nsLTPs. Cross‐reactive carbohydrate determinants (CCDs) IgE was found in about one‐third of AD participants. Hen eggs nGal d 1 IgE sensitization was more prevalent in the paediatric population, whilst rAsp f 6 and rOle e 9 reactivity was found particularly in older patients. Despite the status of widespread IgE sensitization to both environmental and food allergens, a reduced frequency of patient‐reported severe reactions to food or of asthma was observed in AD patients compared to AC, particularly in case of concomitant Ole e 9 reactivity. Conclusion and Clinical Relevance: Testing IgE reactivity to a large panel of molecular components unveils important associations between IgE reactivity profiles and AD clinical presentation, highlights the allergens useful for a precise AD signature and allows the detection of interesting sensitisations patterns. [ABSTRACT FROM AUTHOR]

IgE specific for D1, D2, Der p 1, Der p 2, Der p 10, and Der p 23 was measured by ImmunoCAP (Thermo-Fisher Scientific, Uppsala, Sweden). Mean D1 IgE level was strictly related to the number of recombinant allergens recognized (P < 0.0001) and to the level of IgE to Der p 1 (r = 0.791), Der p 2 (r = 0.83), and Der p 23 IgE (r = 0.66; P < 0.0001 in all three cases). Further, asthma severity was associated with Der p 23 IgE levels (P < 0.0001), which were 3.9 kU/L (SD 9.5), 5.9 kU/L (10.4), 11.0 (17.1), and 17.8 (20.3) in nonasthmatic patients, and patients with slight, moderate, or severe persistent asthma, respectively. [Extracted from the article]

Background: Immunoglobluin E (IgE)-mediated hypersensitivity to natural rubber latex (NRL) is a major problem in allergy practice. Currently, the use of skin prick tests (SPTs) with latex extracts and specific IgE detection for the diagnosis of NRL allergy in suspected patients is directed to identification of risk factors. Many cases of NRL allergy remain undiagnosed due to misreporting of symptoms by the patients or lack of proper questions asked by the physician. Materials and Methods: A total of 6,126 subjects referred for respiratory symptoms underwent SPTs with NRL. Positive subjects were resurveyed for exposure to NRL, and specific IgE for NRL extracts and recombinant molecules was determined. Immunoblots of NRL extracts were performed to identify IgE patterns. Results: Forty-six of 3,930 sensitized subjects had a positive SPT with NRL, displaying a prevalence of NRL sensitization of 0.75% for the general and 1.2% for the sensitized population. Eleven out of 46 (23.9%) subjects could be defined as NRL asymptomatic, whereas 35 (76.1%) developed symptoms upon exposure to NRL. Specific IgE to NRL was detected for 22 (75.86%) of 29 tested sera. Seventeen out of 22 (77%) sera displayed specific IgE to recombinant allergens with most reactions to Hev b 5, Hev b 6.01 and Hev b 6.02. Immunoblots of NRL extract fractions with patients’ sera showed heterogeneous patterns. Conclusions: SPTs with NRL extract should be routinely performed in patients with respiratory symptoms. Hev b 5, Hev b 6.01 and Hev b 6.02 are the most important allergens, but further characterization of NRL extracts is needed to identify novel allergens and to clarify the role of crossreactive carbohydrate determinants. Copyright © 2007 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]