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Endotypes of pollen-food syndrome in children with seasonal allergic rhinoconjunctivitis: a molecular classification
- Publication Year :
- 2016
-
Abstract
- Background Pollen-food syndrome (PFS) is heterogeneous with regard to triggers, severity, natural history, comorbidities, and response to treatment. Our study aimed to classify different endotypes of PFS based on IgE sensitization to panallergens. Methods We examined 1271 Italian children (age 4-18 years) with seasonal allergic rhinoconjunctivitis (SAR). Foods triggering PFS were acquired by questionnaire. Skin prick tests were performed with commercial pollen extracts. IgE to panallergens Phl p 12 (profilin), Bet v 1 (PR-10), and Pru p 3 (nsLTP) were tested by ImmunoCAP FEIA. An unsupervised hierarchical agglomerative clustering method was applied within PFS population. Results PFS was observed in 300/1271 children (24%). Cluster analysis identified five PFS endotypes linked to panallergen IgE sensitization: (i) cosensitization to ≥2 panallergens ('multi-panallergen PFS'); (ii-iv) sensitization to either profilin, or nsLTP, or PR-10 ('mono-panallergen PFS'); (v) no sensitization to panallergens ('no-panallergen PFS'). These endotypes showed peculiar characteristics: (i) 'multi-panallergen PFS': severe disease with frequent allergic comorbidities and multiple offending foods; (ii) 'profilin PFS': oral allergy syndrome (OAS) triggered by Cucurbitaceae; (iii) 'LTP PFS': living in Southern Italy, OAS triggered by hazelnut and peanut; (iv) 'PR-10 PFS': OAS triggered by Rosaceae; and (v) 'no-panallergen PFS': mild disease and OAS triggered by kiwifruit. Conclusions In a Mediterranean country characterized by multiple pollen exposures, PFS is a complex and frequent complication of childhood SAR, with five distinct endotypes marked by peculiar profiles of IgE sensitization to panallergens. Prospective studies in cohorts of patients with PFS are now required to test whether this novel classification may be useful for diagnostic and therapeutic purposes in the clinical practice.
- Subjects :
- Male
pollen-food syndrome
Allergy
Comorbidity
Immunoglobulin E
0302 clinical medicine
Risk Factors
Immunology and Allergy
030212 general & internal medicine
Age of Onset
endotype
Child
Prospective cohort study
Sensitization
Conjunctivitis, Allergic
education.field_of_study
panallergens
biology
Syndrome
medicine.anatomical_structure
Italy
classification
endotypes
Child, Preschool
Population Surveillance
panallergen
Pollen
Female
Seasons
oral allergy syndrome
Food Hypersensitivity
Adolescent
Population
Immunology
pollen food syndrome
03 medical and health sciences
Oral allergy syndrome
children
medicine
cluster analysi
Humans
molecules
education
neoplasms
Skin Tests
Settore MED/38 - Pediatria Generale e Specialistica
molecule
business.industry
allergic rhinoconjunctiviti
Rhinitis, Allergic, Seasonal
allergic rhinoconjunctivitis
Allergens
medicine.disease
cluster analysis
030228 respiratory system
Food
biology.protein
Age of onset
business
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....c9e83f85eff16f295eb938080cd47410