Heterogeneity of pollen food allergy syndrome in seven Southern European countries: The @IT.2020 multicenter study

Theresa Lipp¹, Aydan Acar Şahin², Xenophon Aggelidis³, Stefania Arasi⁴, Andrea Barbalace⁵, Anne Bourgoin⁶, Blerina Bregu⁷, Maria Antonia Brighetti⁸, Elsa Caeiro^{9

10}, Sule Caglayan Sozmen¹¹, Lucia Caminiti⁵, Denis Charpin⁶, Mariana Couto¹², Luís Delgado^{13

14

15}, Andrea Di Rienzo Businco¹⁶, Claire Dimier⁶, Maria V Dimou¹⁷, João A Fonseca^{14

15

18}, Ozlem Goksel¹⁹, Aykut Guvensen²⁰, Dolores Hernandez²¹, Tara Maria Hoffmann¹, Dah Tay Jang²², Fusun Kalpaklioglu²³, Blerta Lame⁷, Ruth Llusar²², Michael P Makris³, Angel Mazon²², Eris Mesonjesi⁷, Antonio Nieto²², Ayse Öztürk²⁴, Laurie Pahus²⁵, Giovanni Battista Pajno⁵, Ilenia Panasiti⁵, Nikolaos G Papadopoulos^{17

26}, Elisabetta Pellegrini²⁷, Simone Pelosi²⁸, Ana M Pereira^{14

15

18}, Mariana Pereira^{14

15}, Munevver Pinar², Ekaterina Potapova¹, Alfred Priftanji⁷, Fotis Psarros²⁹, Cansin Sackesen³⁰, Ifigenia Sfika¹⁶, Javier Suarez³¹, Michel Thibaudon³², Alessandro Travaglini^{8

33}, Salvatore Tripodi^{16

34}, Valentine Verdier⁶, Valeria Villella¹⁶, Paraskevi Xepapadaki³⁵, Duygu Yazici³⁶, Paolo M Matricardi¹, Stephanie Dramburg¹

Affiliations

¹ Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany.
² Department of Biology, Faculty of Science, Ankara University, Ankara, Turkey.
³ Allergy Unit, 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, University Hospital "Attikon", Athens, Greece.
⁴ Pediatric Allergology Unit, Department of Pediatric Medicine, Bambino Gesù Children's Research Hospital (IRCCS), Rome, Italy.
⁵ Department of Pediatrics-Allergy Unit, University of Messina, Messina, Italy.
⁶ Department of Pneumonology and Allergy, La Timone Hospital, APHM, Aix-Marseille University, Marseille, France.
⁷ Department of Allergology and Clinical Immunology, UHC Mother Teresa, Medical University Tirana, Tirana, Albania.
⁸ Department of Biology, Tor Vergata University, Rome, Italy.
⁹ MED-Mediterranean Institute for Agriculture, Environment and Development, Institute for Advanced Studies and Research, University of Évora, Évora, Portugal.
¹⁰ Portuguese Society of Allergology and Clinical Immunology, Lisbon, Portugal.
¹¹ Department of Pediatric Allergy and Immunology, Okan University Faculty of Medicine, Istanbul, Turkey.
¹² Department of Immunoallergology, CUF Decobertas Hospital, José de Mello Saúde, Porto, Portugal.
¹³ Basic and Clinical Immunology Unit, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal.
¹⁴ CINTESIS, Center for Health Technology and Services Research, Porto, Portugal.
¹⁵ Allergy Unit, Instituto & Hospital CUF Porto, Porto, Portugal.
¹⁶ Pediatric Allergy Unit, Sandro Pertini Hospital, Rome, Italy.
¹⁷ Allergy Department, 2nd Pediatric Clinic, Athens General Children's Hospital "P&A Kyriakou", University of Athens, Athens, Greece.
¹⁸ MEDCIDS-Department of Community Medicine, Information, and Health Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.
¹⁹ Department of Pulmonary Medicine, Division of Immunology, Allergy and Asthma, Faculty of Medicine, Ege University, Izmir, Turkey.
²⁰ Department of Biology, Faculty of Science, Ege University, Izmir, Turkey.
²¹ Department of Allergy, Health Research Institute Hospital La Fe, Valencia, Spain.
²² Pediatric Allergy and Pneumology Unit, Children's Hospital La Fe, Health Research Institute La Fe, Valencia, Spain.
²³ Department of Immunology and Allergic Diseases, Kırıkkale University School of Medicine, Ankara, Turkey.
²⁴ Department of Pulmonary Medicine, Division of Allergy and Immunology, Koç University, School of Medicine, Istanbul, Turkey.
²⁵ Department of Pneumonology and Allergy, North Hospital, APHM, Aix-Marseille University, Marseille, France.
²⁶ Division of Infection, Immunity & Respiratory Medicine, Royal Manchester Children's Hospital, University of Manchester, Manchester, UK.
²⁷ Department of Reggio Calabria, ARPA-Regional Agency for Environmental Protection, Calabria, Italy.
²⁸ TPS Production srl, Rome, Italy.
²⁹ Allergy Department, Athens Naval Hospital, Athens, Greece.
³⁰ Division of Pediatric Allergy, Koç University School of Medicine, Istanbul, Turkey.
³¹ Department of Biology of Organisms and Systems, Area of Botany, University of Oviedo, Oviedo, Spain.
³² Réseau National de Surveillance Aérobiologique, Brussieu, France.
³³ Italian Aerobiology Monitoring Network-Italian Aerobiology Association, Rome, Italy.
³⁴ Allergolology Service, Policlinico Casilino, Rome, Italy.
³⁵ Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece.
³⁶ Cellular and Molecular Medicine, KUTTAM, Graduate School of Health Sciences, Koç University, Istanbul, Turkey.

PMID: 33492738
DOI: 10.1111/all.14742

Multicenter Study

Heterogeneity of pollen food allergy syndrome in seven Southern European countries: The @IT.2020 multicenter study

Theresa Lipp et al. Allergy. 2021 Oct.

. 2021 Oct;76(10):3041-3052.

doi: 10.1111/all.14742. Epub 2021 Jul 18.

Authors

Affiliations

¹ Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany.
² Department of Biology, Faculty of Science, Ankara University, Ankara, Turkey.
³ Allergy Unit, 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, University Hospital "Attikon", Athens, Greece.
⁴ Pediatric Allergology Unit, Department of Pediatric Medicine, Bambino Gesù Children's Research Hospital (IRCCS), Rome, Italy.
⁵ Department of Pediatrics-Allergy Unit, University of Messina, Messina, Italy.
⁶ Department of Pneumonology and Allergy, La Timone Hospital, APHM, Aix-Marseille University, Marseille, France.
⁷ Department of Allergology and Clinical Immunology, UHC Mother Teresa, Medical University Tirana, Tirana, Albania.
⁸ Department of Biology, Tor Vergata University, Rome, Italy.
⁹ MED-Mediterranean Institute for Agriculture, Environment and Development, Institute for Advanced Studies and Research, University of Évora, Évora, Portugal.
¹⁰ Portuguese Society of Allergology and Clinical Immunology, Lisbon, Portugal.
¹¹ Department of Pediatric Allergy and Immunology, Okan University Faculty of Medicine, Istanbul, Turkey.
¹² Department of Immunoallergology, CUF Decobertas Hospital, José de Mello Saúde, Porto, Portugal.
¹³ Basic and Clinical Immunology Unit, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal.
¹⁴ CINTESIS, Center for Health Technology and Services Research, Porto, Portugal.
¹⁵ Allergy Unit, Instituto & Hospital CUF Porto, Porto, Portugal.
¹⁶ Pediatric Allergy Unit, Sandro Pertini Hospital, Rome, Italy.
¹⁷ Allergy Department, 2nd Pediatric Clinic, Athens General Children's Hospital "P&A Kyriakou", University of Athens, Athens, Greece.
¹⁸ MEDCIDS-Department of Community Medicine, Information, and Health Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.
¹⁹ Department of Pulmonary Medicine, Division of Immunology, Allergy and Asthma, Faculty of Medicine, Ege University, Izmir, Turkey.
²⁰ Department of Biology, Faculty of Science, Ege University, Izmir, Turkey.
²¹ Department of Allergy, Health Research Institute Hospital La Fe, Valencia, Spain.
²² Pediatric Allergy and Pneumology Unit, Children's Hospital La Fe, Health Research Institute La Fe, Valencia, Spain.
²³ Department of Immunology and Allergic Diseases, Kırıkkale University School of Medicine, Ankara, Turkey.
²⁴ Department of Pulmonary Medicine, Division of Allergy and Immunology, Koç University, School of Medicine, Istanbul, Turkey.
²⁵ Department of Pneumonology and Allergy, North Hospital, APHM, Aix-Marseille University, Marseille, France.
²⁶ Division of Infection, Immunity & Respiratory Medicine, Royal Manchester Children's Hospital, University of Manchester, Manchester, UK.
²⁷ Department of Reggio Calabria, ARPA-Regional Agency for Environmental Protection, Calabria, Italy.
²⁸ TPS Production srl, Rome, Italy.
²⁹ Allergy Department, Athens Naval Hospital, Athens, Greece.
³⁰ Division of Pediatric Allergy, Koç University School of Medicine, Istanbul, Turkey.
³¹ Department of Biology of Organisms and Systems, Area of Botany, University of Oviedo, Oviedo, Spain.
³² Réseau National de Surveillance Aérobiologique, Brussieu, France.
³³ Italian Aerobiology Monitoring Network-Italian Aerobiology Association, Rome, Italy.
³⁴ Allergolology Service, Policlinico Casilino, Rome, Italy.
³⁵ Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece.
³⁶ Cellular and Molecular Medicine, KUTTAM, Graduate School of Health Sciences, Koç University, Istanbul, Turkey.

PMID: 33492738
DOI: 10.1111/all.14742

Abstract

Background: Pollen food allergy syndrome (PFAS) is a frequently underdiagnosed disease due to diverse triggers, clinical presentations, and test results. This is especially relevant in geographic areas with a broad spectrum of pollen sensitization, such as Southern Europe.

Objectives: To elucidate similarities and differences of PFAS in nine Southern European centers and identify associated characteristics and unique markers of PFAS.

Methods: As part of the @IT.2020 Multicenter Study, 815 patients with seasonal allergic rhinitis (SAR), aged 10-60 years, were recruited in seven countries. They completed questionnaires regarding SAR, comorbidities, family history, and PFAS, and underwent skin prick testing (SPT) and serum IgE testing.

Results: Of the 815 patients, 167 (20.5%) reported PFAS reactions. Most commonly, eliciting foods were kiwi (58, 34.7%), peach (43, 25.7%), and melon (26, 15.6%). Reported reactions were mostly local (216/319, 67.7%), occurring within 5 min of contact with elicitors (209/319, 65.5%). Associated characteristics included positive IgE to at least one panallergen (profilin, PR-10, or nsLTP) (p = 0.007), maternal PFAS (OR: 3.716, p = 0.026), and asthma (OR: 1.752, p = 0.073). Between centers, heterogeneity in prevalence (Marseille: 7.5% vs. Rome: 41.4%, p < 0.001) and of clinical characteristics was apparent. Cypress played a limited role, with only 1/22 SPT mono-sensitized patients reporting a food reaction (p < 0.073).

Conclusions: PFAS is a frequent comorbidity in Southern European SAR patients. Significant heterogeneity of clinical characteristics in PFAS patients among the centers was observed and may be related to the different pollen sensitization patterns in each geographic area. IgE to panallergen(s), maternal PFAS, and asthma could be PFAS-associated characteristics.

Keywords: Southern Europe; oral allergy syndrome; panallergen; pollen food allergy syndrome; seasonal allergic rhinitis.

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References

REFERENCES

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Heterogeneity of pollen food allergy syndrome in seven Southern European countries: The @IT.2020 multicenter study

Affiliations

Heterogeneity of pollen food allergy syndrome in seven Southern European countries: The @IT.2020 multicenter study

Authors

Affiliations

Abstract

References

REFERENCES

Publication types

MeSH terms

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LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical

Research Materials

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