Molecular Mapping of Allergen Exposome among Different Atopic Phenotypes

Abstract

Climate change and exposure to environmental pollutants play a key role in the onset and aggravation of allergic diseases. As different climate-dependent patterns of molecular immunoglobulin E (IgE) reactivity have been regionally described, we sought to investigate the evolving allergen exposome in distinctive allergic phenotypes and subtropical weather conditions through a Precision Allergy Molecular Diagnosis (PAMD@) model. Concurrent sensitization to several house dust mites (HDM) and storage mite molecules were broadly dominant in the investigated cohort, followed by the major cat allergen Fel d 1, and regardless of the basal allergic disease. Although a complex repertoire of allergens was recognized, a steadily increasing number of IgE binding molecules was associated with the complexity of the underlying atopic disease. Besides the highly prevalent IgE responses to major HDM allergens, Der p 21, Der p 5, and Der p 7 also showed up as serodominant molecules, especially in subjects bothered by asthma and atopic dermatitis. The accurate characterization of the external exposome at the molecular level and their putative role as clinically relevant allergens is essential to elucidate the phenotypic diversity of atopic disease in terms of personalized diagnosis and therapy.

Keywords: airborne allergens; allergic rhinitis; asthma; atopic dermatitis; atopy; climate change; exposome.

Figure 1

Flow diagram of study selection.

Figure 2

Distribution of patients according to their local municipality on the island of Tenerife, Spain (28°16′7″ N, 16°36′20″ W). Onset of referred clinical symptoms after a minimum of 3 years of local residency was required to meet the inclusion criteria in the present investigation.

Figure 3

Specific IgE serodominance in a comprehensive panel of molecular aeroallergens.

Figure 4

Sensitization profile to specific IgE (sIgE): (A) heatmap and (B) scatter plots with bars of a comprehensive panel of molecular allergens of Dermatophagoides pteronyssinus, Blomia tropicalis, Lepidoglyphus destructor, and Tyrophagus putrescentiae in 50 rhinitis, 50 rhinitis and asthma, and 50 rhinitis, asthma, and atopic dermatitis patients. (C) IgE: Western blot of the different groups included against Dermatophagoides pteronyssinus (DPT), Blomia tropicalis (BTR), and Lepidoglyphus destructor (LDE). Broadly different patterns of sIgE binding were identified for each group of patients.