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Observational Study
. 2024 Apr;79(4):908-923.
doi: 10.1111/all.16029. Epub 2024 Feb 5.

Heterogeneity of sensitization profiles and clinical phenotypes among patients with seasonal allergic rhinitis in Southern European countries-The @IT.2020 multicenter study

S Dramburg  1 , U Grittner  2 , E Potapova  1 , A Travaglini  3   4 , S Tripodi  5   6 , S Arasi  1   7 , S Pelosi  8 , A Acar Şahin  9 , X Aggelidis  10 , A Barbalace  11 , A Bourgoin  12 , B Bregu  13 , M A Brighetti  3 , E Caeiro  14   15 , S Caglayan Sozmen  16 , L Caminiti  11 , D Charpin  12 , M Couto  17 , L Delgado  18   19   20 , A Di Rienzo Businco  5 , C Dimier  12 , M V Dimou  21 , J A Fonseca  19   20   22 , O Goksel  23 , D Hernandez  24 , C J Hernandez Toro  1   2 , T M Hoffmann  1 , D T Jang  25 , F Kalpaklioglu  26 , B Lame  13 , R Llusar  25 , M Makris  10 , A Mazon  25 , E Mesonjesi  13 , A Nieto  25 , A B Öztürk  27 , L Pahus  28 , G Pajno  11 , I Panasiti  11 , N G Papadopoulos  21   29 , E Pellegrini  30 , A M Pereira  20   22 , M Pereira  18   19 , N M Pinar  9 , A Priftanji  13 , F Psarros  31 , C Sackesen  32 , I Sfika  5 , J Suarez  33 , M Thibaudon  34 , U Uguz  35 , V Verdier  12 , V Villella  5 , P Xepapadaki  36 , D Yazici  37   38 , P M Matricardi  1
Affiliations
Observational Study

Heterogeneity of sensitization profiles and clinical phenotypes among patients with seasonal allergic rhinitis in Southern European countries-The @IT.2020 multicenter study

S Dramburg et al. Allergy. 2024 Apr.

Abstract

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: To describe sensitization profiles and clinical phenotypes of pollen allergic patients in nine Southern European cities with a uniform methodological approach.

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: 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: 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.

Keywords: IgE; allergic rhinitis; component‐resolved diagnostics; phenotypes; pollen allergy; sensitization.

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References

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