Distinct regional allergen sensitization patterns in pediatric populations: A comparative latent class analysis of multiple antigen simultaneous test-derived sensitization profiles in Japan and Taiwan

Abstract

Background: Allergen sensitization patterns vary across regions; however, few studies have directly compared pediatric sensitization profiles between Japan and Taiwan.

Objective: This study aimed to compare allergen sensitization patterns in children from Japan and Taiwan using the multiple antigen simultaneous test (MAST) and latent class analysis (LCA).

Methods: A total of 217 Japanese and 166 Taiwanese children (aged 2-12 years) were enrolled. Based on responses to the International Study on Asthma and Allergy in Childhood questionnaire, participants were classified as either healthy or as having allergic rhinitis (AR), bronchial asthma (BA), or atopic dermatitis. Serum samples were analyzed using a commercial MAST kit available in Japan, and 20 allergens shared with the panel used in Taiwan were selected for analysis. Sensitization was defined as a lumicount value ≥2.78 (equivalent to class 2 or higher). LCA was conducted on the combined dataset, and the optimal number of latent classes was determined using the Akaike Information Criterion.

Results: LCA identified 4 latent classes: low-sensitized (LS), house dust mite-dominant (HDM-D), inhalant-sensitized (IH-S), and poly-sensitized (PS). The HDM-D class was more prevalent in Taiwan (50%) than in Japan (6.9%). In contrast, the IH-S and PS classes were more common in Japan (36.4% vs. 3% and 8.8% vs. 2.4%, respectively). AR and BA were primarily associated with HDM-D in Taiwan and with IH-S in Japan, which includes HDM and Japanese cedar pollen. HDM and crab sensitization were strongly correlated in Taiwan.

Conclusion: MAST combined with LCA reveals distinct regional sensitization profiles, suggesting divergent pathways in allergic disease development.

Keywords: Allergen profiling; MAST; cross-national comparison; latent class analysis; pediatric allergy.

Figure 1.

Venn diagram of comorbid allergic diseases in the study population. (A) Total population, (B) Japanese children, (C) Taiwanese children. The overlap of allergic rhinitis, asthma, and atopic dermatitis is illustrated for each group.

Figure 2.

Four sensitization patterns identified through latent class analysis (LCA). The 383 participants were classified into 4 latent classes based on their sensitization profiles to 20 allergens. Each class represents a distinct pattern of allergen-specific immunoglobulin E (IgE) reactivity.

Figure 3.

Differences in class distributions in allergic disease status between Japan and Taiwan. The proportions of participants with allergic rhinitis, asthma, and atopic dermatitis are shown across the 4 latent classes in each country.

Figure 4.

Differences in Lumicount Values for Dermatophagoides farinae (A–D) and Japanese cedar pollen (E–H) across LCA classes in Japan and Taiwan. (A, E) Class 1; (B, F) class 2; (C, G) class 3; and (D, H) class 4. Each panel compares the lumicount values by class and country to highlight class-specific sensitization intensity.

Figure 5.

Differences in Lumicount values for dog dander (A–D) and crab (E–H) across LCA classes in Japan and Taiwan. (A, E) Class 1; (B, F) class 2; (C, G) class 3; and (D, H) class 4. The comparison demonstrates the variation in cross-reactive sensitization patterns between the 2 populations.