Background: Pollen-food syndrome (PFS) is heterogeneous with regard to triggers,severity, natural history, comorbidities, and response to treatment. Our study aimedto classify different endotypes of PFS based on IgE sensitization to panallergens.Methods: We examined 1271 Italian children (age 4–18 years) with seasonal aller-gic rhinoconjunctivitis (SAR). Foods triggering PFS were acquired by question-naire. Skin prick tests were performed with commercial pollen extracts. IgE topanallergens Phl p 12 (profilin), Bet v 1 (PR-10), and Pru p 3 (nsLTP) were testedby ImmunoCAP FEIA. An unsupervised hierarchical agglomerative clusteringmethod was applied within PFS population.Results: PFS was observed in 300/1271 children (24%). Cluster analysis identifiedfive 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 panaller-gens (‘no-panallergen PFS’). These endotypes showed peculiar characteristics: (i)‘multi-panallergen PFS’: severe disease with frequent allergic comorbidities andmultiple offending foods; (ii) ‘ profilin PFS’: oral allergy syndrome (OAS) trig-gered 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 expo-sures, PFS is a complex and frequent complication of childhood SAR, with fivedistinct endotypes marked by peculiar profiles of IgE sensitization to panaller-gens. Prospective studies in cohorts of patients with PFS are now required to testwhether this novel classification may be useful for diagnostic and therapeutic pur-poses in the clinical practice.

Mastrorilli, C., Tripodi, S., Caffarelli, C., Perna, S., Di Rienzo Businco, A., Sfika, I., et al. (2016). Endotypes of pollen-food syndrome in children with seasonal allergic rhinoconjunctivitis: a molecular classification. ALLERGY, 71(8), 1181-1191 [10.1111/all.12888].

Endotypes of pollen-food syndrome in children with seasonal allergic rhinoconjunctivitis: a molecular classification

CHINI, LOREDANA;MOSCHESE, VIVIANA;TRAVAGLINI, ALESSANDRO;
2016

Abstract

Background: Pollen-food syndrome (PFS) is heterogeneous with regard to triggers,severity, natural history, comorbidities, and response to treatment. Our study aimedto classify different endotypes of PFS based on IgE sensitization to panallergens.Methods: We examined 1271 Italian children (age 4–18 years) with seasonal aller-gic rhinoconjunctivitis (SAR). Foods triggering PFS were acquired by question-naire. Skin prick tests were performed with commercial pollen extracts. IgE topanallergens Phl p 12 (profilin), Bet v 1 (PR-10), and Pru p 3 (nsLTP) were testedby ImmunoCAP FEIA. An unsupervised hierarchical agglomerative clusteringmethod was applied within PFS population.Results: PFS was observed in 300/1271 children (24%). Cluster analysis identifiedfive 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 panaller-gens (‘no-panallergen PFS’). These endotypes showed peculiar characteristics: (i)‘multi-panallergen PFS’: severe disease with frequent allergic comorbidities andmultiple offending foods; (ii) ‘ profilin PFS’: oral allergy syndrome (OAS) trig-gered 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 expo-sures, PFS is a complex and frequent complication of childhood SAR, with fivedistinct endotypes marked by peculiar profiles of IgE sensitization to panaller-gens. Prospective studies in cohorts of patients with PFS are now required to testwhether this novel classification may be useful for diagnostic and therapeutic pur-poses in the clinical practice.
Pubblicato
Rilevanza internazionale
Articolo
Esperti anonimi
Settore MED/38 - Pediatria Generale e Specialistica
English
Con Impact Factor ISI
allergic rhinoconjunctivitis; children; classification; cluster analysis; endotypes; molecules; oral allergy syndrome; panallergens; pollen-food syndrome
Mastrorilli, C., Tripodi, S., Caffarelli, C., Perna, S., Di Rienzo Businco, A., Sfika, I., et al. (2016). Endotypes of pollen-food syndrome in children with seasonal allergic rhinoconjunctivitis: a molecular classification. ALLERGY, 71(8), 1181-1191 [10.1111/all.12888].
Mastrorilli, C; Tripodi, S; Caffarelli, C; Perna, S; Di Rienzo Businco, A; Sfika, I; Asero, R; Dondi, A; Bianchi, A; Povesi Dascola, C; Ricci, G; Cipriani, F; Maiello, N; Miraglia Del Giudice, M; Frediani, T; Frediani, S; Macri, F; Pistoletti, C; Dello Iacono, I; Patria, M; Varin, E; Peroni, D; Comberiati, P; Chini, L; Moschese, V; Lucarelli, S; Bernardini, R; Pingitore, G; Pelosi, U; Olcese, R; Moretti, M; Cirisano, A; Faggian, D; Travaglini, A; Plebani, M; Verga, M; Calvani, M; Giordani, P; Matricardi, P
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/168096
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