3 years ago

Diagnostic relevance of IgE sensitization profiles to eight recombinant Phleum pratense molecules

Roberto Bernardini, Pasquale Comberiati, Francesco Macrì, Paolo Maria Matricardi, Annamaria Bianchi, Francesca Cipriani, Carlo Caffarelli, Loredana Chini, Michele Miraglia del Giudice, Elena Varin, Diego Faggian, Maria Carmen Verga, Simone Frediani, Calotta Povesi Dascola, Diego Peroni, Mariangela Tosca, Andrea Di Rienzo Businco, Riccardo Asero, Mario Plebani, Giuseppe Pingitore, Maria Francesca Patria, Francesco Paravati, Viviana Moschese, Arianna Dondi, Caterina Lambiase, Ifigenia Sfika, Sandra Lucarelli, Nunzia Maiello, Giampaolo Ricci, Carla Mastrorilli, Umberto Pelosi, Tullio Frediani, Salvatore Tripodi, , Valentina Panetta, Serena Perna, Iride Dello Iacono, Mauro Calvani
Background Grass pollen–related seasonal allergic rhinoconjunctivitis (SARg) is clinically heterogeneous in severity, comorbidities and response to treatment. The component-resolved diagnostics disclosed also a high heterogeneity at molecular level. Our study aimed at analyzing the characteristics of the IgE sensitization to Phleum pratense molecules and investigating the diagnostic relevance of such molecules in childhood. Methods We examined 1120 children (age 4–18y) with SARg. Standardized questionnaires on atopy were acquired through informatics platform (AllergyCARD™). Skin prick tests were performed with pollen extracts. Serum IgE to airborne allergens and eight Phleum pratense molecules (rPhl p 1, rPhl p 2, rPhl p 4, rPhl p 5b, rPhl p 6, rPhl p 7, rPhl p 11, rPhl p 12) were tested by ImmunoCAP FEIA. Results The analysis of IgE responses against eight Phleum pratense molecules showed 87profiles. According to the number of molecules recognized by IgE, the more complex profiles were characterized by higher serum total IgE, higher grass-specific serum IgE and higher number and degree of sensitization to pollens. The most frequent IgE sensitization profile was the monomolecular Phl p 1. Sensitization to Phl p 7 was a reliable biomarker of asthma, whereas Phl p 12 of oral allergy syndrome. Sensitization to Phl p 7 was associated with a higher severity of SAR, and complex profiles were associated with longer disease duration. Conclusions In a large pediatric population, the complexity of IgE sensitization profiles against Phleum pratense molecules is related to high atopic features although useless for predicting the clinical severity. The detection of serum IgE to Phl p 1, Phl p 7 and Phl p 12 can be used as clinical biomarkers of SARg and comorbidities. Further studies in different areas are required to test the impact of different IgE molecular profiles on AIT response. This article is protected by copyright. All rights reserved.

Publisher URL: http://onlinelibrary.wiley.com/resolve/doi

DOI: 10.1111/all.13338

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