Department of Pediatric Pneumology and Immunology, Charité Medical University, Berlin, Germany.
Pediatric Unit, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
Allergy. 2018 Mar;73(3):673-682. doi: 10.1111/all.13338. Epub 2017 Dec 14.
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.
We examined 1120 children (age 4-18 years) 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 P. 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.
The analysis of IgE responses against eight P. pratense molecules showed 87 profiles. 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 SARg, and complex profiles were associated with longer disease duration.
In a large pediatric population, the complexity of IgE sensitization profiles against P. 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.
草花粉相关的季节性变应性鼻结膜炎（SARg）在严重程度、合并症和治疗反应方面存在临床异质性。成分解析诊断还揭示了分子水平上的高度异质性。我们的研究旨在分析对Phleum pratense 分子的 IgE 致敏的特征，并研究这些分子在儿童中的诊断相关性。
我们检查了 1120 名患有 SARg 的儿童（年龄 4-18 岁）。通过信息平台（AllergyCARD™）获得了关于特应性的标准化问卷。进行花粉提取物的皮肤点刺试验。通过 ImmunoCAP FEIA 测试血清中空气传播过敏原和八种 P. pratense 分子（rPhl p 1、rPhl p 2、rPhl p 4、rPhl p 5b、rPhl p 6、rPhl p 7、rPhl p 11、rPhl p 12）的 IgE。
对八种 P. pratense 分子的 IgE 反应分析显示了 87 种谱型。根据 IgE 识别的分子数量，更复杂的谱型具有更高的血清总 IgE、更高的草特异性血清 IgE 以及更高的花粉致敏数量和程度。最常见的 IgE 致敏谱型是单分子 Phl p 1。Phl p 7 的致敏是哮喘的可靠生物标志物，而 Phl p 12 是口腔过敏综合征的生物标志物。Phl p 7 的致敏与 SARg 的严重程度较高有关，而复杂的谱型与疾病持续时间较长有关。
在大型儿科人群中，对 P. pratense 分子的 IgE 致敏谱型的复杂性与高特应性特征有关，尽管对预测临床严重程度无用。血清中 Phl p 1、Phl p 7 和 Phl p 12 的 IgE 检测可用作 SARg 和合并症的临床生物标志物。需要在不同地区进行进一步的研究，以测试不同的 IgE 分子谱型对 AIT 反应的影响。
