Dezfouli Shadan Ghandizadeh, Mothes-Luksch Nadine, Jensen Annika N, Untersmayr Eva, Kundi Michael, Jensen-Jarolim Erika
Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Austria.
Center for Public Health, Medical University Vienna, Austria.
World Allergy Organ J. 2020 Nov 21;13(12):100483. doi: 10.1016/j.waojou.2020.100483. eCollection 2020 Dec.
Component resolved diagnosis, recently redefined as precision allergy medicine diagnosis - PAMD@, may help understanding allergic cross-reactivity patterns among polysensitized patients and their clinical implication.
We aimed to investigate similarities among allergens by empirically determining the occurrence of co-sensitization patterns and to relate them to clinical features, in particular to asthma.
A retrospective cohort study in 1057 participants suspected to have allergic sensitization was performed in Vienna. To define cross-reactivity patterns, cluster analysis for 671 patients who showed reaction to at least one of the allergens in ISAC112 was performed and followed by multivariate logistic regression analysis to relate clusters and clinical symptoms, in particular current asthma.
We determined 18 cross-reactivity clusters, comprising of 6 food, 10 respiratory, and 2 other clusters of allergens. Overall, 14% of the cohort patients were positive for 1 cross-reactivity cluster and 23% to 2 or more clusters. Multisensitized patients who were sensitized to PR-10 allergen proteins in addition to Bermuda timothy grass pollen clusters showed the highest association with asthma (odds ratio, 4.22 and 95% CI: 2.32-7.68) and an increase of 10 years of the duration of allergy increased the odds for a combined sensitization to PR-10 cluster and Bermuda-timothy cluster by 1.27 (95% CI: 1.06-1.53).
Similarities among IgE positivity patterns determined by ISAC112 revealed 18 cross-reactivity clusters. This PAMD@ approach allowed prediction of clinical features and revealed that certain cross-reactivity patterns are related to duration of allergic symptoms.
组分分辨诊断，最近被重新定义为精准过敏医学诊断（PAMD@），可能有助于理解多敏患者之间的过敏交叉反应模式及其临床意义。
我们旨在通过实证确定共致敏模式的发生率来研究过敏原之间的相似性，并将它们与临床特征，特别是哮喘相关联。
在维也纳对1057名疑似过敏致敏的参与者进行了一项回顾性队列研究。为了定义交叉反应模式，对671名对ISAC112中至少一种过敏原呈反应的患者进行了聚类分析，随后进行多变量逻辑回归分析以关联聚类和临床症状，特别是当前哮喘。
我们确定了18个交叉反应聚类，包括6个食物、10个呼吸道和2个其他过敏原聚类。总体而言，队列患者中有14%对1个交叉反应聚类呈阳性，23%对2个或更多聚类呈阳性。除百慕大梯牧草花粉聚类外还对PR-10过敏原蛋白致敏的多敏患者与哮喘的关联度最高（比值比，4.22；95%置信区间：2.32 - 7.68），过敏持续时间每增加10年，对PR-10聚类和百慕大-梯牧草聚类联合致敏的几率增加1.27（95%置信区间：1.06 - 1.53）。
由ISAC112确定的IgE阳性模式之间的相似性揭示了18个交叉反应聚类。这种PAMD@方法能够预测临床特征，并揭示某些交叉反应模式与过敏症状持续时间相关。
