Department of Pediatric Respiratory Care, Immunology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Institute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Allergy. 2024 Apr;79(4):908-923. doi: 10.1111/all.16029. Epub 2024 Feb 5.
Pollen allergy poses a significant health and economic burden in Europe. Disease patterns are relatively homogeneous within Central and Northern European countries. However, no study broadly assessed the features of seasonal allergic rhinitis (SAR) across different Southern European countries with a standardized approach.
To describe sensitization profiles and clinical phenotypes of pollen allergic patients in nine Southern European cities with a uniform methodological approach.
Within the @IT.2020 multicenter observational study, pediatric and adult patients suffering from SAR were recruited in nine urban study centers located in seven countries. Clinical questionnaires, skin prick tests (SPT) and specific IgE (sIgE) tests with a customized multiplex assay (Euroimmun Labordiagnostika, Lübeck, Germany) were performed.
Three hundred forty-eight children (mean age 13.1 years, SD: 2.4 years) and 467 adults (mean age 35.7 years SD: 10.0 years) with a predominantly moderate to severe, persistent phenotype of SAR were recruited. Grass pollen major allergenic molecules (Phl p 1 and/or Phl p 5) ranged among the top three sensitizers in all study centers. Sensitization profiles were very heterogeneous, considering that patients in Rome were highly poly-sensitized (sIgE to 3.8 major allergenic molecules per patient), while mono-sensitization was prominent and heterogeneous in other cities, such as Marseille (sIgE to Cup a 1: n = 55/80, 68.8%) and Messina (sIgE to Par j 2: n = 47/82, 57.3%). Co-sensitization to perennial allergens, as well as allergic comorbidities also broadly varied between study centers.
In Southern European countries, pollen allergy is heterogeneous in terms of sensitization profiles and clinical manifestations. Despite the complexity, a unique molecular, multiplex, and customized in-vitro IgE test detected relevant sensitization in all study centers. Nevertheless, this geographical diversity in pollen allergic patients imposes localized clinical guidelines and study protocols for clinical trials of SAR in this climatically complex region.
花粉过敏在欧洲造成了重大的健康和经济负担。中欧和北欧国家的疾病模式相对较为一致。然而，尚无研究采用标准化方法广泛评估不同南欧国家季节性过敏性鼻炎（SAR）的特征。
采用统一的方法学方法，描述 9 个南欧城市花粉过敏患者的致敏谱和临床表型。
在@IT.2020 多中心观察性研究中，在位于 7 个国家的 9 个城市研究中心招募患有 SAR 的儿科和成年患者。进行临床问卷调查、皮肤点刺试验（SPT）和使用定制的多重测定法（Euroimmun Labordiagnostika，吕贝克，德国）进行特异性 IgE（sIgE）检测。
共招募 348 名儿童（平均年龄 13.1 岁，标准差：2.4 岁）和 467 名成人（平均年龄 35.7 岁，标准差：10.0 岁），这些患者均表现为以中重度、持续性为特征的 SAR。草花粉主要过敏原分子（Phl p 1 和/或 Phl p 5）在所有研究中心均位列前三种致敏原。考虑到罗马的患者高度多敏（每名患者对 3.8 种主要过敏原分子的 sIgE），致敏谱存在很大差异，而马赛（对 Cup a 1 的 sIgE：n = 80/55，68.8%）和墨西拿（对 Par j 2 的 sIgE：n = 82/47，57.3%）等其他城市的单敏化现象则更为显著且多样化。研究中心之间也广泛存在对常年性过敏原的共致敏和过敏合并症。
在南欧国家，花粉过敏在致敏谱和临床表现方面存在异质性。尽管存在复杂性，但独特的分子、多重和定制的体外 IgE 检测在所有研究中心均能检测到相关致敏原。然而，花粉过敏患者在地理上的这种多样性，对这一气候复杂地区 SAR 临床试验提出了制定本地化临床指南和研究方案的需求。
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