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

Autor: Mastrorilli C; Pediatric Department, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria, University of Parma, Parma, Italy.; Department of Pediatric Pneumology and Immunology, Charité Medical University, Berlin, Germany., Tripodi S; Pediatric Department and Pediatric Allergology Unit, Sandro Pertini Hospital, Rome., Caffarelli C; Pediatric Department, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria, University of Parma, Parma, Italy., Perna S; Department of Pediatric Pneumology and Immunology, Charité Medical University, Berlin, Germany., Di Rienzo-Businco A; Pediatric Department and Pediatric Allergology Unit, Sandro Pertini Hospital, Rome., Sfika I; Pediatric Department and Pediatric Allergology Unit, Sandro Pertini Hospital, Rome., Asero R; Allergology Service, San Carlo Clinic, Paderno Dugnano, Milan., Dondi A; Pediatric Unit, Department for Mother and Child, Ramazzini Hospital, Carpi., Bianchi A; Pediatric Unit, Mazzoni Hospital, Ascoli Piceno., Povesi Dascola C; Pediatric Department, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria, University of Parma, Parma, Italy., Ricci G; Pediatric Unit, Department of Medical and Surgical Sciences, University of Bologna, Bologna., Cipriani F; Pediatric Unit, Department of Medical and Surgical Sciences, University of Bologna, Bologna., Maiello N; Pediatric Department, Second University, Naples., Miraglia Del Giudice M; Pediatric Department, Second University, Naples., Frediani T; Pediatric Department, La Sapienza University, Rome., Frediani S; Pediatric Department, La Sapienza University, Rome., Macrì F; Pediatric Department, La Sapienza University, Rome., Pistoletti C; Pediatric Department, La Sapienza University, Rome., Dello Iacono I; Pediatric Unit, Fatebenefratelli Hospital, Benevento., Patria MF; Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan., Varin E; Pediatric Intermediate Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan., Peroni D; Pediatric Section, Department of Life and Reproduction Sciences, University of Verona, Verona., Comberiati P; Pediatric Section, Department of Life and Reproduction Sciences, University of Verona, Verona., Chini L; Pediatric Department, Policlinico of Tor Vergata, Tor Vergata University, Rome., Moschese V; Pediatric Department, Policlinico of Tor Vergata, Tor Vergata University, Rome., Lucarelli S; Pediatric Department, La Sapienza University, Rome., Bernardini R; Pediatric Unit, San Giuseppe Hospital, Empoli., Pingitore G; Pediatric Unit, Grassi Hospital, Rome., Pelosi U; Pediatric Unit, Santa Barbara Hospital, Iglesias., Olcese R; Pulmonary Disease and Allergy Unit, G. Gaslini Hospital, Genoa., Moretti M; Pediatric Department, La Sapienza University, Rome., Cirisano A; Pediatric Unit, San Giovanni di Dio Hospital, Crotone., Faggian D; Department of Laboratory Medicine, University of Padua, Padua., Travaglini A; Pediatric Department, Policlinico of Tor Vergata, Tor Vergata University, Rome., Plebani M; Department of Laboratory Medicine, University of Padua, Padua., Verga MC; Pediatric Unit, Fatebenefratelli Hospital, Benevento.; Primary Care Pediatrics, ASL Salerno, Rome., Calvani M; UOC Pediatria, San Camillo Forlanini, Rome., Giordani P; Department of Statistical Sciences, Sapienza University of Rome, Rome., Matricardi PM; Department of Pediatric Pneumology and Immunology, Charité Medical University, Berlin, Germany.
Jazyk: angličtina
Zdroj: Allergy [Allergy] 2016 Aug; Vol. 71 (8), pp. 1181-91. Date of Electronic Publication: 2016 May 06.
DOI: 10.1111/all.12888
Abstrakt: Background: Pollen-food syndrome (PFS) is heterogeneous with regard to triggers, severity, natural history, comorbidities, and response to treatment. Our study aimed to classify different endotypes of PFS based on IgE sensitization to panallergens.
Methods: We examined 1271 Italian children (age 4-18 years) with seasonal allergic rhinoconjunctivitis (SAR). Foods triggering PFS were acquired by questionnaire. Skin prick tests were performed with commercial pollen extracts. IgE to panallergens Phl p 12 (profilin), Bet v 1 (PR-10), and Pru p 3 (nsLTP) were tested by ImmunoCAP FEIA. An unsupervised hierarchical agglomerative clustering method was applied within PFS population.
Results: PFS was observed in 300/1271 children (24%). Cluster analysis identified five 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 panallergens ('no-panallergen PFS'). These endotypes showed peculiar characteristics: (i) 'multi-panallergen PFS': severe disease with frequent allergic comorbidities and multiple offending foods; (ii) 'profilin PFS': oral allergy syndrome (OAS) triggered 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 exposures, PFS is a complex and frequent complication of childhood SAR, with five distinct endotypes marked by peculiar profiles of IgE sensitization to panallergens. Prospective studies in cohorts of patients with PFS are now required to test whether this novel classification may be useful for diagnostic and therapeutic purposes in the clinical practice.
(© 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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