Francesca Cipriani1, Salvatore Tripodi2, Valentina Panetta3,4, Serena Perna4, Ekaterina Potapova4, Arianna Dondi4,5, Roberto Bernardini6, Carlo Caffarelli7, Antonella Casani8, Rosa Cervone6, Loredana Chini9, Pasquale Comberiati10,11, Giovanna De Castro12, Michele Miraglia Del Giudice13, Iride Dello Iacono14, Andrea Di Rienzo Businco2, Marcella Gallucci1, Arianna Giannetti1, Carla Mastrorilli4,7, Viviana Moschese9, Simone Pelosi15, Ifigenia Sfika2, Elena Varin16, Valeria Villella2, Anna Maria Zicari12, Giulia Brindisi12, Giampaolo Ricci1, Paolo Maria Matricardi4. 1. Pediatric Unit, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy. 2. Pediatric Department and Pediatric Allergology Unit, Sandro Pertini Hospital, Rome, Italy. 3. Consultancy & Training, Biostatistics, L'altrastatistica srl, Rome, Italy. 4. Department of Pediatric Pneumology and Immunology, Charite Medical University, Berlin, Germany. 5. Pediatric Emergency Unit, S. Orsola-Malpighi Hospital, Bologna, Italy. 6. Pediatric Unit, San Giuseppe Hospital, Empoli, Italy. 7. Clinica Pediatrica, Department of Medicine and Surgery, University of Parma, Parma, Italy. 8. Pediatra di Libera Scelta, Benevento, Italy. 9. UOSD di Immunopatologia ed Allergologia Pediatrica, Policlinico Tor Vergata, Università di Roma Tor Vergata, Rome, Italy. 10. Department of Clinical and Experimental Medicine, Section of Paediatrics, University of Pisa, Pisa, Italy. 11. Department of Clinical Immunology and Allergology, I.M. Sechenov First Moscow State Medical University, Moscow, Russia. 12. Pediatric Department, La Sapienza University, Rome, Italy. 13. Dipartimento della Donna, del Bambino e di Chirurgia Generale e Specialistica, Università della Campania Luigi Vanvitelli, Naples, Italy. 14. Pediatric Unit, Fatebenefratelli Hospital, Benevento, Italy. 15. TPS Production, Rome, Italy. 16. Pediatric Intermediate Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Abstract
BACKGROUND: Pollen-related seasonal allergic rhinoconjunctivitis (SAR) is a very frequent pediatric disease in Westernized countries. Risk factors and disease phenotypes have been thoroughly examined in several cross-sectional studies. By contrast, only a few studies have examined disease evolution in patient cohorts. We investigated predictive biomarkers of disease evolution in a large cohort of children with SAR. METHODS: During 2015-2017 (follow-up), we re-examined 401 patients from those enrolled in 2009-2011 (baseline) by the "Panallergens in Pediatrics" study, a large multicenter survey of Italian children with SAR. Information on clinical history (standard questionnaire, AllergyCARD®; TPS, Italy) and skin prick tests for inhalant and foods extracts (ALK-Abelló, Hørsholm, Denmark) was acquired as at baseline visit. Evolution in clinical and sensitization data of patients was analyzed over time, as well as their association with the main baseline characteristics and atopy risk factors. RESULTS: The average age of participants was 10.4 ± 3.4 years at baseline and 16.2 ± 3.6 years at follow-up. SAR persisted in 93.3% of patients at follow-up and became more frequently associated with asthma (from 36.7% at baseline to 48.6% at follow-up) and oral allergy syndrome (OAS, from 23.4% to 37.7%). Compared to baseline, the prevalence of skin sensitization to some pollens (Phleum pratense, Corylus avellana, Platanus acerifolia, Artemisia vulgaris) and vegetables (hazelnut, wheat, and apple) significantly decreased at follow-up. Earlier onset of SAR and polysensitization at baseline were associated with incident asthma at follow-up. The presence at baseline of serum IgE to the following allergen molecules was identified as biomarkers of clinical evolution: (a) Phl p 1, for persistence of SAR; (b) Phl p 5, for persistence of both rhinitis and asthma; (c) Pru p 3, for new onset of asthma; (d) Bet v 1, for persistence of OAS. CONCLUSIONS: Seasonal allergic rhinoconjunctivitis is clinically heterogeneous in its evolution from childhood to adolescence. The detection of serum IgE to specific molecules (Phl p 1, Phl p 5, Bet v 1, Pru p 3) may be useful as biomarkers to predict SAR persistence and future onset of comorbidities, such as asthma and/or OAS.
BACKGROUND: Pollen-related seasonal allergic rhinoconjunctivitis (SAR) is a very frequent pediatric disease in Westernized countries. Risk factors and disease phenotypes have been thoroughly examined in several cross-sectional studies. By contrast, only a few studies have examined disease evolution in patient cohorts. We investigated predictive biomarkers of disease evolution in a large cohort of children with SAR. METHODS: During 2015-2017 (follow-up), we re-examined 401 patients from those enrolled in 2009-2011 (baseline) by the "Panallergens in Pediatrics" study, a large multicenter survey of Italian children with SAR. Information on clinical history (standard questionnaire, AllergyCARD®; TPS, Italy) and skin prick tests for inhalant and foods extracts (ALK-Abelló, Hørsholm, Denmark) was acquired as at baseline visit. Evolution in clinical and sensitization data of patients was analyzed over time, as well as their association with the main baseline characteristics and atopy risk factors. RESULTS: The average age of participants was 10.4 ± 3.4 years at baseline and 16.2 ± 3.6 years at follow-up. SAR persisted in 93.3% of patients at follow-up and became more frequently associated with asthma (from 36.7% at baseline to 48.6% at follow-up) and oral allergy syndrome (OAS, from 23.4% to 37.7%). Compared to baseline, the prevalence of skin sensitization to some pollens (Phleum pratense, Corylus avellana, Platanus acerifolia, Artemisia vulgaris) and vegetables (hazelnut, wheat, and apple) significantly decreased at follow-up. Earlier onset of SAR and polysensitization at baseline were associated with incident asthma at follow-up. The presence at baseline of serum IgE to the following allergen molecules was identified as biomarkers of clinical evolution: (a) Phl p 1, for persistence of SAR; (b) Phl p 5, for persistence of both rhinitis and asthma; (c) Pru p 3, for new onset of asthma; (d) Bet v 1, for persistence of OAS. CONCLUSIONS:Seasonal allergic rhinoconjunctivitis is clinically heterogeneous in its evolution from childhood to adolescence. The detection of serum IgE to specific molecules (Phl p 1, Phl p 5, Bet v 1, Pru p 3) may be useful as biomarkers to predict SAR persistence and future onset of comorbidities, such as asthma and/or OAS.
Keywords:
Bet v 1; IgE; Phl p 1; Phl p 5; Pru p 3; allergic rhinitis; asthma; biomarkers; children; comorbidities; longitudinal study; pollen; prediction
Authors: Giulia Brindisi; Valentina De Vittori; Rosalba De Nola; Antonio Di Mauro; Giovanna De Castro; Maria Elisabetta Baldassarre; Ettore Cicinelli; Bianca Cinicola; Marzia Duse; Anna Maria Zicari Journal: J Asthma Allergy Date: 2021-03-25
Authors: Glenis Kathleen Scadding; Peter Kenneth Smith; Michael Blaiss; Graham Roberts; Peter William Hellings; Philippe Gevaert; Marinda Mc Donald; Tania Sih; Suzanne Halken; Petra Ursula Zieglmayer; Peter Schmid-Grendelmeier; Erkka Valovirta; Ruby Pawankar; Ulrich Wahn Journal: Front Allergy Date: 2021-07-14