Theresa Lipp1, Aydan Acar Şahin2, Xenophon Aggelidis3, Stefania Arasi4, Andrea Barbalace5, Anne Bourgoin6, Blerina Bregu7, Maria Antonia Brighetti8, Elsa Caeiro9,10, Sule Caglayan Sozmen11, Lucia Caminiti5, Denis Charpin6, Mariana Couto12, Luís Delgado13,14,15, Andrea Di Rienzo Businco16, Claire Dimier6, Maria V Dimou17, João A Fonseca14,15,18, Ozlem Goksel19, Aykut Guvensen20, Dolores Hernandez21, Tara Maria Hoffmann1, Dah Tay Jang22, Fusun Kalpaklioglu23, Blerta Lame7, Ruth Llusar22, Michael P Makris3, Angel Mazon22, Eris Mesonjesi7, Antonio Nieto22, Ayse Öztürk24, Laurie Pahus25, Giovanni Battista Pajno5, Ilenia Panasiti5, Nikolaos G Papadopoulos17,26, Elisabetta Pellegrini27, Simone Pelosi28, Ana M Pereira14,15,18, Mariana Pereira14,15, Munevver Pinar2, Ekaterina Potapova1, Alfred Priftanji7, Fotis Psarros29, Cansin Sackesen30, Ifigenia Sfika16, Javier Suarez31, Michel Thibaudon32, Alessandro Travaglini8,33, Salvatore Tripodi16,34, Valentine Verdier6, Valeria Villella16, Paraskevi Xepapadaki35, Duygu Yazici36, Paolo M Matricardi1, Stephanie Dramburg1. 1. Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany. 2. Department of Biology, Faculty of Science, Ankara University, Ankara, Turkey. 3. Allergy Unit, 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, University Hospital "Attikon", Athens, Greece. 4. Pediatric Allergology Unit, Department of Pediatric Medicine, Bambino Gesù Children's Research Hospital (IRCCS), Rome, Italy. 5. Department of Pediatrics-Allergy Unit, University of Messina, Messina, Italy. 6. Department of Pneumonology and Allergy, La Timone Hospital, APHM, Aix-Marseille University, Marseille, France. 7. Department of Allergology and Clinical Immunology, UHC Mother Teresa, Medical University Tirana, Tirana, Albania. 8. Department of Biology, Tor Vergata University, Rome, Italy. 9. MED-Mediterranean Institute for Agriculture, Environment and Development, Institute for Advanced Studies and Research, University of Évora, Évora, Portugal. 10. Portuguese Society of Allergology and Clinical Immunology, Lisbon, Portugal. 11. Department of Pediatric Allergy and Immunology, Okan University Faculty of Medicine, Istanbul, Turkey. 12. Department of Immunoallergology, CUF Decobertas Hospital, José de Mello Saúde, Porto, Portugal. 13. Basic and Clinical Immunology Unit, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal. 14. CINTESIS, Center for Health Technology and Services Research, Porto, Portugal. 15. Allergy Unit, Instituto & Hospital CUF Porto, Porto, Portugal. 16. Pediatric Allergy Unit, Sandro Pertini Hospital, Rome, Italy. 17. Allergy Department, 2nd Pediatric Clinic, Athens General Children's Hospital "P&A Kyriakou", University of Athens, Athens, Greece. 18. MEDCIDS-Department of Community Medicine, Information, and Health Sciences, Faculty of Medicine, University of Porto, Porto, Portugal. 19. Department of Pulmonary Medicine, Division of Immunology, Allergy and Asthma, Faculty of Medicine, Ege University, Izmir, Turkey. 20. Department of Biology, Faculty of Science, Ege University, Izmir, Turkey. 21. Department of Allergy, Health Research Institute Hospital La Fe, Valencia, Spain. 22. Pediatric Allergy and Pneumology Unit, Children's Hospital La Fe, Health Research Institute La Fe, Valencia, Spain. 23. Department of Immunology and Allergic Diseases, Kırıkkale University School of Medicine, Ankara, Turkey. 24. Department of Pulmonary Medicine, Division of Allergy and Immunology, Koç University, School of Medicine, Istanbul, Turkey. 25. Department of Pneumonology and Allergy, North Hospital, APHM, Aix-Marseille University, Marseille, France. 26. Division of Infection, Immunity & Respiratory Medicine, Royal Manchester Children's Hospital, University of Manchester, Manchester, UK. 27. Department of Reggio Calabria, ARPA-Regional Agency for Environmental Protection, Calabria, Italy. 28. TPS Production srl, Rome, Italy. 29. Allergy Department, Athens Naval Hospital, Athens, Greece. 30. Division of Pediatric Allergy, Koç University School of Medicine, Istanbul, Turkey. 31. Department of Biology of Organisms and Systems, Area of Botany, University of Oviedo, Oviedo, Spain. 32. Réseau National de Surveillance Aérobiologique, Brussieu, France. 33. Italian Aerobiology Monitoring Network-Italian Aerobiology Association, Rome, Italy. 34. Allergolology Service, Policlinico Casilino, Rome, Italy. 35. Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece. 36. Cellular and Molecular Medicine, KUTTAM, Graduate School of Health Sciences, Koç University, Istanbul, Turkey.
Abstract
BACKGROUND: Pollen food allergy syndrome (PFAS) is a frequently underdiagnosed disease due to diverse triggers, clinical presentations, and test results. This is especially relevant in geographic areas with a broad spectrum of pollen sensitization, such as Southern Europe. OBJECTIVES: To elucidate similarities and differences of PFAS in nine Southern European centers and identify associated characteristics and unique markers of PFAS. METHODS: As part of the @IT.2020 Multicenter Study, 815 patients with seasonal allergic rhinitis (SAR), aged 10-60 years, were recruited in seven countries. They completed questionnaires regarding SAR, comorbidities, family history, and PFAS, and underwent skin prick testing (SPT) and serum IgE testing. RESULTS: Of the 815 patients, 167 (20.5%) reported PFAS reactions. Most commonly, eliciting foods were kiwi (58, 34.7%), peach (43, 25.7%), and melon (26, 15.6%). Reported reactions were mostly local (216/319, 67.7%), occurring within 5 min of contact with elicitors (209/319, 65.5%). Associated characteristics included positive IgE to at least one panallergen (profilin, PR-10, or nsLTP) (p = 0.007), maternal PFAS (OR: 3.716, p = 0.026), and asthma (OR: 1.752, p = 0.073). Between centers, heterogeneity in prevalence (Marseille: 7.5% vs. Rome: 41.4%, p < 0.001) and of clinical characteristics was apparent. Cypress played a limited role, with only 1/22 SPT mono-sensitized patients reporting a food reaction (p < 0.073). CONCLUSIONS: PFAS is a frequent comorbidity in Southern European SAR patients. Significant heterogeneity of clinical characteristics in PFAS patients among the centers was observed and may be related to the different pollen sensitization patterns in each geographic area. IgE to panallergen(s), maternal PFAS, and asthma could be PFAS-associated characteristics.
BACKGROUND: Pollen food allergy syndrome (PFAS) is a frequently underdiagnosed disease due to diverse triggers, clinical presentations, and test results. This is especially relevant in geographic areas with a broad spectrum of pollen sensitization, such as Southern Europe. OBJECTIVES: To elucidate similarities and differences of PFAS in nine Southern European centers and identify associated characteristics and unique markers of PFAS. METHODS: As part of the @IT.2020 Multicenter Study, 815 patients with seasonal allergic rhinitis (SAR), aged 10-60 years, were recruited in seven countries. They completed questionnaires regarding SAR, comorbidities, family history, and PFAS, and underwent skin prick testing (SPT) and serum IgE testing. RESULTS: Of the 815 patients, 167 (20.5%) reported PFAS reactions. Most commonly, eliciting foods were kiwi (58, 34.7%), peach (43, 25.7%), and melon (26, 15.6%). Reported reactions were mostly local (216/319, 67.7%), occurring within 5 min of contact with elicitors (209/319, 65.5%). Associated characteristics included positive IgE to at least one panallergen (profilin, PR-10, or nsLTP) (p = 0.007), maternal PFAS (OR: 3.716, p = 0.026), and asthma (OR: 1.752, p = 0.073). Between centers, heterogeneity in prevalence (Marseille: 7.5% vs. Rome: 41.4%, p < 0.001) and of clinical characteristics was apparent. Cypress played a limited role, with only 1/22 SPT mono-sensitized patients reporting a food reaction (p < 0.073). CONCLUSIONS:PFAS is a frequent comorbidity in Southern European SARpatients. Significant heterogeneity of clinical characteristics in PFASpatients among the centers was observed and may be related to the different pollen sensitization patterns in each geographic area. IgE to panallergen(s), maternal PFAS, and asthma could be PFAS-associated characteristics.
Authors: Andrea Wangorsch; Stephan Scheurer; Miguel Blanca; Natalia Blanca-Lopez; María Luisa Somoza; Laura Martín-Pedraza Journal: Front Allergy Date: 2022-02-08
Authors: Michael D Kulis; Johanna M Smeekens; Robert M Immormino; Timothy P Moran Journal: J Allergy Clin Immunol Date: 2021-06-07 Impact factor: 14.290