Sensitization to grass pollen allergen molecules in a birth cohort-natural Phl p 4 as an early indicator of grass pollen allergy

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY

卷:145

Article

Westman, Marit^1,2,3  Aberg, Karin^3,4  Apostolovic, Danijela^1,2  Lupinek, Christian⁵  Gattinger, Pia⁵  Mittermann, Irene⁵  Andersson, Niklas⁶  Melen, Erik^6,7,8  Bergstrom, Anna^6,9  Anto, Josep M.^10,11,12,13  Bousquet, Jean¹⁴  Valenta, Rudolf^5,15,16  Wickman, Magnus⁶  van Hage, Marianne^1,2 

[1] Karolinska Inst, Dept Med Solna, Immunol & Allergy Unit, Stockholm, Sweden

[2] Univ Hosp, Stockholm, Sweden

[3] Karolinska Univ Hosp, Dept Ear Nose & Throat Dis, Stockholm, Sweden

[4] Karolinska Inst, Div Ear Nose & Throat Dis, Dept Clin Sci Intervent & Technol, Stockholm, Sweden

[5] Med Univ Vienna, Ctr Pathophysiol Infectiol & Immunol, Dept Pathophysiol & Allergy Res, Div Immunopathol, Vienna, Austria

[6] Karolinska Inst, Inst Environm Med, Stockholm, Sweden

[7] Sachs Childrens Hosp, Stockholm, Sweden

[8] Soder Sjukhuset, Dept Clin Sci & Educ, Stockholm, Sweden

[9] Ctr Occupat & Environm Med, Stockholm, Region Stockhol, Sweden

[10] Ctr Res Environm Epidemiol, Barcelona, Spain

[11] Hosp del Mar Res Inst, Barcelona, Spain

[12] Univ Pompeu Fabra, Barcelona, Spain

[13] CIBER Epidemiol & Salud Publ, Barcelona, Spain

[14] Univ Hosp Montpellier, Hop Arnaud Villeneuve, Inst Natl Sante & Rech Med 1018, Villejuif, France

[15] Fed Med Biol Agcy Russia, Natl Res Ctr Inst Immunol, Moscow, Russia

[16] Sechenov First Moscow State Med Univ, Dept Clin Immunol & Allergy, Lab Immunopathol, Moscow, Russia

关键词: Allergen molecules;    allergic rhinitis;    BAMSE;    grass pollen;    cohort;    IgE;    MeDALL;    microarray;    Phl p 4;   

DOI  :  10.1016/j.jaci.2020.01.006

来源: Elsevier

【 摘 要 】

Background: Grass pollen allergy is one of the most common allergies worldwide. Objective: The aim of this study was to evaluate the usefulness of grass pollen allergen molecules for prediction of grass pollen allergy during childhood and up to adolescence. Method: Questionnaire data and sera obtained from the study subjects at the ages of 4, 8, and 16 years from the population-based Barn/Children Allergy Milieu Stockholm Epidemiology birth cohort were used. Sera from 763 representative subjects with serum samples available at all 3 ages were analyzed for IgE reactivity to 8 Phleum pratense (Phl p) allergens (MeDALL [Mechanisms for the Development of Allergies] chip) and to timothy grass extract (ImmunoCAP). Allergic rhinitis to grass pollen (ARg) was defined as upper airway symptoms during grass pollen exposure. Results: The prevalence of sensitization to any Phl p molecule was higher compared with that to timothy extract at all 3 ages: at the age of 4 years, 9.7% versus 6.8%; at the age of 8 years, 28.4% versus 15.3%; and at the age of 16 years, 37.1% versus 27.1%. General estimating equations analyses revealed that among children sensitized at the age of 4 years, the overall odds ratio (OR) of later ARg (up to 16 years) was increased only for IgE reactivity to Phl p 1 (OR = 4.9) and natural Phl p 4 (OR = 6.9). The likelihood of later symptoms increased with the number of allergen molecules; at the age of 4 years, 2 or more molecules predicted ARg to 78% and 3 or more molecules predicted ARg to 95%. A positive test result for timothy extract predicted ARg to 70%. Conclusions: Natural Phl p 4 is a hitherto unrecognized early indicator of grass pollen allergy, in addition to Phl p 1. To identify grass pollen sensitization and predict later ARg, allergen molecules are of added value to timothy extract alone and may help clinicians improve prediction of grass pollen allergy.

【 授权许可】

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