Abstract
BackgroundThe introduction of component-resolved diagnosis was a great advance in diagnosis of allergy. In particular, molecular allergy techniques allowed investigation of the association between given molecular profiles and clinical expression of allergy. We evaluated the possible correlation between the level of specific IgE (sIgE) to single components of Phleum pratense and clinical issues such as the severity of allergic rhinitis (AR) and the presence or absence of asthma.MethodsThe study included 140 patients with rhinitis and/or asthma caused by sensitization to grass pollen. sIgE to Phl p 1, Phl p 5, Phl p 7, and Phl p 12 from Phleum pratense were measured, and the correlation between the stage of AR according to Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines and the presence of asthma was studied by multivariate logistic regression in terms of sIgE and ARIA stage, while univariate logistic regression was used for IgE and a dichotomic classification of asthma as present or absent.ResultsTen patients had intermittent AR, 48 had mild persistent AR, and 82 had severe persistent AR. Asthma was present in 86 patients and absent in 54. A significant correlation was found between severe persistent AR and presence of asthma (p < 0.01). The only significant correlation between clinical data and sIgE values was that of low values of sIgE to Phl p 5 and absence of asthma (p < 0.01).ConclusionsThis preliminary finding suggests that low values of sIgE to Phl p 5 are correlated with the absence of asthma in patients with grass-pollen induced allergy. The data, provided they are confirmed by further studies, could be useful when selecting patients who are candidates for allergen immunotherapy, since a higher risk of asthma could be used as a selection criterion for using this approach.
Highlights
The introduction of component-resolved diagnosis was a great advance in diagnosis of allergy
The study population consisted of 140 patients with rhinitis and/or asthma caused by sensitization to grass pollen, as assessed by positive skin prick tests (SPT) and a clear correlation with duration of symptoms obtained by clinical history
All patients were clinically classified according to ARIA guidelines for allergic rhinitis (AR) [14] and to the presence or absence of asthma, as assessed by a physician diagnosis based on clinical symptoms of the disease, as suggested by the Global Initiative on Asthma (GINA) guidelines [15]
Summary
The introduction of component-resolved diagnosis was a great advance in diagnosis of allergy. The availability of single allergen molecules for use instead of whole allergen sources has allowed a significant advance in the diagnostic workup of allergy [1,2]. This diagnostic approach, currently known as component-resolved diagnosis (CRD) [3], allows identification of the individual while Phl 1 and Phl p 5 are grass-specific. Among the cross-reacting allergens, Phl p 4 is a cross-reactive carbohydrate determinant (CCD)-bearing protein recently characterized in vitro [7], but which has an undefined clinical role; Phl p cross-reacts with Ole e 1 from olive pollen [8], Phl p 7 and Phl p are panallergens. Recent studies addressed the response to the various components of grass pollen in patients treated with allergen immunotherapy (AIT), in both subcutaneous and sublingual administration form, but reported different observations [9,10,11,12,13]
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