Linking cross-reactivity clusters of food and respiratory allergens in PAMD@ to asthma and duration of allergy

Abstract

Background Component resolved diagnosis, recently redefined as precision allergy medicine diagnosis — PAMD@, may help understanding allergic cross-reactivity patterns among polysensitized patients and their clinical implication. Objective We aimed to investigate similarities among allergens by empirically determining the occurrence of co-sensitization patterns and to relate them to clinical features, in particular to asthma. Methods A retrospective cohort study in 1057 participants suspected to have allergic sensitization was performed in Vienna. To define cross-reactivity patterns, cluster analysis for 671 patients who showed reaction to at least one of the allergens in ISAC112 was performed and followed by multivariate logistic regression analysis to relate clusters and clinical symptoms, in particular current asthma. Results We determined 18 cross-reactivity clusters, comprising of 6 food, 10 respiratory, and 2 other clusters of allergens. Overall, 14% of the cohort patients were positive for 1 cross-reactivity cluster and 23% to 2 or more clusters. Multisensitized patients who were sensitized to PR-10 allergen proteins in addition to Bermuda timothy grass pollen clusters showed the highest association with asthma (odds ratio, 4.22 and 95% CI: 2.32–7.68) and an increase of 10 years of the duration of allergy increased the odds for a combined sensitization to PR-10 cluster and Bermuda-timothy cluster by 1.27 (95% CI: 1.06–1.53). Conclusion Similarities among IgE positivity patterns determined by ISAC112 revealed 18 cross-reactivity clusters. This PAMD@ approach allowed prediction of clinical features and revealed that certain cross-reactivity patterns are related to duration of allergic symptoms.

Real‐life evaluation of molecular multiplex IgE test methods in the diagnosis of pollen associated food allergy

“…In line with our study, the importance of PR‐10 proteins and profilins was confirmed for PFS patients 27 . A Viennese study examining sensitization clusters highlighted a strong relationship between sensitizations to food and respiratory allergens 28 …”

“… 27 A Viennese study examining sensitization clusters highlighted a strong relationship between sensitizations to food and respiratory allergens. 28 Without any doubt, diagnosis of food allergy depends on clear clinical symptoms, while sIgE testing and positive SPTs only indicate sensitization. However, patients with food sensitization have a high risk of developing food allergy.…”

Revealing clinically relevant specific IgE sensitization patterns in Hymenoptera venom allergy with dimension reduction and clustering

“…The methodology around network analysis revealed previously unknown disease entities in the field of psychopathology 39 as well as disease characteristics in asthmatic patients following sensitization clustering. 40 , 41 Unlike UMAP, however, network analysis commonly uses force directed layouts, 42 which distort the true nature of higher dimensional datasets. 21 …”

Molecular diagnosis contribution for personalized medicine

“…A retrospective study performed in Vienna, revealed that sensitization to PR-10 allergen proteins in addition to Bermuda-timothy grass pollen clusters showed the highest association with asthma (odds ratio, 4.22 and 95% CI: 2.32-7.68) and duration of allergy [38].…”