Prevalence and Clinical Relevance of IgE Sensitization to Profilin in Childhood: A Multicenter Study

Abstract

Background: Little is known about the prevalence and clinical relevance of hypersensitivity to the plant panallergen profilin in children. Objectives: The present study aimed to investigate prevalence, risk factors and clinical relevance of profilin sensitization in a large cohort of Italian children of different ages living in different geographic areas. Methods: Children with pollen allergy enrolled by 16 pediatric outpatient clinics sited in three main geographic areas of Italy were studied. SPT were carried out with commercial pollen extracts and a commercial purified date palm pollen profilin. IgE specific for allergenic pollen molecules, Phl p 12 (grass profilin) and Pru p 3 (peach lipid transfer protein) were tested by ImmunoCAP FEIA. Results: IgE to Phl p 12 (≥0.35 kU/l) was observed in 296 of the 1,271 participants (23%), including 17 of the 108 (16%) preschool children. Profilin SPT was positive (≥3 mm) in 320/1,271 (25%) participants. The two diagnostic methods were concordant in 1,151 (91%, p < 0.0001) cases. Phl p 12 IgE prevalence declined from northern to southern Italy and was directly associated with IgE to Phl p 1 and/or Phl p 5 and Ole e 1. Among children with IgE to Phl p 12, OAS was provoked by kiwi, melon, watermelon, banana, apricot and cucumber. Conclusions: Profilin sensitization is very frequent among pollen-allergic children, occurs at a very young age and contributes to the development of childhood OAS with a typical pattern of offending foods. Pediatricians should always consider IgE sensitization to profilin while examining pollen-allergic children, even if they are at preschool age.

Greater Real-Life Diagnostic Efficacy of Allergen Molecule-Based Diagnosis for Prescription of Immunotherapy in an Area with Multiple Pollen Exposure

“…In fact, a recent study conducted in Italy showed that 23% of pollen-sensitized patients had IgE antibodies to profilins [27] and frequent sensitization to cross-reactive pollen allergens has been reported for many countries such as the southern parts of Europe [7,21,28,29]. In fact, patients in Astana, Kazakhstan, are exposed simultaneously to pollen from several unrelated plant species due to a short summer period with copollination of trees, grasses, and weeds.…”

Progress in pediatrics in 2015: choices in allergy, endocrinology, gastroenterology, genetics, haematology, infectious diseases, neonatology, nephrology, neurology, nutrition, oncology and pulmonology

“…Along this line, it has been recently shown that this happens also with molecular allergens. Asero et al [12] found that results of specific IgE to Phl p 12 (grass profilin) and skin prick tests to natural profilin (Pho d 2), purified from date palm extract gave a concordant response in 91 % of cases. In asthmatic patients, exhaled breath biomarkers [13] may be useful for identifying allergic patients.…”

Could Profilin Be a ‘Canary in a Coal Mine' of the Increasing Allergy Epidemic?

“…In the paper by Asero et al in this issue of International Archives of Allergy and Immunology [7], an epidemiological, multicenter study of the prevalence and clinical relevance of profilin in an Italian sample of pollen-allergic children is presented. The study was performed on a sample of 1,271 children recruited from across Italy.…”

“…According to Asero et al [7], ‘early sensitization to profilin… might thus be an early biomarker of a strong atopic predisposition and therefore imply a more severe clinical history of pollen allergy'. Another interesting and practical piece of information is that the potential involvement of profilin in oral symptoms should be investigated, even in the preschool population.…”

“…The study by Asero et al [7] has some limitations, the most relevant being the lack of objective demonstration of food allergy by provocation test, but, on the other hand, it proves that this type of survey can be easily performed using new molecular diagnostics, either in vitro or in vivo [9,10]. …”