Molecular sensitization patterns and influence of molecular diagnosis in immunotherapy prescription in children sensitized to both grass and olive pollen

• Published in: Pediatric allergy and immunology 2018-06, Vol.29 (4), p.369-374
• Main Authors: Martínez‐Cañavate Burgos, Ana, Torres‐Borrego, Javier, Molina Terán, Ana Belén, Corzo, Jose Luis, García, Blanca Esther, Rodríguez Pacheco, Ramón, Moreno Aguilar, Carmen, Dávila, Ignacio
• Format: Article
• Language: English
• Subjects: Allergens; Allergic rhinitis; Allergies; Children; Diagnosis; double sensitization; Epidemiology; grass; Grasses; Immunoglobulin E; Immunotherapy; Medical diagnosis; Medical personnel; Molecular chains; molecular diagnosis; Nose; olive; pediatric population; Pollen; Rhinitis; seasonal allergic rhinitis; Skin tests; specific IgE
• ISSN: 0905-6157; 1399-3038
• DOI: 10.1111/pai.12866

Background The overlapping grass and olive pollen seasons in Spain and the phenomenon of cross‐reactivity can make it difficult to determine the true causative agent of seasonal allergic rhinitis when only skin prick tests with whole extracts are used. The aim of the GRAMOLE study was to determine sensitization patterns to the major grass and olive pollen allergens detected using specific recombinant IgE and to explore how this knowledge affected physicians’ choice of allergen‐specific immunotherapy. Methods Epidemiological, observational, multicenter, cross‐sectional study. Results from children under 18 years of age diagnosed with seasonal allergic rhinitis by positive skin prick tests to olive and grass pollen were analyzed. Specific IgE to Phl p 1+5, Ole e 1, and Phl p 7+12 was determined. Investigators specified the optimal composition of allergen immunotherapy before and after knowing the results of the molecular diagnosis. Results A total of 281 patients with a mean age of 13.4 years were included. Double sensitization to both major allergens was found in vitro in 76% of children for an IgE cutoff point of 0.35 kU/L. When the molecular diagnosis results were known, specialists changed the composition of the prescribed immunotherapy in 52.87% of cases. Conclusions Double sensitization to grass and olive pollen is common in Spain and also occurs in the pediatric population. Molecular diagnosis using specific IgE may help improve immunotherapy selection in polysensitized patients.