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Sensitization to grass pollen allergen molecules in a birth cohort-natural Phl p 4 as an early indicator of grass pollen allergy.
J Allergy Clin Immunol. 2020 04; 145(4):1174-1181.e6.JA

Abstract

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.

Authors+Show Affiliations

Immunology and Allergy Unit, Department of Medicine Solna, Karolinska Institutet and University Hospital, Stockholm, Sweden; Department of Ear, Nose and Throat Diseases, Karolinska University Hospital, Stockholm, Sweden. Electronic address: marit.westman@ki.se.Department of Ear, Nose and Throat Diseases, Karolinska University Hospital, Stockholm, Sweden; Department of Clinical Science, Intervention and Technology, Division of Ear, Nose and Throat Diseases, Karolinska Institutet, Stockholm, Sweden.Immunology and Allergy Unit, Department of Medicine Solna, Karolinska Institutet and University Hospital, Stockholm, Sweden.Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna.Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna.Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna.Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Sachs' Children's Hospital, and Department of Clinical Science and Education Södersjukhuset, Stockholm, Sweden.Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Center of Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden.Centre for Research in Environmental Epidemiology, Barcelona, Spain; Hospital del Mar Research Institute, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública, Barcelona, Spain.University Hospital of Montpellier, Hôpital Arnaud de Villeneuve, Montpellier, Institut National de la Santé et de la Recherche Médicale 1018, Villejuif, France.Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna; National Research Center Institute of Immunology, Federal Medical-Biological Agency of Russia, Moscow, Russia; Laboratory for Immunopathology, Department of Clinical Immunology and Allergy, Sechenov First Moscow State Medical University, Moscow, Russia.Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.Immunology and Allergy Unit, Department of Medicine Solna, Karolinska Institutet and University Hospital, Stockholm, Sweden.No affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

31954777

Citation

Westman, Marit, et al. "Sensitization to Grass Pollen Allergen Molecules in a Birth Cohort-natural Phl P 4 as an Early Indicator of Grass Pollen Allergy." The Journal of Allergy and Clinical Immunology, vol. 145, no. 4, 2020, pp. 1174-1181.e6.
Westman M, Åberg K, Apostolovic D, et al. Sensitization to grass pollen allergen molecules in a birth cohort-natural Phl p 4 as an early indicator of grass pollen allergy. J Allergy Clin Immunol. 2020;145(4):1174-1181.e6.
Westman, M., Åberg, K., Apostolovic, D., Lupinek, C., Gattinger, P., Mittermann, I., Andersson, N., Melén, E., Bergström, A., Antó, J. M., Bousquet, J., Valenta, R., Wickman, M., & van Hage, M. (2020). Sensitization to grass pollen allergen molecules in a birth cohort-natural Phl p 4 as an early indicator of grass pollen allergy. The Journal of Allergy and Clinical Immunology, 145(4), 1174-e6. https://doi.org/10.1016/j.jaci.2020.01.006
Westman M, et al. Sensitization to Grass Pollen Allergen Molecules in a Birth Cohort-natural Phl P 4 as an Early Indicator of Grass Pollen Allergy. J Allergy Clin Immunol. 2020;145(4):1174-1181.e6. PubMed PMID: 31954777.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sensitization to grass pollen allergen molecules in a birth cohort-natural Phl p 4 as an early indicator of grass pollen allergy. AU - Westman,Marit, AU - Åberg,Karin, AU - Apostolovic,Danijela, AU - Lupinek,Christian, AU - Gattinger,Pia, AU - Mittermann,Irene, AU - Andersson,Niklas, AU - Melén,Erik, AU - Bergström,Anna, AU - Antó,Josep M, AU - Bousquet,Jean, AU - Valenta,Rudolf, AU - Wickman,Magnus, AU - van Hage,Marianne, AU - ,, Y1 - 2020/01/17/ PY - 2019/06/28/received PY - 2019/12/19/revised PY - 2020/01/09/accepted PY - 2020/1/20/pubmed PY - 2021/1/26/medline PY - 2020/1/20/entrez KW - Allergen molecules KW - BAMSE KW - IgE KW - MeDALL KW - Phl p 4 KW - allergic rhinitis KW - cohort KW - grass pollen KW - microarray SP - 1174 EP - 1181.e6 JF - The Journal of allergy and clinical immunology JO - J Allergy Clin Immunol VL - 145 IS - 4 N2 - 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. SN - 1097-6825 UR - https://www.unboundmedicine.com/medline/citation/31954777/Sensitization_to_grass_pollen_allergen_molecules_in_a_birth_cohort_natural_Phl_p_4_as_an_early_indicator_of_grass_pollen_allergy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0091-6749(20)30040-3 DB - PRIME DP - Unbound Medicine ER -