Polysensitisation is associated with more severe symptoms: The reality of patients with allergy

Cacheiro-Llaguno C, Mösges R, Calzada D, González-de la Fuente S, Quintero E, Carnés J. Clin Exp Allergy. 2024; 00: 1-14. doi:10.1111/cea.14486

Abstract

Background

Studying the sensitisation profiles of patients with allergies allows for a deeper understanding of the disease which may facilitate the selection of the best-personalised allergen immunotherapy. This observational, cross-sectional, multicentre study aimed to demonstrate the heterogeneity of the German population with allergies by analysing specific immunoglobulin E (sIgE) patterns towards aeroallergens and exploring the relationship between sensitisation and clinical symptoms.

Methods

In total, 500 patients with allergies from different regions of Germany were recruited based on their case histories, clinical allergic symptoms and skin prick test data for aeroallergens. Serum samples were analysed using ImmunoCAP assays to determine sIgE levels for 33 allergenic sources and 43 molecular allergens.

Results

(A) Percentage of patients sensitised to each of the 16 allergenic sources analysed in the first phase (left axis)
and the log10 mean value of specific immunoglobulin E (sIgE; kUA/L, right axis).(B) Percentage of patients
sensitised to each of the 17 allergenic sources analysed in the second phase (left axis)
and the log10 mean value of sIgE (kUA/L, right axis). 

Most patients (81%) were polysensitised. Betula verrucosa pollen was the most common cause of sensitisation (59%), followed by Phleum pratense (58%) and Dermatophagoides pteronyssinus (44%). The highest prevalence rates of molecular allergens were observed for Bet v 1 (84%) from birch pollen, Phl p 1 from grass pollen (82%), Der p 2 (69%) from mites and Fel d 1 (69%) from cat. Polysensitisation was significantly associated with the presence of asthma and the severity of rhinitis symptoms.

Conclusions

Our findings show a high rate of polysensitisation and emphasise the importance of molecular diagnosis for more precise and comprehensive insights into sensitisation patterns and their association with clinical symptoms. These data may help improve personalised diagnosis and immunotherapy adapted to the needs of individual patients in the region.

Key messages

• More than 80% of patients with allergies are polysensitised. A challenge for treating patients correctly.
• Polysensitisation is significantly associated with asthma presence, confirming its clinical relevance.
• An accurate molecular diagnosis is key for precise and personalised allergic treatment.

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