Summary
Background
Immunoglobulin E-mediated allergy is the most important hypersensitivity disease affecting more than 30% of the population worldwide. The analysis of molecular IgE sensitization profiles in defined populations and age groups is important for the development of allergen-specific preventive and therapeutic interventions. The present study was performed to examine if there are differences regarding molecular IgE reactivity profiles in children and adults from two regions with similar climate and exposome.
Methods
This two-step cross-sectional study assessed molecular IgE reactivity profiles using an experimental allergen microarray comprising 105 allergen molecules. In the first step, an exploratory cross-sectional study, serum samples from 539 allergic patients (259 children, 280 adults) who were born and grew up in the Algiers region were analyzed. The second step was a prospective cross-sectional study performed in 272 Turkish allergic patients (133 children, 139 adults) from Istanbul and Samsun regions with a climate and allergen exposome similar to Algiers, with the goal of investigating the reproducibility of possible differences in molecular IgE sensitization profiles between children and adults.
Findings
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| Age-stratified molecular sensitization to (A, C) indoor and (B, D) outdoor aeroallergens in children (N = 173; blue bars) and adults (N = 244; orange bars) with respiratory allergy from Algiers (A, B) and children (N = 133; blue bars) and adults (N = 139; orange bars) with respiratory allergy from Türkiye (C, D). |
Interpretation
Our study demonstrates different molecular IgE sensitization profiles in two age groups (children and adults) on two different continents with a similar climate and allergen exposome which may be due to exogenous factors such as climate change, different lifestyles, pollution and changes in vegetation. Both major house dust mite sensitization and asthma were more common in children, suggesting sensitization profile may contribute to asthma risk.
Research in context
Evidence before this study
Immunoglobulin E-mediated allergy is the most common hypersensitivity disease affecting more than one third of the population. Prior research has established that IgE sensitization is affected by multiple endogenous and exogenous factors. Among exogenous factors, early-life contact with allergens from the environment (i.e., allergen exposome) determines the allergen sensitization profile of an allergic person. In addition, environmental factors such as hygienic conditions at birth (e.g., cesarean section) and early life (e.g., rural vs urban environment, anthroposophic lifestyle) were reported to influence the general frequency of IgE sensitization. The possibility of investigating molecular IgE sensitization profiles with comprehensive panels of micro-arrayed allergen molecules has enabled the study of the evolution of molecular IgE sensitization profiles in birth cohorts and confirmed that the early-life allergen exposome determines life-long allergen sensitization profiles. However, detailed investigations into differences in respiratory-allergen sensitization profiles between age groups, such as children and adults from the same region, and their associations with allergic symptoms are lacking.
Added value of this study
This study is a two-step study comprising an exploratory cross-sectional analysis of molecular IgE sensitization profiles in the Algiers region and a prospective cross-sectional study performed in a region with similar climate and allergen exposome in Türkiye. In both steps of the study, significantly more children than adults with respiratory allergy were sensitized to major respiratory house dust mite allergens whereas significantly more adults than children were sensitized to regionally common respiratory outdoor allergens. Asthma was significantly more common in children than in adult patients with respiratory allergy.
Implications of all the available evidence
The present findings highlight that molecular sensitization patterns may differ substantially between age groups within regions with comparable climate and allergen exposome, suggesting a potential role of environmental and lifestyle-related factors in shaping sensitization profiles. Further prospective longitudinal studies investigating the impact of environmental and lifestyle-related factors on molecular IgE sensitization profiles and allergic phenotypes are warranted. Whether major house dust mite sensitization directly contributes to asthma risk, independent of age, is a link future studies should test directly, adjusting for age.
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