Sensitization profiles in polysensitized patients from a restricted geographical area: further lessons from multiplexed component resolved diagnosis.

Background: The micro-array techniques for the detection of specific IgE has improved the diagnostic procedures for allergic diseases. This method also allows to define sensitisation profiles from an epidemiological point of view. We studied the sensitisation pattern in a population of polysensitized patients with respiratory allergy, living in a restricted geographical area in the north-west Italy.

Methods: Consecutive patients with asthma/rhinitis, living in the province of Cuneo, and having at least two positive skin prick test for non related aeroallergens were studied by a microarray (Phadia, Milan Italy) which allowed to detect specific IgE against 103 different allergen components.

Results: The 70 patients included had specific IgE towards a mean of 4.3 allergens/patient (range 2-12 allergens). Concerning pollens, 63 (90%) had specific IgE to at least one genuine grass pollen allergen, 32 (45.7%) had Ole e 1 specific IgE antibodies, although olive tree is not present in the area. A relevant percentage of sensitisation to mite was found (47,1%). True co-sensitisation to grass-pollen allergens/Bet v 1/Ole e 1 was observed in 15 individuals (21.4%). Prup 1, resulted to be a sensitising allergen in 23 patients (32.85%), 4 of whom were co-sensitised to Prup 3 and/or Art v 3.

Conclusion: A detailed knowledge of the sensitisation pattern may have relevant implications for the prescription of specific immunotherapy. Moreover, sensitisation to PR-10 (or profilin), frequently associated to oral allergy syndrome, in some cases could hide the sensitisation to LTPs which are clinically more relevant.