[Multicenter component-resolved study of inhalant allergen sensitization and cross-reactivity in airway allergic patients].

Objective

To investigate the molecular sensitization profiles of inhalant allergens in Chinese patients with airway allergies using component-resolved diagnosis (CRD) and to analyze their distributional characteristics.

Methods

In this cross-sectional study, allergen component testing data were collected from 225 patients diagnosed with allergic rhinitis (AR) and/or allergic asthma (AS) across 20 medical centers in 13 provinces (Northern, Southern, and Northwestern China) between October 2019 and January 2023. Specific immunoglobulin E (sIgE) levels for 132 components were analyzed. Sensitization differences were compared across clinical phenotypes, age stratifications, and geographical regions. Spearman correlation analysis was employed to evaluate molecular cross-reactivity.

Results

Among the 225 patients [mean age: (19.40±17.53) years; 119 males, 106 females], children aged 0-6 and 7-14 years accounted for 58.67% (132/225). Regarding overall distribution, the predominant sensitizing components were Artemisia vulgaris (Art v 1, 43.11%), dust mites (Der p 2, 39.11%; Der f 2, 38.22%), and Phleum pratense (Phl p 12, 39.11%). Phenotypically, while the AR combined with AS group exhibited the broadest polysensitization, the AR only group was distinct for its significantly higher sensitization to cat (Fel d 1, 68.42%) and dog (Can f 1,36.84%) dander (both P<0.05). Conversely, pollen sensitization was relatively lower in the AS only group. Regarding age, children (0-6 and 7-14 years) showed early sensitization to pan-allergens (e.g., Phl p 12, Bet v 2) and fungi (Alt a 1), whereas dust mite components (Der f 2, Der p 2, Der p 23) showed lower prevalence in the 0-6 group (23.19%, 23.19%, and 10.14%, respectively). Regional analysis highlighted a "Northern Pollen vs Southern Mite" dichotomy: weeds (Artemisia>60%) and tree pollen dominated the Northwest and North, whereas mites (>60%) and cockroaches dominated the South (P<0.001). Furthermore, extensive molecular cross-reactivity was confirmed within the Serum Albumin and Profilin families.

Conclusions

Significant heterogeneity exists in sensitization profiles across phenotypes, ages, and regions. Mugwort and mites are core allergens. CRD facilitates the identification of cross-reactivity and guides precise, regionalized management.