Precision Medicine in Allergic Rhinitis and Conjunctivitis: Integrative Molecular Mapping of the Allergic Exposome in Spain (EXPOMOL Study).
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González-Pérez Ruperto, Poza-Guedes Paloma, Igea Aznar Juan M, Rondón Segovia Carmen, Testera Montes Almudena, Fernández Parra Beatriz, Vásquez-Suero Melvin, Navarro Pulido Ana M, Sánchez Hernández María C, Lemus Calderón Jose A, Montoro-Ferrer Ana, Dordal Culla María T, Martí-Garrido Jaume, Lluch Bernal Magdalena, Letrán Camacho Antonio, Ojea Sánchez Guillermo, Marques Lluis, Lara Alcón Silvia, Nieto Cid María, El-Qutob David, Rodríguez Fernando, Albarracín Contreras Ángel, Martínez María J, Santano Guillén Elena, Abel-Fernández Eva, Galán Díez Tania, Pineda de la Losa Fernando
Аннотация
METHODS: A cross-sectional, multicenter study was performed in 12 Spanish cities. The study population comprised 291 patients diagnosed with allergic rhinitis and/or conjunctivitis according to the modified ARIA/DECA criteria. Participants underwent skin prick testing with standardized allergen extracts and multiplex molecular IgE analysis. Clinical, demographic, and regional bioclimatic variables were integrated to define exposomic sensitization patterns. Patients previously treated with allergen immunotherapy or biologics were excluded. Regional pooled sera were analyzed by ELISA and IgE immunoblotting to validate molecular data and identify IgE binding to nonrecombinant or poorly characterized allergenic components.
RESULTS: Distinct regional sensitization profiles were identified. Grass pollen allergens predominated in oceanic and continental climates, while olive and cypress pollens were more frequent in Mediterranean areas. Sensitization to house dust mite, particularly Dermatophagoides pteronyssinus and Blomia tropicalis, was highly prevalent in subtropical and humid zones. Molecular assays confirmed skin test findings and identified major allergenic molecules, including Phl p 1, Ole e 1, Der p 1, and Der p 2, along with region-specific components such as Der p 23, Cup a 1, Alt a 1, and Pla a 2.
CONCLUSIONS: This multicenter exposomic study demonstrated that climatic diversity modulates allergen sensitization in Spain, supporting region-tailored precision diagnostic and therapeutic strategies in respiratory allergy.