Associations of molecular sensitization patterns identified by latent class analysis with clinical phenotypes in patients with allergic rhinitis with and without asthma.

INTRODUCTION: Sensitization to different allergen components is associated with distinct clinical characteristics including disease phenotypes and severity. A better understanding of the individual patterns of sensitization is important for the diagnosis and personalized management of the allergic patient. This is one of the first comprehensive studies of the molecular sensitization patterns investigating both indoor and outdoor allergens in Albanian patients.

METHODS: A cross-sectional study among patients with allergic rhinitis (AR) with and without asthma was conducted in Tirana. Patients underwent a detailed interview on clinical allergy history, skin prick testing and the Allergy Explorer Test 2 (ALEX 2) multiplex array. Latent class analysis was carried out to identify distinct sensitization profiles.

RESULTS: Data from 140 cases were analyzed. Four distinct sensitization classes were derived in our study population: Class 1, predominant sensitization to grass pollen molecular allergens (n=56,40%); Class 2, predominant sensitization to house dust mites (HDM) molecular allergens (n=38, 27.1%); Class 3, predominant sensitization to pathogenesis-related class 10 (PR-10) molecular allergens (n=25,17.9%) and Class 4, broad sensitization to multiple inhalant and food components (n=21, 15%). Patients in CL2 had higher odds of having AR with asthma compared to AR only (OR= 2.430, 95% CI [1.016-5.811], p=0.046), whereas patients in CL3 (OR=10.286, 95% CI [3.334-31.731], p<0.001) were associated with higher odds of Pollen-food allergy syndrome.

CONCLUSION: Sensitization patterns are heterogeneous within a country-level cohort of patients and are associated with distinct clinical phenotypes. In the overall study population, sensitization to HDM and persistent, severe AR were associated with AR with concomitant asthma.