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Heterogeneity of Pollen Food Allergy Syndrome in Seven Southern European Countries: The@ IT. 2020 Multicenter Study

Lipp, Theresa, Acar Şahin, Aydan, Aggelidis, Xenophon, Arasi, Stefania, Barbalace, Andrea, Bourgoin, Anne, Bregu, Blerina, Brighetti, Maria Antonia, Caeiro, Elsa, Caglayan Sozmen, Sule, Caminiti, Lucia, Charpin, Denis, Couto, Mariana, Delgado, Luís, Di Rienzo Businco, Andrea, Dimier, Claire, Dimou, Maria V., Fonseca, João A., Goksel, Ozlem, Guvensen, Aykut, Hernandez, Dolores, Hoffmann, Tara Maria, Jang, Dah Tay, Kalpaklioglu, Fusun, Lame, Blerta, Llusar, Ruth, Makris, Michael P., Mazon, Angel, Mesonjesi, Eris, Nieto, Antonio, Öztürk, Ayse, Pahus, Laurie, Pajno, Giovanni Battista, Panasiti, Ilenia, Papadopoulos, Nikolaos G., Pellegrini, Elisabetta, Pelosi, Simone, Pereira, Ana M., Pereira, Mariana, Pinar, Munevver, Potapova, Ekaterina, Priftanji, Alfred, Psarros, Fotis, Sackesen, Cansin, Sfika, Ifigenia, Suarez, Javier, Thibaudon, Michel, Travaglini, Alessandro, Tripodi, Salvatore, Verdier, Valentine, Villella, Valeria, Xepapadaki, Paraskevi, Yazici, Duygu, Matricardi, Paolo M., Dramburg, Stephanie·2021·Allergy
DOI 10.1111/all.14742
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Abstract

Background: Pollen food allergy syndrome (PFAS) is a frequently underdiagnosed disease due to diverse triggers, clinical presentations, and test results. This is especially relevant in geographic areas with a broad spectrum of pollen sensitization, such as Southern Europe. Objectives: To elucidate similarities and differences of PFAS in nine Southern European centers and identify associated characteristics and unique markers of PFAS. Methods: As part of the @IT.2020 Multicenter Study, 815 patients with seasonal allergic rhinitis (SAR), aged 10–60 years, were recruited in seven countries. They completed questionnaires regarding SAR, comorbidities, family history, and PFAS, and underwent skin prick testing (SPT) and serum IgE testing. Results: Of the 815 patients, 167 (20.5%) reported PFAS reactions. Most commonly, eliciting foods were kiwi (58, 34.7%), peach (43, 25.7%), and melon (26, 15.6%). Reported reactions were mostly local (216/319, 67.7%), occurring within 5 min of contact with elicitors (209/319, 65.5%). Associated characteristics included positive IgE to at least one panallergen (profilin, PR‐10, or nsLTP) (p = 0.007), maternal PFAS (OR: 3.716, p = 0.026), and asthma (OR: 1.752, p = 0.073). Between centers, heterogeneity in prevalence (Marseille: 7.5% vs. Rome: 41.4%, p < 0.001) and of clinical characteristics was apparent. Cypress played a limited role, with only 1/22 SPT mono‐sensitized patients reporting a food reaction (p < 0.073). Conclusions: PFAS is a frequent comorbidity in Southern European SAR patients. Significant heterogeneity of clinical characteristics in PFAS patients among the centers was observed and may be related to the different pollen sensitization patterns in each geographic area. IgE to panallergen(s), maternal PFAS, and asthma could be PFAS‐associated characteristics.

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Metadata

Authors
Lipp, T., Acar Şahin, A., Aggelidis, X., Arasi, S., Barbalace, A., Bourgoin, A., Bregu, B., Brighetti, M. A., Caeiro, E., Caglayan Sozmen, S., Caminiti, L., Charpin, D., Couto, M., Delgado, L., Di Rienzo Businco, A., Dimier, C., Dimou, M. V., Fonseca, J. A., Goksel, O., Guvensen, A., Hernandez, D., Hoffmann, T. M., Jang, D. T., Kalpaklioglu, F., Lame, B., Llusar, R., Makris, M. P., Mazon, A., Mesonjesi, E., Nieto, A., Öztürk, A., Pahus, L., Pajno, G. B., Panasiti, I., Papadopoulos, N. G., Pellegrini, E., Pelosi, S., Pereira, A. M., Pereira, M., Pinar, M., Potapova, E., Priftanji, A., Psarros, F., Sackesen, C., Sfika, I., Suarez, J., Thibaudon, M., Travaglini, A., Tripodi, S., Verdier, V., Villella, V., Xepapadaki, P., Yazici, D., Matricardi, P. M., & Dramburg, S.
Affiliations
  • Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine Charité – Universitätsmedizin Berlin Berlin Germany
  • Department of Biology Faculty of Science Ankara University Ankara Turkey
  • Allergy Unit, 2nd Department of Dermatology and Venereology National and Kapodistrian University of Athens University Hospital "Attikon" Athens Greece
  • Pediatric Allergology Unit Department of Pediatric Medicine Bambino Gesù Children's Research Hospital (IRCCS) Rome Italy
  • Department of Pediatrics‐Allergy Unit University of Messina Messina Italy
  • Department of Pneumonology and Allergy La Timone Hospital APHM Aix‐Marseille University Marseille France
  • Department of Allergology and Clinical Immunology UHC Mother Teresa Medical University Tirana Tirana Albania
  • Department of Biology Tor Vergata University Rome Italy
  • MED‐Mediterranean Institute for Agriculture, Environment and Development Institute for Advanced Studies and Research University of Évora Évora Portugal
  • Department of Pediatric Allergy and Immunology Okan University Faculty of Medicine Istanbul Turkey
  • Department of Immunoallergology CUF Decobertas Hospital José de Mello Saúde Porto Portugal
  • Basic and Clinical Immunology Unit Department of Pathology Faculty of Medicine University of Porto Porto Portugal
  • Pediatric Allergy Unit Sandro Pertini Hospital Rome Italy
  • Allergy Department 2nd Pediatric Clinic Athens General Children's Hospital “P&amp;A Kyriakou” University of Athens Athens Greece
  • CINTESIS Center for Health Technology and Services Research Porto Portugal
  • Department of Pulmonary Medicine Division of Immunology, Allergy and Asthma Faculty of Medicine Ege University Izmir Turkey
  • Department of Biology Faculty of Science Ege University Izmir Turkey
  • Department of Allergy Health Research Institute Hospital La Fe Valencia Spain
  • Pediatric Allergy and Pneumology Unit Children's Hospital La Fe Health Research Institute La Fe Valencia Spain
  • Department of Immunology and Allergic Diseases Kırıkkale University School of Medicine Ankara Turkey
  • Department of Pulmonary Medicine Division of Allergy and Immunology Koç University, School of Medicine Istanbul Turkey
  • Department of Pneumonology and Allergy North Hospital APHM Aix‐Marseille University Marseille France
  • Department of Reggio Calabria ARPA‐Regional Agency for Environmental Protection Calabria Italy
  • TPS Production srl Rome Italy
  • Allergy Department Athens Naval Hospital Athens Greece
  • Division of Pediatric Allergy Koç University School of Medicine Istanbul Turkey
  • Department of Biology of Organisms and Systems Area of Botany University of Oviedo Oviedo Spain
  • Réseau National de Surveillance Aérobiologique Brussieu France
  • Allergy Department 2nd Pediatric Clinic National and Kapodistrian University of Athens Athens Greece
  • Cellular and Molecular Medicine KUTTAM Graduate School of Health Sciences Koç University Istanbul Turkey
ORCID
Venue
Allergy
Publisher
Wiley
Published
2021-07-18
Volume
76
Issue
10
Pages
3041-3052
ISSN
  • 0105-4538
  • 1398-9995
DOI
10.1111/all.14742
Cited by
39
References
1
Language
en
Licence
creativecommons.org/licenses/by-nc/4.0/ (vor)

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