Sensitization patterns to Poaceae pollen indicates a hierarchy in allergens and a lead of tropical grasses

Clin Transl Allergy. 2023 Aug;13(8):e12287. doi: 10.1002/clt2.12287.

Abstract

Background: The allergenicity of pollen of Poaceae family members is a well-known and confirmed fact. Using the data of component-resolved molecular diagnostics of allergy, we set a goal to establish the population and individual characteristics of sensitization to grass pollen and assess the patterns of its development.

Methods: Multiplex allergy Alex2 test results of 20,033 patients were used. In addition to descriptive statistics to uncover traits of the sensitized population, statistical inference was utilized to establish the conditional probability of sensitisation, the nature of links between allergens, and the most frequent combinations of allergens in individual patient profiles.

Results: Sensitivity to grass pollen comprised 30.79% of the studied sample. Children accounted for 62.21%, adults-37.79%. Sensitisation to Phl p 1, Lol p 1, and Cyn d 1 was the most frequent in all age groups. Among them, Phl p 1 and Lol p 1 were the major ones. Phl p 2, Phl p 5.0101, and Phl p 6 were also responsible for primary sensitization; Phl p 5.0101 promoted the highest sIgE levels. A combination "Lol p 1-Phl p 1", where Lol p 1 might play a leading role, was most frequent in individual profiles. Monosensitization to Phl p 2 was the second most frequent and Bayesian Network suggested its independent development. Monosensitization to Cyn d 1, especially among children, may indicate the impact of climate change, promoting the spread of the subtropical grasses to the temperate region.

Conclusions: Descriptive statistics and known clinical data coincide well with statistical inference results and can provide for new clinical insights.

Keywords: climate change; component-resolved allergy diagnostics; grass pollen groups I, II/III, V, VI; grass pollen sensitization; statistical inference.