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　　原标题：儿童季节性变应性鼻炎的花粉-食物综合征内行：分子分类
　　① 花粉-食物综合征(PFS)在触发、严重程度、自然病史、并发症和对治疗的反应方面具有异质性；② 纳入1271名意大利儿童，使用ImmunoCAP FEIA测定泛过敏源Phl p 12 (profilin), Bet v 1 (PR-10), 和Pru p 3 (nsLTP)的IgE；④ 在一个以多次接触花粉为特征的地中海国家，PFS是儿童SAR复杂而频繁的并发症，具有五种不同的内型，以特异性IgE对泛变应原的敏感性为特征。


延伸阅读


Allergy
Endotypes of pollen-food syndrome in children with seasonal allergic rhinoconjunctivitis: a molecular classification
DOI: 10.1111/all.12888
Abstract:
Background: Pollen-food syndrome (PFS) is heterogeneous with regard to triggers,severity, natural history, comorbidities, and response to treatment. Our study aimed to classify different endotypes of PFS based on IgE sensitization to panallergens.
Methods: We examined 1271 Italian children (age 4–18 years) with seasonal allergic rhinoconjunctivitis (SAR). Foods triggering PFS were acquired by questionnaire. Skin prick tests were performed with commercial pollen extracts. IgE to panallergens Phl p 12 (profilin), Bet v 1 (PR-10), and Pru p 3 (nsLTP) were tested by ImmunoCAP FEIA. An unsupervised hierarchical agglomerative clustering method was applied within PFS population.
Results: PFS was observed in 300/1271 children (24%). Cluster analysis identified five PFS endotypes linked to panallergen IgE sensitization: (i) cosensitization to≥2 panallergens (‘multi-panallergen PFS’); (ii–iv) sensitization to either profilin,or nsLTP, or PR-10 (‘mono-panallergen PFS’); (v) no sensitization to panallergens (‘no-panallergen PFS’). These endotypes showed peculiar characteristics: (i)‘multi-panallergen PFS’: severe disease with frequent allergic comorbidities and multiple offending foods; (ii) ‘profilin PFS’: oral allergy syndrome (OAS) triggered by Cucurbitaceae; (iii) ‘LTP PFS’: living in Southern Italy, OAS triggered by hazelnut and peanut; (iv) ‘PR-10 PFS’: OAS triggered by Rosaceae; and (v) ‘no-panallergen PFS’: mild disease and OAS triggered by kiwifruit.
Conclusions: In a Mediterranean country characterized by multiple pollen exposures, PFS is a complex and frequent complication of childhood SAR, with five distinct endotypes marked by peculiar profiles of IgE sensitization to panallergens. Prospective studies in cohorts of patients with PFS are now required to test whether this novel classification may be useful for diagnostic and therapeutic purposes in the clinical practice.
First Author:
C. Mastrorilli
Correspondence:
Matricardi, Department of Pediatric Pneumology and Immunology, Charite Medical University, Augustenburger Platz
All Authors:
C. Mastrorilli, S. Tripodi, C. Caffarelli1, S. Perna, A. Di Rienzo-Businco, I. Sfika, R. Asero, A. Dondi, A. Bianchi, C. Povesi Dascola, G. Ricci, F. Cipriani, N. Maiello, M. Miraglia Del Giudice, T. Frediani, S. Frediani, F. Macrı, C. Pistoletti, I. Dello Iacono, M. F. Patria,E. Varin, D. Peroni, P. Comberiati, L. Chini, V. Moschese, S. Lucarelli, R. Bernardini,G. Pingitore, U. Pelosi, R. Olcese, M. Moretti, A. Cirisano, D. Faggian, A. Travaglini,M. Plebani, M. C. Verga, M. Calvani, P. Giordani&P. M.
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