Regional patterns of molecular sensitization to dust mites and pollens in a Portuguese pediatric population: a...

Molecular tools enable detailed analysis of molecular allergens. Understanding their regional variability, considering environmental factors, improves diagnostic accuracy and allows individualized approaches in pediatric allergy management. This multicenter retrospective study analyzed the results of ImmunoCAP ISAC^® test (n = 1010) performed in pediatric patients from 14 Portuguese hospitals. Sensitization to dust mite (DM) molecular allergens was found in 64% of patients, mainly to major allergens Der p 1, Der p 2, and Der p 23. There were 96 patients (10%) monosensitized to one DM molecular allergen with almost half of them being sensitized to Der p 23 (48%), followed by Der p 1 (26%). Urbanization and coastal residence were associated with a higher risk of DM sensitization, particularly to Dermatophagoides species. Pollen sensitization affected 57% of patients, with grass pollens-mainly Phl p 1 and Cyn d 1-being the most prevalent pollens. Interior regions, characterized by greater vegetation, showed a significantly higher prevalence of pollen sensitization. Regional trends that reflected the native flora were noted, such as elevated sensitivity to olive pollen allergen Ole e 1 in Trás-os-Montes region and Arizona cypress pollen allergen Cup a 1 in Coimbra region. Sensitization to birch pollen allergen Bet v 1 and proteins of the pathogenesis-related class 10 plant protein family (PR-10) was associated with food allergy. The findings of this research emphasized the need for incorporating these regional variations into clinical practice and draw attention to notable regional variations in allergy sensitivity patterns among Portuguese children.