D2.480 - Features of the molecular sensitization profile in children with autism spectrum disorder

Studying the molecular profile of sensitization to non-food and food allergens in children with autism spectrum disorder (ASD) is relevant due to the high frequency of comorbid allergic pathology and the insufficient knowledge of this issue.

Objective. To study the features of the molecular sensitization profile in children with autism spectrum disorder.

 The study included 115 children with ASD. All patients underwent quantitative determination of specific IgE to extractable and molecular allergens on the ALEX2 platform (threshold > 0.3 kUA/L). sIgE levels were assessed according to gradations: low (0.3–1.0), moderate (1.0–5.0), high (5.0–15.0), and very high (> 15.0 kUA/L), as well as a clinical examination by an allergist. Descriptive statistical methods were used for data analysis.

This descriptive study, conducted from 2022 to 2025, included 115 children with ASD, of which 85 (73.9%) were boys and 30 (26.1%) were girls. Comprehensive allergological testing revealed sensitization to at least one allergen in 49 (42.6%) patients. A detailed analysis of the spectrum of causative allergens demonstrated an absolute predominance of inhalant allergens, with tree pollen components leading: Bet v 1 (silver birch) — 14.7%, Fag s 1 (beech) — 11.3%, and Cor a 1.0103 (hazel) — 10.4%. Sensitization to the epidermal allergen Fel d 1 (cat) played a significant role — 13.9%. Food sensitization was less pronounced and predominantly had a cross-reactive nature associated with Bet v 1 homologues, as illustrated by the example of Cor a 1.0401 (hazelnut) — 9.5%. Statistical analysis revealed no dependence of the overall sensitization frequency on the patient's sex (χ² = 0.59; p = 0.444), however, in the sensitization structure, boys showed a statistically significant higher frequency of sensitivity to the cat allergen Fel d 1. Clinical signs of allergic disease were observed in 40% (n=46) of all examined children. At the same time, among patients with laboratory-confirmed sensitization, the frequency of clinical manifestation reached 93.8%. The structure of clinically expressed allergic pathology was dominated by: allergic rhinitis — 18 cases (39.1% of the symptomatic group), food allergy — 14 (30.4%), atopic dermatitis — 5 (10.9%), drug allergy — 6 (13.0%) and bronchial asthma — 3 (6.5%). Asymptomatic sensitization was detected in three children (10.2% of the sensitized group); they were given recommendations for primary prevention of allergic disease manifestation.

The study confirmed a high prevalence of sensitization (42.6%) and allergic diseases (40%) in children with ASD. The molecular profile is dominated by inhalant allergens: Bet v 1 (14.7%) and Fel d 1 (13.9%). Food sensitization is cross-reactive with Bet v 1 homologues. The obtained data indicate the necessity of including molecular diagnostics in the examination algorithm for children with ASD to develop personalized patient management approaches.