D3.80 - Molecular allergy profiling of sensitization in adult patients with asthma in real practice

Molecular allergy diagnosics have created a new perspective in sensitization profiles determining in clinical practice. During last decades allergy increases worldwide, so accurate sensitization data may improve diagnosis and management of asthma patients.

We performed a retrospective and descriptive study of 63 outpatients (55% male, aged 18-80 yr, mean age 42 yrs) with asthma between 2022 and 2025. Forty one percent had mild asthma, 43% - moderate and 16% - severe asthma. Among patient with asthma 8% were obese, 13% had aspirin-induced asthma and 2% were steroid-dependent, 35% had late onset of the disease, fixed airway obstruction was diagnosed in 16%. Patients experienced about 0.71 exacerbations per year, had mean FEV₁ of 87% pred. and ACQ-5≥1.5 in 45% of cases. Current smokers were 5% of patients and 17% were former smokers. The molecular study was performed using the ALEX2® diagnostic platform (MAD®, Vienna).

Eleven patients were not atopic due to ALEX2 and 52 patients (83%) had any level of sensitization to at least one of distinct molecular allergens. In 38 asthmatics (60%) we revealed specific IgE≥0.35 kUA/L to at least one of studied allergens. Among atopic patients 37% were positive for grass pollen allergens. The most frequent among them were Phl p 1 (31%) and Lol p 1 (19%). Positive tests to tree pollen allergens were revealed in 52% of cases and the most frequent were Bet v 1 (44%), Aln g 1 (35%) and Cor a pollen (27%). In patients 33% were positive for at least one of weeds pollen allergens (Art v1 -17%). Only 8 patients (15%) were positive for at least one of mites allergens (Der p 2 – 15%, Der f 2 – 13%) and 10% were sensitized for moulds (Alt a 1 - 6%). Sensitization to food allergens had 58% of patients (Ara h 8 – 23%, Gly m 4 – 19%, Mal d 1 – 31%, Cor a 1.0401 – 25%) and 23% were sensitized for insects (Ves v 5 - 8%). The most frequent was sensitization to animal allergens – 60% (Fel d 1 – 46%, Can f 1 – 37%, Can f 4 – 25%, Equ c 1 – 21%). Hypersensitivity to 2 and more unrelated allergens was diagnosed in 29% patients with asthma. Total IgE level correlated with rate of asthma exacerbations (r=0.37, p<0.05) and sensitization to grass pollen (r=0.39, p<0.05), tree pollen (r=0.38, p<0.05) and mites (r=0.44, p<0.05) but not with moulds, food, insect or animal allergens.

According to molecular allergy diagnosics the most frequent sensitization in adult patients with asthma was revealed to animal, food and tree pollen allergens. Polysensitization was diagnosed in approximately one third of patients.