D1.168 - ASSOCIATION BETWEEN MOLECULAR ALLERGEN SENSITIZATION AND FeNO IN CHILDREN WITH ALLERGIC ASTHMA

Fractional exhaled nitric oxide (FeNO) is an important biomarker used in clinical practice to assess eosinophilic airway inflammation (Wang, J., Li, M., Huang, S. et al. 2025). While the role of aeroallergen sensitization in asthma is well established, limited data are available on the association between specific molecular allergen components and FENO levels in pediatric patients.

This study included 40 children with allergic asthma (mean age 9.8 ± 3.1 years). Baseline clinical characteristics, total IgE, and molecular allergen sensitization profiles were assessed using component-resolved diagnostics. FENO was measured at baseline and after 3 months of follow-up. Descriptive statistics were used to characterize the study population. Spearman correlation analysis was performed to evaluate associations between baseline FENO and molecular allergen components.

The most frequent molecular sensitizations were to Fel d 1 (42.5%), Der f 2 (37.5%), Der p 2 (35.0%), Der p 23 (32.5%) and Alt a 1 (22.5%). Mean baseline FENO was 41.7 ± 30.0 ppb and decreased to 25.1 ± 16.5 ppb after 3 months of asthma controller treatment. Allergic rhinitis was present in 92.5% of patients and atopic dermatitis in 30.0%. In patients with asthma, FeNO levels were significantly correlated with the number of sensitizing allergens (r = 0.46; p < 0.01), underscoring a direct relationship between polysensitization and the intensity of Th2-mediated airway inflammation. It should be especially emphasized that the baseline FENO level showed a significant positive correlation with sensitization to Alt a 1 (r = 0.78; p = 0.013).

In this pediatric cohort with allergic asthma, baseline FENO was associated with specific molecular allergen sensitization patterns. Sensitization to Alt a 1 showed a significant positive association with FENO, suggesting a potential link between certain fungal allergens and type 2 airway inflammation.