D3.92 - Precision Allergy Diagnostics in Tunisia: Integrating Molecular Allergology into the Management of Respiratory and Food Allergies

In Tunisia, allergic diseases are increasingly prevalent, while diagnostic strategies still rely largely on clinical history and extract-based testing. The implementation of molecular allergology offers a unique opportunity to improve diagnostic accuracy, prognostic assessment, and personalized management, particularly in complex sensitization profiles.To present a comprehensive overview of the contribution of biological and molecular diagnostics to the management of respiratory and food allergies in a real-life Tunisian setting.

This communication synthesizes data from several retrospective studies conducted at the Pasteur Institute of Tunis between 2020 and 2025. Patients investigated for respiratory allergies (house dust mites, olive and grass pollens) and food allergies (cow’s milk, egg, peach, shrimp) underwent total IgE measurement, extract-based specific IgE testing, and component-resolved diagnostics using ImmunoCAP®. Clinical relevance, persistence risk, and cross-reactivity were analyzed.

For respiratory allergies, molecular markers enabled identification of clinically relevant sensitizations, particularly in polysensitized patients, with olive pollen emerging as a major allergen of high clinical impact. For food allergies, component-resolved diagnostics refined diagnosis and prognosis: casein-specific IgE thresholds predicted persistence of cow’s milk allergy; ovomucoid dominated egg allergy profiles; peach allergy followed a Mediterranean LTP-driven pattern with predominant Pru p 3 sensitization; and shrimp allergy was mainly associated with tropomyosin, explaining cross-reactivity with mites and snails.

Biological allergy diagnostics, and especially molecular allergology, significantly enhance the precision of allergy diagnosis and management in Tunisia. These findings support the integration of component-resolved diagnostics into routine allergy care to promote personalized medicine in North African populations.