Documents from the SIAIP Commissions

Issue 3 - 2024

Alternatives to the allergen- specific nasal provocation test: role of molecular allergens for grasses in poly-sensitized children with seasonal allergic rhinitis

Authors

SIAIP New Digital Technologies Commission , Mario Barreto , Auro Della Giustina , Ifigenia Sfika , Stefano Pattini , Alessandro Travaglini , Maria Antonia Brighetti , Denise De Franco , Alessandro Di Menno Di Bucchianico , Velia Malizia , Salvatore Tripodi

Key words: Allergic rhinitis, AllergyMonitor, nasal provocation test, grass pollens, polysensitized children
DOI: 10.53151/2531-3916/2024-564
Publication Date: 2024-10-07

Abstract

Allergic rhinitis (AR) affects 10-30% of the global population, notably children and adolescents, leading to reduced quality of life and comorbidities like asthma. An Italian multicenter study indicated that 85% of children tested positive for multiple pollen allergens, with Timothy grass predominant. IgE antibodies against Phleum Pratense, Bermuda grass, olive, and cypress are highly prevalent in southern Europe, where overlapping pollination periods complicate the identification of specific seasonal allergens in poly-sensitized patients. For some patients, allergen-specific immunotherapy is necessary when symptomatic therapy is insufficient. Molecular diagnostics and nasal provocation testing (NPT) are crucial to identify relevant allergens. NPT remains the gold standard for documenting clinical relevance in seasonal AR, but is challenging in poly-sensitized children. Non-invasive strategies, e-Diary for symptoms, and IgE-specific activity analysis are being explored. This summary reviews the predictive value of clinical and biological data for NPT outcomes in pediatric patients co-sensitized to grasses and other seasonal pollens. Clinical data assessed with the visual analogue scale can predict NPT outcomes. Biological data, including specific IgE levels and skin prick tests, have shown varying predictive values. Combining clinical scores and biological markers, such as IgE-specific activity for grass-pollen molecules, enhances prediction accuracy for positive NPT outcomes

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Authors

SIAIP New Digital Technologies Commission - SIAIP

Mario Barreto - NESMOS Department, Faculty of Medicine and Psychology, Pediatric Unit Sant’Andrea Hospital, “Sapienza” University, Rome, Italy

Auro Della Giustina - Private Practice, Parma, Italy

Ifigenia Sfika - Private Practice, Rome, Italy

Stefano Pattini - Pediatric Unit, Department of Medical and Surgical Sciences of the Mother, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy

Alessandro Travaglini - Department of Biology, Tor Vergata University, Rome, Italy

Maria Antonia Brighetti - Department of Biology, Tor Vergata University, Rome, Italy

Denise De Franco - Department of Biology, Tor Vergata University, Rome, Italy

Alessandro Di Menno Di Bucchianico - Italian National Institute for Environmental Pro- tection and Research (ISPRA), Rome, Italy

Velia Malizia - Institute of Translational Pharmacology, National Research Council (CNR), Palermo, Italy

Salvatore Tripodi - Allergology Service, Policlinico Casilino, Rome, Italy

License

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Copyright

Copyright (c) 2024 Italian Journal of Pediatric Allergy and Immunology

How to Cite
Commission, S. N. D. T., Barreto, M., Della Giustina, A. ., Sfika, . I. ., Pattini, . S., Travaglini, A., Brighetti , M. A., De Franco, . D., Di Menno Di Bucchianico , A., Malizia , . V., & Tripodi, S. (2024). Alternatives to the allergen- specific nasal provocation test: role of molecular allergens for grasses in poly-sensitized children with seasonal allergic rhinitis. Italian Journal of Pediatric Allergy and Immunology, 38(3). https://doi.org/10.53151/2531-3916/2024-564
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