Identifying Potential Co-Sensitization and Cross-Reactivity Patterns Based on Component-Resolved Diagnosis
Authors: Huang Zhifeng , Zou Xiangwei , Chen Hao , Liao Chenxi , Hu Haisheng , Luo Wenting , Sun Baoqing 
Published: November 2019

<b><i>Background:</i></b> Component-Resolved diagnosis (CRD) can help to establish immunoglobulin E (IgE) sensitization profiles and potential risks and determines whether specific IgE is the result of primary sensitization or cross-reactivity, especially for those who are polysensitized. <b><i>Methods:</i></b> We recruited 432 patients with mite-sensitized respiratory allergic diseases to study the co-sensitization and cross-reactivity of the 17 allergen components in Guangdong Province, China, using the CRD method and to describe the potential association between allergen components. <b><i>Results:</i></b> Among the 432 patients, serum specific immunoglobulin E of the 17 components were tested by EUROIMMUN system. Der <i>p</i> 1 (81.48%), Der <i>f</i> 2 (77.78%), Der <i>f</i> 1 (74.07%), Der <i>p</i> 2 (66.20%) and Der <i>p</i> 23 (54.63%) were the main sensitized components in patients with mite-sensitized respiratory allergy, while the components of cockroach, crab, and shrimp had a lower positive rate. In the crude extract allergen-positive samples, Der <i>f</i> 2 (91.06%) and Der <i>f</i> 1 (86.72%) were the major sensitized components of Der <i>f</i>, while Der <i>p</i> 1 (94.52%), Der <i>p</i> 2 (78.36%), Der <i>p</i> 23 (63.29%) were the major sensitized components of Der <i>p</i>, And other components of Der <i>p</i> such as Der <i>p</i> 7 (34.25%), Der <i>p</i> 5 (17.81%), Der <i>p</i> 10 (12.05%), Der <i>p</i> 3 (1.92%) were all below 50.00%. Blo <i>t</i> 5 (54.55%) was one of the major components of Blo <i>t</i>. The positive rates of all Bla g components were as follows, rBla g 2 (15.56%) &#x3e;rBla g 5 (8.89%) &#x3e;rBla g 4 (4.44%) &#x3e;rBla g 1 (1.11%). The positive rate of the only available pen a 1 component was 9.43%. Using hierarchical cluster and optimal scale analysis, 17 components can be roughly divided into 5 different sensitization clusters. Also, from the results of the Venn diagram, the allergen component in each cluster has a high proportion of co-sensitization and cross-reactivity. Regardless of age, total IgE levels, and disease type factors, similar sensitization profiles were observed for each component in the same category based on hierarchical clustering analysis. <b><i>Conclusions:</i></b> Epidemiological data on allergen components causing allergic symptoms can be further understood using CRD. Der <i>p</i> 1, Der <i>p</i> 2, Der <i>p</i> 23, Der <i>f</i> 1, Der <i>f</i> 2 as the primary sensitizing component of the study cohort. The positive rate for Blo <i>t</i> 5 was 28.01% for all populations and 54.45% for Blo <i>t</i>-positive samples. In addition, CRD allows us to identify more potential allergen associations such as common sensitivities and cross-reactions between component proteins. Based on these results, we suggest that when patients are identified as sensitized to a particular allergen, clinicians can pay more attention to other allergy components that are closely related to it.