Early molecular biomarkers predicting the evolution of allergic rhinitis and its comorbidities: A longitudinal multicenter study of a patient cohort

for the Italian Pediatric Allergy Network (I-PAN), Francesca Cipriani, Salvatore Tripodi, Valentina Panetta, Serena Perna, Ekaterina Potapova, Arianna Dondi, Roberto Bernardini, Carlo Caffarelli, Antonella Casani, Rosa Cervone, Loredana Chini, Pasquale Comberiati, Giovanna De Castro, Michele Miraglia Del Giudice, Iride Dello Iacono, Andrea Di Rienzo Businco, Marcella Gallucci, Arianna Giannetti, Carla MastrorilliViviana Moschese, Simone Pelosi, Ifigenia Sfika, Elena Varin, Valeria Villella, Anna Maria Zicari, Giulia Brindisi, Giampaolo Ricci, Paolo Maria Matricardi

Research output: Contribution to journalArticlepeer-review


Background: Pollen-related seasonal allergic rhinoconjunctivitis (SAR) is a very frequent pediatric disease in Westernized countries. Risk factors and disease phenotypes have been thoroughly examined in several cross-sectional studies. By contrast, only a few studies have examined disease evolution in patient cohorts. We investigated predictive biomarkers of disease evolution in a large cohort of children with SAR. Methods: During 2015-2017 (follow-up), we re-examined 401 patients from those enrolled in 2009-2011 (baseline) by the “Panallergens in Pediatrics” study, a large multicenter survey of Italian children with SAR. Information on clinical history (standard questionnaire, AllergyCARD®; TPS, Italy) and skin prick tests for inhalant and foods extracts (ALK-Abelló, Hørsholm, Denmark) was acquired as at baseline visit. Evolution in clinical and sensitization data of patients was analyzed over time, as well as their association with the main baseline characteristics and atopy risk factors. Results: The average age of participants was 10.4 ± 3.4 years at baseline and 16.2 ± 3.6 years at follow-up. SAR persisted in 93.3% of patients at follow-up and became more frequently associated with asthma (from 36.7% at baseline to 48.6% at follow-up) and oral allergy syndrome (OAS, from 23.4% to 37.7%). Compared to baseline, the prevalence of skin sensitization to some pollens (Phleum pratense, Corylus avellana, Platanus acerifolia, Artemisia vulgaris) and vegetables (hazelnut, wheat, and apple) significantly decreased at follow-up. Earlier onset of SAR and polysensitization at baseline were associated with incident asthma at follow-up. The presence at baseline of serum IgE to the following allergen molecules was identified as biomarkers of clinical evolution: (a) Phl p 1, for persistence of SAR; (b) Phl p 5, for persistence of both rhinitis and asthma; (c) Pru p 3, for new onset of asthma; (d) Bet v 1, for persistence of OAS. Conclusions: Seasonal allergic rhinoconjunctivitis is clinically heterogeneous in its evolution from childhood to adolescence. The detection of serum IgE to specific molecules (Phl p 1, Phl p 5, Bet v 1, Pru p 3) may be useful as biomarkers to predict SAR persistence and future onset of comorbidities, such as asthma and/or OAS.

Original languageEnglish
Pages (from-to)325-334
JournalPediatric Allergy and Immunology
Issue number3
Publication statusPublished - Jan 1 2019


  • allergic rhinitis
  • asthma
  • Bet v 1
  • biomarkers
  • children
  • comorbidities
  • IgE
  • longitudinal study
  • Phl p 1
  • Phl p 5
  • pollen
  • prediction
  • Pru p 3

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Immunology and Allergy
  • Immunology


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