Prevalența sensibilizării la Cryptomeria japonica la pacienţii cu rinită alergică şi astm

Abstract

Introducere. Cryptomeria japonica, specie de conifere originară din Asia de Est, este o sursă emergentă de aler-geni respiratorii majori, precum Cry j1 - pectat-liază. Pec-tat-liazele sunt alergeni majori prezenţi la specii de conifere precum Cedrus, Juniperus, Cupressus. Induc reacţii IgE-me-diate, preponderent respiratorii. Scop. Ne-am propus evaluarea prevalenţei sensibilizării la Cryptomeria (Cry j 1) şi analiza profilului de co-sensibilizare moleculară printre pacienţi cu rinită alergică şi/sau astm. Material şi metode. A fost efectuat un studiu retrospectiv care a inclus 1107 pacienţi cu rinită alergică şi/sau astm, 57,66% bărbaţi şi 42,34% femei, testaţi prin teste alergenice moleculare multiplex. Au fost analizate date privind vârsta, sexul, nivelul IgE, clasele de sensibilizare, co-sensibilizarea la alergeni din familia coniferelor (Cup a, Cup a 1). Rezultate. Dintre cei 1107 pacienţi incluşi în studiu, 12,37% (137 pacienţi) au prezentat sensibilizare la Cry j 1, cu o frecvenţă mai mare la grupa de vârstă 1-17 ani (41,61% dintre cazuri). Distribuţia pe sexe a arătat o predominanţă masculină: 57,66% bărbaţi şi 42,34% femei. Niveluri crescute de IgE total (>100 kU/L) au fost identificate la 70,8% dintre pacienţii sensibilizaţi. Distribuţia pe clase de sensibilizare: clasa 1 - 15,33%, clasa 2 - 34,31%, clasa 3 - 25,55%, clasa 4 - 24,82%. Un procent de 97,8% dintre pacienţii cu sensibilizare la Cry j 1 au prezentat co-sensibilizare la alte molecule, inclusiv alergeni non-conifere. Concluzii. Rezultatele confirmă prevalenţa relevantă a sensibilizării la Cry j1 - alergen major şi important clinic în patologiile alergice respiratorii, frecvent implicat în polisensibilizare. Diagnosticul molecular contribuie la stabilirea diagnosticului de precizie şi orientarea terapiei alergen-specifice.

Introduction. Cryptomeria japonica, a conifer native to East Asia, is an emerging source of major respiratory allergens such as Cry j 1-a pectate lyase. Pectate lyases are major allergens also found in Cedrus, Juniperus, and Cupressus, and they predominantly induce IgE-mediated respiratory allergic reactions. Objective. This study aimed to evaluate the prevalence of sensitization to Cryptomeria (Cry j 1) and to analyze the molecular co-sensitization profile among patients with allergic rhinitis and/or asthma. Material and methods. A retrospective study was conducted including 1107 patients diagnosed with allergic rhinitis and/or asthma (57.66% male and 42.34% female), all tested using multiplex molecular allergy diagnostics. Data regarding age, sex, total IgE levels, sensitization classes, and co-sensitization to other conifer allergens (e.g., Cup a, Cup a 1) were analyzed. Results. Of the 1107 patients included in the study, 12.37% (137 patients) demonstrated sensitization to Cry j 1, with the highest proportion observed in the 1-17 years age group (41.61% of cases). The gender distribution showed a male predominance: 57.66%. Elevated total IgE levels (>100 kU/L) were identified in 70.8% of Cry j 1-sen-sitized patients. Sensitization class distribution was as follows: class 1 - 15.33%, class 2 - 34.31%, class 3 - 25.55%, class 4 - 24.82%. A high rate of molecular co-sensitization was observed, with 97.8% of Cry j 1-sensitized patients also sensitized to other allergenic molecules, including non-conifer allergens. Conclusion. The results confirm the relevant prevalence of sensitization to Cry j 1 - a major allergen of clinical importance in allergic respiratory diseases, frequently involved in polysensitization. Molecular diagnosis contributes to establishing an accurate diagnosis and guiding allergen-specific therapy.