ArticleFrontiers in immunology2026
Molecular sensitization clusters in adult atopy: an ALEX
Article in Frontiers in immunology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Allergen sensitization profiles vary geographically, yet Eastern Europe data remain scarce. This study aimed to identify and characterize molecular sensitization clusters in adults with allergic rhinitis (AR), asthma, and/or atopic dermatitis (AD) at a Romanian tertiary allergy center using ALEX Methods: Among 213 consecutive adults undergoing ALEX Results: The present study identified four primary molecular allergen sensitization clusters in an adult atopic cohort from Romania, with an exploratory, five-cluster refinement further resolving heterogeneity within the dominant cluster. Cluster 1 (pauci-sensitized, n=42) paradoxically showed a high asthma prevalence (54.8%) despite the lowest sensitization breadth (median 2 sensitizations) and total IgE (133.5 kU/L), though this finding did not reach significance in the global cluster comparison and should be considered exploratory. Cluster 2 (grass pollen-dominant, n=24) and Cluster 3 (polysensitized, n=47) showed near-universal AR prevalence. Cluster 4 (multi-panallergen PR-10/nsLTP, n=10) carried the highest rate of oral allergy syndrome (OAS) (30%), driven by PR-10 and nsLTP, whereas Cluster 5 (ragweed and profilin-dominant, n=16) showed exclusively profilin-mediated OAS. Age was negatively correlated with sensitization breadth (Spearman r= -0.265, p=0.0016), with paradoxically elevated total IgE in older patients. Conclusion: Unsupervised clustering of ALEX
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