3/ Minor groups of children are characterized by distinct
patterns, with sensitization to pan-allergens
Our cluster analysis found that some preschool and school-age children
showed multiple sensitization, including sensitization to pan-allergens.
Two small clusters were characterized by sensitization to PR-10
proteins, a super-family of highly conserved pan-allergens, previously
shown to be associated with asthma and allergic rhinitis at school-age
(13,14,16,17). In particular, Bet v 1 was identified to be one of
the five allergen molecules associated with a high risk of asthma and/or
rhinitis at 16 years of age in two North European birth cohorts (18).
More broadly, studies conducted in birch-free areas have suggested that
sensitization to PR-10 proteins is associated with clinical phenotypes
and sensitization to other allergens (19,20). Our study confirms
these observations by identifying one of the PR-10 clusters in preschool
recurrent wheezers, suggesting that children developing early
sensitization to these pan-allergens may constitute a distinct endotype.
These results also complement the findings from the network analysis of
component sensitization among children from the U-BIOPRED cohort,
showing that patients with SA had more frequent connections between
components than those with milder disease (10).