Abstract
BACKGROUND: Molecular immunoglobulin E (IgE) reactivity profiling with multiple micro-arrayed allergens is a valuable tool in allergy diagnosis and has provided fundamental insights into the evolution of allergic sensitization in longitudinal birth cohort studies. However, there is a need for systematic cross-sectional population-based studies. METHODS: A prospective, systematic and cross-sectional population study was performed involving 1000 adult subjects from five centers (İstanbul, Ankara, İzmir, Kayseri, Samsun) representing different climatic areas of Türkiye (Turkey). In each center adult subjects with (n = 100) and without (n = 100) allergic symptoms who were born and grew up in the region were recruited. Subjects underwent skin prick testing with a panel of common aeroallergen extracts and were tested for IgE reactivity to 108 micro-arrayed allergen molecules. RESULTS: IgE reactivity profiles of respiratory allergens differed in the five centers according to the regional allergen exposome and climate. Interestingly, Kayseri with a high-altitude, continental climate was identified as hypoallergenic region with low frequency of allergic symptoms and strongly reduced molecular sensitization rates. Between 31%-55% of subjects without allergic symptoms showed IgE sensitization to at least one of the allergens tested but allergen-specific IgE levels, numbers of recognized allergens and rates of poly-sensitization were more frequent in symptomatic individuals. CONCLUSIONS: This is the first comprehensive, systematic, prospective and cross-sectional study investigating molecular IgE sensitization profiles in a region at the crossroads of Europe, Asia, and Africa with different climatic conditions. It reveals clinically relevant differences in regional molecular IgE sensitization profiles depending on the allergen exposome and identifies a hypoallergenic region with distinct climatic features.