Cross-sensitization between inhalant allergens and food allergens: the extent, intensity, and age-related shifts

BACKGROUND: Encountering individuals sensitized to both inhalant and food allergens is challenging in clinical practice. Despite its rarity, studies have documented cross-sensitization between these allergens. However, the extent, diversity, and age-related variations of this phenomenon remain unclear. OBJECTIVE: Hence, our objective was to investigate a substantial quantity of allergy sensitivity test results in which both inhalant and food allergens were concurrently examined. The primary goal of our study is to calculate the cross-sensitization ratio, with a secondary objective of analyzing this phenomenon across four age groups. METHODS: A retrospective analysis was conducted on a multiple-antigen simultaneous test (MAST) obtained from a domestic laboratory medicine facility and comprising 55 food allergens and 49 inhalant allergens from 368,156 individuals aged 1 to 89. By calculating the cross-sensitization ratio, the degree of cross-sensitization between each food allergen and inhalant allergen was determined. Further subgroup analysis was conducted to ascertain the cross-sensitization ratio between the four subgroups categorized by age. RESULTS: The median cross-sensitization ratio between food and inhalant allergens was 5.14, indicating a significant level of cross-sensitization. The cross-sensitization ratio was greatest among pollen allergens and plant-derived food allergens, followed by between some animal aeroallergens and meat/fish/dairy/poultry food allergens. The degree of overall cross-sensitization was least prominent in adolescents, greater in adults and children, and most pronounced in the elderly. CONCLUSION: Our findings reveal that various inhalant and dietary allergens have considerable cross-sensitivity, with the elderly having the highest degree of cross-sensitivity and adolescents the lowest.