title: Profiles of Birch Sensitization (Bet v 1, Bet v 2, and Bet v 4) and Oral Allergy Syndrome Across Italy.
abstract: BACKGROUND
  Birch allergy (BA) is a common pollinosis caused by the allergens Bet v 1, Bet v 2, and Bet v 4. Oral allergy syndrome (OAS) is frequently associated with BA. A gradient of sensitization to birch allergen across Europe has been reported. Therefore, this study aimed to investigate the birch sensitization profile, including OAS, across Italy.
  
  
  METHODS
  We performed a retrospective study of 854 patients (391 males, mean age 35.9 years, range 18-93 years): 196 patients were recruited in Genoa, 188 in northern Italy, 359 in central Italy, and 111 in southern Italy. Serum IgE to Bet v 1, Bet v 2, and Bet v 4 was assessed, and OAS was analyzed.
  
  
  RESULTS
  With respect to the geographical path Genoa-North-Center-South, the frequency of sensitization to Bet v 1 decreased significantly (P<.0001) from Genoa (95.41%) to southern Italy (58.56%). The frequency of sensitization to Bet v 2 increased significantly (P<.0001) from Genoa (6.12%) to southern Italy (52.25%). The frequency of Bet v 4 also increased significantly (P=.0002) from Genoa (6.12%) to southern Italy (14.41%). The distribution of patients with OAS differed significantly across the areas (P<.0001), the most marked difference ranging between 33.5% in Genoa and 76.9% in northern Italy. The frequency of birch allergens correlated with OAS in central Italy only.
  
  
  CONCLUSIONS
  The present study demonstrated a significant difference between sensitization to birch and its clinical expression across Italy.
authors.affiliation: Allergy Department, IRCCS-AOU San Martino-IST, Genoa, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Ciprandi
authors.affiliation: Laboratory Medicine Department, IRCCS-AOU San Martino, Genoa, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Comite
authors.affiliation: Laboratory Medicine Department, IRCCS-AOU San Martino, Genoa, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Mussap
authors.affiliation: Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, Pavia, Italy.
authors.forename: M
authors.initials: M
authors.lastname: De Amici
authors.affiliation: Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Quaglini
authors.affiliation: Immunohematology and Transfusion Medicine Unit, Rho, Italy, A.O. G. Salvini, Garbagnate Milanese, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Barocci
authors.affiliation: Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, Pavia, Italy.
authors.forename: G L
authors.initials: GL
authors.lastname: Marseglia
authors.affiliation: Experimental Allergy Unit, IDI-IRCCS, Rome, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Scala
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D052179:Antigens, Plant / Q000276:immunology; D029662:Betula / Q000276:immunology*; D002135:Calcium-Binding Proteins / Q000276:immunology; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010940:Plant Proteins / Q000276:immunology; D012189:Retrospective Studies; D006255:Rhinitis, Allergic, Seasonal / Q000453:epidemiology / Q000209:etiology*; D055815:Young Adult
chemical_list: D052179:Antigens, Plant; C530739:BETV2 protein, Betula pendula; C108867:BETV4 protein, Betula pendula; D002135:Calcium-Binding Proteins; D010940:Plant Proteins; C061312:Bet v 1 allergen, Betula
keywords: Bet v 1; Bet v 2; Bet v 4; Birch allergy; Italy; Oral allergy syndrome; Serum IgE