Possible effect of landscape design on IgE recognition profiles of two generations revealed with micro‐arrayed allergens

Abstract The aim of this study was to investigate possible effects of landscape design on the IgE sensitization profile toward inhalant allergens in patients with respiratory allergy from Uzbekistan where green areas have been changed during the last two decades by a State program. Sera from two different generations of Uzbek (n=58) and, for control purposes, from two generations of Austrian (n=58) patients were analyzed for IgE reactivity to 112 different micro‐arrayed allergen molecules by ImmunoCAP ISAC technology. Changes in molecular IgE sensitization profiles to pollen allergens in the young vs the middle‐aged Uzbek population were associated with replanting, whereas those in the Vienna populations reflected natural changes in plant growth. Our data indicate that anthropologic as well as natural changes in the biome may have effects on IgE sensitization profiles already from one to another generation.

ISAC technology. Changes in molecular IgE sensitization profiles to pollen allergens in the young vs the middle-aged Uzbek population were associated with replanting, whereas those in the Vienna populations reflected natural changes in plant growth.
Our data indicate that anthropologic as well as natural changes in the biome may have effects on IgE sensitization profiles already from one to another generation.  that the lower incidence of birch pollen allergy in southern parts of Europe reflected lower exposure to birch pollen, whereas sensitization to cross-reactive allergens due to exposure to other plants increased. 2 Likewise, molecular diagnosis with recombinant allergens revealed different sensitization profiles regarding olive and grass pollen allergens in different regions of Spain as well as unique sensitizations profiles in Africa and in the Asia-Pacific area. [3][4][5] there are major studies ongoing using micro-arrayed allergens to study the molecular recognition profiles in different parts of Europe. 6 However, so far no attempt has been made to investigate whether changes in the environment through anthropologic transformation of the biome may have an effect on allergic sensitization profiles in a population. To study this question, we determined the prevalence and patterns of IgE-mediated sensitization toward a broad panel of pollen allergen molecules in sera from two generations of patients with respiratory allergy from Tashkent using micro-arrayed allergens.

| ME TH ODS
One hundred and twenty patients with respiratory allergy referred to the Allergy and Respiratory Unit of Republic's Specialized Scientific-Practical Center for Therapy and Medical Rehabilitation (RSSPMC T&R), Tashkent, Uzbekistan, were studied. Patients were interviewed and included in the study only if • they were born and always lived in Tashkent.
• they were of Uzbek nationality for three or more generations. • they suffered from respiratory pollen allergy. • they had not undergone allergen-specific immunotherapy (AIT) with pollen/plant allergens.
Patients fulfilling these inclusion criteria (n=58) were divided into two groups according to anthropological periodization and landscape program implementation in Tashkent: a group of young adults (18-28 years; mean age 24.5 years; n=21) and a group of middle-aged adults (29-49 years; mean age: 41.7 years; n=37) ( Figure 1). There were no relevant differences regarding lifestyle (ie, housing, diet).
The only drastic change in living habits during the last twenty years was that families started to keep cats as pets inside their houses/ apartments. Patients (n=58) from Vienna were included if they were born and always lived in Vienna and were Austrian for more than three generations and never had AIT with pollen/plant allergens. These patients were also grouped in young (18-28 years; mean age 24 years; n=27) and middle-aged (29-59 years; mean age 41 years; n=31) adults

| RESULTS AND DISCUSSION
The analysis of the allergen IgE recognition frequencies in the young and middle-aged patients from Tashkent revealed striking and highly significant differences. nSal k 1 from saltwort (Salsola kali) was the most prevalent weed allergen recognized by the middle-aged population with a sensitization rate of 48.6% in patients older than 30 years. This fits to reports from countries which are close to Tashkent. Also for southern Europe, western United States, and semidesert areas of Saudi Arabia, Kuwait, and Iran, saltwort represents a major allergen source which besides the major allergen Sal k 1 contains also additional other allergens. 10 In contrast to the middle-aged population, we found a significantly lower IgE sensitization rate to Sal k 1 in the young population (ie, 23.8%) (Figure 2), which may be explained by the eradication of saltwort through the reorganization of the landscape in the last 20 years. Consistent with the landscape reorganization, we found significant increases in IgE sensitizations toward the grass pollen allergens Cyn d 1 and Phl p 5 as well as to the allergens of cypress Cry j 1 and cedar Cup a 1 (Figure 2). The increase in IgE recognition of profilins (Bet v 2, Phl p 12, Mer a 1) may well be explained by replanting with ornamental plants and eventually also by increased grass pollen exposure. The sensitization rates to the mugwort allergens showed no significant differences between the two age groups from Tashkent.
Unlike in Tashkent where the frequencies of IgE reactivities to grass pollen allergens increased due to replanting, the frequencies of IgE reactivities to grass pollen allergens did not change in Vienna ( Figure 2). Likewise, sensitizations to the major tree pollen allergens from birch, Bet v 1, and alder, Aln g 1, showed no significant changes in Vienna. However, the frequencies of IgE reactivities to certain allergens increased in the young Vienna population significantly, such as to Ole e 1, which is a marker for ash sensitization 11 ; to Cry j 1, a marker for allergy to Cupressaceae; and to the major mugwort allergen Art v 1. We therefore studied data regarding whereas birch and alder volumes did not increase. Pollen count measurements showed that there were strong increases in ash and cypress pollen in the latter period, whereas birch pollen exposure showed no relevant difference (Table S1A-C). Regarding mugwort and ragweed, it is known that weed pollen exposure is on a continuous rise in Vienna due to climate changes and migration of weeds from Hungary and Eastern Europe toward Vienna. 12,13 The changes in molecular sensitization profiles found in the younger generations of the Uzbek and Austrian pollen-allergic