Fungal allergy is the third most frequent cause of respiratory pathologies and the most related to a poor prognosis of asthma. The genera Alternaria and Cladosporium are the most frequently associated with allergic respiratory diseases, with Alternaria being the one with the highest prevalence of sensitization. Alternaria alternata is an outdoor fungus whose spores disseminate in warm and dry air, reaching peak levels in temperate summers. Alternaria can also be found in damp and insufficiently ventilated houses, causing what is known as sick building syndrome. Thus, exposure to fungal allergens can occur outdoors and indoors. However, not only spores but also fungal fragments contain detectable amounts of allergens and may function as aeroallergenic sources. Allergenic extracts of Alternaria hyphae and spores are still in use for the diagnosis and treatment of allergic diseases but are variable and insufficiently standardised, as they are often a random mixture of allergenic ingredients and casual impurities. Thus, diagnosis of fungal allergy has been difficult, and knowledge about new fungal allergens is stuck. The number of allergens described in Fungi remains almost constant while new allergens are being found in the Plantae and Animalia kingdoms. Given Alt a 1 is not the unique Alternaria allergen eliciting allergy symptoms, component-resolved diagnosis strategies should be applied to diagnose fungal allergy. To date, twelve A. alternata allergens are accepted in the WHO/IUIS Allergen Nomenclature Subcommittee, many of them are enzymes: Alt a 4 (disulfide isomerase), Alt a 6 (enolase), Alt a 8 (mannitol de-hydrogenase), Alt a 10 (aldehyde dehydrogenase), Alt a 13 (glutathione-S-transferase) and Alt a MnSOD (Mn superoxide dismutase), and others have structural and regulatory functions such as Alt a 5 and Alt a 12, Alt a 3, Alt a 7. The function of Alt a 1 and Alt a 9 remains unknown. Other four allergens are included in other medical databases (e.g., Allergome): Alt a NTF2, Alt a TCTP, and Alt a 70 kDa. Despite Alt a 1 being the A. alternata major allergen, other allergens, such as enolase, Alt a 6 or MnSOD, Alt a 14 have been suggested to be included in the diagnosis panel of fungal allergy.

Climate change and exposure to environmental pollutants play a key role in the onset and aggravation of allergic diseases. As different climate-dependent patterns of molecular immunoglobulin E (IgE) reactivity have been regionally described, we sought to investigate the evolving allergen exposome in distinctive allergic phenotypes and subtropical weather conditions through a Precision Allergy Molecular Diagnosis (PAMD@) model. Concurrent sensitization to several house dust mites (HDM) and storage mite molecules were broadly dominant in the investigated cohort, followed by the major cat allergen Fel d 1, and regardless of the basal allergic disease. Although a complex repertoire of allergens was recognized, a steadily increasing number of IgE binding molecules was associated with the complexity of the underlying atopic disease. Besides the highly prevalent IgE responses to major HDM allergens, Der p 21, Der p 5, and Der p 7 also showed up as serodominant molecules, especially in subjects bothered by asthma and atopic dermatitis. The accurate characterization of the external exposome at the molecular level and their putative role as clinically relevant allergens is essential to elucidate the phenotypic diversity of atopic disease in terms of personalized diagnosis and therapy.

Spain exhibits significant climatic variability across its regions, ranging from the humid oceanic climate in the north to the Mediterranean and stepped climates in the southern and central areas. These climatic differences influence environmental allergen exposure, which may, in turn, affect allergic sensitization patterns in the pediatric population. Variations in temperature, humidity, and airborne allergen distribution, such as pollen, dust mites, animal epithelia, and mold, contribute to regional disparities in allergic responses among children. Understanding how climatic conditions shape allergen recognition patterns across different geographical areas is essential for improving allergy prevention and management strategies. This study aims to shed light on this issue by identifying sensitization patterns in a pediatric population of 236 patients (with 2 age groups analyzed: 6–10 and 11–15 years old) from different climatic regions of Spain. Skin tests with standard aeroallergens were performed, and specific IgE (sIgE) analysis by Allergy Explorer of Macroarray Diagnostic test (ALEX²) and Western blot. The results revealed different sensitization trends across patients from the eight cities analyzed (Barcelona, Granada, Lugo, Sagunto, Santiago de Compostela, Valencia, and Zaragoza).

Climate change and exposure to environmental pollutants play a key role in the onset and aggravation of allergic diseases. As different climate-dependent patterns of molecular immunoglobulin E (IgE) reactivity have been regionally described, we sought to investigate the evolving allergen exposome in distinctive allergic phenotypes, and subtropical weather conditions through a Precision Allergy Molecular Diagnosis (PAMD@) model. Concurrent sensitization to several house dust mites (HDM) and storage mite molecules were broadly dominant in the investigated cohort, followed by the major cat allergen Fel d 1, and regardless of the basal allergic disease. Although a complex repertoire of allergens was recognized, a steadily increasing number of IgE binding molecules was associated with the complexity of the underlying atopic disease. Besides the highly prevalent IgE responses to HMD major allergens, Der p 21, Der p 5, and Der p 7 also showed as serodominant molecules, especially in those subjects bothered with asthma and atopic dermatitis. The accurate characterization of the external exposome at the molecular level and their putative role as clinically relevant allergens is essential to elucidate the phenotypic diversity of atopic disease in terms of personalized diagnosis and therapy.

Climate change is significantly altering the dynamics of airborne allergens, affecting their seasonality, allergenicity, and geographic distribution, which correlates with increasing rates of allergic diseases. This study investigates aeroallergen sensitization among populations from Tenerife, Spain, and Lima, Peru—two regions with similar climates but distinct socio-economic conditions. Our findings reveal that Spanish individuals, particularly those with asthma, demonstrate higher sensitization levels to a broader range of allergens, especially mites, with 85% of participants reacting to at least one mite allergen. In contrast, Peruvian patients exhibit a narrower spectrum of sensitization. These results highlight the influence of environmental factors, such as pollution and socio-economic disparities, on allergen exposure and immune responses. Moreover, this study underscores the necessity for region-specific diagnostic and therapeutic strategies to effectively address these variations. By elucidating the intricate relationship between climate change, environmental factors, and allergen sensitization, this research offers insights into respiratory allergic conditions, advocating for tailored interventions to mitigate their impact across diverse populations.

Climate change is significantly altering the dynamics of airborne allergens, affecting their seasonality, allergenicity, and geographic distribution, which correlates with increasing rates of allergic diseases. This study investigates aeroallergen sensitization among populations from Tenerife, Spain, and Lima, Peru—two regions with similar climates but distinct socio-economic conditions. Our findings reveal that Spanish individuals, particularly those with asthma, demonstrate higher sensitization levels to a broader range of allergens, especially mites, with 85% of participants reacting to at least one mite allergen. In contrast, Peruvian patients exhibit a narrower spectrum of sensitization. These results highlight the influence of environmental factors, such as pollution and socioeconomic disparities, on allergen exposure and immune responses. Moreover, the study underscores the necessity for region-specific diagnostic and therapeutic strategies to effectively address these variations. By elucidating the intricate relationship between climate change, environmental factors, and allergen sensitization, this research offers insights into respiratory allergic conditions, advocating for tailored interventions to mitigate their impact across diverse populations.