Supplementary Figure 1 and Table 1 from CXCL13 Is Highly Produced by Sézary Cells and Enhances Their Migratory Ability via a Synergistic Mechanism Involving CCL19 and CCL21 Chemokines

Allergy to olive pollen (Olea europaea) is caused in most cases by Ole e 1, but other allergens, for example, profilin (Ole e 2), polcalcin (Ole e 3 and Ole e 8), glucanase (Ole e 4 and Ole e 9), and lipid transfer protein (LTP) (Ole e 7)1Tejera M.L. Villalba M. Batanero E. Rodriguez R. Identification, isolation, and characterization of Ole e 7, a new allergen of olive tree pollen.J Allergy Clin Immunol. 1999; 104: 797-802Abstract Full Text Full Text PDF PubMed Scopus (72) Google Scholar, 2Ledesma A. Rodriguez R. Villalba M. Olive-pollen profilin: molecular and immunologic properties.Allergy. 1998; 53: 520-526Crossref PubMed Google Scholar may also be involved (World Health Organization/International Union of Immunological Societies database: www.allergen.org) (see Table E1 in this article's Online Repository at www.jacionline.org). Genuine molecules such as Ole e 1, Ole e 7, and Ole e 9 and panallergens such as profilin (Bet v 2.0101, Hev b 8.0204, Mer a 1.0101, and Phl p 12.0101) or polcalcin (Bet v 4.0101 and Phl p 7.0101)3Hiller R. Laffer S. Harwanegg C. Huber M. Schmidt W.M. Twardosz A. et al.Microarrayed allergen molecules: diagnostic gatekeepers for allergy treatment.FASEB J. 2002; 16: 414-416Crossref PubMed Scopus (399) Google Scholar can nowadays be detected by ImmunoCAP-ISAC. Nine hundred ninety-five consecutive Italian outpatient subjects of the Allergy Unit of IDI-IRCCS, Rome, with positive results on skin prick test with olive tree pollen extract (Stallergenes S.A., Antony, France) were studied between May 2013 and December 2014, after approval by the IDI-IRCCS Ethical Committee as well as written informed consent from the participants. At baseline, using a standardized questionnaire and before allergen testing, all patients were grouped into 4 overlapping categories: (1) asthma, allergic rhinitis, allergic conjunctivitis (“Respiratory symptoms” [RS]); (2) atopic dermatitis (AD); (3) localized oral mucosal symptoms (“Oral allergic syndrome” [OAS]); and (4) symptoms suggestive of systemic reactions to food, including urticaria, angioedema, and anaphylaxis according to Sampson et al4Sampson H.A. Munoz-Furlong A. Campbell R.L. Adkinson N.F. Bock S.A. Branum A. et al.Second symposium on the definition and management of anaphylaxis: summary report—Second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network symposium.J Allergy Clin Immunol. 2006; 117: 391-397Abstract Full Text Full Text PDF PubMed Scopus (1648) Google Scholar (“Severe Reactions” [SR]). Sera were collected during the first visit, and IgE reactivity was analyzed using the 112 ImmunoCAP-ISAC platform (ThermoFisher Scientific, Uppsala, Sweden). A genuine sensitization to olive tree pollen molecules was observed in 839 of the 995 subjects (84.3%, 435 females and 404 males; mean age, 27.5 ± 16.2 years; range, 3-76 years). The remaining 156 (15.7%) reacted to profilin (n = 117, 75%), polcalcin (n = 33, 2.1%), or both (n = 6, 3.8%) and were excluded from the study. No differences in the prevalence of IgE recognition were noted between male and female patients, but males were younger (24 ± 15 years vs 30 ± 15 years; P < .01). The demographic characteristics and the distribution among clinical categories are summarized in Table I.Table IClinical and molecular characteristics of participantsCharacteristicN (%)Age (y)Female (age)Male (age)All patients83927 ± 16435 (30 ± 15)404 (24 ± 15)N (%)Age (y)Female (%)Male (%)Ole e 1708 (84.4)27 ± 16360 (50.8)348 (49.2)Ole e 7180 (21.5)27 ± 1390 (50)90 (50)Ole e 985 (10.1)24 ± 1435 (41.2)50 (58.8)1. RS674 (80.3)28 ± 16354 (52.5)320 (47.5)2. AD189 (22.5)23 ± 1499 (52.4)90 (47.6)3. OAS327 (39)27 ± 15168 (51.4)159 (48.6)4. SR365 (43.5)28 ± 16186 (51)179 (49) Open table in a new tab Ole e 1 reactivity was detected in 84.4% of the patients, followed by Ole e 7 (21.5%), a higher prevalence than in another Mediterranean population,5Barber D. De la Torre F. Feo F. Florido F. Guardia P. Moreno C. et al.Understanding patient sensitization profiles in complex pollen areas: a molecular epidemiological study.Allergy. 2008; 63: 1550-1558Crossref PubMed Scopus (187) Google Scholar and Ole e 9 (10.1%). Ole e 9 reactivity was higher among males than among females (12.4% vs 8.0%; P = .038). Ole e 7 IgE reactivity was significantly less frequent in children younger than 15 years (12.6% vs 24.1%; P < .001). The association between reactivity to olive tree molecules and the self-reported clinical profiles at baseline is shown in Fig 1. Ole e 1 reactivity was associated with RS (81.6%; P < .03), but inversely related to the occurrence of local symptoms or systemic reactions to food (36.9% for OAS, P < .005, and 39% for SR, P < .001). In contrast, Ole e 7 reactors showed a clinical history suggestive of both local (52.2%; P < .001) and/or systemic reactions to food (60.6%; P < .001), and a lower prevalence of RS (P < .03). Accordingly, a slight inverse relationship was observed between Ole e 1 and Ole e 7 IgE recognition (P < .001; ρ = −0.218) (see Fig E1 in this article's Online Repository at www.jacionline.org). Multiple logistic regression analysis, considering all the molecules studied as a whole, including also age and sex, showed a significant relationship between Ole e 7 reactivity and a history of OAS (P < .01; adjusted odds ratio [aOR], 1.730; 95% CI, 1.156-2.590) or SR (P = 0.03; aOR, 1.586; 95% CI, 1.060-2.371). Ole e 1 reactivity remained inversely associated with SR even after multiple adjustment (P < .001; aOR, 0.393; 95% CI, 0.241-0.639). Ole e 9–positive subjects presented a positive association with AD (49.4% vs 19.5% among Ole e 9–negative subjects; P < .001) and a lower rate of RS (P < .001). Multiple regression also confirmed the finding that Ole e 9 reactivity identifies a subset of patients with a history of AD (P < .001; aOR, 4.189; 95% CI, 2.540-6.919) and a lower risk of RS (P < .001; aOR, 0.319; 95% CI, 0.193-0.527). On the basis of these observations, Ole e 7 and Ole e 9 seem to be markers of sensitization to other panallergens, rather than specific olive pollen molecules. In effect, it has been suggested that Ole e 7 or Ole e 9 reactors might show a lower tolerance to immunotherapy at the recommended doses.5Barber D. De la Torre F. Feo F. Florido F. Guardia P. Moreno C. et al.Understanding patient sensitization profiles in complex pollen areas: a molecular epidemiological study.Allergy. 2008; 63: 1550-1558Crossref PubMed Scopus (187) Google Scholar Unlike mugwort and plane tree LTPs (Art v 3 and Pla a 3, respectively), which show approximately 50% sequence identity with the peach LTP Pru p 3,6Scala E. Till S.J. Asero R. Abeni D. Guerra E.C. Pirrotta L. et al.Lipid transfer protein sensitization: reactivity profiles and clinical risk assessment in an Italian cohort.Allergy. 2015; 70: 933-943Crossref PubMed Scopus (91) Google Scholar Ole e 7 shares less than 20% of amino acid sequence with Pru p 3, and therefore seems to be neither structurally nor immunologically related to food LTPs.7Tordesillas L. Sirvent S. Diaz-Perales A. Villalba M. Cuesta-Herranz J. Rodriguez R. et al.Plant lipid transfer protein allergens: no cross-reactivity between those from foods and olive and parietaria pollen.Int Arch Allergy Immunol. 2011; 156: 291-296Crossref PubMed Scopus (48) Google Scholar However, our study demonstrates that Ole e 7 reactivity is in strict relationship with adverse reactions to plant-derived food (mainly peach, walnut, and peanut), thus suggesting an intriguing involvement of Ole e 7 in the LTP panallergen family, despite the lack of structural homology.7Tordesillas L. Sirvent S. Diaz-Perales A. Villalba M. Cuesta-Herranz J. Rodriguez R. et al.Plant lipid transfer protein allergens: no cross-reactivity between those from foods and olive and parietaria pollen.Int Arch Allergy Immunol. 2011; 156: 291-296Crossref PubMed Scopus (48) Google Scholar Moreover, about 80% of Ole e 7 reactors were also positive to at least 1 of the plant food LTP tested on the microarray versus only 30% of Ole e 1 reactors. To our knowledge, the association between Ole e 9 reactivity and the higher prevalence of AD has never been described before. Ole e 9 contains 2 immunologically and structurally independent domains8Palomares O. Villalba M. Quiralte J. Polo F. Rodriguez R. 1,3-Beta-glucanases as candidates in latex-pollen-vegetable food cross-reactivity.Clin Exp Allergy. 2005; 35: 345-351Crossref PubMed Scopus (87) Google Scholar: the N-terminal domain has a 1,3-β-glucanase activity, thus belonging to the pathogenesis-related protein family-2, which is implicated in latex-pollen-vegetable food allergy syndrome.8Palomares O. Villalba M. Quiralte J. Polo F. Rodriguez R. 1,3-Beta-glucanases as candidates in latex-pollen-vegetable food cross-reactivity.Clin Exp Allergy. 2005; 35: 345-351Crossref PubMed Scopus (87) Google Scholar Accordingly, we observed a higher occurrence of latex reactivity among Ole e 9 reactors (15.3% vs 3.3% among nonreactors; P < .001; χ2 = 25.348; OR, 5.265; 95% CI, 2.582-10.737). Ole e 9 reactivity was never associated with a higher incidence of food reactions (OAS or SR). In conclusion, our study shows that distinct subsets can be recognized among olive tree reactors on the basis of molecular reactivity. Ole e 1 positivity identifies the specific olive tree pollen–allergic population with RS, possibly deserving specific immunotherapy, whereas Ole e 7 and Ole e 9 IgE recognition is associated with local or systemic reactions to food and AD, respectively. This suggests that testing for olive components may be useful for a better characterization of patients with atopy, as is the case for peanut components.9Klemans R.J. Broekman H.C. Knol E.F. Bruijnzeel-Koomen C.A. Otten H.G. Pasmans S.G. et al.Ara h 2 is the best predictor for peanut allergy in adults.J Allergy Clin Immunol Pract. 2013; 1: 632-638Abstract Full Text Full Text PDF PubMed Scopus (66) Google Scholar It is likely, in the near future, that this concept could be extended to other allergens as well. We are grateful to Dr Marina Ruffelli, Dr Silvia Cadoni, and Miss Monica Bondi who performed the ISAC test. We thank Professor Moira Egan for the English revision of the manuscript. Table E1Olive tree pollen allergens identified to date according to the WHO/IUIS database (www.allergen.org)AllergenBiochemical nameBiological functionMWIgE prevalenceE1Ledesma A. Rodriguez R. Villalba M. Olive-pollen profilin: molecular and immunologic properties.Allergy. 1998; 53: 520-526Crossref PubMed Scopus (70) Google Scholar,E2Huecas S. Villalba M. Rodriguez R. Ole e 9, a major olive pollen allergen is a b-1,3-glucanase. Isolation, characterization, amino acid sequence and tissue specificity.J Biol Chem. 2001; 276: 27959-27966Crossref PubMed Scopus (92) Google ScholarOle e 1Common olive group 1Trypsin inhibitors16>70Ole e 2ProfilinActin-binding proteins15>40Ole e 3PolcalcinCalcium-binding proteins920Ole e 4∗Ole e 4 could be a proteolytic degradation product of Ole e 9 and not a genuine allergen.Glucanases3280Ole e 5Superoxide dismutaseSuperoxide Dismutases1635Ole e 6Cysteine-enriched allergenUnknown1015-55Ole e 7Putative nonspecific LTPLTPs9-1047Ole e 8Polcalcin-like protein (4 EF-hands)Calcium-binding proteins215Ole e 91,3-Beta glucanaseGlucanases4650Ole e 10X8 domain–containing proteinGlycosyl hydrolase1154Ole e 11Pectin methylesterasePectinesterases39.4EF, Calcium-binding motifs composed of 2 helixes (E and F) joined by a loop; IUIS, International Union of Immunological Societies; MF, molecular weight; WHO, World Health Organization.∗ Ole e 4 could be a proteolytic degradation product of Ole e 9 and not a genuine allergen. Open table in a new tab EF, Calcium-binding motifs composed of 2 helixes (E and F) joined by a loop; IUIS, International Union of Immunological Societies; MF, molecular weight; WHO, World Health Organization.

BACKGROUND:Nonspecific lipid transfer proteins (nsLTPs) represent a major cause of systemic food allergic reactions in the Mediterranean area. This study investigate hierarchical patterns and cluster relationships of IgE sensitization to different nsLTPs, and the relationship to clinical allergy in a large Italian cohort. METHODS:A total of 568 nsLTP-positive subjects after IgE ImmunoCAP-ISAC microarray analysis with Ara h 9, Art v 3, Cor a 8, Jug r 3, Pla a 3, Pru p 3 and Tri a 14 allergens were studied. IgE inhibition experiments were carried out with mugwort and plane tree pollen extracts. RESULTS:Eighty-two per cent of nsLTP-positive participants (94% if <6 years old) were Pru p 3(pos) , and 71% were Jug r 3(pos) . Participants who reacted to >5 nsLTPs reported a higher incidence of food-induced systemic reactions. Only Art v 3 and Pla a 3 (mugwort and plane tree nsLTPs, respectively) were associated with respiratory symptoms, and a correlation was observed between sensitization to pollen and plant food nsLTPs, particularly between Pla a 3 and tree nut/peanut nsLTPs. Co-sensitization to Par j 2 and PR-10 or profilin pan-allergens was associated with a lower prior prevalence of severe food-induced reactions. In inhibition assays, plane and mugwort pollen extracts inhibited 50-100% of IgE binding to food nsLTPs in microarrays. CONCLUSIONS:Testing IgE reactivity to a panel of nsLTP allergens unveils important associations between nsLTP sensitization profiles and clinical presentation and allows the identification of novel cluster patterns indicating likely cross-reactivities and highlighting potential allergens for nsLTP immunotherapy.

Sézary Syndrome (SS/L-CTCL) is a rare but aggressive variant of cutaneous T cell lymphoma (CTCL), characterized by erythroderma, lymphadenopathy, and the presence of a circulating memory CD4(+) T cell malignant clone with a skin homing behavior, lacking CD26 and CD49d and over-expressing CD60. The availability of a panel of monoclonal antibodies recognizing distinct TCR-Vβ families, allows to typify the clone by flow cytometry in about 70 % of cases. The TCR-Vβ repertoire of 533 individuals, comprising 308 patients affected by CTCL, 50 healthy donors, and subjects affected by various non-neoplastic dermatological affections was evaluated by flow cytometry. Statistical analyses were performed using the SPSS statistical software package for Microsoft Windows (SPSS, version 21, Chicago, IL). TCR-Vβ2 levels below 5.4 % or above 39.5 %, within total CD4(+) T cells, showed the best balance between sensitivity (98.1 %) and specificity (96 %) to identify the presence of a clone in the peripheral blood of patients affected by SS. Based on this observation, a "two-step" procedure in the detection of the malignant T cell clone in CTCLs is herein suggested. TCR-Vβ2 assessment in all cases (first step). In the case of TCR-Vβ2 levels above 39.5 %, the presence of a clonal expansion of this family is suggested, deserving further confirmation by means of T cell gene rearrangement evaluation. In patients having a TCR-Vβ2 reactivity below 5.4 % (second step), the entire TCR-Vβ repertoire should be evaluated to typify the expanded clone. In conclusion, the single TCR-Vβ2 expression check, instead of the entire repertoire assessment, represents an easy and cost-effective method for the recognition of CTCL aggressive leukemic variant.

BACKGROUND:Among the peach-derived allergens which are already known, the lipid transfer protein (Pru p 3) seems to be the one to exert severe allergic reactions.OBJECTIVE:To identify and characterize a new peach allergen causing a clinical picture similar to that of Pru p 3.METHODS:Patients were selected on the basis of their severe clinical reactivity and negative results to a panel of peach allergens available on the ISAC103 microarray. Several in-house and commercial preparations were compared. Several methods were used to characterize the newly identified molecule. Specific IgE and inhibition assays were performed using the Allergen micro-Beads Array (ABA) assay.RESULTS:Negative ISAC results to Pru p 3 were confirmed by additional testing in contrast with the positive results obtained by commercial Pru p 3-enriched peach peel extracts. The analyses of one of these preparations led to the identification of Peamaclein, a new allergenic protein. It is a small, basic, cysteine-rich, heat-stable, digestion-resistant protein, homologous to a potato antimicrobial peptide. Peamaclein was able to trigger positive skin test reactions and to bind IgE in the ABA assay. It displays an electrophoretic mobility and chromatographic behaviour similar to that of Pru p 3; therefore, it can be hidden in Pru p 3 preparations. In fact, Pru p 3-enriched peach peel extracts were found to contain both Pru p 3 and Peamaclein by means of comparative in vivo testing, and by biochemical and immunochemical assays. Commercially available anti-Pru p 3 polyclonal antibodies were found to have a double specificity for the two molecules.CONCLUSIONS AND CLINICAL RELEVANCE:A new allergen from peach belonging to a new family of allergenic proteins has been identified and characterized. This knowledge on Peamaclein will improve our understanding on the clinical aspects of the peach allergy and the quality of diagnostic reagents.

Background Bullous pemphigoid (BP) is an autoimmune skin disease in which patient autoantibodies react with BP180 and BP230 proteins. In addition to IgG, IgE has been shown to play a role in the disease.

The incidence of IgE-mediated allergic disorders has increased over the last decades in the western world [1,2]. Consequently, the availability of reliable tools for the diagnosis of allergic disea...

SCOPE:Manioc (Manihot esculenta) is a tuber mainly consumed in the Southern Hemisphere and used worldwide by food and chemistry industry. We aimed to recombinantly produce and characterize the first manioc allergen and evaluate its IgE reactivity in sera of Brazilian and Italian patients.METHODS AND RESULTS:The molecule, termed Man e5, was expressed in E. coli, characterized by amino acid analysis, mass spectrometry, circular dichroism, HPLC, and dynamic light scattering. A tertiary structural model of the protein was produced using bioinformatics and susceptibility to pepsin digestion was analyzed in vitro. Based on its high content of charged residues, heat stability, flexibility and lack of secondary structure elements, the allergen was determined a member of the intrinsically disordered protein family. Brazilian patients were selected based on manioc allergy and Italians based on latex allergy and sensitization to Hev b 5.71% of Brazilians and 40% of Italians were in vitro IgE positive to Man e5. Cross-inhibition assays suggest a possible involvement of this allergen in the latex-fruit syndrome.CONCLUSION:Man e5, the first purified allergen from manioc demonstrates IgE cross-reactivity with Hev b 5. Data suggest Hev b 5 might act as primary sensitizer and could therefore lead to allergic manifestations upon manioc consumption without prior exposition.

Background Allergies represent the most prevalent non infective diseases worldwide. Approaching IgE-mediated sensitizations improved much by adopting allergenic molecules instead of extracts, and by using the micro-technology for multiplex testing. Objective and Methods To provide a proof-of-concept that a flow cytometric bead array is a feasible mean for the detection of specific IgE reactivity to allergenic molecules in a multiplex-like way. A flow cytometry Allergenic Molecule-based micro-bead Array system (ABA) was set by coupling allergenic molecules with commercially available micro-beads. Allergen specific polyclonal and monoclonal antibodies, as well as samples from 167 allergic patients, characterized by means of the ISAC microarray system, were used as means to show the feasibility of the ABA. Three hundred and thirty-six sera were tested for 1 or more of the 16 selected allergens, for a total number of 1,519 tests on each of the two systems. Results Successful coupling was initially verified by detecting the binding of rabbit polyclonal IgG, mouse monoclonal, and pooled human IgE toward three allergens, namely nDer s 1, nPen m 1, and nPru p 3. The ABA assay showed to detect IgE to nAct d 1, nAct d 11, rAln g 1, nAmb a 1, nArt v 3, rBet v 1, rCor a 1, nCup a 1, nDer p 1, nDer s 1, rHev b 5, nOle e 1, rPar j 2, nPen m 1, rPhl p 1, and nPru p 3. Results obtained by ABA IgE testing were highly correlated to ISAC testing (r = 0.87, p<0.0001). No unspecific binding was recorded because of high total IgE values. Conclusion The ABA assay represents a useful and flexible method for multiplex IgE detection using allergenic molecules. As also shown by our initial experiments with monoclonals and polyclonals, ABA is suitable for detecting other human and non-human immunoglobulins.

Background: Sézary syndrome (SS) is the aggressive leukemic form of cutaneous T cell lymphoma characterized by erythroderma, the presence of a malignant circulating T memory cells with skin homing potential, and the ability to produce a variety of Th2 soluble factors, such as IL-4 and IL-5. We measured total and specific IgE in SS patients as a further parameter of a Th2-skewed immune system, and studied their clinical impact. Methods: Specific IgE production in a cohort of 55 SS patients was evaluated by the molecule-based ISAC microarray system. We then evaluated survival times and the hazard ratios in this cohort by Kaplan-Meier and Cox methods. Results: Twenty-four (43.6%) SS patients had specific IgE to both environmental and food allergens. For survival analysis, patients found positive to at least one allergen were defined as IgE+. By comparing IgE+ versus IgE– we found a significant difference in the median survival times, 2.9 versus 8.9 years (p < 0.001). Conversely, no survival difference could be observed when total IgE levels were considered. IgE+ patients had higher levels of CD60+CD49–CD4+ T cells, which also represent another worse prognostic index recently identified. Conclusion: SS patients had specific IgE to both environmental and food allergens. IgE+ SS patients had a significant lower survival rate. High levels of CD60–CD49+CD4+ T cells associated with an IgE– phenotype allow the identification of a restricted group of long survivor SS patients. Therefore, specific measurement of IgE seems to be useful in discriminating survival.

Allergic diseases are important concern of public health. A reliable diagnosis is of utmost importance for the management of allergic patients both when immunotherapy is planned and when the treatment is essentially based on the avoidance of the allergy source. However, the available diagnostic systems sometimes fail to detect specific IgE antibodies thus impairing the correct diagnosis. The traditional test systems are generally based on the use of protein extracts derived from the allergenic sources whose composition is very variable and cannot be standardized. The development of a new methodology combining the so-called allergenic molecule-based diagnosis with the multiplex microarray technology and allowing the analysis of multiple purified allergens in a single test represents an important improvement in allergy diagnosis. In addition, the biochemical and immunological characterisation of individual allergens has provided new insights into the understanding of allergen-IgE recognition that could be exploited for further improvements of allergy diagnostic tests.

Summary Immune dysregulation, polyendocrinopathy, enteropathy, X-linked (IPEX) is a rare syndrome due to a mutation in the forkhead box protein 3 gene (FOXP3) leading to an impaired regulatory T cell (Treg) activity associated both with skewed T helper type 2 (Th2) response and autoreactive phenomena. The purpose of this study was to describe a combined proteomics and genomics approach to comprehensively evaluate clinical and immunological phenotypes of patients affected by IPEX. T cell receptor (TCR)-Vβ repertoire and peripheral blood lymphocytes phenotype from three brothers affected by IPEX were studied by flow cytometry. Specific immunoglobulin (Ig)E were evaluated by means of an allergenic molecules microarray [immuno solid-phase allergen chip (ISAC)]. Total RNA was extracted and hybridized to Affymetrix oligonucleotide arrays to obtain quantitative gene-expression levels. No FOXP3 protein was detectable within CD127-CD25highCD4+ T cells from peripheral blood. A T cell-naive phenotype (CD62L+CD45R0-) associated with a reduction of both CD26 and CD7 expression and a TCR-Vβ 8 and 22 family expansions were found. B lymphocytes were mainly CD5+ (B1) cells expressing a naive phenotype (tcl1+CD27-). The three IPEX patients had severe food allergy and specific IgE reactivity to cow's milk allergens, a hen's egg allergen and a wheat allergen. Gene expression profile analysis revealed a dysregulation associated mainly with Th1/Th2 pathways. The multiplexing evaluation reported in this study represents a comprehensive approach in the assessment of genetic conditions affecting the immune system such as the IPEX syndrome, paving the way for the development of diagnostic tools to improve the standard clinical and immunological profiling of the disease.

Background IgE recognition of panallergens having highly conserved sequence regions, structure, and function and shared by inhalant and food allergen sources is often observed. Methods We evaluated the IgE recognition profile of profilins (Bet v 2, Cyn d 12, Hel a 2, Hev b 8, Mer a 1, Ole e 2, Par j 3, Phl p 12, Pho d 2), PR-10 proteins (Aln g 1, Api g 1, Bet v 1.0101, Bet v 1.0401, Cor a 1, Dau c 1 and Mal d 1.0108) and tropomyosins (Ani s 3, Der p 10, Hel as 1, Pen i 1, Pen m 1, Per a 7) using the Immuno-Solid phase Allergen Chip (ISAC) microarray system. The three panallergen groups were well represented among the allergenic molecules immobilized on the ISAC. Moreover, they are distributed in several taxonomical allergenic sources, either close or distant, and have a route of exposure being either inhalation or ingestion. Results 3,113 individuals (49.9% female) were selected on the basis of their reactivity to profilins, PR-10 or tropomyosins. 1,521 (48.8%) patients were reactive to profilins (77.6% Mer a 1 IgE+), 1,420 (45.6%) to PR-10 (92.5% Bet v 1 IgE+) and 632 (20.3%) to tropomyosins (68% Der p 10 IgE+). A significant direct relationship between different representative molecules within each group of panallergens was found. 2,688 patients (86.4%) recognized only one out of the three distinct groups of molecules as confirmed also by hierarchical clustering analysis. Conclusions Unless exposed to most of the allergens in the same or related allergenic sources, a preferential IgE response to distinct panallergens has been recorded. Allergen microarray IgE testing increases our knowledge of the IgE immune response and related epidemiological features within and between homologous molecules better describing the patients' immunological phenotypes.