A longitudinal birth cohort study reveals that persistent sensitisation to the mold Alternaria is strongly associated with ongoing asthma and rhinitis from childhood into adulthood. Researchers identified the recombinant allergen rAlt a 1 as a potentially superior marker for asthma risk detection in younger individuals.
The study, conducted on participants from the Isle of Wight birth cohort, assessed individuals at ages 4, 10, 18, and 26 years. Sensitisation was measured via skin prick testing and serum IgE testing to whole Alternaria extract and rAlt a 1.
Among 434 participants, 84.1% were never sensitised, 11.1% showed intermittent sensitisation, and 4.8% demonstrated persistent sensitisation. Persistent sensitisation was linked to the highest risks of asthma and rhinitis, with rAlt a 1 offering better discrimination of asthma risk during childhood and adolescence. By age 26, diagnostic assays became largely interchangeable.
The authors concluded that Alternaria sensitisation consolidates from late adolescence onward, and that persistent sensitisation may serve as a long-term marker for allergic respiratory disease. Early testing with rAlt a 1 could help identify at-risk children.