{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T18:00:54Z","timestamp":1790359254246,"version":"4.1.0"},"reference-count":50,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Allergy Immunology"],"published-print":{"date-parts":[[2026,9]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Allergic rhinitis and asthma in childhood arise from dynamic interactions between genetic predisposition and the exposome. However, how environmental heterogeneity shapes molecular IgE sensitization profiles during early life remains insufficiently characterized.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We conducted a prospective, observational, multicentre,\n cross\u2010sectional<\/jats:bold>\n study including 354 children (0\u201315\u2009years) with allergic rhinitis and\/or asthma recruited across eight Spanish cities contrasting regional climatic contexts. All patients were skin prick test\u2010positive to at least one aeroallergen and underwent multiplex component\u2010resolved diagnostics using the ALEX platform. Sensitization patterns were analyzed, and unsupervised approaches were applied to identify molecular signatures.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Molecular IgE profiling revealed a structured sensitization landscape, with 97.5% of children exhibiting reactivity to at least one allergen. A dominant mite\u2010related pattern and partially distinct pollen\u2010 and epithelial\u2010related patterns were observed. PCA identified composite molecular sensitization gradients and descriptive differences in participant distributions across recruitment centres, although substantial overlap was observed between centres. Age\u2010stratified analyses identified a non\u2010linear trajectory of sensitization, characterized by early molecular priming in high\u2010exposure environments, followed by a marked expansion of IgE levels and allergen sensitization during school age. Rhinitis severity was strongly associated with a denser mite sensitization network. In contrast, asthma severity was driven not by mite sensitization alone but by a complex pollen\u2010related polysensitization.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Pediatric IgE sensitization is structured into molecular patterns associated with geography and age, consistent with a role for environmental context in early allergic trajectories.<\/jats:p>\n \n \n \n image<\/jats:alt-text>\n <\/jats:graphic>\n <\/jats:boxed-text>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/pai.70472","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T16:56:38Z","timestamp":1789577798000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Exposome\u2010driven molecular sensitization signatures in pediatric rhinitis and asthma across Spanish regions"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5528-8043","authenticated-orcid":false,"given":"Montserrat","family":"\u00c1lvaro\u2010Lozano","sequence":"first","affiliation":[{"name":"Hospital Sant Joan de D\u00e9u Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7018-5942","authenticated-orcid":false,"given":"Ana Mar\u00eda","family":"Mart\u00ednez\u2010Ca\u00f1avate","sequence":"additional","affiliation":[{"name":"Hospital Universitario Virgen de Las Nieves Granada Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7707-0339","authenticated-orcid":false,"given":"Francisco","family":"Carballada","sequence":"additional","affiliation":[{"name":"Hospital Universitario Lucus Augusti Lugo Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0687-5142","authenticated-orcid":false,"given":"Mar\u00eda","family":"Mesa\u2010Del\u2010Castillo","sequence":"additional","affiliation":[{"name":"Hospital Universitario de M\u00f3stoles Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-3226-9518","authenticated-orcid":false,"given":"Jos\u00e9 \u00c1ngel Porto","family":"Arceo","sequence":"additional","affiliation":[{"name":"Hospital Policl\u00ednico Rosaleda Santiago de Compostela Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4644-1242","authenticated-orcid":false,"given":"Carlos Garc\u00eda","family":"Mag\u00e1n","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednico Universitario de Santiago de Compostela Santiago de Compostela Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7514-3645","authenticated-orcid":false,"given":"Cristina Blasco","family":"Valero","sequence":"additional","affiliation":[{"name":"Hospital Miguel Servet Zaragoza Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-4824-297X","authenticated-orcid":false,"given":"Jaime Lozano","family":"Blasco","sequence":"additional","affiliation":[{"name":"Hospital Sant Joan de D\u00e9u Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2505-1966","authenticated-orcid":false,"given":"Juli\u00e1n Andr\u00e9s Manrique","family":"Ni\u00f1o","sequence":"additional","affiliation":[{"name":"Hospital Sant Joan de D\u00e9u Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5744-9201","authenticated-orcid":false,"given":"Guillermo 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