{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T18:22:47Z","timestamp":1791829367710,"version":"4.3.4"},"reference-count":27,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,3,22]],"date-time":"2026-03-22T00:00:00Z","timestamp":1774137600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006595","name":"UEFISCDI","doi-asserted-by":"crossref","award":["99PHE\/2025"],"award-info":[{"award-number":["99PHE\/2025"]}],"id":[{"id":"10.13039\/501100006595","id-type":"DOI","asserted-by":"crossref"}]},{"name":"University of Medicine and Pharmacy \u201cVictor Babes\u201d of Timis\u0326oara, Romania"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Ragweed (Ambrosia artemisiifolia) represents a major and expanding source of aeroallergen exposure in Europe, with rising sensitization rates and substantial clinical impact. However, population-level data integrating airborne pollen exposure with detailed clinical sensitization patterns remain limited. We conducted a 5-year retrospective cross-sectional observational analysis of sensitization prevalence, complemented by a parallel temporal analysis of aerobiological data and symptom-driven healthcare presentation patterns (2020\u20132024) in Timisoara, Romania, including all patients undergoing first-time sensitization evaluation at a tertiary referral hospital. Sensitization was assessed using standardized skin prick testing to common aeroallergens and other allergen categories, while airborne ragweed pollen concentrations were monitored through a peri-urban network of real-time bio-particle analyzers. Statistical analyses included descriptive statistics, multivariable logistic regression, \u03c72 tests for co-sensitization patterns, and comparative analyses of clinical manifestations across sensitization profiles. Among 4404 eligible patients, 50.7% were sensitized to at least one allergen. Ragweed sensitization was identified in 24.1% of patients, with a mean age of 31.1 years at diagnosis and no significant sex-related difference. Most ragweed-sensitized patients were polysensitized (71.5%), predominantly to other aeroallergens. Increasing age was independently associated with lower odds of polysensitization to other aeroallergens (adjusted OR = 0.97 per year, 95% CI: 0.96\u20130.98), while sex showed no independent association. Patients with ragweed sensitization alone and those cosensitized with aeroallergens exhibited similar prevalence of respiratory manifestations, whereas individuals with additional non-aeroallergen sensitization showed lower prevalence of rhinitis, conjunctivitis, and asthma but slightly higher rates of asthma exacerbations. Weekly diagnoses of ragweed sensitization demonstrated a pronounced seasonal peak between calendar weeks 33 and 38 (mid-August to late September), coinciding with peak airborne ragweed pollen concentrations. Ragweed sensitization therefore represents a substantial and seasonally driven healthcare burden in western Romania, characterized by frequent polysensitization, distinct clinical manifestation patterns across sensitization profiles, and close temporal alignment between airborne pollen exposure and clinical presentation. Integrating aerobiological monitoring with clinical surveillance may support targeted prevention strategies and improved patient management.<\/jats:p>","DOI":"10.3390\/life16030526","type":"journal-article","created":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T13:07:06Z","timestamp":1774271226000},"page":"526","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Airborne Ragweed (Ambrosia artemisiifolia) Allergen Exposure and Sensitization Pattern in Western Romania: A 5-Year Retrospective Cross-Sectional Observational Analysis of Sensitization Prevalence, Complemented by a Parallel Temporal Analysis of Aerobiological Data and Symptom-Driven Healthcare Presentation Patterns Study"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-1552-7961","authenticated-orcid":false,"given":"Valentin-Cristian","family":"Iovin","sequence":"first","affiliation":[{"name":"Doctoral School Department, \u201cVictor Babes\u201d University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania"},{"name":"Department III Functional Sciences, Physiology Discipline, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Centre of Immuno-Physiology and Biotechnologies (CIFBIOTEH), Department of Functional Sciences, Physiology, \u201cVictor Babes\u201d University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4766-5945","authenticated-orcid":false,"given":"Carmen","family":"Neamtu","sequence":"additional","affiliation":[{"name":"Faculty of Dentistry, \u201cVasile Goldis\u201d Western University of Arad, 310045 Arad, Romania"},{"name":"Department of Surgery I, Clinical County Emergency Hospital of Arad, 310037 Arad, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roxana","family":"Buzan","sequence":"additional","affiliation":[{"name":"OncoGen Center, Pius Brinzeu County Clinical Emergency Hospital, 300723 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7255-0835","authenticated-orcid":false,"given":"Corina","family":"Porr","sequence":"additional","affiliation":[{"name":"Allergology Department, Faculty of Medicine, Lucian Blaga University, 550169 Sibiu, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alina-Daniela","family":"Totorean","sequence":"additional","affiliation":[{"name":"Department of Balneology, Medical Rehabilitation and Rheumatology, \u201cVictor Babes\u201d University of Medicine and Pharmacy of Timisoara, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania"},{"name":"Department of Physical and Rehabilitation Medicine, \u201cPius Brinzeu\u201d Clinical County Emergency Hospital Timisoara, Liviu Rebreanu Boulevard, No. 156, 300723 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana-Adina","family":"Iovin","sequence":"additional","affiliation":[{"name":"Department of Pathology, Clinical County Emergency Hospital of Arad, Andrenyi Karoly Str., No. 2\u20134, 310037 Arad, Romania"},{"name":"Department of Pathology, \u201cPius Brinzeu\u201d Clinical County Emergency Hospital Timisoara, Liviu Rebreanu Boulevard, No. 156, 300723 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5219-5466","authenticated-orcid":false,"given":"Andreea-Adriana","family":"Neamtu","sequence":"additional","affiliation":[{"name":"Department of Pathology, Clinical County Emergency Hospital of Arad, Andrenyi Karoly Str., No. 2\u20134, 310037 Arad, Romania"},{"name":"Department of Pathology, \u201cPius Brinzeu\u201d Clinical County Emergency Hospital Timisoara, Liviu Rebreanu Boulevard, No. 156, 300723 Timisoara, Romania"},{"name":"Department of Toxicology, \u201cVictor Babes\u201d University of Medicine and Pharmacy of Timisoara, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania"},{"name":"Research Centre for Pharmaco-Toxicological Evaluation, \u201cVictor Babes\u201d University of Medicine and Pharmacy of Timisoara, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-8001-7672","authenticated-orcid":false,"given":"Diana Luisa","family":"Lighezan","sequence":"additional","affiliation":[{"name":"Department of Hematology, \u201cVictor Babes\u201d University of Medicine and Pharmacy of Timisoara, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8749-9972","authenticated-orcid":false,"given":"Carmen","family":"Panaitescu","sequence":"additional","affiliation":[{"name":"Department III Functional Sciences, Physiology Discipline, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Centre of Immuno-Physiology and Biotechnologies (CIFBIOTEH), Department of Functional Sciences, Physiology, \u201cVictor Babes\u201d University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania"},{"name":"OncoGen Center, Pius Brinzeu County Clinical Emergency Hospital, 300723 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1159\/000504297","article-title":"Allergic Rhinitis to Weed Pollen in Germany: Dominance by Plantain, Rising Prevalence, and Polysensitization Rates over 20 Years","volume":"181","author":"Forkel","year":"2020","journal-title":"Int. Arch. Allergy Immunol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"94","DOI":"10.37349\/eaa.2024.00062","article-title":"Allergy in the Po Valley: Evolution of sensitization profiles and phenology throughout 33 years and possible relationship with climate change","volume":"2","author":"Antico","year":"2024","journal-title":"Explor. Asthma Allergy"},{"key":"ref_3","first-page":"12","article-title":"Sensitization characteristics of ragweed pollen in Beijing area","volume":"37","author":"Suo","year":"2023","journal-title":"J. Clin. Otorhinolaryngol. Head Neck Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1354","DOI":"10.15586\/aei.v53i5.1354","article-title":"Ragweed (Ambrosia artemisiifolia) is the most important seasonal allergen in the Black Sea Region","volume":"53","author":"Aksakal","year":"2025","journal-title":"Allergol. Immunopathol."},{"key":"ref_5","first-page":"143","article-title":"New European-scale high-spatial-resolution atmospheric composition reanalysis (CAMSRA) data for ragweed pollen","volume":"37","author":"Karatzas","year":"2021","journal-title":"Aerobiologia"},{"key":"ref_6","first-page":"40","article-title":"Global climate warming and the expansion of ragweed\u2014New problems in the spread of allergopathology, forecasts and prevention","volume":"23","author":"Shogenova","year":"2023","journal-title":"Med. News North Cauc."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"15559","DOI":"10.1038\/s41598-022-20069-y","article-title":"Ragweed pollen concentration predicts seasonal rhino-conjunctivitis and asthma severity in patients allergic to ragweed","volume":"12","author":"Bonini","year":"2022","journal-title":"Sci. Rep."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Zb\u00eercea, L.E., Buzan, M.R., Grijincu, M., Tama\u0219, T.P., Vulpe, C.B., Hu\u021bu, I., P\u0103unescu, V., Panaitescu, C., and Chen, K.W. (2024). Cross-Reactivity of Ragweed Pollen Calcium-Binding Proteins and IgE Sensitization in a Ragweed-Allergic Population from Western Romania. Adv. Respir. Med., 92.","DOI":"10.3390\/arm92030022"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Zb\u00eercea, L.E., Buzan, M.R., Grijincu, M., Babaev, E., Stolz, F., Valenta, R., P\u0103unescu, V., Panaitescu, C., and Chen, K.W. (2024). Relationship between IgE Levels Specific for Ragweed Pollen Extract, Amb a 1 and Cross-Reactive Allergen Molecules. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms24044040"},{"key":"ref_10","first-page":"94","article-title":"Relationship between Climate Change, Air Pollution and Allergic Diseases Caused by Ambrosia artemisiifolia (Common Ragweed)","volume":"19","author":"Stoian","year":"2024","journal-title":"Maedica"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1289\/EHP173","article-title":"Climate change and future pollen allergy in Europe","volume":"125","author":"Lake","year":"2020","journal-title":"Environ. Health Perspect."},{"key":"ref_12","first-page":"685","article-title":"Pollen seasons of selected tree and herbaceous plant taxa in Krakow and the effect of meteorological conditions on their dynamics","volume":"37","author":"Myszkowska","year":"2021","journal-title":"Aerobiologia"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1007\/s10453-025-09860-2","article-title":"Ragweed (Ambrosia) pollen transport and seed production in Finland during 1990\u20132022","volume":"41","author":"Ahola","year":"2025","journal-title":"Aerobiologia"},{"key":"ref_14","first-page":"11","article-title":"Frequency of ragweed sensitization and allergy among patients with respiratory allergy","volume":"29","author":"Esmail","year":"2022","journal-title":"Egypt. J. Immunol."},{"key":"ref_15","unstructured":"Institutul National de Statistica (2026, January 31). Recensamantul Populatiei si Locuintelor. Romania. Available online: https:\/\/www.recensamantromania.ro\/."},{"key":"ref_16","unstructured":"Global Initiative for Asthma (2026, January 31). Asthma Management and Prevention for Adults, Adolescents and Children 6\u201311 Years A Summary Guide for Healthcare Providers. Published June 2025. Available online: https:\/\/www.Ginasthma.org."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1111\/all.70100","article-title":"Methodology for the Development of the Allergic Rhinitis and Its Impact on Asthma (ARIA)-EAACI 2024\u20132025 Guidelines: From Evidence-to-Decision Frameworks to Digitalised Shared Decision-Making Algorithms","volume":"81","author":"Bousquet","year":"2026","journal-title":"Allergy"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Sousa-Pinto, B., Bousquet, J., Vieira, R.J., Sch\u00fcnemann, H.J., Zuberbier, T., Bognanni, A., Togias, A., Samolinski, B., Valiulis, A., and Williams, S. (2025). Allergic Rhinitis and Its Impact on Asthma (ARIA)-EAACI Guidelines\u20142024\u20132025 Revision: Part I\u2014Guidelines on Intranasal Treatments. Allergy, early view.","DOI":"10.1111\/all.70131"},{"key":"ref_19","first-page":"31","article-title":"Sensitization to inhalation allergens in children with allergic rhinitis","volume":"29","year":"2024","journal-title":"Signa Vitae"},{"key":"ref_20","first-page":"111","article-title":"Determination of co-sensitization is an important step in improving the effectiveness of allergen-specific immunotherapy in patients with pollen disease","volume":"27","author":"Dityatkovska","year":"2022","journal-title":"Med. Perspect."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Keselman, A., and Heller, N. (2015). Estrogen Signaling Modulates Allergic Inflammation and Contributes to Sex Differences in Asthma. Front. Immunol., 6.","DOI":"10.3389\/fimmu.2015.00568"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Guti\u00e9rrez-Brito, J.A., Lomel\u00ed-Nieto, J.\u00c1., Mu\u00f1oz-Valle, J.F., Oregon-Romero, E., Corona-Angeles, J.A., and Hern\u00e1ndez-Bello, J. (2025). Sex hormones and allergies: Exploring the gender differences in immune responses. Front. Allergy, 5.","DOI":"10.3389\/falgy.2024.1483919"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Faur, F.I., Clim, I.A., Dobrescu, A., Isaic, A., Prodan, C., Florea, S., Tarta, C., Totolici, B., Du\u0163\u0103, C., and Pasca, P. (2023). The Use of Wound Infiltration for Postoperative Pain Management after Breast Cancer Surgery: A Randomized Clinical Study. Biomedicines, 11.","DOI":"10.3390\/biomedicines11041195"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"90","DOI":"10.3934\/Allergy.2022009","article-title":"Understanding sex differences in the allergic immune response to food","volume":"6","author":"Vininski","year":"2022","journal-title":"AIMS Allergy Immunol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1016\/j.aller.2016.10.004","article-title":"The impact of age on serum allergen-specific IgE to inhaled molecular components","volume":"45","author":"Tosca","year":"2017","journal-title":"Allergol. Immunopathol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"468","DOI":"10.3892\/etm.2021.9957","article-title":"Symptom patterns and comparison of diagnostic methods in ragweed pollen allergy","volume":"21","author":"Haidar","year":"2021","journal-title":"Exp. Ther. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1016\/j.anai.2015.08.007","article-title":"The impact of anxiety and depression on outpatients with asthma","volume":"115","author":"Ciprandi","year":"2015","journal-title":"Ann. Allergy Asthma Immunol."}],"container-title":["Life"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-1729\/16\/3\/526\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T05:46:00Z","timestamp":1774331160000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-1729\/16\/3\/526"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,22]]},"references-count":27,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["life16030526"],"URL":"https:\/\/doi.org\/10.3390\/life16030526","relation":{},"ISSN":["2075-1729"],"issn-type":[{"value":"2075-1729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,22]]}}}