Abstract / Summary
Abstract Background/Objectives: Allergy Explorer 2 (ALEX²) combines allergen extracts and molecular components in a multiplex IgE assay. We described sensitization profiles, clinical and ear, nose and throat (ENT) findings, and documented allergen immunotherapy (AIT) recommendations in adults with allergic rhinitis and/or rhinoconjunctivitis. Methods This retrospective observational study included 100 eligible adults evaluated between August 2025 and July 2026. Symptoms, ENT findings, skin prick testing (SPT), total immunoglobulin E (IgE), ALEX² profiles, and AIT-related decisions were extracted from routine records. Polysensitization was defined as sensitization to at least two distinct allergen sources. SPT–ALEX² comparisons were restricted to documented SPT-positive sources with corresponding ALEX² source-group results. Analyses were descriptive and exploratory, without adjustment for multiple comparisons. Results Seasonal symptoms were documented in 73% of patients. The most frequently recorded allergen sources were ragweed/Ambrosia (41%), grass pollen (36%), and house dust mites (25%). Polysensitization was present in 57%, and allergologist-interpreted patterns compatible with cross-reactivity in 22%. SPT was performed in 73 patients, with positive results recorded in 71 (97.3%). Across six comparable allergen sources, 64 patients had at least one documented SPT-positive source available for comparison; six had at least one corresponding negative ALEX² result. AIT was recommended in 31 patients (31%) and had been started or was planned in 15 (15%). Among 45 patients with a recorded or considered AIT target, ragweed/Ambrosia was the most frequent target (16/45, 35.6%). Conclusions This selected sample showed heterogeneous sensitization profiles and documented AIT recommendations within an integrated ENT–allergology assessment. The study does not establish overall agreement between SPT and ALEX² or the independent contribution of molecular testing to AIT decisions. Exploratory findings require prospective validation.