Research Article

Endotyping Cellular and Humoral Cross-reactivity against Hazelnut (Corylus avellana), Apple (Malus domestica), and Pollen in Allergic Multimorbidity

Abstract

Background: Patients with sensitivity to pollen and pollen-associated allergens may present with multiple phenotypes and severity features, suggesting multiple endotypes that underlie clinical symptoms. Aim: To evaluate the potential of the Tube Titration of Precipitins (TTP) and the Leukocyte Adherence Inhibition Test (LAIT) to differentiate cellular and humoral immunoreactivity against pollen-related foods (Malus domestica and Corylus avellana), while simultaneously challenging their extracts and pollen extract against blood samples of patients presenting multimorbidity allergies. Study Design: We retrospectively reviewed the medical charts of two patient cohorts clinically diagnosed with allergic multimorbidity related to inhalation of pollen and/or consumption of hazelnut and/or apple, who were evaluated using TTP or LAIT. Methodology: The registered results for TTP and LAIT on pollen, apple, and hazelnut extracts were displayed through a cascade distribution chart to illustrate the variability of the results. The statistical differences within these cohorts were calculated. The Pearson correlation test was calculated between paired results. Results: Pearson’s correlation indicated a significant relationship between LAIT pollen extract and LAIT apple extract; r (98) = 0.492 (p-value <0.001). There was no other significant correlation between pollen and hazelnut LAIT, and between apple and hazelnut LAIT. There was no significant correlation between the TTP tests among the pollen, apple, and hazelnut extracts. Conclusion: Our preliminary results support the view that TTP and LAIT, when performed with pollen, apple, and hazelnut extracts, may differentiate degrees of humoral and cellular immunoreactivity.

Authors affiliation:

Celso Eduardo Olivier (ORCID): Instituto Alergoimuno de Americana, Brazil.
Daiana Guedes Pinto (ORCID): Instituto Alergoimuno de Americana, Brazil.
Ana Paula Monezzi Teixeira (ORCID): Instituto Alergoimuno de Americana, Brazil.
Cibele Silva Miguel (ORCID): Instituto Alergoimuno de Americana, Brazil.
Nicole Sartoreto Rocha (ORCID): Faculdade de Americana, Sao Paulo, Brazil.
Alessandra Vieira Oliveira (ORCID): Faculdade de Americana, Sao Paulo, Brazil.
Luciana Sacilotto Carvalho (ORCID): Faculdade de Americana, Sao Paulo, Brazil.
Raquel Acacia Pereira Goncalves Santos (ORCID): Instituto Alergoimuno de Americana, Brazil.
Lubna Shaik (ORCID): School of Biosciences and Bioengineering, D Y Patil International University, Akurdi, India.
Serce Damla Unat (ORCID): Department of Pulmonology, Bakırcay University, Faculty of Medicine, Izmir, Turkiye.

How to Cite: C.E. Olivier, D.G. Pinto, A.P.M. Teixeira, C.S. Miguel, N.S. Rocha, A.V. Oliveira, L.S. Carvalho, R.A.P.G. Santos, L. Shaik and S.D. Unat. Endotyping Cellular and Humoral Cross-reactivity against Hazelnut (Corylus avellana), Apple (Malus domestica), and Pollen in Allergic Multimorbidity. Journal of Applied Health Sciences and Medicine, 6(8):14–28, 2026. https://doi.org/10.58614/jahsm684