Distinct regional allergen sensitization patterns in pediatric populations: A comparative latent class analysis of multiple antigen simultaneous test-derived sensitization profiles in Japan and Taiwan.

Background: Allergen sensitization patterns vary across regions; however, few studies have directly compared pediatric sensitization profiles between Japan and Taiwan. Objective: This study aimed to compare allergen sensitization patterns in children from Japan and Taiwan using the multiple antigen simultaneous test (MAST) and latent class analysis (LCA). Methods: A total of 217 Japanese and 166 Taiwanese children (aged 2-12 years) were enrolled. Based on responses to the International Study on Asthma and Allergy in Childhood questionnaire, participants were classified as either healthy or as having allergic rhinitis (AR), bronchial asthma (BA), or atopic dermatitis. Serum samples were analyzed using a commercial MAST kit available in Japan, and 20 allergens shared with the panel used in Taiwan were selected for analysis. Sensitization was defined as a lumicount value ≥2.78 (equivalent to class 2 or higher). LCA was conducted on the combined dataset, and the optimal number of latent classes was determined using the Akaike Information Criterion. Results: LCA identified 4 latent classes: low-sensitized (LS), house dust mite-dominant (HDM-D), inhalant-sensitized (IH-S), and poly-sensitized (PS). The HDM-D class was more prevalent in Taiwan (50%) than in Japan (6.9%). In contrast, the IH-S and PS classes were more common in Japan (36.4% vs. 3% and 8.8% vs. 2.4%, respectively). AR and BA were primarily associated with HDM-D in Taiwan and with IH-S in Japan, which includes HDM and Japanese cedar pollen. HDM and crab sensitization were strongly correlated in Taiwan. Conclusion: MAST combined with LCA reveals distinct regional sensitization profiles, suggesting divergent pathways in allergic disease development.