Molecular Allergen Diagnosis Reveals That Asthma Risk Is Linked to Desert Mugwort Pollen Exposure

BACKGROUND: Artemisia desertorum (desert mugwort) is widely planted in the Mu Us Desert of northwestern China for windbreak and sand fixation, but extensive cultivation has unexpectedly increased pollen-induced allergies. This study aims to perform allergen molecular diagnosis and evaluate its utility in characterizing immunoglobulin E (IgE) sensitization profiles linked to allergic phenotypes. METHODS: One hundred and thirty-five Artemisia-allergic patients from three regions differing in the Artemisia pollen exposure were examined. Eleven allergens were either purified naturally or recombinantly for IgE quantification using the ImmunoCAP assay. RESULTS: At least one allergen response was detected in 134 patients. Major allergens included Art d 1 (85.2%), Art d 2 (62.2%), Art d 3 (88.9%), Art d 7 (82.2%), and Art d 9 (54.1%). Patients from the high desert mugwort exposure region exhibited elevated serum-specific immunoglobulin E (sIgE) levels, increased sensitization to mugwort extract and allergen molecules, broader polysensitization, and higher asthma prevalence. Number of sensitized allergens and sIgE levels to mugwort extract and Art d 3 were independently associated with asthma in multivariable analysis. A predictive model was developed for asthma prediction with an AUC of 0.832. CONCLUSIONS: High environmental exposure to A. desertorum pollen increases pollen allergy prevalence and asthma risk in Mu Us Desert residents. Molecular allergy diagnostics with a comprehensive A. desertorum allergen panel enhanced diagnostic precision, supported disease severity prediction, and provided critical insights for improved clinical management.