# Molecular Biomarkers in IgE Immunoassays Used for Grass Pollen Allergy Diagnosis in European Clinical Settings

## TL;DR

This paper reviews molecular biomarkers used in diagnosing grass pollen allergies in Europe, emphasizing their role in accurate diagnosis and personalized treatment.

## Contribution

The paper provides a structured overview of allergen components and diagnostic algorithms for grass pollen allergy in European clinical settings.

## Key findings

- Molecular biomarkers help distinguish true grass pollen sensitization from cross-reactivity.
- Diagnostic algorithms support personalized decisions for managing grass pollen allergies.
- Multiplex IgE immunoassays improve the precision of allergy diagnosis.

## Abstract

Grass pollen allergy has a high prevalence worldwide, making an accurate diagnosis critical in the framework of multifaceted environmental exposures. Our narrative review provides a comprehensive synopsis of component-resolved diagnosis biomarkers for pollen of Pooideae and Chloridoideae grasses, along with practical approaches in European clinical settings. We present a structured overview of allergen components utilized in singleplex, multiparameter, and multiplex IgE immunoassays. Molecular biomarkers have key roles in distinguishing genuine grass pollen sensitization from cross-reactivity and in assessing the risks associated with various IgE sensitization patterns, thereby enabling precise allergy diagnosis and facilitating targeted allergen immunotherapy. Diagnostic algorithms are provided to assist clinicians in making molecular biomarker-based personalized decisions. This tailored approach supports better management of patients with grass pollen sensitizations and allergies.