The ’Travelling salesman problem’: A new approach for identification of differences among pollen allergens

Background: It is not easy to identify the specific plant species that causes an allergic response in a certain patient at a certain time. This is further complicated by the fact that closely related plant species cause similar allergic responses. A novel mathematical technique is used for analysis of skin responses of a large number of patients to several groups of allergens for improvement of the understanding of their similarity or dissimilarity and their status regarding cross-reactivity. Methods: The responses of 153 atopic patients to 42 different pollen extracts were tested by skin prick tests. Among the responses of patients to various extracts, a measure of dissimilarity was introduced and calculated for all pairs of allergens. A matrix-structuring technique, based on a solution of the ’Travelling Salesman Problem’, was used for clustering of the investigated allergens into groups according to patients’ responses. The discrimination among clusters was confirmed by statistical analysis. Results: Sub groups can be discerned even among allergens of closely related plants, i.e. allergens that are usually regarded as fully cross-reactive. A few such cases are demonstrated for various cultivars of olives and pecans and for various sources of date palms, turf grasses, three wild chenopods and an amaranth. Conclusion: The usefulness of the proposed approach for the understanding of similarity and dissimilarity among various pollen allergens is demonstrated.