Analysis of the inhalant allergen spectrum in 4 488 children with allergic rhinitis in Tianjin / 中华实用儿科临床杂志

Objective:To investigate the types and characteristics of inhalant allergens in children with allergic rhinitis (AR) in Tianjin, and to provide foundation for the prevention and treatment of AR in children.Methods:The data of 4 488 patients with AR at the Pediatric Asthma and Allergy Clinic of the Second Hospital of Tianjin Medical University from March 2016 to February 2022 were collected and analyzed retrospectively in this study.The distribution features of inhalant allergens in AR children were explored.The relationship between the positive results of inhalant allergens and the gender, age and other comorbid allergic diseases was discussed.Serum allergen-specific immunoglobulin E (sIgE) was determined using the UniCAP100 system(fluorescent enzyme-linked immunoassay). Enumeration data were expressed as the number of cases and percentage (%), and data were compared between groups by χ2 test. Results:(1)In the serum of 4 488 AR patients, 3 116 cases were positive for inhalant allergens, with a positive rate of 69.43%.There were 28.47%(887/3 116) AR patients positive for 1 allergen, 25.22%(786/3 116) positive for 2 allergens, 19.67%(613/3 116) positive for 3 allergens, and 26.64%(830/3 116) positive for 4 or more allergens.The most common inhalant allergens were moulds (45.72%, 2 052/4 488), followed by dermatophagoides farinae (34.71%, 1 558/4 488), mugwort (33.95%, 313/922), dermatophagoides pteronyssinus (31.13%, 1 397/4 488), and ragweed (30.97%, 227/733). (2)The positive rates of inhalant allergens in preschool, school age and adolescent groups were 56.15%(1 132/2 016), 79.26%(1 624/2 049) and 85.11%(360/423), respectively ( χ2=309.72, P<0.001). The most common inhalant allergen in the preschool and school age groups was moulds (40.23%, 50.85%). In the adolescent group, dermatophagoides farina (56.74%) was the predominant inhalant allergen, followed by dermatophagoides pteronyssinus (53.66%) and moulds (47.04%). There were significant differences in the types of positive inhalant allergens among the 3 groups ( χ2=466.99, P<0.001). Children in the preschool group were mostly positive for single allergens, while those in the school age and adolescent groups were positive for 4 or more inhalant allergens.(3)The positive rate of inhalant allergens in boys reached 73.28%(2 139/2 919), significantly higher than that in girls (62.40%, 979/1 569) ( χ2=58.28, P<0.001). The top 3 common inhalant allergens in boys and girls were moulds, dermatophagoides farinae, and dermatophagoides pteronyssinus.There were significant differences in the types of positive inhalant allergens between boys and girls ( χ2=75.02, P<0.001). About 20.78% of the girls were positive for single allergens, and 20.45% of the boys were positive for 4 or more allergens.(4)The AR group complicated with asthma and atopic dermatitis had the highest positive rate (79.21%)of inhalant allergens, followed by AR patients with asthma (73.67%), AR patients with atopic dermatitis (61.05%) and AR patients (57.05%) successively.There were significant differences between the groups ( χ2=178.57, P<0.001). Conclusions:The main inhalant allergens in AR children in Tianjin are moulds, dermatophagoides farinae, mugwort, dermatophagoides pteronyssinus, and ragweed.The distribution characteristics of inhalant allergens vary with the age, gender and combined allergic diseases.Allergens should be detected for AR children as soon as possible, so as to prevent AR in advance, reduce drug use, and provide evidence for specific allergen immunotherapy.

Correlation between house dust mites’ sensitization and allergic diseases - A retrospective study of Saudi Arabia

Background: Globally, inhalant allergen sensitization (IAS) in allergic diseases (ADs) is commonly associated with indoor allergens, mainly house dust mites (HDMs). Objective: The objective of this study was to determine the association between HDM sensitization (HDM-SN) and ADs. Materials and Methods: A retrospective study was conducted which included all patients with allergies, >15 years of age, and seen over a 1-year period at the Allergy Center, Lalune clinics, Jeddah, Saudi Arabia. Results of serum specific immunoglobulin E (sIgE) to 30 common inhalant allergens (INHs) were collected by medical students. Severity of sensitization was classified as 1–6 (1–2 being mild, 3–4 being moderate, and 5–6 being severe). Medical records of patients with HDM-SN were reviewed to determine any clinical diagnosis of ADs and other associated IAS. Results: A total of 55 adults with HDM-SN, 34 males (62%) and 21 females (38%), with an age range of 15>56 years were studied. ADs associated with HDM-SN were allergic rhinitis (AR) (27%), asthma (22%), allergic conjunctivitis (AC) (18%), atopic dermatitis (ATD) (16%), allergic sinusitis (9%), and chronic urticaria (8%). The average severity class of HDM-SN in our sample was moderate (Dermatophagoides pteronyssinus [2.3] and Dermatophagoides farinae [2.2]). Other IAS found to be associated with HDM-SN were cockroaches (13.86%), Alternaria (12.4%), cats (12.4%), Bermuda (11.67%), and mesquite (10.21%). Conclusion: Average HDM-SN severity class was moderate in the studied group of patients (early to middle adult ages). HDM-SN is always associated with other IAS (INH-SNs) which explains the importance of obtaining an all-INH panel in patients with HDM-SN. IAS which most frequently had an association with HDM-SN was cockroaches, Alternaria, and cats with two outdoor allergens Bermuda, and mesquite, following closely. HDM-SN is usually associated with multiple ADs mainly involving INHs including AR, asthma, and AC, and less commonly ATD, sinusitis, and chronic urticaria.

Assessment of Total/Specific IgE Levels Against 7 Inhalant Allergens in Children Aged 3 to 6 Years in Seoul, Korea

PURPOSE: Childhood allergies are a serious problem, as they may lead to lifetime chronic disease. Determination of total and specific IgE levels is known to be a diagnostic tool for allergic sensitization; however, IgE levels are affected by various factors, such as age, sex, ethnicity, and geographic area. Thus, we evaluated the distribution of total and specific serum IgE levels against seven inhalant allergens in preschool children and examined their association with allergic diseases in Seoul, Korea. METHODS: Total/specific serum IgE determination and skin prick tests for seven common allergens were performed on 509 children aged 3 to 6 years from 16 child care centers in Seoul, Korea. Demographic characteristics were surveyed from parents using a modified International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. A diagnosis of atopic dermatitis was made by physicians. RESULTS: The geometric mean of total IgE was 80.48+/-3.80 kU/L in preschool children. IgE levels were higher in boys (boys, 102.34+/-3.52 kU/L; girls, 62.37+/-3.93 kU/L; P<0.001) and atopic subjects (atopic, 158.00+/-3.35 kU/L; non-atopic, 52.75+/-3.44 kU/L; P<0.001). An increased prevalence of atopy was associated with a high monthly household income (P=0.004) and higher maternal education level (above university-level education; P=0.009), as well as increased total IgE levels (P=0.036). Physician-diagnosed atopic dermatitis was associated with sensitization to inhalant allergens. CONCLUSIONS: Total IgE levels were very high as compared with those in previous reports from other countries. The most common sensitized allergen was Dermatophagoides farinae, and the positive response rate peaked at age 3 years and was maintained thereafter, particularly in boys. Specific IgE levels for seven inhalant allergens varied with age in preschool children. Although further investigations are needed with a broad range of ages and various allergens, the distribution of the total and specific serum IgE levels in preschool children might help to serve as a reference value to diagnose atopy.

Changing patterns of skin reactivity to inhalant allergens in asthmatic patients / 천식및알레르기

BACKGROUND: Skin prick test has been the primary diagnostic tool used to recognize causative allergens, and there is some evidence that skin reactivity to allergens can be altered by changes in the environment. OBJECTIVE: We performed this study to evaluate whether there are changes in skin reactivity to inhalant allergens among patients with bronchial asthma. MATERIALS AND METHOD: We reviewed the skin prick test results of 384 bronchial asthmatics tested in the early 1990s (June 1992-May 1994) with 52 common inhalant allergens and compared the results of 500 asthmatics tested in the mid 1980s (Jan 1984 - May 1987) with the same kinds of allergens provided by the same manufacturer. RESULTS: Of the 384 subjects tested in the early 1990s, 276 subjects(71.9%) had positive reaction to one or more inhalant allergens and the positive rate was not different from that of the mid 1980s(74%). But, skin reactivity to pollens was significantly increased. In individual allergens, house dust mite(D. farinae and D. pteronyssinus) was the most reactive allergen (52.3%, 43.2% respectively) in the early 1990s. Significant differences in skin reactivity to ragweed (10.0% vs 22.1%, p<0.05) and cockroach (12.7% vs 25.0%, p<0.05) were found when the results of the 1980s and the 1990s were compared. CONCLUSION: House dust mite was the most important allergen in asthmatics from the mid 1980s to the early 1990s. There was increased sensitization to cockroach and ragweed allergen in the early 1990s. Further prospective immunologic and environmental studies are recommended for proper interpretation of the changes in skin reactivity.

A study of total eosinophil count, total IgE concentration and sensitization of house dust mite allergens as atopic parameters in recurrent wheezing infants / 천식및알레르기

BACKGROUND: Recurrent wheezing is probably related to airway hyperresponsiveness. Many young infants wheeze during viral lower respiratory tract infections, but the pathogenesis of these episodes and their relation to the development of asthma or other allergic disease later in life are not well understood. Whether environmental allergen exposure affects the inception of asthma remains to be determined. OBJECTIVE: We performed this study to determine whether recurrent wheezing in infancy is related to atopy and if so, when infantile asthmatics become sensitized to house dust mite allergens. METHODS: In a cross-sectional study, we investigated the factors related to recurrent wheezing before the age of three. A total of 119 infants were selected for this study and they were divided into two groups : 88 infants who experienced wheezing episodes more than three times before the age of two as infantile asthmatics, and 31 infants who had never experienced wheezing before visiting our hospital between January 1998 and July 1999. For these subjects, we performed assessments including measurement of peripheral total eosinophil counts, serum total IgE levels, specific IgE levels (Dermatophagoides pteronyssinus, Dermatophagoides farinae and food allergens) and questionnaires were completed by the children's parents. RESULTS: The group who experienced recurrent wheezing showed significantly higher total eosinophil counts, serum concentrations of total IgE, D.p- and D.f-specific IgE than controls (p<0.05). There were no significant differences in the history of respiratory disease, familial history of allergic disease and environmental factors(domestic animals, bed cloth, carpet, smoking etc) between the group with recurrent wheezing and controls. The group who experienced recurrent wheezing showed significantly higher total eosinophil counts among those over 12 months old, and serum concentration of total IgE among those under 12 months old than controls(p<0.05). The concentration of D.p-specific IgE, but not D.f-specific IgE, in the recurrent wheezing group was higher than controls who were aged over 24 months(p<0.05). CONCLUSION: The infants with recurrent wheezing are strongly related to a predisposition to atopy. Eosinophilia is one of the important markers of recurrent wheezing. The period of sen- sitization of inhalant allergens like a D.p occurs as early as 24 months old. These findings suggest that early recognition of atopy and environmental controls are important to manage re- current wheezing in infants.