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

ABSTRACT

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.