Open AccessAllergen sensitization linked to climate and age, not to intermittent‐persistent rhinitis in a cross‐sectional cohort study in the (sub)tropics
Author(s) -
LarenasLinnemann Désirée,
Michels Alexandra,
Dinger Hanna,
ShahHosseini Kijawasch,
Mösges Ralph,
AriasCruz Alfredo,
AmbrizMoreno Marichuy,
Barajas Martín Bedolla,
Javier Ruth Cerino,
Prado María,
Moreno Manuel Alejandro Cruz,
Almaráz Roberto García,
GarcíaCobas Cecilia Y,
Garcia Imperial Daniel A,
Muñoz Rosa Garcia,
HernándezColín Dante,
LinaresZapien Francisco J,
LunaPech Jorge A,
MattaCampos Juan J,
Jiménez Norma Martinez,
MedinaÁvalos Miguel A,
Hernández Alejandra Medina,
Maldonado Alberto Monteverde,
López Doris N,
Pizano Nazara Luis J,
Sanchez Emmanuel Ramirez,
RamosLópez José D,
RodríguezPérez Noel,
RodríguezOrtiz Pablo G
Publication year - 2014
Publication title -
clinical and translational allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.979
H-Index - 37
ISSN - 2045-7022
DOI - 10.1186/2045-7022-4-20
Subject(s) - sensitization , medicine , allergy , airborne allergen , allergen , asthma , pollen , cross sectional study , immunology , tropical climate , house dust mite , pathology , biology , ecology
Background Allergen exposure leads to allergen sensitization in susceptible individuals and this might influence allergic rhinitis (AR) phenotype expression. We investigated whether sensitization patterns vary in a country with subtropical and tropical regions and if sensitization patterns relate to AR phenotypes or age. Methods In a national, cross‐sectional study AR patients (2‐70 y) seen by allergists underwent blinded skin prick testing with a panel of 18 allergens and completed a validated questionnaire on AR phenotypes. Results 628 patients were recruited. The major sensitizing allergen was house dust mite (HDM) (56%), followed by Bermuda grass (26%), ash (24%), oak (23%) and mesquite (21%) pollen, cat (22%) and cockroach (21%). Patients living in the tropical region were almost exclusively sensitized to HDM (87%). In the central agricultural zones sensitization is primarily to grass and tree pollen. Nationwide, most study subjects had perennial (82.2%), intermittent (56.5%) and moderate‐severe (84.7%) AR. Sensitization was not related to the intermittent‐persistent AR classification or to AR severity; seasonal AR was associated with tree (p < 0.05) and grass pollen sensitization (p < 0.01). HDM sensitization was more frequent in children (0‐11 y) and adolescents (12‐17 y) (subtropical region: p < 0.0005; tropical region p < 0.05), but pollen sensitization becomes more important in the adult patients visiting allergists (Adults vs children + adolescents for tree pollen: p < 0.0001, weeds: p < 0.0005). Conclusions In a country with (sub)tropical climate zones SPT sensitization patterns varied according to climatological zones; they were different from those found in Europe, HDM sensitization far outweighing pollen allergies and Bermuda grass and Ash pollen being the main grass and tree allergens, respectively. Pollen sensitization was related to SAR, but no relation between sensitization and intermittent‐persistent AR or AR severity could be detected. Sensitization patterns vary with age (child HDM, adult pollen). Clinical implications of our findings are dual: only a few allergens –some region specific‐ cover the majority of sensitizations in (sub)tropical climate zones. This is of major importance for allergen manufacturers and immunotherapy planning. Secondly, patient selection in clinical trials should be based on the intermittent‐persistent and severity classifications, rather than on the seasonal‐perennial AR subtypes, especially when conducted in (sub)tropical countries.