The sensitization pattern differs according to rhinitis and asthma multimorbidity in adults: the EGEA study (original) (raw)
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Allergy, 2018
Background: Children with multimorbid asthma and rhinitis show IgE polysensitization to several allergen sources. This association remain poorly studied in adolescents and adults using defined allergen molecules. We investigated IgE sensitization patterns towards a broad panel of aeroallergen components in adults and adolescents with a focus on individuals with asthma and rhinitis multimorbidity. Methods: IgE reactivity to 64 microarrayed aeroallergen molecules was determined with the MeDALL-chip in samples from the French EGEA study (n=840, age=40.7±17.1) and the Swedish population-based birth cohort BAMSE (n=786, age=16±0.26). The age-and sex-adjusted associations between the number of IgE-reactive allergen molecules (≥0.3 ISU) and the asthma-rhinitis phenotypes were assessed using a negative binomial model. Results: Groups representing four phenotypes were identified: no asthma-no rhinitis (A-R-; 30% in EGEA and 54% in BAMSE), asthma alone (A+R-; 11% and 8%), rhinitis alone (A-R+; 15% and 24%), and asthma-rhinitis (A+R+; 44% and 14%). The numbers of IgE-reactive aeroallergen molecules significantly differed between phenotypes
Vojnosanitetski pregled, 2011
Background/Aim. Asthma is one of the most common chronic pulmonary diseases. The number of asthmatics has been continuously increasing all over the world. Depending on its causing agent, asthma is classified as allergic and nonallergic. Asthma is often associated with other allergic diseases, and it is most commonly preceded by the symptoms of rhinitis. The aim of this study was to establish the type and frequency of allergic sensitization to inhalatory allergens, frequency of concomitant rhinitis, gender and age-related distribution of asthma, and the presence of some risk factors in patients with diagnosed asthma. Methods. This retrospective and partially prospective analysis included 733 patients with asthma diagnosed in the Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica over the period January, 2004-December, 2008. The obtained date were statistically processed. Results. Females were significantly more often affected by asthma (p < 0.05), most frequently at 20-29 years of age. A hereditary predisposition to the diseases in terms of atopy was registered in 34.9% of the examined subjects. Most patients had allergic asthma (79.5%). Sensitization to internal and external inhalatory allergens was verified in 77.5% and 67.6% of the patients respectively, and combined hypersensitivity to both allergen types in 48.8% of the patients. Rhinitis was registered in 63.9% and 28% of the patients with allergic and nonallergic asthma, respectively. Rhinitis symptoms preceded the occurrence of asthma in 60% of the patients, with the precedence of rhinitis ranging from 1 to 27 years. A high correlation between rhinitis and asthma was established for the disease of both allergic (r = 0.92) and nonallergic (r = 0.88) etiology. Conclusion. The majority of the patients have allergic asthma, and they are females at 20-29 years of age. Senstization to internal allergens is most common, and then to external ones. Rhinitis is the most common concomitant disease, usually preceding the occurrence of asthmatic symptoms.
Allergic Sensitization in Rhinitis and Asthma
Primary Care in Practice - Integration is Needed, 2016
Allergic rhinitis (AR) is usually defined as an inflammatory disease of the nasal mucosa induced by an interaction of environmental allergens and IgE in sensitized patients. Its symptoms are sneezing, nasal itching, rhinorrhoea and nasal obstruction. Allergic rhinitis affects approximately 20-30% of the population worldwide and its prevalence is increasing. Isolated AR is rare and it actually has to be considered as a systemic allergic disease, associated to comorbidities, such as conjunctivitis, chronic middle ear effusions, irregular sleep, sinusitis, lymphoid hypertrophy with obstructive sleep apnoea. The most relevant comorbidity is asthma, a heterogeneous disease, usually characterized by chronic airway inflammation in which many cells and cellular elements play an important role. Bronchial asthma is characterized by bronchial hyper-reactivity and symptoms may be triggered or worsened by factors such as viral infections, allergens, tobacco smoke, exercise and stress. A state of "minimal persistent inflammation" is permanently maintained in the lower respiratory tract of asthmatic individuals. The diagnosis of asthma is based on evidence of variable airflow limitation tested with spirometry and a positive bronchodilation reversibility test. Skin prick tests (SPTs) are widely used to demonstrate an immediate IgE-mediated allergic reaction. They represent a major diagnostic tool in the field of allergy. Skin prick tests have a high specificity and sensitivity for the diagnosis of inhalant allergens. Immunotherapy (AIT) for allergic diseases has entered in a new age characterized by the development of a few innovative therapeutic classes of standardized allergen formulations registered. Clinical randomized trials have demonstrated the efficacy of AIT in allergic rhinitis in children and in adults, expressed in terms of reduction of symptom score and use of rescue medication. The efficacy is confirmed both for subcutaneous (SCIT) and sublingual (SLIT) immunotherapy in adults and in pediatric patients. The long lasting effect of AIT after its discontinuation is an important added value of this therapy. Controlled studies are available, where the carry-over effect of AIT is demonstrated for two years after discontinuance. The capacity to prevent new sensitizations, and to modify the evolution of the disease from the rhinitis to asthma are two important features of AIT. Allergen immunotherapy showed preventive capacity and also a carryover effect once treatment is discontinued.
A Study on Total Serum IgE Levels and Absolute Eosinophil Count in Allergic Rhinitis Patients
Journal of Evolution of Medical and Dental Sciences, 2020
BACKGROUND Allergic rhinitis is an IgE mediated hypersensitivity disease of the mucous membrane of nasal airway characterized by sneezing, itching, watery nasal discharge and sensation of nasal obstruction. METHODS The aim of the study was to evaluate the total serum IgE levels and absolute eosinophil counts in patients with allergic rhinitis, and rhinitis with asthma. In this study, 160 patients of allergic rhinitis attending ENT OPD were clinically examined and investigated with Total Serum IgE levels and absolute eosinophil counts. Statistical analysis was done using SPSS software. RESULTS 160 study subjects with signs and symptoms of allergic rhinitis were investigated with total serum IgE levels and absolute eosinophil count. 46.25% were males and 53.75% were females. The patients included in the study were aged 10-60 years. Seasonal symptoms were observed in 44% of patients while perennial symptoms were experienced by 56% of the patients. As per ARIA classification, 66.3% had mild, 6.9% had moderate and 26.9% had severe allergic rhinitis. Bronchial asthma was found to be the most common comorbidity present in 13% of subjects, associated sinonasal polyps which was present in 13.8%. 71.9% had raised Total Serum IgE levels and eosinophilia was present in 59.4%. A significant relationship exists between total IgE levels and eosinophilia in patients with allergic rhinitis. CONCLUSIONS Allergic rhinitis is an IgE mediated inflammatory disease and raised total serum IgE levels and raised absolute eosinophil count in study subjects with clinical signs and symptoms of rhinitis are likely to correlate with allergic aetiology.
World Allergy Organization Journal, 2007
Background: The aim is the comparison of a frequency of positive skin prick test for cat allergen, and the frequency of animal presence at home in various areas of Poland (rural versus urban). The presented data are a part of the earliest outcome of large epidemiological study in the field of allergies which is now run in Poland. Methods: Randomized probe of various polish populations differing in the age range (20Y44 13Y14, 6-7 years old) were included in to the study. Analyzed urban population was gathered in Warsaw (capital of Poland). The second selected region was Zamojszczyzna, being the typical rural area with low industrial density. 3833 respondents completed questionnaires ECRHS II and ISAAC (1596 at urban and 2237 at rural region). 1103 of them were subjected to medical examination directed towards allergy recognition, and had made a skin prick test (474 at the urban and 629 at rural region). Results: 65,5% of persons from urban area revealed the positive skin results (for at least one allergen), while of the rural one the prevalence was significantly lower and equal to 34,5% (p = 0.0001). An frequency of positive cat prick test is significantly higher for urban region when compared to the rural region (18,4% vs. 10.8), and the intensity of the reaction measured as the average diameter of the observed skin prick test bubble is also significantly higher (4,01 vs. 3,63 mm). It was found that a significant difference between urban and rural areas was observed for the cat frequency of presence at home 15% vs. 30%. This data can be also compared with the general frequency of the cat presence in the home and surrounding. For rural areas cat is present in about 59.8% of homes and surroundings, while in urban areas cat is present in 15.4% of homes and surroundings. About 50% of people with positive skin tests for cat have cat at home. In urban area these values are significantly lower and equal to 19.5%. Conclusion: For cat allergies one can observe that frequency of positive skin prick test is higher on the urban region than on the rural region, contrastively to the lower presence of the animal allergy sources. Additionally the frequency of cat presence in homes of sensitive persons is much higher in rural areas than in urban ones. This observation can lead to the conclusion of protective, immunotherapeutic role of the high environmental allergen concentration in rural region.
Allergy, 2002
Background: It has been hypothesized that allergic rhinitis and allergic asthma are manifestations of the same disease entity. We aimed to investigate the relationship between allergic rhinitis and allergic asthma. Methods: Participants in a population-based study of 15-69-year-olds in 1990 were invited to a follow-up in 1998. A total of 734 subjects were examined on two occasions eight years apart. Allergic rhinitis to pollen was defined as a history of nasal symptoms on exposure to pollens and IgE specific to pollen. Allergic asthma to pollen was defined as a history of lower airway symptoms on exposure to pollens and IgE specific to pollen. Similarly, diagnoses of allergic rhinitis and allergic asthma to animals or mite were defined. Results: At follow-up, all subjects with allergic asthma to pollen (n=52) had in addition allergic rhinitis to pollen. In the longitudinal analysis, there were a total of 28 new (incident) cases of allergic asthma to pollen. They all had allergic rhinitis to pollen at baseline, or had developed allergic rhinitis to pollen at followup. Accordingly, allergic rhinitis to animals and mite were ubiquitous in subjects with allergic asthma to animals and mite, respectively. Conclusions: he results support the hypothesis that allergic rhinitis and allergic asthma are manifestations of the same disease entity.
Clinical and Translational Allergy, 2021
Background: Allergic rhinitis (AR), allergic conjunctivitis (AC), and asthma composing multiple phenotypes and improved understanding of these phenotypes and their respective risk factors are needed. Objectives: The objective of this study was to define the prevalence of AR, AC, and asthma and their association with allergen-specific immunoglobulin E (sIgE) sensitization in a large cohort of blood donors and identify risk factors. Methods: From the nationwide population-based Danish Blood Donor Study, 52,976 participants completed an electronic questionnaire including AR, AC, asthma, allergic predisposition, and childhood residence. Of these, 25,257 were additionally tested for sIgE to inhalation allergens (Phadiatop). This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Characteristics of patients with allergic polysensitization: the POLISMAIL study
European annals of allergy and clinical immunology, 2008
The natural history of respiratory allergy is commonly characterized by a worsening of symptom severity, frequent comorbidity of rhinitis and asthma, and polysensitization to aeroallergens. The polysensitization phenomenon starts since childhood and is rare to find monosensitized adult patients. However, there are few studies investigating the characteristics of polysensitized patients. This study was performed on a large cohort of patients with allergic rhinitis (assessed by ARIA criteria) and/or mild to moderate asthma (assessed by GINA). The kind and the number of sensitizations, their patterns, and the relation with quality of life (QoL) measured by the Juniper's RQLQ guestionnaire, were evaluated. Globally 418 patients (50.2% males, 49.8% females, mean age 26.4 years, range 3.5-65 years, 64 smokers, 371 non-smokers) were enrolled: 220 had allergic rhinitis alone, and 198 allergic rhinitis and asthma. The mean number ofsensitizations was 2.6. Three hundred-five patients (73%...
Clinical <html_ent glyph="@amp;" ascii="&"/> Experimental Allergy, 2000
Background We investigated whether the association of allergy symptoms with sensitization to inhalant allergens depends on bronchial hyperresponsiveness, blood eosinophil count, or the degree and nature of sensitization. Methods Data on asthma and rhino-conjunctivitis symptoms were obtained from 1904 subjects from a random sample of the Dutch population, aged 20±70 years by the ECRHS questionnaire. Total IgE and speci®c IgE to four inhalant allergens were measured using CAP System. Bronchial hyperresponsiveness (BHR) was de®ned as PD 20 # 2 mg methacholine and`high eosinophil count' as an eosinophil count in the highest quartile. Results Forty-three percent of the subjects with speci®c IgE to inhalant allergens was asymptomatic. These subjects had a lower degree of sensitization than symptomatic sensitized subjects and had`normal' prevalences of BHR and`high eosinophil count'. Logistic regression showed that the presence of BHR increased the risk of having symptoms for subjects who were sensitized to indoor allergens. Low levels of speci®c IgE to indoor allergens were only associated with symptoms when BHR was present. Sensitization to outdoor allergens was associated with symptoms at all levels of speci®c IgE, independently of BHR or eosinophils. Conclusion Our epidemiological data suggest that whether low levels of speci®c IgE to indoor allergens lead to allergic symptoms is probably determined by the concurrent existence of in¯ammation of the airways.