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In the (Sub)Tropics Allergic Rhinitis and Its Impact on Asthma Classification of Allergic Rhinitis is More Useful than Perennial–Seasonal Classification

2014; SAGE Publishing; Volume: 28; Issue: 3 Linguagem: Inglês

10.2500/ajra.2014.28.4035

1945-8924

Désirée Larenas‐Linnemann, Alexandra Michels, Hanna Dinger, Alfredo Arias‐Cruz, Marichuy Ambriz Moreno, Martín Bedolla‐Barajas, R Cerino Javier, María de la Luz Cid del Prado, Manuel Alejandro Cruz Moreno, Laura Diego Vergara, Roberto García-Almaráz, Cecilia Yvonne García-Cobas, Daniel Alberto García Imperial, Rosa Garcia Muñoz, Dante Hernández Colín, Francisco Javier Linares Zapién, Jorge A. Luna‐Pech, Juan José Matta Campos, Norma Martínez Jiménez, M.M. Avalos, Alejandra Medina Hernández, Albero Monteverde Maldonado, Doris Nereida López, Luis Julian Pizano Nazara, Emanuel Ramirez Sanchez, José Domingo Ramos López, Noel Rodríguez‐Pérez, Pablo Gabriel Rodríguez Ortiz, Kija Shah‐Hosseini, Ralph Mösges,

Dermatology and Skin Diseases

Background Two different allergic rhinitis (AR) symptom phenotype classifications exist. Treatment recommendations are based on intermittent–persistent (INT-PER) cataloging, but clinical trials still use the former seasonal AR–perennial AR (SAR-PAR) classification. This study was designed to describe how INT-PER, mild–moderate/severe and SAR-PAR of patients seen by allergists are distributed over the different climate zones in a (subtropical country and how these phenotypes relate to allergen sensitization patterns. Methods Six climate zones throughout Mexico were determined, based on National Geographic Institute (Instituto Nacional de Estadística y Geografía) data. Subsequent AR patients (2–68 years old) underwent a blinded, standardized skin-prick test and filled out a validated questionnaire phenotyping AR. Results Five hundred twenty-nine subjects participated in this study. In the tropical zone with 87% house-dust mite sensitization, INT (80.9%; p < 0.001) and PAR (91%; p = 0.04) were more frequent than in the subtropics. In the central high-pollen areas, there was less moderate/severe AR (65.5%; p < 0.005). Frequency of comorbid asthma showed a clear no -south gradient, from 25% in the dry north to 59% in the tropics (p < 0.005). No differences exist in AR cataloging among patients with different sensitization patterns, with two minor exceptions (more PER in tree sensitized and more PAR in mold positives; p < 0.05). Conclusion In a (sub)tropical country the SAR-PAR classification seems of limited value and bears poor relation with the INT-PER classification. INT is more frequent in the tropical zone. Because PER has been shown to relate to AR severity, clinical trials should select patients based on INT-PER combined with the severity cataloging because these make for a better treatment guide than SAR-PAR.