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Allergen sensitization linked to climate and age, not to intermittent‐persistent rhinitis in a cross‐sectional cohort study in the (sub)tropics

2014; Springer Science+Business Media; Volume: 4; Issue: 1 Linguagem: Inglês

10.1186/2045-7022-4-20

2045-7022

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

Dermatology and Skin Diseases

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.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.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).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.