Characteristics of Sensitization to Inhalant and Food Allergens

George Ch. Christoff^{1, 2,} and Emilia G. Karova³

¹Faculty of Public Health, Department of Health Economics, Medical University, Sofia, Bulgaria

²Allergy outpatient clinic. Tokuda Medical Centre, Sofia, Bulgaria

³Faculty of Dental Medicine, Department of Conservative Dentistry, Medical University, Sofia, Bulgaria

Cite this paper

George Ch. Christoff and Emilia G. Karova. Characteristics of Sensitization to Inhalant and Food Allergens. American Journal of Clinical Medicine Research. 2014; 2(3):61-67. doi: 10.12691/AJCMR-2-3-3

Abstract

Background: Many studies worldwide have reported prevalence of atopic sensitization and its international variations. A positive skin prick reaction, however, does not always correlate with clinical symptoms. Positive skin tests (SPT) reveal rather atopy - specific IgE presence, than an atopic disease itself. When combined clinical manifestation and SPT are a powerful instrument for defining allergic diseases. Such data for Bulgaria are, however, scarce. The objective of the present study is to assess prevalence patterns and clinical relevance of sensitization to environmental and food allergens in a cross-sectional community sample in Bulgaria. Methodology and results: Patients, 225 men and women, age 4-81 years, were included. They completed a questionnaire to define asthma and rhinitis. Patients were skin prick tested to 18 commercial inhalant and food allergen extracts. The clinical relevance of each of the positively tested allergens was assessed. Among 225 patients 129 (57.3%) were sensitized to at least one allergen, using cut-off level ≥3 mm. In the inhalant allergens group the highest were rates of sensitization to 12 grasses – 26.6% and 4 cereals – 24.0%, followed by these to DFR – 18.2%, DPT – 17.8% and cockroach -16.4%. Among food allergens the highest rates of sensitizations were found to pork – 16.9%, walnut – 15.1%, apple – 13.3%, egg whole – 10.7%, celery – 9.8% and milk – 9.3%. The highest proportions of relevant tests in the inhalant allergens group were for DPT - 72.2%, DFR - 62.9%, 4 cereals - 69.2%, 12 grasses - 69%, Penicillium mix – 61.9, cockroach - 54.8%, Betulaceae - 52.4%. Among food allergens the highest proportions of relevant sensitization were found for walnut – 32.3%, peanut 29.4%, Milk - 22.2%, egg whole - 21.1%. Conclusions: We found rates and patterns of sensitization which were in line with data from other studies. The percentage of clinically relevant sensitizations differed significantly depending on the allergen.

Keywords

prevalence, clinical relevance, sensitization, atopy, inhalant allergens, food allergens

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]	Arbes SJ, Gergen PJ, Vaughn B, Zeldin DC. “Asthma cases attributable to atopy: results from the Third National Health and Nutrition Examination Survey”. J Allergy Clin Immunol. 120 (5): 1139-45, November 2007.
[2]	Arbes, S J “Prevalences of positive skin test responses to10 common allergens in the US population: Results from the Third National Health and Nutrition Examination Survey.” J Allergy Clin Immunol, 116 (2): 377-83, August 2005.
[3]	Arshad SH, Kurukulaaratchy RJ, Fenn M, Matthews S. “Early life risk factors for current wheeze, asthma, and bronchial hyperresponsiveness at 10 years of age.” Chest; 127 (2): 502-508. February 2005.
[4]	Blomme K1, Tomassen P, Lapeere H, Huvenne W, Bonny M, Acke F, Bachert C, Gevaert P. “Prevalence of allergic sensitization versus allergic rhinitis symptoms in an unselected population.” Int Arch Allergy Immunol, 160 (2): 200-7, January 2013.
[5]	Bousquet J., Khaltaev N., Cruz A. A. et al. Allergic Rhinitis and its Impact on Asthma (ARIA). Allergy 63 (s86): 7-160, April 2008.
[6]	Bousquet, J. et al. “Practical guide to skin prick tests in allergy to aeroallergens.” Allergy, 67 (1): 18-24 January 2012
[7]	Bousquet, P.-J. et al. “GA2LEN skin test study III: Minimum battery of test inhalant allergens needed in epidemiological studies in patients.” Allergy 64 (11): 1656-1662, November 2009.
[8]	Burbach, G. J. et al. “GA2LEN skin test study II: clinical relevance of inhalant allergen sensitizations in Europe.” Allergy, 64 (11): 1507-1515, November, 2009.
[9]	Burney PGJ, Potts J, Kummeling I, Mills ENC, Clausen M, Dubakiene R, Barreales L, Fernandez-Perez C, Fernandez-Rivas M, Le T-M, Knulst AC, Kowalski ML et al. “The prevalence and distribution of food sensitization in European adults.” Allergy, 69 (3): 365-37, March 2014.
[10]	Eigenmann PA, Atanaskovic-Markovic M, O’B Hourihane J, et al. “Testing children for allergies: why, how, who and when.” Pediatr Allergy Immunol 24 (2): 195-209, March 2013.
[11]	Finnbogadottir AF, Ardal B, Eiriksson H, et al. “A long-term follow-up of allergic diseases in Iceland.” Pediatr Allergy Immunol 23 (2): 181-5, March 2012.
[12]	Heinzerling, L. et al. “The skin prick test-European standards.” Clinical and Translational Allergy 3: 3, February 2013
[13]	Heinzerling, L. M. et al, “GA2LEN skin test study I: GA2LEN harmonization of skin prick testing: novel sensitization patterns for inhalant allergens in Europe.” Allergy, 64 (10): 1498-1506, October 2009.
[14]	Heinzerling, L. “Standard skin prick testing and sensitization to inhalant allergens. across Europe-a survey from the GA2LEN network.” Allergy 60 (10): 1287-1300, October 2005.
[15]	Hoffmann-Petersen, B. et al. “Prevalence of IgE sensitization in Danish children with suspected asthma.” Pediatr Allergy Immunol, 24 (8): 727-733, December 2013.
[16]	Lau S, Illi S, Sommerfeld C, et al. “Early exposure to house-dust mite and cat allergens and development of childhood asthma: a cohort study.” Multicentre Allergy Study Group. Lancet: 356 (9239): 1392-7, October 2000.
[17]	Lazic1 N., Roberts G, Custovic, “A. Multiple atopy phenotypes and their associations with asthma: similar findings from two birth cohorts.” Allergy 68 (6): 764-70. June 2013.
[18]	Nissen, S. P et al. “The natural course of sensitization and allergic diseases from childhood to adulthood.” Pediatr Allergy Immunol, 24 (6): 540-548, September 2013.
[19]	Nwaru, B. I. et al. “The epidemiology of food allergy in Europe: a systematic review and meta-analysi” s. Allergy 69 (1): 62-75, January 2014.
[20]	Ronchetti R, Haluszka J, Martella S, Falasca C, Guglielmi F, Parmiani S et al. “Skin reactivity to histamine and to allergens in unselected 9-year-old children living in Poland and Italy.” Pediatr Allergy Immunol 14 (3): 201-206, June 2003.
[21]	Scott H. Sicherer, MD, and Hugh A. Sampson, MD. “Food allergy: Epidemiology, pathogenesis, diagnosis, and treatment.” J Allergy Clin Immunol 133 (2): 291-307 February 2014.
[22]	Sears MR, Greene JM, Willan AR, et al. “A longitudinal, population-based, cohort study of childhood asthma followed to adulthood.” N Engl J Med, 349 (15): 1414-22, October 2003.
[23]	Sly PD, et al. “Early identification of atopy in the prediction of persistent asthma in children.” Lancet 372 (9643): 1100-1106. September 2008.
[24]	Worldwide variation in prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema: “ISAAC. The International Study of Asthma and Allergies in Childhood (ISAAC) Steering Committee.” Lancet 351 (9111): 1225-1232, April 1998.
[25]	Zureik M, Neukirch C, Leynaert B, Liard R, Bousquet J, Neukirch F. “Sensitisation to airborne moulds and severity of asthma: cross sectional study from European Community respiratory health survey”. BMJ 325 (7361): 411-414, August 2002.