[Choosing the best panel of aeroallergen prick-tests for patients in Lebanon with rhinitis and asthma: A retrospective study of 2350 patients]

Respiratory allergies: Salicaceae sensitization (Review)

Seasonal allergic rhinitis (SAR) is one of the most frequent chronic conditions of the modern world. Pollen carried by the wind from pollinated trees is a major source of SAR. Betulaceae, Oleaceae and Platanus are the most important sources of airway sensitization with regard to tree pollen and, therefore, they are included in the official recommendations of skin prick testing by different official societies. Salicaceae pollen is a moderate source of pollen sensitization. Conversely, large areas are covered with poplars and willows around the world. A number of studies from many countries showed that in some particular situations (large and compacted areas covered by Salicaceae, weather conditions, air pollution, urban ornamental vegetation), poplar and willow pollens may become of local importance in producing SAR. The aim of this review was to present a synthesis of information regarding Salicaceae pollen allergy showing that, if various unfavorable aspects are brought together, a minor problem (Salicaceae sensitization) can became a public health problem.

Aeroallergen sensitization in Lebanese asthmatic children: the results of a cohort national study

Atopic asthma is characterized by the presence of sensitization to common aeroallergens, which tends to have a worse prognosis than non-atopic asthma. The objectives were to determine the prevalence of aeroallergens sensitization in the Lebanese pediatric asthmatic population and determine the relationship between allergens sensitization (indoor and outdoor) and age, area of residence and altitude. A sample, consisting of 919 asthmatic children (aged 1 to 18 years, from 2010 until 2017), underwent skin prick testing (SPT) with 21 common allergens: 5 grasses (cocksfoot, sweet vernal-grass, rye-grass, meadow grass, timothy), Parietaria, olive, Dermatophagoides pteronyssinus and Dermatophagoides farina (DP-DF), dog and cat dander, Alternaria longipens, Aspergillus fumigatus and nidulans, Cupressaceae, pine, German cockroach, and 4 cereals (oat, wheat, barley, maize). Seven hundred fifty-two patients had positive SPT. The distribution of sensitization was as follows: DP-DF 59%; 5 grasses 34%; 4 cereals 33.9%; cat 29.9%; Alternaria 27.9%; Parietaria 23%; dog 21.9%; olive 20.5%; Aspergillus mix 18.6%; Cupressaceae 18.2%; pine 17%; cockroach 15.3%. House dust mites sensitization was frequent at lower altitude (< 900 m) (56.3%) and in the whole country (a median prevalence of 53.05%) except for the Beqaa region (negative HDM in 82.4%). Non-atopic asthma was more frequent in early childhood (40.5% at 1-4 years vs 11.2% at 11-18 years). The sensitization rate increased with age, starting at 5 years. Higher age (aOR = 1.24) and altitude less than 900 m compared with ≥ 900 m (aOR = 2.03) were significantly associated with the presence of aeroallergens in children. House dust mites and grasses are the most common allergens in Lebanese asthmatic children. Non-atopic asthma is more frequent at early age. Lebanese children with asthma showed a polysensitized pattern starting at 5 years.

Evaluation of allergic sensitization in Lebanese patients with allergic conjunctivitis

PURPOSE

To describe the profile of patients with allergic conjunctivitis (AC) regarding their demographics, symptomatology and specific allergen sensitization, in a Lebanese tertiary hospital.

METHODS

Cross-sectional study conducted at the Hôtel-Dieu de France hospital (Beirut, Lebanon) during a period of 18 months. Patients with seasonal or perennial AC presenting for ophthalmic consultation had measurements of total and specific IgE. A matching group of patients with AC seen at the allergist office during the same period underwent skin prick tests (SPTs).

RESULTS

Forty-four patients were enrolled for blood work by their ophthalmologists. Seasonal and perennial forms were almost equivalent. In total, 56.8% had positive specific IgE, with higher prevalence in patients with seasonal AC (p = 0.002), other associated allergies particularly allergic rhinitis (p = 0.002) or a family history of allergy (p = 0.005). Ocular surface severity scales were not shown as predictors. High levels of total IgE were commonly detected in those with positive specific IgE. Thirty-eight patients were assessed with SPT, and all had a positive result for at least one allergen. Dust mites were found to be the most frequent allergens based upon both specific IgE (72%) and SPT (92%), followed by Parietaria and other pollens.

CONCLUSION

In our study, dust mites mono- or co-sensitization is present in the majority of patients with AC, with odds of positivity being higher using SPT than specific IgE. The latter are found more readily in seasonal AC and in the presence of personal and family history of allergy.

[Skin sensitisation profiles to inhalant allergens for patients in Tétouan city (North West of Morocco)]

The prevalence of respiratory allergies is increasing and is a serious global health problem. The objective of the study was to determine the prevalence of skin sensitization to inhalant allergens in patients consulting for respiratory allergy, to identify the main allergens involved and to evaluate the profile of skin prick-test reactivity related to sex, age and season. This retrospective study included 379 patients consulting during 2009-2012 in three private medical offices of Tetouan. Of the 379 patients, 39.6% were monosensitized and 60.4% polysensitized. The percentages of polysensitized patients were higher in patients exhibiting rhinoconjunctivitis and astma-rhinoconjunctivitis than in subjects with asthma. The prevalence of symptoms according to sex showed no significant difference (P=0.64). Regarding age, a significant difference was observed in the case of rhinoconjunctivitis (P<0.01), while asthma and asthma-rhinoconjunctivitis showed no significant difference. Sensitization to house dust mites was the most frequent followed by grasses, olives and Parietaria. The multiple correspondence analyses (ACM) showed that patients under 20-years of age with asthma and asthma-rhinoconjunctivitis profile are more associated with sensitization to mites during the spring and autumn. The 20-49-year age group was represented mainly by polysensitized patients with rhinoconjunctivitis. Sensitization to mites ranks first in Tetouan followed by the percentage of sensitized patients to grass pollen and olive. The ACM showed that the house dust mite asthma seems to affect more children and adolescents while the 20-49 year age of polysensitized group suffers significantly rhinoconjunctivitis.