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Dimou MV, Xepapadaki P, Lakoumentas J, Mageiros L, Aggelidis X, Antonopoulou M, Bakakos P, Βotskariova S, Chliveros K, Chrysoulakis S, Dimas D, Douladiris N, Gaga M, Grigoreas C, Kalogiros L, Katotomichelakis M, Kompoti E, Constantinidis J, Koutsogianni Z, Loukides S, Makris M, Manousakis E, Marangoudakis P, Marmara M, Mikos N, Mitsakou P, Mitsias D, Pagalos A, Papanikolaou V, Paraskevopoulos I, Pitsios C, Psarros F, Rovina N, Samitas K, Stefanaki E, Vallianatou M, Vourdas D, Tsiligianni I, Bousquet J, Papadopoulos NG. Levels of IgE sensitization drive symptom thresholds in allergic rhinitis. Ann Allergy Asthma Immunol 2024; 133:177-185.e10. [PMID: 38679157 DOI: 10.1016/j.anai.2024.04.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 04/20/2024] [Accepted: 04/23/2024] [Indexed: 05/01/2024]
Abstract
BACKGROUND Allergic rhinitis (AR) is a common respiratory disease encompassing a variety of phenotypes. Patients can be sensitized to 1 or more allergens. There are indications that polysensitization is associated with more severe disease. However, the extent to which the level of sensitization is associated with clinical disease variability, underlying the distinct nature of AR from AR+ conjunctivitis or AR+ asthma, is not known. OBJECTIVE To evaluate phenotypical differences between monosensitized and polysensitized patients with AR and to quantify their symptomatic variability. METHODS A total of 565 patients with a confirmed diagnosis of AR were included in this cross-sectional study. Of those, 155 were monosensitized and 410 were polysensitized. Interactions between sensitization levels and the reporting of different symptoms of AR and co-morbidities, disease duration, and impact were assessed. Furthermore, patients were stratified into monosensitized, oligosensitized, and polysensitized to assess whether the effect of sensitization on the phenotype was ranked. RESULTS Polysensitized patients reported itchy eyes significantly more often (P = .001) and had a higher number of ocular (P = .005), itch-related (P = .036), and total symptoms (P = .007) than monosensitized patients. In addition, polysensitized adults and children more often reported wheeze (P = .015) and throat-clearing (P = .04), respectively. Polysensitization was associated with more burdensome AR based on a visual analog scale (P = .005). Increased sensitization level was reflected in more itchy eyes, a higher number of ocular, itch-related, and total number of symptoms, and disease burden. CONCLUSION With an increasing number of sensitizations, patients with AR experience an increased diversity of symptoms. Multimorbidity-related symptoms increase with sensitization rank, suggesting organ-specific thresholds.
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Affiliation(s)
- Maria V Dimou
- Allergy Department, Second Pediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
| | - Paraskevi Xepapadaki
- Allergy Department, Second Pediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
| | - John Lakoumentas
- Allergy Department, Second Pediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
| | - Leonardos Mageiros
- Allergy Department, Second Pediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
| | - Xenophon Aggelidis
- D. Kalogeromitros Allergy Unit, Second Department of Dermatology and Venereology, University General Hospital, National University of Athens Medical School, Attiko, Athens, Greece
| | | | - Petros Bakakos
- First Department of Respiratory Medicine, Medical School, Sotiria Regional Chest Diseases Hospital, National Kapodistrian University of Athens, Athens, Greece
| | - Sophia Βotskariova
- Allergy Department, Second Pediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
| | | | | | - Dionysios Dimas
- General Practitioner, Health Centre of Chalastra, Tessaloniki, Greece
| | - Nikolaos Douladiris
- Allergy Department, Second Pediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
| | - Mina Gaga
- Αsthma Center, Athens Chest Hospital, Sotiria, Athens, Greece
| | - Christos Grigoreas
- Former President of Hellenic Society of Allergology and Clinical Immunology
| | | | | | - Evangelia Kompoti
- Department of Allergology and Clinical Immunology, Laikon General Hospital, Athens, Greece
| | - Jannis Constantinidis
- First Academic Otorhinolaryngology Department, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Stelios Loukides
- Second Respiratory Department, Attiko University Hospital, University of Athens Medical School, Athens, Greece
| | - Michael Makris
- D. Kalogeromitros Allergy Unit, Second Department of Dermatology and Venereology, University General Hospital, National University of Athens Medical School, Attiko, Athens, Greece
| | - Emmanouil Manousakis
- Allergy Department, Second Pediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
| | - Pavlos Marangoudakis
- Second Otorhinolaryngology Clinic, Attiko University General Hospital, National University of Athens Medical School, Athens, Greece
| | | | - Nikolaos Mikos
- Department of Allergology and Clinical Immunology, Laikon General Hospital, Athens, Greece
| | | | - Dimitrios Mitsias
- Allergy Department, Second Pediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
| | - Aris Pagalos
- Private Otorhinolaryngologist, Agios Nikolaos, Crete, Greece
| | | | | | | | | | - Nikoletta Rovina
- First Department of Respiratory Medicine, Medical School, Sotiria Regional Chest Diseases Hospital, National Kapodistrian University of Athens, Athens, Greece
| | | | | | - Mina Vallianatou
- Allergy Department, Second Pediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Ioanna Tsiligianni
- Department of Social Medicine, University of Crete, Heraklion, Crete, Greece
| | - Jean Bousquet
- Montpellier University Hospital, Montpellier, France; MACVIA-France, Contre les Maladies Chroniques pour un Vieillissement Actif en France, European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France. INSERM, U1168, Ageing and Chronic Diseases Epidemiological and Public Health Approaches, CHRU Arnaud de Villeneuve, Villejuif, France
| | - Nikolaos G Papadopoulos
- Allergy Department, Second Pediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece.
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Czolk R, Ruiz‐Castell M, Hunewald O, Wanniang N, Le Coroller G, Hilger C, Vaillant M, Fagherazzi G, Morel‐Codreanu F, Ollert M, Kuehn A. Novel, computational IgE-clustering in a population-based cross-sectional study: Mapping the allergy burden. Clin Transl Allergy 2023; 13:e12292. [PMID: 37746799 PMCID: PMC10478827 DOI: 10.1002/clt2.12292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 07/12/2023] [Accepted: 07/27/2023] [Indexed: 09/26/2023] Open
Abstract
BACKGROUND Even though the prevalence of allergies is increasing, population-based data are still scarce. As a read-out for chronic inflammatory information, new methods are needed to integrate individual biological measurements and lifestyle parameters to mitigate the consequences and costs of allergic burden for society. METHODS More than 480.000 data points were collected from 1462 Luxembourg adults during the representative, cross-sectional European Health Examination Survey, spanning health and lifestyle reports. Deep IgE-profiles based on unsupervised clustering were correlated with data of the health survey. FINDINGS 42.6% of the participants reported a physician-diagnosed allergy and 44% were found to be IgE-positive to at least one allergen or extract. The main sensitization sources were tree pollens followed by grass pollens and mites (52.4%, 51.8% and 40.3% of sensitized participants respectively), suggesting seasonal as well as perennial burden. The youngest group of participants (25-34 years old) showed the highest burden of sensitization, with 18.2% of them having IgE to 10 or more allergen groups. Unsupervised clustering revealed that the biggest cluster of 24.4% of participants was also the one with the highest medical need, marked by their multi-sensitization to respiratory sources. INTERPRETATION Our novel approach to analyzing large biosample datasets together with health information allows the measurement of the chronic inflammatory disease burden in the general population and led to the identification of the most vulnerable groups in need of better medical care.
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Affiliation(s)
- Rebecca Czolk
- Department of Infection and ImmunityLuxembourg Institute of HealthEsch‐sur‐AlzetteLuxembourg
- Faculty of Science, Technology and MedicineUniversity of LuxembourgEsch‐sur‐AlzetteLuxembourg
| | - Maria Ruiz‐Castell
- Epidemiology and Public Health Research UnitDepartment of Precision HealthLuxembourg Institute of HealthStrassenLuxembourg
| | - Oliver Hunewald
- Department of Infection and ImmunityLuxembourg Institute of HealthEsch‐sur‐AlzetteLuxembourg
| | - Naphisabet Wanniang
- Department of Infection and ImmunityLuxembourg Institute of HealthEsch‐sur‐AlzetteLuxembourg
- Faculty of Science, Technology and MedicineUniversity of LuxembourgEsch‐sur‐AlzetteLuxembourg
| | - Gwenaëlle Le Coroller
- Competence Center for Methodology and StatisticsTranslational Medicine Operations HubLuxembourg Institute of HealthStrassenLuxembourg
| | - Christiane Hilger
- Department of Infection and ImmunityLuxembourg Institute of HealthEsch‐sur‐AlzetteLuxembourg
| | - Michel Vaillant
- Competence Center for Methodology and StatisticsTranslational Medicine Operations HubLuxembourg Institute of HealthStrassenLuxembourg
| | - Guy Fagherazzi
- Epidemiology and Public Health Research UnitDepartment of Precision HealthLuxembourg Institute of HealthStrassenLuxembourg
| | - Françoise Morel‐Codreanu
- Department of Allergology and ImmunologyCentre Hospitalier de Luxembourg‐Kanner KlinikLuxembourgLuxembourg
| | - Markus Ollert
- Department of Infection and ImmunityLuxembourg Institute of HealthEsch‐sur‐AlzetteLuxembourg
- Department of Dermatology and Allergy CenterOdense Research Center for AnaphylaxisOdense University HospitalUniversity of Southern DenmarkOdenseDenmark
| | - Annette Kuehn
- Department of Infection and ImmunityLuxembourg Institute of HealthEsch‐sur‐AlzetteLuxembourg
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Beutner C, Wrobel C, Dombrowski T, Beutner D, Forkel S, Buhl T. Inconsistent Skin Prick Tests for Allergy to Birch Homologous Trees May Result from Cross-Reacting Allergens or Technical Errors. Int Arch Allergy Immunol 2023; 184:841-848. [PMID: 37271127 DOI: 10.1159/000530201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 03/15/2023] [Indexed: 06/06/2023] Open
Abstract
INTRODUCTION Skin prick tests (SPTs) are the gold standard for diagnosis of allergic rhinitis (AR). A decrease in the number of allergens included in standard SPT panels has recently been debated - particularly regarding the cross-reacting homologous pollen from birch, alder, and hazel trees - but has not yet been implemented in clinical guidelines. METHODS A subgroup of patients with AR (n = 69) who showed inconsistent SPT results among birch, alder, and hazel was investigated in detail. Beyond SPT, patient workup included assessment of clinical relevance and various serological parameters (total IgE, and specific IgE to birch, alder, and hazel and to Bet v 1, Bet v 2, and Bet v 4). RESULTS More than half the study group had negative SPT results for birch but positive results for alder and/or hazel, and 87% of the study group was polysensitized, showing at least one more positive SPT result for other plants. Whereas 30.4% of patients showed serological sensitization to birch pollen extract, only 18.8% displayed positive specific IgE to Bet v 1. Clinical assessment revealed that most patients with AR were polysensitized and had perennial symptoms or symptoms also occurring during times other than tree flowering times. If the SPT panel is limited to testing birch only, 52.2% of patients in this subgroup would have been overlooked. CONCLUSION Inconsistent SPT results in the birch homologous group may result from cross-reacting allergens or technical errors. If patients report convincing clinical symptoms despite negative results from a reduced SPT panel or inconsistent results for homologous allergens, SPT should be repeated, and molecular markers should be added to achieve a correct diagnosis.
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Affiliation(s)
- Caroline Beutner
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Christian Wrobel
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Göttingen, Göttingen, Germany
| | - Tobias Dombrowski
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Göttingen, Göttingen, Germany
| | - Dirk Beutner
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Göttingen, Göttingen, Germany
| | - Susann Forkel
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Timo Buhl
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
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Farraia M, Mendes FC, Sokhatska O, Severo M, Rufo JC, Barros H, Moreira A. Sensitization trajectories to multiple allergen components in a population-based birth-cohort. Pediatr Allergy Immunol 2023; 34:e13963. [PMID: 37366209 DOI: 10.1111/pai.13963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 04/18/2023] [Accepted: 05/11/2023] [Indexed: 06/28/2023]
Abstract
BACKGROUND The characteristics of allergic sensitization profiles can differ between populations and geographic regions, contributing differently to the association with allergic diseases. Consequently, the sensitization trajectories found in previous studies conducted in Northern Europe may not apply in Southern European countries. OBJECTIVE To identify trajectories of allergic sensitization profiles during childhood and evaluate the association with allergic outcomes, using data from a Portuguese birth cohort. METHODS A random sample from Generation XXI was screened for allergic sensitization at 10 years of age. Among 452 allergic sensitized children, 186 were tested with ImmunoCAP™ ISAC multiplex array that detects 112 molecular components, at three follow-ups (4, 7, and 10 years old). Information on allergic outcomes (asthma, rhinitis, atopic dermatitis) was obtained at the 13-year-old follow-up. Latent class analysis (LCA) was used to identify clusters of participants with similar sensitization profiles. Then, sensitization trajectories were defined based on the most prevalent transitions between clusters over time. Logistic regression was applied to estimate the association between sensitization trajectories and allergic diseases. RESULTS Five trajectories were proposed: "no/few sensitizations," "early persistent house dust mites (HDM)," "early HDM and persistent/late grass pollen," "late grass pollen," and "late HDM." The "early HDM and persistent/late grass pollen" trajectory was associated with rhinitis and "early persistent HDM" with asthma and rhinitis. CONCLUSION Distinct sensitization trajectories pose different risks in the development of allergic diseases. These trajectories present some differences from those in Northern European countries and are important for planning adequate prevention health plans.
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Affiliation(s)
- Mariana Farraia
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Porto, Portugal
- Basic and Clinical Immunology Unit, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Francisca Castro Mendes
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Porto, Portugal
- Basic and Clinical Immunology Unit, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Oksana Sokhatska
- Basic and Clinical Immunology Unit, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Milton Severo
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Porto, Portugal
- Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - João Cavaleiro Rufo
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Porto, Portugal
| | - Henrique Barros
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Porto, Portugal
| | - André Moreira
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Porto, Portugal
- Basic and Clinical Immunology Unit, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal
- Serviço de Imunoalergologia, Centro Hospitalar Universitário São João, Porto, Portugal
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Wang Y, Xiang Z, An M, Jia H, Bu C, Xue Y, Wei Y, Li R, Qi X, Cheng F, Zhao C, Xue J, Yang P. Livin promotes Th2-type immune response in airway allergic diseases. Immunol Res 2022; 70:624-632. [PMID: 35717553 PMCID: PMC9499890 DOI: 10.1007/s12026-022-09294-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 05/16/2022] [Indexed: 11/07/2022]
Abstract
Objectives To investigate the effects of livin on the Th2 immune response in airway allergic diseases (AAD) and explore the interaction among livin, GATA3, IL-4 in peripheral blood CD4+ T cells of AAD patients. Methods WT mice and livin KO mice were developed for model of AAD. Th2 cell levels in the lung tissues and spleen were assessed by flow cytometry. Also, it was assessed in the culture after exposing to livin inhibitor (Lp-15); the protein and mRNA levels of livin, GATA3 and IL-4 in peripheral blood CD4+ T cells isolated from patients with or without AAD were measured by real-time quantitative polymerase chain reaction (RT-qPCR) and Western blotting, respectively. Finally, Co-immunoprecipitation (Co-IP) was employed to identify the interaction between livin and GATA3. Results Compared with WT mouse, Th2 cell frequency in lung tissues and spleen was significantly decreased in livin KO mouse; after adding Lp-15, the differentiation from Naive CD4+T cells in spleen to Th2 cells was blocked; the protein and mRNA levels of livin, GATA3 and IL-4 in AAD group were higher than that in control group. The levels of livin were positively correlated with IL-4, and GATA3 was also positively correlated with IL-4 and livin. GATA3 was detected in the protein complex co-precipitated with livin antibody, and livin was also detected in the protein complex co-precipitated by GATA3 antibody. Conclusion Livin increases the expression of IL-4 and facilitates naive CD4+ T cells to differentiate into Th2 cells, which triggers airway allergy.
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Affiliation(s)
- Yue Wang
- Department of Otolaryngology, Head & Neck Surgery, The Second Clinical Medical College, Shanxi Medical University, Taiyuan, China
| | - Zhiyu Xiang
- Department of Otolaryngology, Head & Neck Surgery, The Second Clinical Medical College, Shanxi Medical University, Taiyuan, China
| | - Miaomiao An
- Department of Otolaryngology, Head & Neck Surgery, The Second Clinical Medical College, Shanxi Medical University, Taiyuan, China
| | - Huijing Jia
- Department of Otolaryngology, Head & Neck Surgery, The Second Clinical Medical College, Shanxi Medical University, Taiyuan, China
| | - Chunyan Bu
- Department of Otolaryngology, Head & Neck Surgery, The First Hospital of Yulin, Yulin, China
| | - Yanfeng Xue
- Special Needs Ward, Shanxi Cancer Hospital, Taiyuan, China
| | - Yao Wei
- Department of Otolaryngology, Head & Neck Surgery, The Second Clinical Medical College, Shanxi Medical University, Taiyuan, China
| | - Ruiying Li
- Department of Otolaryngology, Head & Neck Surgery, The Second Clinical Medical College, Shanxi Medical University, Taiyuan, China
| | - Xueping Qi
- Department of Otolaryngology, Head & Neck Surgery, The Second Hospital of Shanxi Medical University, Taiyuan, China.,Key Research Laboratory of Airway Neuroimmunology, Shanxi Province, Taiyuan, China
| | - Fengli Cheng
- Department of Otolaryngology, Head & Neck Surgery, The Second Hospital of Shanxi Medical University, Taiyuan, China.,Key Research Laboratory of Airway Neuroimmunology, Shanxi Province, Taiyuan, China
| | - Changqing Zhao
- Department of Otolaryngology, Head & Neck Surgery, The Second Hospital of Shanxi Medical University, Taiyuan, China.,Key Research Laboratory of Airway Neuroimmunology, Shanxi Province, Taiyuan, China
| | - Jinmei Xue
- Department of Otolaryngology, Head & Neck Surgery, The Second Hospital of Shanxi Medical University, Taiyuan, China. .,Key Research Laboratory of Airway Neuroimmunology, Shanxi Province, Taiyuan, China.
| | - Pingchang Yang
- Research Center of Allergy & Immunology, Shenzhen University School of Medicine, Shenzhen, China.
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Pothirat C, Chaiwong W. Aeroallergen Sensitization and Clinical Characteristics of Subjects with Chronic Rhinitis in Chiang Mai, Thailand: A Twenty-Year Retrospective Study. J Asthma Allergy 2021; 14:789-795. [PMID: 34262297 PMCID: PMC8274822 DOI: 10.2147/jaa.s315081] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 06/16/2021] [Indexed: 11/23/2022] Open
Abstract
Background The prevalence of common aeroallergen sensitization in subjects with AR and clinical comparison between AR and Non-AR (NAR) subjects in Thailand remains limited. The primary objective of this study was to illustrate the prevalence of the common aeroallergen sensitization in AR subjects and the differences in clinical characteristics between AR and NAR subjects. Methods Data were retrospectively collected from all subjects with chronic rhinitis who have visited the Chest and Allergy Clinic in three settings in Chiang Mai, Thailand between January 1998 and December 2018. Clinical characteristics and the result of skin prick test (SPT) to common aeroallergen were collected. Results A total of 2164 subjects with chronic rhinitis were enrolled, SPT was performed in 1001 (46.3%); 655 (65.4%) and 346 (34.6%) were AR and NAR, respectively. Mite mixed was the most frequent aeroallergen sensitization in subjects with AR both without asthma and with asthma (86.4% and 85.6%) followed by cockroach mixed (54.4% and 58.9%), grass pollen (38.9% and 40.4%), animal dander (15.5% and 19.9%), and mold mixed (5.7% and 11.0%). Polysensitization was higher in younger adults compared to middle aged adult and older adult (72.5%, 67.4%, and 58.7%, respectively, p=0.041). The AR subjects had lower age, earlier age of disease onset, and longer duration of disease (32.6±16.3 vs 40.2±15.4 years, 24 (10–36) vs 34 years (22–45), 3 (1–10) vs 2 years (0–5), respectively, p<0.001). The AR subjects also had more asthma, conjunctivitis, and family history of chronic rhinitis (22.3% vs 15.6%, 25.3% vs 4.3%, and 58.0% vs 43.3%, respectively, p<0.05). Conclusion The most common aeroallergen for AR (with and without asthma) was mite mixed followed by cockroach mixed and grass pollen. Polysensitization was significant higher in younger adult than middle aged and older adult. AR was significantly associated with asthma, conjunctivitis and family history of chronic rhinitis compared to NAR.
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Affiliation(s)
- Chaicharn Pothirat
- Division of Pulmonary, Critical Care and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Warawut Chaiwong
- Division of Pulmonary, Critical Care and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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