Academic journal article Iranian Journal of Public Health

Sensitization to Aeroallergens in Patients with Respiratory Allergies Based on Skin-Prick Test Results

Academic journal article Iranian Journal of Public Health

Sensitization to Aeroallergens in Patients with Respiratory Allergies Based on Skin-Prick Test Results

Article excerpt

Abstract

Background: The aim of this study was to identify the most common aeroallergens in patients with asthma and rhinitis.

Methods: The study enrolled 102 participants including 64 patients with respiratory allergies (among them 15 were clinically diagnosed as asthma patients, 41 with rhinitis, 8 were both) and 38 healthy controls. All of participants were subject of skin prick tests (SPT) with series of common allergenic extracts. Sera from all participants were tested for total IgE and eosinophil count. To measure airflow limitation and reversibility in asthma patients the pulmonary function testing were carried out.

Results: M/F ratio was 1:1.6 in patients and 1:0.7 in control group with mean age 28.88 year (SD 13.16; range 6 55 year) and 20.47 respectively (SD 1.16; range 19-23 year). The most common risk factors in these patients were total IgE more than 100 IU/ml, eosinophils above 4% and positive family history of atopy. Skin prick testing results showed prevalence rates for allergen groups in this manner: house dust mites 81.3 %, pollens 57.8 %, animal dandruff12.5% and moulds 4.9%. Polysensitization was common in 51.6% of all sensitized patients being positive to more than one group of allergens.

Conclusion: House dust mites are the main sensitizing allergens among our allergic patients as well as healthy controls. Next in importance, in all participants, are grasses. This pattern of prevalence was expected based on herbal geography, climate and specially lifestyle. It was also compatible with the results from studies carried out in places with the same habitat.

Keywords: Aeroallergens, Asthma, Eosinophil, Immunoglobulin E, Rhinitis, Skin prick test

Introduction

"Half of the European Union's population will suffer from an allergic disease within eight years, according to experts" (1). Clinical manifestation of allergic diseases is extremely broad and involves a number of systems. Respiratory manifestations, as allergic asthma and rhinitis, are most commonly encountered, but frequently associated with them is conjunctivitis. In overall they represent a raising global health problem of epidemic proportions (24).

There are to blame several factors for these disorders, including genetic predisposition and environmental factors (5). Studies of twins, molecular studies of genome, genetic linkage of β-2 adrenergic therapy response along with "hygiene hypothesis" are the best predictors of clinical manife station of allergic symptoms (6-10). As an allergic response begins with sensitization to an antigen, in atopic individuals, allergen exposure results in binding to IgE, activation of mast cells and releasing of preformed and newly synthesized mediators (11-13). These effects, along with neuronal parasympathetic reflexes result in the clinical syndrome of immediate and late phase allergic response, which includes well known symptoms of coughing, wheezing, nasal itching, sneezing and discharge (14). Although, upper and lower, respiratory symptoms develop for other reasons, allergic etiologies are strongly related to inhaled allergens (15). Dust mites, pollens, moulds and animal dandruffare well known elicitors of immunemediated response. When will someone experience these symptoms depends on genetic background, sensitization, family size, climate, allergen burden and lifestyle (16-18). In industrialized countries with a Western lifestyle, sensitization to perennial aeroallergens is strongly associated with asthma, whereas sensitization to seasonal aeroallergens is closely related to allergic rhinitis (19). Epidemiological, pathophysiological and clinical studies conducted in the last decade have contributed to the new widely accepted united airways concept (1).

The objective of this study was to investigate the association between skin test reactivity to aeroallergens and asthma or rhinitis in favour of better preventive strategies.

Material and Methods

We included only patients with physician-diagnosed asthma and rhinitis who reacted positive to skin prick tests. …

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