Increase in sensitization to common airborne allergens among adults – two population-based studies 15 years apart

Allergy, Asthma & Clinical Immunology

Katja Warm¹  Anne Lindberg¹  Bo Lundbäck²  Eva Rönmark¹ 

[1] Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden

[2] Institute of Medicine/Krefting Research Center, University of Gothenburg, Gothenburg, Sweden

关键词: Skin prick test;    Prevalence;    Population study;    IgE;    Epidemiology;    Allergic sensitization;   

Others  :  792280
DOI  :  10.1186/1710-1492-9-20

 received in 2013-03-06, accepted in 2013-06-05,  发布年份 2013

【 摘 要 】

Background

Studies on time trends of allergic sensitization among adults are rare. The aim of the study was to compare the prevalence of allergic sensitization to common airborne allergens among adults 15 years apart and to identify risk factors for allergic sensitization.

Methods

Clinical examinations including skin prick test (SPT) and structured interviews were performed in two random population samples in 1994 and 2009. Furthermore, specific IgE was analyzed in 2009. SPT data were available for 483 subjects in 1994 and for 463 subjects in 2009 in ages 20–60 years. Specific IgE was analyzed in 692 subjects in ages 20–79 years.

Results

Sensitization to cat (16% to 26%, p < 0.001), dog (13% to 25%, p < 0.001), birch (13% to 18%, p = 0.031) and timothy (12% to 21%, p < 0.001), based on SPT, increased significantly from 1994 to 2009. Sensitization to any positive SPT increased from 35% to 39%, p = 0.13.The proportion of having ≥3 positive SPT reactions increased from 40% to 56%, p = 0.002. The sensitization pattern yielded similar results based on specific IgE. Risk factors for allergic sensitization were having a family history of allergy (OR 3.1, 95% CI 2.0-4.8 for any positive SPT; OR 2.7, 95% CI 1.8-4.0 for any elevated IgE) and urban living (OR 1.7, 95% CI 1.0-2.7; OR 1.5, 95% CI 1.0-2.4).

Conclusions

The prevalence of allergic sensitization to major airborne allergens as well as multi-sensitization increased significantly between the study years. Young age, a family history of allergy and urban living were significant risk factors for allergic sensitization.

【 授权许可】

   
2013 Warm et al.; licensee BioMed Central Ltd.

【 图 表 】

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【 参考文献 】

• [1]Law M, Morris JK, Wald N, Luczynska C, Burney P: Changes in atopy over a quarter of a century, based on cross sectional data at three time periods. BMJ 2005, 330:1187-1188.
• [2]Linneberg A, Gislum M, Johansen N, Husemoen LL, Jorgensen T: Temporal trends of aeroallergen sensitization over twenty-five years. Clin Exp Allergy 2007, 37:1137-1142.
• [3]Seiskari T, Viskari H, Kaila M, Haapala AM, Koskela P, Hyoty H: Time trends in allergic sensitisation and helicobacter pylori prevalence in finnish pregnant women. Int Arch Allergy Immunol 2009, 150:83-88.
• [4]Braun-Fahrlander C, Gassner M, Grize L, Takken-Sahli K, Neu U, Stricker T, Varonier HS, Wuthrich B, Sennhauser FH: Swiss Study on Childhood Allergy and Respiratory symptoms, Air Pollution (SCARPOL team). No further increase in asthma, hay fever and atopic sensitisation in adolescents living in switzerland . Eur Respir J 2004, 23:407-413.
• [5]Zollner IK, Weiland SK, Piechotowski I, Gabrio T, von Mutius E, Link B, Pfaff G, Kouros B, Wuthe J: No increase in the prevalence of asthma, allergies, and atopic sensitisation among children in germany: 1992–2001. Thorax 2005, 60:545-548.
• [6]Krause T, Koch A, Friborg J, Poulsen LK, Kristensen B, Melbye M: Frequency of atopy in the arctic in 1987 and 1998. Lancet 2002, 360:691-692.
• [7]Ronmark E, Bjerg A, Perzanowski M, Platts-Mills T, Lundback B: Major increase in allergic sensitization in schoolchildren from 1996 to 2006 in Northern Sweden. J Allergy Clin Immunol 2009, 124:357-363. e1-15
• [8]Pallasaho P, Ronmark E, Haahtela T, Sovijarvi AR, Lundback B: Degree and clinical relevance of sensitization to common allergens among adults: a population study in Helsinki, Finland. Clin Exp Allergy 2006, 36:503-509.
• [9]Olivieri M, Zock JP, Accordini S, Heinrich J, Jarvis D, Kunzli N, Anto JM, Norback D, Svanes C, Verlato G: Indoor Working Group of the European Community Respiratory Health Survey II. Risk factors for new-onset cat sensitization among adults: a population-based international cohort study . J Allergy Clin Immunol 2012, 129:420-425.
• [10]Majkowska-Wojciechowska B, Pelka J, Korzon L, Kozlowska A, Kaczala M, Jarzebska M, Gwardys T, Kowalski ML: Prevalence of allergy, patterns of allergic sensitization and allergy risk factors in rural and urban children. Allergy 2007, 62:1044-1050.
• [11]Kramer MS, Matush L, Bogdanovich N, Dahhou M, Platt RW, Mazer B: The low prevalence of allergic disease in eastern europe: are risk factors consistent with the hygiene hypothesis? Clin Exp Allergy 2009, 39:708-716.
• [12]D'Amato G, Cecchi L, D'Amato M, Liccardi G: Urban air pollution and climate change as environmental risk factors of respiratory allergy: an update. J Investig Allergol Clin Immunol 2010, 20:95-102.
• [13]Carlsten C, Melen E: Air pollution, genetics, and allergy: an update. Curr Opin Allergy Clin Immunol 2012, 12:455-460.
• [14]Perzanowski MS, Ronmark E, Nold B, Lundback B, Platts-Mills TA: Relevance of allergens from cats and dogs to asthma in the northernmost province of Sweden: schools as a major site of exposure. J Allergy Clin Immunol 1999, 103:1018-1024.
• [15]Warm K, Backman H, Lindberg A, Lundback B, Ronmark E: Low incidence and high remission of allergic sensitization among adults. J Allergy Clin Immunol 2012, 129:136-142.
• [16]Ronmark E, Lundback B, Jonsson E, Jonsson AC, Lindstrom M, Sandstrom T: Incidence of asthma in adults–report from the obstructive lung disease in Northern Sweden study. Allergy 1997, 52:1071-1078.
• [17]Hoang Thi L, Van Nguyen T, Lundback B, Ronmark E: Storage mites are the main sensitizers among adults in Northern Vietnam: results from a population survey. Allergy 2011, 66:1620-1621.
• [18]Ekerljung L, Ronmark E, Lotvall J, Wennergren G, Toren K, Lundback B: Questionnaire layout and wording influence prevalence and risk estimates of respiratory symptoms in a population cohort. Clin Respir J 2012,  : . [Epub ahead of print]
• [19]Dreborg S, Backman E, Basomba A, Bousquet J, Malling D: Skin tests used in type I allergy testing position paper of european academy of allergology and clinical immunology. Allergy 1989, 44(Suppl 10):1-59.
• [20]Linneberg A, Nielsen NH, Madsen F, Frolund L, Dirksen A, Jorgensen T: Increasing prevalence of specific IgE to aeroallergens in an adult population: two cross-sectional surveys 8 years apart. J Allergy Clin Immunol 2000, 106:247-252.
• [21]Arbes SJ Jr, Gergen PJ, Elliott L, Zeldin DC: Prevalences of positive skin test responses to 10 common allergens in the US population: results from the third National Health and Nutrition examination survey. J Allergy Clin Immunol 2005, 116:377-383.
• [22]Plaschke P, Janson C, Norrman E, Bjornsson E, Ellbjar S, Jarvholm B: Association between atopic sensitization and asthma and bronchial hyperresponsiveness in Swedish adults: pets, and not mites, are the most important allergens. J Allergy Clin Immunol 1999, 104:58-65.
• [23]Vidal C, Boquete O, Gude F, Rey J, Meijide LM, Fernandez-Merino MC, Gonzalez-Quintela A: High prevalence of storage mite sensitization in a general adult population. Allergy 2004, 59:401-405.
• [24]Antonicelli L, Micucci C, Voltolini S, Feliziani V, Senna GE, Di Blasi P, Visona G, De Marco R, Bonifazi F: Allergic rhinitis and asthma comorbidity: ARIA classification of rhinitis does not correlate with the prevalence of asthma. Clin Exp Allergy 2007, 37:954-960.
• [25]Ciprandi G, Cirillo I: Monosensitization and polysensitization in allergic rhinitis. Eur J Intern Med 2011, 22:e75-e79.
• [26]Craig TJ, King TS, Lemanske RF Jr, Wechsler ME, Icitovic N, Zimmerman RR Jr, Wasserman S, National Heart: Aeroallergen sensitization correlates with PC(20) and exhaled nitric oxide in subjects with mild-to-moderate asthma . J Allergy Clin Immunol 2008, 121:671-677.
• [27]Kerkhof M, Postma DS, Schouten JP, de Monchy JG: Allergic sensitization to indoor and outdoor allergens and relevance to bronchial hyperresponsiveness in younger and older subjects. Allergy 2003, 58:1261-1267.
• [28]Mandhane PJ, Sears MR, Poulton R, Greene JM, Lou WY, Taylor DR, Hancox RJ: Cats and dogs and the risk of atopy in childhood and adulthood. J Allergy Clin Immunol 2009, 124:745-750.
• [29]Lampi J, Canoy D, Jarvis D, Hartikainen AL, Keski-Nisula L, Jarvelin MR, Pekkanen J: Farming environment and prevalence of atopy at age 31: prospective birth cohort study in Finland. Clin Exp Allergy 2011, 41:987-993.
• [30]Eriksson J, Ekerljung L, Lotvall J, Pullerits T, Wennergren G, Ronmark E, Toren K, Lundback B: Growing up on a farm leads to lifelong protection against allergic rhinitis. Allergy 2010, 65:1397-1403.
• [31]Chen Y, Rennie D, Cormier Y, McDuffie H, Pahwa P, Dosman J: Reduced risk of atopic sensitization among farmers: the humboldt study. Int Arch Allergy Immunol 2007, 144:338-342.
• [32]Linneberg A, Nielsen NH, Madsen F, Frolund L, Dirksen A, Jorgensen T: Smoking and the development of allergic sensitization to aeroallergens in adults: a prospective population-based study. The Copenhagen Allergy Study. Allergy 2001, 56:328-332.
• [33]Hancox RJ, Welch D, Poulton R, Taylor DR, McLachlan CR, Greene JM, Sears MR: Cigarette smoking and allergic sensitization: a 32-year population-based cohort study. J Allergy Clin Immunol 2008, 121:38-42.
• [34]Ouyang Y, Virasch N, Hao P, Aubrey MT, Mukerjee N, Bierer BE, Freed BM: Suppression of human IL-1 beta, IL-2, IFN-gamma, and TNF-alpha production by cigarette smoke extracts. J Allergy Clin Immunol 2000, 106:280-287.
• [35]Behrendt H, Kasche A, Ebner Von Eschenbach C, Risse U, Huss-Marp J, Ring J: Secretion of proinflammatory eicosanoid-like substances precedes allergen release from pollen grains in the initiation of allergic sensitization. Int Arch Allergy Immunol 2001, 124:121-125.
• [36]Bryce M, Drews O, Schenk MF, Menzel A, Estrella N, Weichenmeier I, Smulders MJ, Buters J, Ring J, Gorg A, Behrendt H, Traidl-Hoffmann C: Impact of urbanization on the proteome of birch pollen and its chemotactic activity on human granulocytes. Int Arch Allergy Immunol 2010, 151:46-55.
• [37]Ghiani A, Aina R, Asero R, Bellotto E, Citterio S: Ragweed pollen collected along high-traffic roads shows a higher allergenicity than pollen sampled in vegetated areas. Allergy 2012, 67:887-894.
• [38]Motta AC, Marliere M, Peltre G, Sterenberg PA, Lacroix G: Traffic-related air pollutants induce the release of allergen-containing cytoplasmic granules from grass pollen. Int Arch Allergy Immunol 2006, 139:294-298.
• [39]Bedada GB, Heinrich J, Gotschi T, Downs SH, Forsberg B, Jarvis D, Luczynska C, Soon A, Sunyer J, Toren K, Kunzli N: Urban background particulate matter and allergic sensitization in adults of ECRHS II. Int J Hyg Environ Health 2007, 210:691-700.
• [40]Vartiainen E, Petays T, Haahtela T, Jousilahti P, Pekkanen J: Allergic diseases, skin prick test responses, and IgE levels in North Karelia, Finland, and the Republic of Karelia, Russia. J Allergy Clin Immunol 2002, 109:643-648.