Sensitization to Indigenous Pollen and Molds and Other Outdoor and Indoor Allergens in Allergic Patients From Saudi Arabia, United Arab Emirates, and Sudan

World Allergy Organization Journal

S Al-Sedairy⁶  OA Musa^1,11  E Alaqi⁸  M Al-Yamani²  K Al-Abbad²  R Khouqeer⁹  H Al-Matar⁷  S Al-Sowaidi³  H Al-Mehdar^1,10  E Koshak⁴  MO Gad-El-Rab⁵  T Geith¹  M Casanovas^1,12  Enrique Fernández-Caldas^1,12  JL Subiza^1,12  AR Al-Frayh⁵  SM Hasnain⁶ 

[1] Elaj Medical Services, Riyadh and Khamis Mushait, Saudi Arabia;Maternity & Children's Hospital, Dammam, Saudi Arabia;Faculty of Medicine and Health Sciences, UAE University, Abu Dhabi, United Arab Emirates;Faculty of Medicine, King Abdulaziz University Hospital, Jeddah, Saudi Arabia;College of Medicine, King Saud University, Riyadh, Saudi Arabia;King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia;Al Imam Abdulrahman Bin Faisal Hospital, Dammam, Saudi Arabia;Children's Hospital, Riyadh Medical Complex, Riyadh, Saudi Arabia;Saad Specialist Hospital, Al-Khobar, Saudi Arabia;King Fahad Medical Research Centre, King Abdulaziz University, Jeddah, Saudi Arabia;Faculty of Medicine, The National Ribat University, Khartoum, Sudan;Inmunotek, Madrid, Spain

关键词: mites;    Prosopis;    Salsola;    Saudi Arabia;    allergic rhinitis;    bronchial asthma;    diagnostics;    allergens;   

Others  :  1137685
DOI  :  10.1097/WOX.0b013e31825a73cd

【 摘 要 】

Background

Airborne allergens vary from one climatic region to another. Therefore, it is important to analyze the environment of the region to select the most prevalent allergens for the diagnosis and treatment of allergic patients.

Objective

To evaluate the prevalence of positive skin tests to pollen and fungal allergens collected from local indigenous plants or isolated molds, as well as other outdoor and indoor allergens in allergic patients in 6 different geographical areas in the Kingdom of Saudi Arabia (KSA), the United Arab Emirates, and Sudan.

Materials and methods

Four hundred ninety-two consecutive patients evaluated at different Allergy Clinics (276 women and 256 men; mean age, 30 years) participated in this study. The selection of indigenous allergens was based on research findings in different areas from Riyadh and adjoining areas. Indigenous raw material for pollen grains was collected from the desert near the capital city of Riyadh, KSA. The following plants were included: Chenopodium murale, Salsola imbricata, Rumex vesicarius, Ricinus communis, Artiplexnummularia, Amaranthus viridis, Artemisia monosperma, Plantago boissieri, and Prosopis juliflora. Indigenous molds were isolated from air sampling in Riyadh and grown to obtain the raw material. These included the following: Ulocladium spp., Penicillium spp., Aspergillus fumigatus, Cladosporium spp., and Alternaria spp. The raw material was processed under Good Manufacturing Practices for skin testing. Other commercially available outdoor (grass and tree pollens) and indoor (mites, cockroach, and cat dander) allergens were also tested.

Results

The highest sensitization to indigenous pollens was detected to C. murale (32%) in Khartoum (Sudan) and S. imbricata (30%) and P. juliflora (24%) in the Riyadh region. The highest sensitization to molds was detected in Khartoum, especially to Cladosporium spp. (42%), Aspergillus (40%), and Alternaria spp. (38%). Sensitization to mites was also very prevalent in Khartoum (72%), as well as in Abu Dhabi (United Arab Emirates) (46%) and Jeddah (KSA) (30%).

Conclusions

The allergenicity of several indigenous pollens and molds derived from autochthonous sources was demonstrated. Prevalence studies in different regions of KSA and neighbor countries indicate different sensitization rates to these and other outdoor and indoor allergens.

【 授权许可】

   
2012 World Allergy Organization; licensee BioMed Central Ltd.

【 图 表 】

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【 参考文献 】

• [1]Al-Nahdi M, al-Frayh R, Hasnain SM: An aerobiological survey of allergens in al Khobar, Saudi Arabia. Allerg Immunol (Paris) 1989, 21:278-282.
• [2]Hasnain SM, Al-Frayh A, Gad-El-Rab MO, Al-Sedairy S: Airborne Alternaria spores: potential allergic sensitizers in Saudi Arabia. Ann Saudi Med 1998, 18:497-501.
• [3]Hasnain SM, Al-Frayh AS, Al-Suwaine A, Gad-El-Rab MO, Fatima K, Al-Sedairy S: Cladosporium and respiratory allergy: diagnostic implications in Saudi Arabia. Mycopathologia 2004, 157:171-179.
• [4]Al-Suwaine AS, Bahkali AH, Hasnain SM: Seasonal incidence of airborne fungal allergens in Riyadh, Saudi Arabia. Mycopathologia 1999, 145:15-22.
• [5]A-Suwaini AS, Bahkali AH, Hasnain SM: Airborne viable fungi in Riyadh and allergenic response of their extracts. Mycoses 2001, 44:401-406.
• [6]Almogren A: Airway allergy and skin reactivity to aeroallergens in Riyadh. Saudi Med J 2009, 30:392-396.
• [7]Kwaasi AA, Harfi HA, Parhar RS, Collison KS, Al-Sedairy ST, Al-Mohanna FA: Cultivar-specific IgE-epitopes in date (Phoenix dactylifera L.) fruit allergy. Correlation of skin test reactivity and Ige-binding properties in selecting date cultivars for allergen standardization. Int Arch Allergy Immunol 2000, 123:137-144.
• [8]Al-Frayh A, Hasnain SM, Gad-El-Rab MO, Al-Turki T, Al-Mobeireek K, Al-Sedairy ST: Human sensitization to Prosopis juliflora antigen in Saudi Arabia. Ann Saudi Med 1999, 19:331-336.
• [9]Al-Dowaisan A, Fakim N, Khan MR, Arifhodzic N, Panicker R, Hanoon A, Khan I: Salsola pollen as a predominant cause of respiratory allergies in Kuwait. Ann Allergy Asthma Immunol 2004, 92:262-267.
• [10]Sears MR, Greene JM, Willan AR, Wiecek EM, Taylor DR, et al.: A longitudinal, population-based, cohort study of childhood asthma followed to adulthood. N Engl J Med 2003, 349:1414-1422.
• [11]Al-Qurashi AM: House dust mites and allergic manifestations among some children in Dammam, Saudi Arabia. J Egypt Soc Parasitol 2006, 36:283-288.
• [12]Al-Frayh AS, Hasnain SM, Gad-El-Rab MO, Schwartz B, Al-Mobairek K, Al-Sedairy ST: House dust mite allergens in Saudi Arabia: regional variations and immune response. Ann Saudi Med 1997, 17:156-160.
• [13]al-Dusari SN, Somorin AO, Zaman AU: IgE antibodies to mites in Saudi Arabia. Allergy 1997, 52:234-235.
• [14]El-Shazly AM, El-Beshbishi SN, Azab MS, El-Nahas HA, Soliman ME, Fouad MA, Monib Mel-S: Present situation of house dust mites in Dakahlia Governorate, Egypt. J Egypt Soc Parasitol 2006, 36:113-126.
• [15]Sørensen H, Gravesen S, Lind P, Schwartz B, Ashoor AA, Maglad S: The occurrence of indoor allergens in Saudi Arabia. Ann Allergy 1985, 54:530-533.
• [16]Mustafa S, Gad-El-Rab MO: A study of clinical and allergic aspects of rhinitis patients in Riyadh. Ann Saudi Med 1996, 16:550-553.
• [17]Bousquet J, Reid J, van Weel C, Baena Cagnani C, Canonica GW, et al.: Allergic rhinitis management pocket reference 2008. Allergy 2008, 63:990-996.
• [18]van Weel C, Bateman ED, Bousquet J, Reid J, Grouse L, et al.: Asthma management pocket reference 2008. Allergy 2008, 63:997-1004.
• [19]Nordic-Council-on-Medicines: Registration of Allergen Preparations. Nordic Guidelines. Prepared by the Nordic Council on Medicines in Cooperation With the Drug Regulatory Authorities in Denmark, Finland, Iceland, Norway and Sweden. Uppsala, Sweden: Nordiska Läkemedelsnämnden; 1989.
• [20]Dreborg S, Frew A: Position paper: allergen standardization and skin tests. The European Academy of Allergology and Clinical Immunology. Allergy 1993, 48(suppl 14):48-82.
• [21]Al-Tamemi SH, Al-Shidhani AN, Al-Abri RK, Jothi B, Al-Rawas OA, Al-Riyami BM: The pattern of sensitisation to inhalant allergens in Omani patients with asthma, allergic rhinitis and rhinoconjunctivitis. Sultan Qaboos Univ Med J 2008, 8:319-324.
• [22]Assarehzadegan MA, Sankian M, Jabbari F, Noorbakhsh R, Varasteh A: Allergy to Salsola kali in a Salsola incanescens-rich area: role of extensive cross allergenicity. Allergol Int 2009, 58:261-266.
• [23]Fereidouni M, Hossini RF, Azad FJ, Assarehzadegan MA, Varasteh A: Skin prick test reactivity to common aeroallergens among allergic rhinitis patients in Iran. Allergol Immunopathol (Madr) 2009, 37:73-79.
• [24]Salo PM, Arbes SJ, Cohn RD, Burge HA, London SJ, Zeldin DC: Alternaria alternata antigens in US homes. J Allergy Clin Immunol 2006, 117:473.
• [25]Salo PM, Yin M, Arbes SJ, Cohn RD, Sever M, et al.: Dustborne Alternaria alternata antigens in US homes: results from the National Survey of Lead and Allergens in Housing. J Allergy Clin Immunol 2005, 116:623-629.
• [26]Ezeamuzie CI, Al-Ali S, Khan M, Hijazi Z, Dowaisan A, Thomson MS, Georgi J: IgE-mediated sensitization to mould allergens among patients with allergic respiratory diseases in a desert environment. Int Arch Allergy Immunol 2000, 121:300-307.
• [27]Hasnain SM, Al-Frayh AR, Al-Suwaine AR, Gad-El-Rab MO, Harfi HA, Al-Sedairy ST: Allergenic implications of airborne Ulocladium in Saudi Arabia. GRANA 1995, 34:70-76.
• [28]Al-Subai AAT: Air-borne fungi at Doha, Qatar. Aerobiologia 2002, 18:175-183.
• [29]Koshak EA: Skin test reactivity to indoor allergens correlates with asthma severity in Jeddah, Saudi Arabia. Allergy Asthma Clin Immunol 2006, 2:11-19.
• [30]Murray AB, Ferguson AC, Morrison BJ: Sensitization to house dust mites in different climatic areas. J Allergy Clin Immunol 1985, 76:108-112.
• [31]Sastre J, Iraola V, Figueredo E, Tornero P, Fernández-Caldas E: Mites in Madrid. Allergy 2002, 57:58-59.
• [32]Perzanowski MS, Platts-Mills TA: Further confirmation of the relevance of cockroach and dust mite sensitization to inner-city asthma morbidity. Clin Exp Allergy 2009, 39:1291-1293.
• [33]Sun BQ, Lai XX, Gjesing B, Spangfort MD, Zhong NS: Prevalence of sensitivity to cockroach allergens and IgE cross-reactivity between cockroach and house dust mite allergens in Chinese patients with allergic rhinitis and asthma. Chin Med J (Engl) 2010, 123:3540-3544.
• [34]Helm RM, Squillace DL, Jones RT, Brenner RJ: Shared allergenic activity in Asian (Blattella asahinai), German (Blattella germanica), American (Periplaneta americana), and Oriental (Blatta orientalis) cockroach species. Int Arch Allergy Appl Immunol 1990, 92:154-161.
• [35]Aburuz S, Bulatova N, Tawalbeh M: Skin prick test reactivity to aeroallergens in Jordanian allergic rhinitis patients. East Mediterr Health J 2011, 17:604-610.
• [36]Pescollderungg L, Pietrobelli A, Boner AL: Cat sensitivity: 7-yr audit in children attending a paediatric allergy clinic in North Italy. Eur Respir J 2000, 16:857-860.