Allergen sensitization linked to climate and age, not to intermittent‐persistent rhinitis in a cross‐sectional cohort study in the (sub)tropics

Wiley - 2014
Désirée Larenas‐Linnemann1, Alexandra Michels2, Hanna Dinger2, Kija Shah‐Hosseini2, Ralph Mösges2, Alfredo Arias-Cruz3,4, Marichuy Ambriz-Moreno5, Martín Bedolla-Barajas6,3, R Cerino Javier3,7, María de la Luz Cid del Prado5, Manuel Alejandro Cruz Moreno3,8, Roberto García Almaráz9,10, Cecilia Yvonne García-Cobas11,3, Daniel Alberto García Imperial10,12, Rosa Garcia Muñoz5, Dante Daniel Hernández-Colín3,6, Francisco Javier Linares‐Zapién13, Jorge A. Luna-Pech3,11, Juan José Matta-Campos3,14, Norma Martínez Jiménez5, Miguel Alejandro Medina-Ávalos5, Alejandra Medina Hernández3,15, Alberto Monteverde Maldonado5, Doris Nereida López5, Luis Julian Pizano Nazara10,16, Emmanuel Ramirez Sanchez10,17, José Domingo Ramos-López3,18, Noel Rodríguez-Pérez10,19, Pablo Rodríguez-Ortiz13
1Hospital Médica Sur, Torre 2, cons.602, Puente de Piedra 150, Colonia Toriello Guerra; Delegación Tlalpan, México, DF 14050, Mexico.
2University of Cologne, Cologne, Germany
3Mexican Study Group on Allergic Rhinitis and Skin Sensitivity. Hospital Médica Sur, Torre 2, cons.602Puente de Piedra 150Colonia Toriello Guerra; Delegación Tlalpan14050MéxicoDFMexico
4<idGroup xmlns="http://www.wiley.com/namespaces/wiley"><id type="grid" value="grid.411455.0"></id><id type="isni" value="0000000122030321"></id></idGroup>Centro Regional de Alergia e Inmunología ClínicaHospital Universitario “Dr. José Eleuterio González” de la Universidad Autónoma de Nuevo LeónMonterreyNuevo León
5Mexican Study Group on Allergic Rhinitis and Skin Sensitivity. Hospital Médica Sur, Torre 2, cons.602, Puente de Piedra 150, Colonia Toriello Guerra; Delegación Tlalpan, México, DF 14050, Mexico.
6<idGroup xmlns="http://www.wiley.com/namespaces/wiley"><id type="grid" value="grid.412890.6"></id><id type="isni" value="0000000121580196"></id></idGroup>Servicio de Alergia e Inmunología Clínica, División de Medicina InternaHospital Civil de Guadalajara “Dr. Juan I. Menchaca”Universidad de GuadalajaraJaliscoGuadalajaraMexico
7CEINTAP (centro de investigación y tratamiento del asma pediátrico)Hospital Regional de Alta Especialidad del Niño. Dr. Rodolfo Nieto PadrónTabascoVillahermosaMexico
8Clinica Santa Cruz, Villahermosa, Tabasco
9Allergy Department Hospital Infantil de Tamaulipas Tamaulipas Cd.Victoria Mexico
10Mexican Study Group on Allergic Rhinitis and Skin Sensitivity. Hospital Médica Sur, Torre 2, cons.602 Puente de Piedra 150 Colonia Toriello Guerra; Delegación Tlalpan 14050 México DF Mexico
11Inmunología y AlergiaUMAE Hospital de Especialidades, CMNOIMSSJaliscoGuadalajaraMexico
12Allergy Department Hospital Médica Tec 100 Querétaro Querétaro Mexico
13Mexican Study Group on Allergic Rhinitis and Skin Sensitivity. Hospital Médica Sur, Torre 2, cons.602, Puente de Piedra 150, Colonia Toriello Guerra; Delegación Tlalpan, México, Mexico
14Allergy and Clinical Immunology DepartmentHospital of specializations CMN ‘Siglo XXI’MexicoDFMexico
15<idGroup xmlns="http://www.wiley.com/namespaces/wiley"><id type="grid" value="grid.412861.8"></id><id type="isni" value="0000000122072097"></id></idGroup>Coordination of evidence based medicine (EBM)Facultad de medicinaUniversidad Autonoma de QueretaroQuerétaroQuerétaroMexico
16Clinical immunology &amp; allergy department Clínica Hospital San Jose Sonora Cd.Obregón Mexico
17Allergy and immunology department General Hospital of Cancun “Dr. Jesus Kumate Rodriguez” Quintana Roo Cancun Mexico
18<idGroup xmlns="http://www.wiley.com/namespaces/wiley"><id type="grid" value="grid.488996.2"></id><id type="isni" value="0000000417897088"></id></idGroup>Servicio de Alergia e Inmunología ClínicSeguro SocialHospital General de Zona No2PotosíPotosíMexico
19Pediatrics and Immunology Autonomous university of Tamaulipas Tamaulipas H.Matamoros Mexico

Tóm tắt

AbstractBackgroundAllergen exposure leads to allergen sensitization in susceptible individuals and this might influence allergic rhinitis (AR) phenotype expression. We investigated whether sensitization patterns vary in a country with subtropical and tropical regions and if sensitization patterns relate to AR phenotypes or age.MethodsIn a national, cross‐sectional study AR patients (2‐70 y) seen by allergists underwent blinded skin prick testing with a panel of 18 allergens and completed a validated questionnaire on AR phenotypes.Results628 patients were recruited. The major sensitizing allergen was house dust mite (HDM) (56%), followed by Bermuda grass (26%), ash (24%), oak (23%) and mesquite (21%) pollen, cat (22%) and cockroach (21%). Patients living in the tropical region were almost exclusively sensitized to HDM (87%). In the central agricultural zones sensitization is primarily to grass and tree pollen. Nationwide, most study subjects had perennial (82.2%), intermittent (56.5%) and moderate‐severe (84.7%) AR. Sensitization was not related to the intermittent‐persistent AR classification or to AR severity; seasonal AR was associated with tree (p < 0.05) and grass pollen sensitization (p < 0.01). HDM sensitization was more frequent in children (0‐11 y) and adolescents (12‐17 y) (subtropical region: p < 0.0005; tropical region p < 0.05), but pollen sensitization becomes more important in the adult patients visiting allergists (Adults vs children + adolescents for tree pollen: p < 0.0001, weeds: p < 0.0005).ConclusionsIn a country with (sub)tropical climate zones SPT sensitization patterns varied according to climatological zones; they were different from those found in Europe, HDM sensitization far outweighing pollen allergies and Bermuda grass and Ash pollen being the main grass and tree allergens, respectively. Pollen sensitization was related to SAR, but no relation between sensitization and intermittent‐persistent AR or AR severity could be detected. Sensitization patterns vary with age (child HDM, adult pollen). Clinical implications of our findings are dual: only a few allergens –some region specific‐ cover the majority of sensitizations in (sub)tropical climate zones. This is of major importance for allergen manufacturers and immunotherapy planning. Secondly, patient selection in clinical trials should be based on the intermittent‐persistent and severity classifications, rather than on the seasonal‐perennial AR subtypes, especially when conducted in (sub)tropical countries.

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