Abstract
BackgroundThe association between sensitizations and severity of allergic diseases is controversial.ObjectiveThis study was to investigate the association between severity of asthma and rhinitis and degree of specific allergic sensitization in allergic patients in China.MethodA cross-sectional survey was performed in 6304 patients with asthma and/or rhinitis from 4 regions of China. Patients completed a standardized questionnaire documenting their respiratory and allergic symptoms, their impact on sleep, daily activities, school and work. They also underwent skin prick tests with 13 common aeroallergens. Among the recruited subjects, 2268 provided blood samples for serum measurement of specific IgE (sIgE) against 16 common aeroallergens.ResultsSignificantly higher percentage of patients with moderate-severe intermittent rhinitis were sensitized to outdoor allergens while percentage of patients sensitized to indoor allergens was increased with increasing severity of asthma. Moderate-severe intermittent rhinitis was associated with the skin wheal size and the level of sIgE to Artemisia vulgaris and Ambrosia artemisifolia (p < 0.001). Moderate-severe asthma was associated with increasing wheal size and sIgE response to Dermatophagoides (D.) pteronyssinus and D. farinae (p < 0.001). Moderate-severe rhinitis and asthma were also associated with increase in number of positive skin prick test and sIgE.ConclusionsArtemisia vulgaris and Ambrosia artemisifolia sensitizations are associated with the severity of intermittent rhinitis and D. pteronyssinus and D. farinae sensitizations are associated with increasing severity of asthma in China. Increase in number of allergens the patients are sensitized to may also increase the severity of rhinitis and asthma.
Highlights
The association between sensitizations and severity of allergic diseases is controversial
Moderate-severe asthma was associated with increasing wheal size and specific IgE (sIgE) response to Dermatophagoides (D.) pteronyssinus and D. farinae (p < 0.001)
Artemisia vulgaris and Ambrosia artemisifolia sensitizations are associated with the severity of intermittent rhinitis and D. pteronyssinus and D. farinae sensitizations are associated with increasing severity of asthma in China
Summary
The association between sensitizations and severity of allergic diseases is controversial. Exposure to allergens the patients are sensitized to may exacerbate symptoms of rhinitis and asthma by promoting airway inflammation, airflow limitation, and airway hyperreponsiveness (AHR). Exposure and sensitivity follows a dose-dependent relationship [9]. Evidence supporting this relationship is strong for house dust mite (HDM) sensitization [9]. We have previously performed an epidemiological study of the prevalence of sensitization in patients with asthma and/or rhinitis in mainland China [12]. For indoor and outdoor allergens, we found that house dust mite sensitization was consistently associated with asthma whereas Artemisia vulgaris and Ambrosia artemisifolia pollen sensitizaions were associated with the development of rhinitis [12]
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