Sensitization patterns and minimum screening panels for aeroallergens in self-reported allergic rhinitis in China

Hongfei Lou,Fei He,Feifei Cao,Luo Zhang,Siyuan Ma,Claus Bachert,Zhongyan Liu,Jean Bousquet,Yan Zhao,Chengshuo Wang

doi:10.1038/s41598-017-10111-9

Abstract

Optimization of skin prick test (SPT) panels, especially in view of significant differences in sensitizations patterns within different geographical areas, is an unmet need within China. Our aim was to assess the patterns and clinical relevance of aeroallergen sensitizations in allergic rhinitis (AR) and define the minimal battery of SPT allergens, classified according to the Köppen-Geiger climate map. Overall, 7148 subjects with self-reported AR completed a standard questionnaire and were assessed for sensitization to relevant allergens by SPT. 6340 (88.7%) patients had at least one positive skin prick reaction, and demonstrated unique sensitization patterns by stratification with age, gender, and geographic region. Sensitization to house dust mites (HDM) was highest in south China, whereas the three most prevalent aeroallergens were mugwort, ragweed and dandelion pollen in north-west China. Higher sensitization rates and multiple sensitizations were associated with AR comorbidities. Eight allergens (Der f, mugwort, Blatella, hazel, goosefoot, Penicillium notatum, animal dander and Der p) allowed identification >96% of sensitized subjects in central China. Differences in optimal panels were observed between regions, with five to six allergens being sufficient for north-east, north-west and south China. These SPT panels may provide a cost-effective tool for screening sensitized patients in China.

Highlights

Allergic rhinitis (AR) is an increasing challenge to public health worldwide[1]
Our results demonstrated that the sensitization profile in allergic rhinitis (AR) patients varied widely between regions, differed according to age and gender, and correlated with concomitant allergic diseases
This study demonstrated that a Skin prick tests (SPT) panel comprising only eight specific allergens; including Dermatophagoides farinae (Der f), mugwort, Blatella, hazel, goosefoot, Penicillium notatum, animal dander and Dermatophagoides pteronyssinus (Der p); could be used as a cost-effective tool for sensitization screening of AR in China

Summary

Introduction

Allergic rhinitis (AR) is an increasing challenge to public health worldwide[1]. Self-reported AR prevalence in China has increased from 11.1% to 17.6% over a 6-year period[2, 3]. Mathematical spatial models were used to estimate the epidemic patterns[6,7,8,9] Both long distance travel and increased transportation rates associated with modern day living as well as migration may exert prominent effects on the formation of sensitization patterns within the population[4, 9,10,11]. Li and colleagues[5] assessed the prevalence of sensitizations by SPT in patients with asthma and/or rhinitis in 17 Chinese cities from 2006 to 2007, and demonstrated significant differences in patterns of sensitizations from different geographical areas, age groups as well as asthma and/or rhinitis. The present study was designed to firstly investigate the prevalence and novel patterns of sensitization in AR patients from 28 provinces within China and secondly analyze the clinical relevance of SPT results. Last but not least, based on these findings, we aimed to develop optimal SPT panels as a cost-effective tool for screening AR in the different regions

Objectives

Methods

Results

Conclusion