The Impact of Sex and Age on the Prevalence of Clinically Relevant Sensitization and Asymptomatic Sensitization in the General Population

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Abstract

The objective of our study was to evaluate the impact of sex and age on the prevalence of sensitization to inhalant allergens. The study was performed as a part of Polish Epidemiology of Allergic Diseases study, and data concerning citizens of Wroclaw were analyzed. The participants were divided into three age groups (6–7, 13–14, and 20–44 years) with a subdivision according to sex. We randomly selected 1409 individuals, 439 people complied; the complete set of tests was performed on 421 of them. We found that 37.7 % of the study population demonstrated sensitization to at least one of the allergens tested. Positive skin tests were found more frequently in males than in females ( p = 0.003); among 6–7-year-old children, the sensitization was independent of sex ( p = 0.26), while in two other groups, it was higher in males ( p = 0.002 and p = 0.03, respectively). Clinically asymptomatic sensitization (AS) was found more often in females than in males ( p = 0.04). The higher rate of AS in women was observed only in the two younger age groups, while in the 20–44-year-old group AS did not differ between the sexes ( p = 0.72). Female sex hormones may contribute to a later change in the nature of sensitization from clinically asymptomatic to symptomatic. Further studies are needed to confirm the results of our study.

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Prevalences of positive skin test responses to 10 common allergens in the US population: results from the third National Health and Nutrition Examination Survey.

Samuel Arbes Jr., Peter Gergen, Leslie Elliott … (2005)

Allergy skin tests were administered in the second and third National Health and Nutrition Examination Surveys (NHANES II and III) conducted in the United States from 1976 through 1980 and 1988 through 1994, respectively. This study estimated positive skin test response rates in NHANES III and identified predictors of one or more positive test responses. Comparisons with NHANES II were also made. In NHANES III, 10 allergens and 2 controls were tested in all subjects aged 6 to 19 years and a random half-sample of subjects aged 20 to 59 years. A wheal-based definition of a positive test response was used. In NHANES III, 54.3% of the population had positive test responses to 1 or more allergens. Prevalences were 27.5% for dust mite, 26.9% for perennial rye, 26.2% for short ragweed, 26.1% for German cockroach, 18.1% for Bermuda grass, 17.0% for cat, 15.2% for Russian thistle, 13.2% for white oak, 12.9% for Alternaria alternata, and 8.6% for peanut. Among those with positive test responses, the median number of positive responses was 3.0. Adjusted odds of a positive test response were higher for the following variables: age of 20 to 29 years, male sex, minority race, western region, old homes, and lower serum cotinine levels. For the 6 allergens common to NHANES II and III, prevalences were 2.1 to 5.5 times higher in NHANES III. The majority of the US population represented in NHANES III was sensitized to 1 or more allergens. Whether the higher prevalences observed in NHANES III reflect true changes in prevalence or methodological differences between the surveys cannot be determined with certainty.

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GA(2)LEN skin test study I: GA(2)LEN harmonization of skin prick testing: novel sensitization patterns for inhalant allergens in Europe.

L Heinzerling, G J Burbach, G Edenharter … (2009)

Skin prick testing is the standard for diagnosing IgE-mediated allergies. However, different allergen extracts and different testing procedures have been applied by European allergy centres. Thus, it has been difficult to compare results from different centres or studies across Europe. It was, therefore, crucial to standardize and harmonize procedures in allergy diagnosis and treatment within Europe. The Global Asthma and Allergy European Network (GA(2)LEN), with partners and collaborating centres across Europe, was in a unique position to take on this task. The current study is the first approach to implement a standardized procedure for skin prick testing in allergies against inhalant allergens with a standardized pan-European allergen panel. The study population consisted of patients who were referred to one of the 17 participating centres in 14 European countries (n = 3034, median age = 33 years). Skin prick testing and evaluation was performed with the same 18 allergens in a standardized procedure across all centres. The study clearly shows that many allergens previously regarded as untypical for some regions in Europe have been underestimated. This could partly be related to changes in mobility of patients, vegetation or climate in Europe. The results of this large pan-European study demonstrate for the first time sensitization patterns for different inhalant allergens in patients across Europe. The standardized skin prick test with the standardized allergen battery should be recommended for clinical use and research. Further EU-wide monitoring of sensitization patterns is urgently needed.

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GA(2)LEN skin test study II: clinical relevance of inhalant allergen sensitizations in Europe.

G J Burbach, L Heinzerling, G Edenharter … (2009)

Skin prick testing is the standard for diagnosing IgE-mediated allergies. A positive skin prick reaction, however, does not always correlate with clinical symptoms. A large database from a Global Asthma and Allergy European Network (GA(2)LEN) study with data on clinical relevance was used to determine the clinical relevance of sensitizations against the 18 most frequent inhalant allergens in Europe. The study population consisted of patients referred to one of the 17 allergy centres in 14 European countries (n = 3034, median age = 33 years). The aim of the study was to assess the clinical relevance of positive skin prick test reactions against inhalant allergens considering the predominating type of symptoms in a pan-European population of patients presenting with suspected allergic disease. Clinical relevance of skin prick tests was recorded with regard to patient history and optional additional tests. A putative correlation between sensitization and allergic disease was assessed using logistic regression analysis. While an overall rate of >or=60% clinically relevant sensitizations was observed in all countries, a differential distribution of clinically relevant sensitizations was demonstrated depending on type of allergen and country where the prick test was performed. Furthermore, a significant correlation between the presence of allergic disease and the number of sensitizations was demonstrated. This study strongly emphasizes the importance of evaluating the clinical relevance of positive skin prick tests and calls for further studies, which may, ultimately, help increase the positive predictive value of allergy testing.

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Author and article information

Contributors

Anna Dor-Wojnarowska: dor_anna@yahoo.co.uk

Journal

Journal ID (nlm-ta): Arch Immunol Ther Exp (Warsz)

Journal ID (iso-abbrev): Arch. Immunol. Ther. Exp. (Warsz.)

Title: Archivum Immunologiae et Therapiae Experimentalis

Publisher: Springer International Publishing (Cham )

ISSN (Print): 0004-069X

ISSN (Electronic): 1661-4917

Publication date (Electronic): 20 September 2016

Publication date PMC-release: 20 September 2016

Publication date (Print): 2017

Volume: 65

Issue: 3

Pages: 253-261

Affiliations

[1 ]ISNI 0000 0001 1090 049X, GRID grid.4495.c, Department of Internal Diseases and Allergology, , Wroclaw Medical University, ; M. Skłodowskiej-Curie 66, 50-369 Wrocław, Poland

[2 ]ISNI 0000000113287408, GRID grid.13339.3b, Department of Prevention of Environmental Hazards and Allergology, , Medical University, ; Warsaw, Poland

Article

Publisher ID: 425

DOI: 10.1007/s00005-016-0425-7

PMC ID: 5434121

PubMed ID: 27652380

SO-VID: dad09501-2e93-4201-8363-d2885c2c1926

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

History

Date received : 20 January 2016

Date accepted : 4 July 2016

Funding

Funded by: the Minister for Health and Minister for Science

Award ID: 6 P05 2005 C/06572

Custom metadata

ScienceOpen disciplines: Immunology

Keywords: asymptomatic sensitization,population study,“prick” skin test,total ige

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ScienceOpen disciplines: Immunology

Keywords: asymptomatic sensitization, population study, “prick” skin test, total ige

The Impact of Sex and Age on the Prevalence of Clinically Relevant Sensitization and Asymptomatic Sensitization in the General Population

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Most cited references 29

Prevalences of positive skin test responses to 10 common allergens in the US population: results from the third National Health and Nutrition Examination Survey.

GA(2)LEN skin test study I: GA(2)LEN harmonization of skin prick testing: novel sensitization patterns for inhalant allergens in Europe.

GA(2)LEN skin test study II: clinical relevance of inhalant allergen sensitizations in Europe.

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