Aero-Allergen Sensitization in the General Population: Longitudinal Analyses of the LEAD (Lung Heart Social Body) Study

Kölli, Franziska; Breyer, Marie-Kathrin; Hartl, Sylvia; Burghuber, Otto Chris; Wouters, Emiel F.M.; Sigsgaard, Torben; Pohl, Wolfgang; Kohlböck, Gabriele; Breyer‐Kohansal, Robab

doi:10.2147/jaa.s349614

Cited by 13 publications

(9 citation statements)

References 52 publications

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“…We designed a retrospective/cross-sectional study to address the influence of atopy on the clinical severity of CSU and clinical response to omalizumab, in a cohort of 96 patients with severe CSU followed in a UCARE center. Atopy was diagnosed in approximately 1/3 of CSU patients, which is in line with the prevalence in general population in Portugal [10,11]. Pattern of sensitization was also concordant with the sensitization levels described in literature in Portuguese patients, in particular with the distribution of aeroallergens in the region of Lisbon [12].…”

Section: Discussionsupporting

confidence: 85%

Atopy and Response to Omalizumab Treatment in Chronic Spontaneous Urticaria

Costa,

Esteves Caldeira,

Paulino

et al. 2023

Int Arch Allergy Immunol

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Introduction: The possible influence of sensitization to aeroallergens on omalizumab response in chronic spontaneous urticaria (CSU) has been insufficiently investigated. This study’s aim was to investigate atopy’s influence on omalizumab response in CSU patients. Method: Retrospective study of CSU patients followed at a Portuguese Urticaria Center of Reference and Excellence (UCARE), treated with omalizumab for at least 6 months, between 2015 and 2022. At T0, all patients underwent quantification of specific immunoglobulin E (IgE) for total extract of most prevalent aeroallergens (ImmunoCAP Thermo Fisher Scientific®) and were divided in 2 groups, according to their response to omalizumab during the first 16 weeks of treatment: responders (R) (UAS7 <7) versus partial (PR) (UAS7 = 7–15) and nonresponders (UAS7 >15). R were further classified as fast (FR) (4–6 weeks) and slow responders (SR) (12–16 weeks). Total serum IgE, circulating eosinophil, and basophil counts were compared between groups at T0. p < 0.05 was considered statistically significant (SPSS® v25.0). Results: Ninety-six patients (80% female) were studied, mean age 49 ± 14 years. Median CSU duration pre-omalizumab was 3 (0.6–20) years and mean omalizumab treatment duration was 3.7 ± 2.3 years. 38 (40%) had concomitant chronic inducible urticaria and 72 (75%) angioedema. Based on positive results of the specific IgE assay, 35 patients (36%) were considered atopic. Most patients (n = 30; 86%) were sensitized to house dust mites (HDM) (Dermatophagoides farinae = 28, Dermatophagoides pteronyssinus = 27, Blomia tropicalis = 19, Lepidoglyphus destructor = 17), followed by pollens (n = 12; 34%) (mixture of grasses = 10, Olea europaea = 7, Parietaria officinalis = 6), epithelia (n = 9; 26%) (dog = 8, cat = 7), and fungi (Alternaria alternata = 4; 11%). Eight patients (23%) were monosensitized to HDM and 4 (11%) to pollens. No significant association was found between aeroallergen sensitization and CSU duration, concomitant chronic inducible urticaria, or angioedema. Atopic patients featured significantly higher levels of baseline total serum IgE than nonatopic (469 vs. 94 U/mL, respectively; p = 0.0009). Mean baseline counts of eosinophils and basophils were not significantly different between atopic and non-atopic, respectively: eosinophils (128 vs. 121/mm3) and basophils (26 vs. 28/mm3). Regarding response to omalizumab, most patients (58; 60%) were responders: FR – 46 (79%); SR – 12 (21%). There was no significant association between aeroallergen sensitization and omalizumab response or speed of response. Conclusions: As far as we know, this is the first study exploring the influence of atopy sensitization pattern on omalizumab response in CSU. According to our results, presence of atopy/sensitization pattern does not influence omalizumab response in CSU patients.

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Section: Discussionsupporting

confidence: 85%

Atopy and Response to Omalizumab Treatment in Chronic Spontaneous Urticaria

Costa,

Esteves Caldeira,

Paulino

et al. 2023

Int Arch Allergy Immunol

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“…Atopic state was defined by skin prick allergen testing: a positive skin prick test was defined as the presence of a reaction ≥3mm to aero-allergens. 24 In brief, antihistamines or glucocorticoids were withdrawn for at least 48h before testing. The following aero-allergens were tested: ash tree, tree pollen mix (hazel, alder, birch), grass mix (Anthoxantum, Dactylis, Lolium, Phleum and Poa), mugwort, ragweed, ribwort, mites mix (Dermatophagoides Farinae and Dermatophagoides Pteronyssinus), mildew, and dog and cat dander.…”

Section: Methodsmentioning

confidence: 99%

“…Positive (0.1% histamine) and negative (0.9% sodium chloride) controls were included in the test panel. 24 Additionally, doctor’s diagnosis of allergy and atopy were recorded, as well as questionnaires on the presence of atopic symptoms. Venous blood was collected from each participant, processed, and blood plasma was analysed for eosinophil counts using the Sysmex XN1000 hematology analyzer, performed by specialists at the Institute for Laboratory Medicine at Klinik Penzing, Vienna, Austria.…”

Section: Methodsmentioning

confidence: 99%

Asthma Prevalence and Phenotyping in the General Population: The LEAD (Lung, hEart, sociAl, boDy) Study

Schiffers¹,

Wouters²,

Breyer‐Kohansal³

et al. 2023

JAA

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Background Asthma is a chronic heterogeneous respiratory disease involving differential pathophysiological pathways and consequently distinct asthma phenotypes. Objective and Methods In the LEAD Study, a general population cohort (n=11.423) in Vienna ranging from 6–82 years of age, we addressed the prevalence of asthma and explored inflammatory asthma phenotypes that included allergic and non-allergic asthma, and within these phenotypes, an eosinophilic (eosinophils ≥300 cells/µL, or ≥150 cells/µL in the presence of ICS medication) or non-eosinophilic (eosinophils <300 cells/µL, or <150 cells/µL in the presence of ICS) phenotype. In addition, we compared various factors related to biomarkers, body composition, lung function, and symptoms in control subjects versus subjects with current asthma (current doctor’s diagnosis of asthma). Results An overall prevalence of 4.6% was observed for current asthma. Furthermore, an age-dependent shift from allergic to non-allergic asthma was found. The non-eosinophilic phenotype was more prominent. Obesity was a prevalent condition, and body composition including visceral adipose tissue (VAT), is affected in current asthma versus controls. Conclusion This broad-aged and large general population cohort identified differential patterns of inflammatory asthma phenotypes that were age-dependent. The presence of eosinophilia was associated with worse asthma control, increased asthma medication, increased VAT, and lower lung function, the opposite was found for the presence of an allergic asthma.

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“…Besides pollen and mites, furry mammals kept as companion, laboratory or farm animals are among the most common sources of allergens, causing development of sensitization and allergic diseases. The prevalence of sensitization to hair and dander from various animals appears to be increasing worldwide in the general population [ 1 , 2 , 3 ]. Animal allergy may also occur in various veterinary professions where workers are heavily and unavoidably exposed to animal allergens during most of their working time [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Animal exposure, sensitization, and allergic symptoms in first-year veterinary medicine students

Zahradnik,

Nöllenheidt,

Sander

et al. 2024

ALS

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The AllergoVet study longitudinally examines the influence of animal exposure on the development of sensitization and allergic diseases among veterinary medicine students. In this group, contact to animals usually existed long before the study began. Therefore, the aim of this analysis was to investigate lifelong animal species-specific exposure and the prevalence of sensitizations and allergic symptoms already existing before the start of the study. Questionnaire data, including exposure history, were summarized to determine the duration and intensity of animal-related exposure as well as the prevalence of allergic symptoms to animals. Serologically, specific IgE was determined against ubiquitous inhalant allergens (atopy screen sx1) and against animal allergens using ImmunoCAP. The association between animal-specific sensitization, allergic symptoms, and exposure was analyzed using Fisher’s exact test or Cochran-Armitage trend test. All study participants (n = 313) had previous contact with animals, with dogs mentioned most frequently (91.1%) followed by cats (89.5%) and horses (72.2%). Sensitization to ubiquitous allergens (positive sx1 value) was detected in 38.4% of subjects. Approximately 11%, 7%, and 5% were sensitized to cats, dogs, and horses, respectively. Only a small proportion of these sensitizations were associated with self-reported symptoms (41% for cat, 9% for dog, and 13% for horse). While no significant association between animal-specific exposure and sensitization was found for cats and horses, a clear trend emerged for dogs. With increasing duration of exposure to dogs, the number of dog-specific sensitizations decreased significantly (p = 0.0069). Furthermore, a decreasing trend in sx1 sensitization was noted with increasing cat (p = 0.0288) and dog (p = 0.0107) exposure. None of the subjects who grew up on a farm (n = 40) had any sensitization to animals. The sensitization prevalence determined among first-year students in veterinary medicine roughly corresponds to that in the general population. Most animal sensitizations were not clinically relevant. In this collective, a protective effect of increasing exposure to animals in childhood and adolescence was found on sensitization, which was particularly pronounced during contact with dogs.

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Aero-Allergen Sensitization in the General Population: Longitudinal Analyses of the LEAD (Lung Heart Social Body) Study

Cited by 13 publications

References 52 publications

Atopy and Response to Omalizumab Treatment in Chronic Spontaneous Urticaria

Atopy and Response to Omalizumab Treatment in Chronic Spontaneous Urticaria

Asthma Prevalence and Phenotyping in the General Population: The LEAD (Lung, hEart, sociAl, boDy) Study

Animal exposure, sensitization, and allergic symptoms in first-year veterinary medicine students

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