Allergic sensitization is age-dependently associated with rhinitis, but less so with asthma

Warm, Katja; Hedman, Linnéa; Lindberg, Anne; Lötvall, Jan; Lundbäck, Bo; Rönmark, Eva

doi:10.1016/j.jaci.2015.06.015

Cited by 64 publications

(66 citation statements)

References 41 publications

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“…The prevalence and changing patterns of allergen sensitization in our study are similar to those in other Korean studies 21. Although sensitization to pollen is reported to be related to AR, we did not confirm this finding in our study 3738…”

Section: Discussionsupporting

confidence: 57%

Comorbidities and Phenotypes of Rhinitis in Korean Children and Adolescents: A Cross-sectional, Multicenter Study

Lee

Yum

Sheen

et al. 2017

Allergy Asthma Immunol Res

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PurposeRhinitis is a nasal inflammatory disease in children and adolescents. However, little is known about the phenotypes and characteristics of allergic rhinitis (AR) in Korean children and adolescents. The objective of this study was to analyze the symptoms and comorbidities of rhinitis, to compare AR to non-allergic rhinitis (NAR), and to reveal the phenotypes and features of AR in a Korean pediatric population.MethodsPatients under 18 years of age with rhinitis symptoms were recruited from January 2013 to January 2015 by pediatric allergists. We analyzed symptoms, phenotypes, comorbidities, and allergen sensitization in this cross-sectional, multicenter study.ResultsMedical records were collected from 11 hospitals. The AR group has 641 (68.3%) patients, with 63.2% of boys and 7.5 (±3.4) years of mean age. The NAR group has 136 (14.5%) patients, with 55.1% of boys and 5.5 (±2.9) years of mean age. Moderate-severe persistent AR affected 41.2% of AR patients. Nasal obstruction was more common in NAR patients (P<0.050), whereas AR patients sneezed more (P<0.050) and more commonly had conjunctivitis, asthma, and otitis media (P<0.050). Sinusitis was the most common comorbidity in both groups. Allergen sensitization was caused by house dust mites (HDMs) (90.2%), pollen (38.7%), and animal dander (24.8%) in AR patients. Pollen and animal dander sensitization significantly increased age-dependently (P<0.050), but 91.9% of AR patients were already sensitized to HDMs before 5 years old.ConclusionsOur study revealed that AR was more prevalent than NAR and that 41.2% of AR presented with moderate-severe disease in Korean pediatric populations. Sinusitis was the most common comorbidity, and sleep disturbance was associated with the severity of rhinitis. The majority of AR patients were sensitized to HDMs in preschool ages. Further studies, including nationwide and longitudinal data, will help understand the relationship between these diseases.

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Section: Discussionsupporting

confidence: 57%

Comorbidities and Phenotypes of Rhinitis in Korean Children and Adolescents: A Cross-sectional, Multicenter Study

Lee

Yum

Sheen

et al. 2017

Allergy Asthma Immunol Res

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“…Patients with early‐onset allergic asthma tend to have a clear association between allergen exposure and symptoms, as well as between upper and lower airway symptoms . Whereas in late‐onset severe asthma, patients may frequently have allergic sensitization to aeroallergens, but in most cases their symptoms do not seem to be aggravated by allergen exposure or associated with symptoms of allergic rhinitis …”

Section: Allergic Rhinitismentioning

confidence: 99%

Co‐morbidities in severe asthma: Clinical impact and management

2017

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Patients with severe asthma represent a minority of the total asthma population, but carry a majority of the morbidity and healthcare costs. Achieving better asthma control in this group of patients is therefore of key importance. Systematic assessment of patients with possible severe asthma to identify treatment barriers and triggers of asthma symptoms, including co-morbidities, improves asthma control and reduces healthcare costs and is recommended by international guidelines on management of severe asthma. This review provides the clinician with an overview of the prevalence and clinical impact of the most common co-morbidities in severe asthma, including chronic rhinosinusitis, nasal polyposis, allergic rhinitis, dysfunctional breathing, vocal cord dysfunction, anxiety and depression, obesity, obstructive sleep apnoea syndrome (OSAS), gastroesophageal reflux disease (GERD), bronchiectasis, allergic bronchopulmonary aspergillosis (ABPA) and eosinophilic granulomatous with polyangiitis (EGPA). Furthermore, the review offers a summary of recommended diagnostic and management approaches for each co-morbidity. Finally, the review links co-morbid conditions to specific phenotypes of severe asthma, in order to guide the clinician on which co-morbidities to look for in specific patients.

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“…The strength with our study was the large population-based cohort with a high participation rate resulting in a representative study population. Furthermore, the questionnaire and questions [7–10,14,16,24,26,28,35] have been used in several studies.…”

Section: Discussionmentioning

confidence: 99%

“…A cohort recruited to a similar survey in 1996 was at the same time in 2006 invited for follow-up, now aged 30–84 years ( n = 7,004) and 85% participated. In total 12,055 (80.4%) responded and the same questionnaire was used in both cohorts [24]. The questionnaire was based on a British Medical Research Council questionnaire but included questions from the US Tucson and ATS questionnaires and has been described previously [25] The study population in the current study includes all individuals 30–69 years of age ( n = 9,992, 50.3% women).…”

Section: Methodsmentioning

confidence: 99%

Job titles classified into socioeconomic and occupational groups identify subjects with increased risk for respiratory symptoms independent of occupational exposure to vapour, gas, dust, or fumes

Schyllert

Andersson

Hedman

et al. 2018

European Clinical Respiratory Journal

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Objectives: To evaluate the ability of three different job title classification systems to identify subjects at risk for respiratory symptoms and asthma by also taking the effect of exposure to vapours, gas, dust, and fumes (VGDF) into account. Background: Respiratory symptoms and asthma may be caused by occupational factors. There are different ways to classify occupational exposure. In this study, self-reported occupational exposure to vapours, gas, dust and fumes was used as well as job titles classifed into occupational and socioeconomic Groups according to three different systems. Design: This was a large population-based study of adults aged 30–69 years in Northern Sweden (n = 9,992, 50% women). Information on job titles, VGDF-exposure, smoking habits, asthma and respiratory symptoms was collected by a postal survey. Job titles were used for classification into socioeconomic and occupational groups based on three classification systems; Socioeconomic classification (SEI), the Nordic Occupations Classification 1983 (NYK), and the Swedish Standard Classification of Occupations 2012 (SSYK). Associations were analysed by multivariable logistic regression. Results: Occupational exposure to VGDF was a risk factor for all respiratory symptoms and asthma (odds ratios (ORs) 1.3–2.4). Productive cough was associated with the socioeconomic groups of manual workers (ORs 1.5–2.1) and non-manual employees (ORs 1.6–1.9). These groups include occupations such as construction and transportation workers, service workers, nurses, teachers and administration clerks which by the SSYK classification were associated with productive cough (ORs 2.4–3.7). Recurrent wheeze was significantly associated with the SEI group manual workers (ORs 1.5–1.7). After adjustment for also VGDF, productive cough remained significantly associated with the SEI groups manual workers in service and non-manual employees, and the SSYK-occupational groups administration, service, and elementary occupations. Conclusions: In this cross-sectional study, two of the three different classification systems, SSYK and SEI gave similar results and identified groups with increased risk for respiratory symptoms while NYK did not give conclusive results. Furthermore, several associations were independent of exposure to VGDF indicating that also other job-related factors than VGDF are of importance.

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Allergic sensitization is age-dependently associated with rhinitis, but less so with asthma

Cited by 64 publications

References 41 publications

Comorbidities and Phenotypes of Rhinitis in Korean Children and Adolescents: A Cross-sectional, Multicenter Study

Comorbidities and Phenotypes of Rhinitis in Korean Children and Adolescents: A Cross-sectional, Multicenter Study

Co‐morbidities in severe asthma: Clinical impact and management

Job titles classified into socioeconomic and occupational groups identify subjects with increased risk for respiratory symptoms independent of occupational exposure to vapour, gas, dust, or fumes

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