Clinical Characteristics and Allergen Sensitization Patterns of Patients with Local Allergic Rhinitis in Southern China

Abstract

Background: Local allergic rhinitis (LAR) is characterized by the production of specific IgE (sIgE) in the nasal mucosa without evidence of systemic atopy. The characteristics of LAR in Caucasians have been well documented. LAR is understudied in China, with prevalence, patient demographics, symptomatology, and the allergen sensitization profile being poorly understood. The purpose of this study is to investigate the demographics, characteristics, and allergen sensitization profile of patients with LAR in Southern China. Methods: A total of 194 patients with rhinitis and 13 healthy subjects were enrolled in the current study. The patients' demographic data, clinical history, and symptoms were recorded. Local and systemic sIgE to a wide panel of specific allergens were measured in the nasal secretion and serum samples. Results: Among the rhinitis patients, 115 were classified as allergic rhinitis (AR; 59.3%), 15 as LAR (7.7%), and 64 as non-AR (33.0%). The demographic characteristics, duration, frequency, and severity of symptoms were similar, although LAR exhibited higher symptom scores for nasal itch. Monosensitization was the predominant pattern of sensitization in both AR (109 out of 115, 95%) and LAR (14 out of 15, 93%). House dust mite was the dominant allergen in AR patients (109 out of 115, 95%), while pollen was the dominant allergen in LAR patients (11 out of 15, 73%). Conclusion: The prevalence of LAR patients in Southern China was 7.7%. Pollen was the most common sensitizing allergen for the local LAR patients, which differs from Caucasian studies, in which house dust mite was the dominant sensitizing allergen. Monosensitization was the predominant pattern in both AR and LAR.

How to Diagnose and Treat Local Allergic Rhinitis: A Challenge for Clinicians

“…Nevertheless, the existing literature reflects an extremely wide range of LAR prevalence among non-atopic rhinitis patients (0–100%) [9,21,22,23,24,26,27,28,29,30,31,32,33,34,37]. In recent years, several studies from Asian countries have become available and overall report a lower (<20%) prevalence of LAR as compared to Western countries [26,27,29,33,37]. It has been suggested that LAR prevalence in the Mediterranean areas (Portugal, Spain, Italy, Greece, etc.)…”

Local Respiratory Allergy: From Rhinitis Phenotype to Disease Spectrum

“…In this regard, a systematic review concluded that 16% of non-atopic children with rhinitis fulfill diagnostic criteria for LAR ( 19 ). Nevertheless, regional differences in LAR prevalence might exist, as published data consistently identify a higher frequency of LAR among Western (29-67%) ( 20 – 23 ) as compared to Asian (0-19%) ( 24 – 27 ) non-atopic children with rhinitis. To address this aspects, we recently conducted a systematic evaluation (SPT, serum sIgE and NAC) of pediatric patients referred to specialized units for chronic nasal symptoms, and found a 46%, 12%, 25% and 18% prevalence for AR, DAR, LAR and NAR, respectively ( 18 ).…”

Research on allergic rhinitis improvement in asthmatic children after dust mite exposure reduction: a randomized, double-blind, cross-placebo study protocol

“…Dust mites are a common trigger for AR [10]. The prevalence of house dust mites (HDMs) in AR patients in southern China is 95% [11]. Avoiding allergen exposure is an important measure to treat AR.…”