The risk of respiratory symptoms on allergen exposure increases with increasing specific IgE levels

Olivieri, Mario; Heinrich, Joachim; Schlünssen, Vivi; Antó, Josep M.; Forsberg, Bertil; Janson, Christer; Leynaert, Bénédicte; Norbäck, Dan; Sigsgaard, Torben; Svanes, Cecilie; Tischer, Christina; Villani, Simona; Jarvis, Déborah; Verlato, Giuseppe

doi:10.1111/all.12841

Cited by 45 publications

(39 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As all Bet v 6 sensitizations remain clinically silent, this finding contradicts recently published data that the level of specific IgE is the most important predictor for allergic symptoms [13]. As incidental finding, our data confirm the recent study reporting that patients with clinical relevant sensitization show higher specific IgE levels for the major allergen Bet v 1 than patients with silent sensitization [14].…”

Section: Discussionsupporting

confidence: 67%

The Clinical Impact of Bet v 6 in Birch Pollen-Sensitized Patients

Gellrich

Eder²,

Nicoló³

et al. 2017

Int Arch Allergy Immunol

View full text Add to dashboard Cite

Background: Bet v 6, a minor birch pollen allergen, is commercially available for allergen-specific IgE antibody testing. However, there is hardly any literature on the clinical impact of Bet v 6. The aim of the present study was to analyze if testing specific IgE against Bet v 6 can add valuable benefit to the standard diagnostics of birch pollen-sensitized patients, especially in patients with unknown sensitization-eliciting allergens. Methods: Birch pollen-sensitized patients with missing IgE reactivity against Bet v 1, 2, and 4 were tested for specific IgE antibodies against Bet v 6. For comparison, an equal number of randomly selected patients with birch pollen sensitization, regardless of their individual sensitization patterns, were tested for specific anti-Bet v 6. Results: Of 57 cases with missing reactivity against the standard birch pollen allergens, 2 patients were positive for Bet v 6. In the representative sample, 3 patients showed specific IgE against Bet v 6 - resulting in a total prevalence of 5%. None of the Bet v 6-positive patients showed allergic symptoms after exposure to birch pollen or an oral allergy syndrome. An increased prevalence of asthma and a higher degree of sensitization were the only distinctive clinical features in Bet v 6-positive patients. Conclusions: Among birch pollen-sensitized patients, the prevalence of specific IgE against Bet v 6 is low. Further, sensitization to Bet v 6, which shows characteristics of a panallergen, remains clinically silent. Therefore, determination of anti-Bet v 6 is not considered useful in the clinical routine.

show abstract

Section: Discussionsupporting

confidence: 67%

The Clinical Impact of Bet v 6 in Birch Pollen-Sensitized Patients

Gellrich

Eder²,

Nicoló³

et al. 2017

Int Arch Allergy Immunol

View full text Add to dashboard Cite

show abstract

“…This is a clear limitation, and additional analyses on allergic sensitisation would have improved the study. However, a high correlation between immunoglobulin E (IgE)-mediated sensitisation and self-reported allergic rhinitis has been shown in several other studies (21, 22). Our results are more pronounced for allergic rhinitis than for nasal symptoms, which probably reflects that the term ‘nasal symptoms’ is unspecific and covers a range of symptoms.…”

Section: Discussionmentioning

confidence: 94%

A clear urban–rural gradient of allergic rhinitis in a population-based study in Northern Europe

Christensen

Timm

Janson

et al. 2016

European Clinical Respiratory Journal

View full text Add to dashboard Cite

BackgroundThe protective effect of farm upbringing on allergic rhinitis is well known, but how upbringing in other environments influences the development of allergic rhinitis is scarcely investigated. The aim of this study was to investigate the association between place of upbringing and pet keeping in childhood and allergic rhinitis and nasal symptoms in adulthood.MethodsThe population-based Respiratory Health in Northern Europe study includes subjects from Denmark, Norway, Sweden, Iceland, and Estonia born in 1945–1973. This paper analyses 13,376 participants of the third study wave. Six categories of place of upbringing were defined: farm with livestock, farm without livestock, village in rural area, small town, city suburb, and inner city. Pets in the home at birth and during childhood were recorded. Data were analysed using adjusted logistic regression models.ResultsLivestock farm upbringing predicted less adult allergic rhinitis [odds ratio (OR) 0.68, 0.54–0.85] and nasal symptoms (OR 0.82, 0.68–0.99) than city upbringing, and an urban–rural gradient with decreasing risk per level of urbanisation was observed (OR 0.92, 0.88–0.94). Pets in the home at birth (OR 0.78, 0.68–0.88) and during childhood (OR 0.83, 0.74–0.93) were associated with less subsequent allergic rhinitis. Pet keeping did not explain the protective effect of place of upbringing.ConclusionRisk of allergic rhinitis and nasal symptoms in adulthood was inversely associated with the level of urbanisation during upbringing. Pets at birth decreased the risk further, but did not explain the urban–rural gradient. Persistent beneficial effects of microbial diversity in early life might be an explanation for the findings.

show abstract

“…These results suggest that rye grass pollen was the principal allergen for patients who presented to hospital with ETA. An earlier community study of allergic rhinitis found that a high level RAST result for grass pollen (17.5 kIU/L or more) was associated with a 50‐fold relative risk (compared with non‐allergic controls) of rhinitis and asthma symptoms when exposed to grass pollen 2 . Combined with our findings, this suggests that a high level positive RAST result for rye grass may be useful for predicting the likelihood of risk of ETA in individuals with allergic rhinitis, with or without asthma.…”

mentioning

confidence: 99%