Evaluation of clinical and demographic characteristics in children with aeroallergen sensitization: A study based on skin prick test results
Main Article Content
Keywords
Allergens, child, pollen, respiratory hypersensitivity, secale
Abstract
Objective: This study aimed to evaluate the demographic and clinical features of pediatric aeroallergen sensitization and seasonal symptom patterns, focusing on pollen.
Materials and methods: This retrospective single-center study included children aged 1–18 years who underwent standardized skin prick testing (SPT) between January 2020 and July 2021. Patients with chronic or immunological disorders other than asthma, allergic rhinitis (AR), and atopic dermatitis (AD) were excluded. Clinical and laboratory data, including symptom profiles, family atopy history, eosinophil counts, and total IgE, were extracted from records. Aeroallergen panels included pollens, house dust mites, molds, and animal dander. Comparisons were performed between monosensitized and polysensitized patients, and between those sensitized to pollen versus house dust mites.
Results: Of 2247 children tested, 2017 were eligible, and 500 (24.7%) with clinically relevant sensitization were analyzed (57% male; median age: 12 years, IQR: 8–15). Pollen was the most frequent sensitizer (78.6%), followed by house dust mites (36.6%). Within pollens, Poaceae predominated (98.1%), with Secale as the leading species (88.4%). Seasonal peaks of symptoms in pollen-sensitized patients occurred in May (31.8%), April (29.6%), and June (27%). Polysensitization was observed in 38.8%. AR was the most common diagnosis (83.2%), while asthma and AD were present in 36.4% and 34.0%, respectively. Pollen sensitization was significantly associated with AR (88% vs. 63%, p < 0.01) and sneezing (38% vs. 16%, p < 0.01), whereas house dust mite sensitization was more often linked with skin rashes (25.5% vs. 13%, p = 0.008). Patients with eosinophilia were younger, predominantly male, and more frequently diagnosed with AR (p < 0.001).
Conclusions: Pollen, particularly from the Poaceae family, was the predominant aeroallergen, and symptom timing matched seasonal pollen trends. Inclusion of region-specific pollens such as Secale in SPT panels is crucial for accurate sensitization detection and for guiding localized public health strategies.
References
2 Wahn U, Lau S, Bergmann R, Kulig M, Forster J, Bergmann K, et al. Indoor allergen exposure is a risk factor for sensitization during the first three years of life. J Allergy Clin Immunol. 1997;99(6 Pt 1):763–9. 10.1016/s0091-6749(97)80009-7
3 Li J, Wang H, Chen Y, Zheng J, Wong GW, Zhong N. House dust mite sensitization is the main risk factor for the increase in prevalence of wheeze in 13-to 14-year-old schoolchildren in Guangzhou city, China. Clin Exp Allergy. 2013;43(10):1171–9. 10.1111/cea.12157
4 Dickel H, Kuhlmann L, Bauer A, Bircher AJ, Breuer K, Fuchs T, et al. Atopy patch testing with aeroallergens in a large clinical population of dermatitis patients in Germany and Switzerland, 2000-2015: A retrospective multicentre study. J Eur Acad Dermatol Venereol. 2020;34(9):2086–95. 10.1111/jdv.16250
5 Gureczny T, Heindl B, Klug L, Wantke F, Hemmer W, Wöhrl S. Allergy screening with extract-based skin prick tests demonstrates higher sensitivity over in vitro molecular allergy testing. Clin Transl Allergy. 2023;13(2):e12220. 10.1002/clt2.12220
6 Oezguen N, Rider NL, Dowlin M, Singh I. Identifying region-specific allergy sensitization clusters to optimize diagnosis and reduce costs. J Pediatr. 2024;270:113999.
7 Dramburg S, Hilger C, Santos AF, de Las Vecillas L, Aalberse RC, Acevedo N, et al. EAACI Molecular Allergology User’s Guide 2.0. Pediatr Allergy Immunol. 2023;34 Suppl 28:e13854. 10.1111/pai.13854
8 Shetty NS, Lunge S, Sardesai VR, Dalal AB. A cross-sectional study comparing application of Hanifin and Rajka criteria in Indian pediatric atopic dermatitis patients to that of other countries. Indian Dermatol Online J. 2022;14(1):32–7. 10.4103/idoj.idoj_192_22
9 Brozek JL, Bousquet J, Baena-Cagnani CE, Bonini S, Canonica GW, Casale TB, et al. Allergic rhinitis and its impact on asthma (ARIA) guidelines: 2010 revision. J Allergy Clin Immunol. 2010;126(3):466–76. 10.1016/j.jaci.2010.06.047
10 Levy ML, Bacharier LB, Bateman E, Boulet LP, Brightling C, Buhl R, et al. Key recommendations for primary care from the 2022 Global Initiative for Asthma (GINA) update. NPJ Prim Care Respir Med. 2023;33(1):7. 10.1038/s41533-023-00330-1
11 Guan K, Zhu W, Sha L, Liu C, Zhao J, Yin J, et al. Prevalence of sensitization to aeroallergens in greater Beijing region children with respiratory allergy. Front Pediatr. 2022;10:848357. 10.3389/fped.2022.848357
12 Akcakaya N, Cokugras H, Camcioglu Y, Ozdemir M. Skin test hypersensitivity for childhood asthma in Istanbul during a period of 16 years. Allergol Immunopathol (Madr). 2005;33(1):15–9. 10.1157/13070603
13 Ayçin GD, Bayrak M, Çadırcı K. Alerjik rinit ve astım olan hastalarda prick testi sonuçlarımız. J Health Sci Med. 2020; 3(3):245–9. 10.32322/jhsm.710017
14 Çiçek D, Kandi B, Bakar S, Ucak H. Elazığ yöresinde allerjik astma, allerjik rinit, allerjik konjunktivit, kronik ürtiker ve atopik dermatitli olgularda prick test sonuçlarının değerlendirilmesi. Fırat Üniversitesi Sağlık Bilimleri Tıp Dergisi. 2008; 22(4):193–6.
15 Sevgi SÇ, Gizem A. Aeroallergen distributions in skin prick tests in children with asthma and allergic rhinitis living in the Elazığ and Malatya regions. J Child. 2023; 23(1):35–41. 10.26650/jchild.2023.1152191
16 Dey D, Mondal P, Laha A, Sarkar T, Moitra S, Bhattacharyya S, et al. Sensitization to common aeroallergens in the atopic population of West Bengal, India: An investigation by skin prick test. Int Arch Allergy Immunol. 2019; 178(1):60–5. 10.1159/000492584
17 Bian S, Zhu W, Guan K, Sha L. Prevalence of aeroallergen sensitization in children in Northern China. J Asthma. 2024; 61(9):1021–8. 10.1080/02770903.2024.2320783
18 Kim YJ, Lee MY, Yang AR, Sol IS, Kwak JH, Jung HL, et al. Trends of sensitization to inhalant allergens in Korean children over the last 10 years. Yonsei Med J. 2020;61(9):797–804. 10.3349/ymj.2020.61.9.797
19 Kim JH, Oh JW, Lee HB, Kim SW, Kang IJ, Kook MH, et al. Changes in sensitization rate to weed allergens in children with increased weeds pollen counts in Seoul metropolitan area. J Korean Med Sci. 2012;27(4):350–5. 10.3346/jkms.2012.27.4.350
20 Choi SW, Lee J-H, Kim Y, Oh I-B, Choi K-R. Association between the sensitization rate for inhalant allergens in patients with respiratory allergies and the pollen concentration in Ulsan, Korea. Korean J Med. 201;86(4):453–61. 10.3904/kjm.2014.86.4.453
21 Yoon BJ, Kim SH, Kim DH, Koh YI. Longitudinal changes of sensitization rates to inhalant allergens in patients with allergic diseases from Gwangju and Chonnam areas: their association with annual changes in temperature. Korean J Asthma Allergy Clin Immunol. 2011;31(2):93.
22 Harmancı K, Bakırtaş A, Türktaş İJTRJ. Sensitization to aeroallergens in preschool children with respiratory problems in Ankara, Turkey. Turk Thorac J. 2006;7(1):10–4.
23 Huang Z, Li A, Zhu H, Pan J, Xiao J, Wu J, et al. Multicenter study of seasonal and regional airborne allergens in Chinese preschoolers with allergic rhinitis. Sci Rep. 2024;14(1):4754.
24 Wang W, Zhang XH, Zhu L, Liu YX. Investigation of allergic sensitization pattern in 4,203 children in Northern China. Int Arch Allergy Immunol. 2021;182(5):455–8. 10.1159/000511976