Proposed GA2LEN standardized allergen battery: what about regional sensitization differences?
نویسندگان
چکیده
In 2009, the Global Asthma and Allergy European Network (GALEN) proposed a pan-European standardized allergen battery for clinical practice and research [1]. While Parietaria species sensitization is an unquestionable cause of seasonal allergy in Mediterranean countries [2], and as such is included in this battery, Plantago lanceolata is widely considered to be a rare, isolated cause of hay fever and/or allergic asthma. This weed tolerates a wide variety of climatic conditions, and thrives in dry environments with low fertility. The Portuguese city of Porto and its surroundings belong, in biogeographic terms, to the Euro-Siberian region, the Cantabrian-Atlantic province, the Galician-Asturian subprovince, and the Galician-Portuguese sector; the climate is Mediterranean (Köppen climate classifi cation, Csb) with a cool summer and substantial winter rainfall. Since a higher-than-expected prevalence of this pollen has been described in climatically similar regions of Spain [3-5], and since not infrequently, we have obtained signifi cant levels of in vitro and in vivo specifi c immunoglobulin (Ig) E to this allergen, we launched a project designed to estimate the rate of P lanceolata sensitization in a sample of inhabitants of Porto and to compare it to the rate of Parietaria judaica sensitization. Furthermore, because Ole e 1 and Pla l 1 allergens share common epitopes [6], as a secondary outcome, we decided to investigate whether or not concomitant sensitization might be a consequence of crossreactivity between these allergen sources. To accomplish this, we reviewed skin prick test (SPT) results performed with a standardized set of aeroallergens by our university hospital allergy department over 2 consecutive years. Patients with positive SPTs to P Judaica and/or P lanceolata living near Porto were selected. The largest and perpendicular wheal diameter for each allergen was measured and the following value calculated: largest + perpendicular diameter/2; the test was considered positive when this mean value was ≥3 mm and controls showed adequate reactions [1]. Measurements were performed by 2 independent observers and the average of both observations was used. Pollen grains were collected in a Burckhardt trap and counted by a specialized botanist. All data analyses were performed using the SPSS statistical package version 18.0 for Windows (SPSS, Chicago, Illinois, USA).The χ test was used to analyze differences between categorical variables, and independent sample tests were used for continuous variables (the t test for normally distributed variables and the Mann-Whitney U test for asymmetrically distributed variables). A P value of less than .05 was considered statistically signifi cant. A total of 1588 patients (628 with pollinosis) were enrolled. Of these, 229 were sensitized to P lanceolata, corresponding to a sensitization rate of 14.4% of all patients and 36% of pollenallergic patients. Sensitization to P judaica was detected in 203 patients (sensitization rates of 12.8% and 32%, respectively). No statistically signifi cant differences were observed between the 2 samples for demographic data, sensitization rates, symptoms, mean wheal sizes, or monosensitization rate (Table 1). During this 2-year period, a pollen count was performed on 662 days. A total of 24 792 grains/mm were collected, of which 696 grains/mm belonged to P lanceolata. The sensitization rate detected for P lanceolata was higher than that observed for P judaica, although the latter is considered to be a more common cause of weed pollinosis. Since only 38% of individuals sensitized to P lanceolata were also sensitized to Olea europeae, the higher-than-expected rate of P lanceolata sensitization is not fully explained by common
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ورودعنوان ژورنال:
- Journal of investigational allergology & clinical immunology
دوره 21 6 شماره
صفحات -
تاریخ انتشار 2011