Dane EDİGER, Ümmühan ŞEKER, Müge ERBAY, Fatma Esra GÜNAYDIN

Trends of sensitization to aeroallergens in patients with allergic rhinitis and asthma in the city of Bursa, South Marmara Sea Region of Turkey

Background/aim: Allergic rhinitis (AR) and asthma are the most common allergic disorders worldwide. Aeroallergens are criticalcausative factors in the pathogenesis of these disorders and sensitization to aeroallergens differs in various countries and regions.Identification of the most common aeroallergen sensitization is crucial in the diagnosis and management of AR and asthma. Weexamined the distribution of aeroallergen sensitizations detected by skin prick tests (SPTs) in adult patients with AR and/or asthma inthe city of Bursa.Materials and methods: Five hundred forty-five patients who underwent a SPT and were diagnosed with rhinitis and/or asthma inthe Uludağ University Faculty of Medicine’s Department of Immunology and Allergic Diseases Outpatient Clinic from March 2018 toAugust 2018 were retrospectively evaluated. SPTs with standard extracts including house dust mites, pollens, molds, animal dander, andlatex were performed for patients.Results: A total of 545 patients were included and most of the patients (270; 49.5%) were between 30 and 49 years of age. The prevalenceof atopy was 57.9%. The most common aeroallergens detected in SPTs were Dermatophagoides farinae (50%) and D. pteronyssinus (44%),followed by grass-rye mix (43%), grass mix (38.6%), olive (33.2%), and wheat (32.3%). The sensitization to olive pollen was higher incases of mild asthma (52%), while sensitization to D. farinae was higher in patients with mild and moderate asthma (54.5%, 54.2%) (P< 0.05) .Conclusions: Our study revealed that house dust mite was the most common sensitizing aeroallergen in patients with AR and asthmawhile pollens were the most common allergen in patients with only AR. The sensitization to grass and olive pollen was higher in casesof mild asthma than moderate and severe. Regional allergy panels may provide important clinical clues for characteristics and coursesof allergic diseases.

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1. Asher MI, Montefort S, Bjorksten B, Lai CK, Strachan DP et al. Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC Phases One and Three repeat multicountry crosssectional surveys. Lancet 2006; 368: 733-743. doi: 10.1016/ S0140-6736(06)69283-0
2. Chhabra SK, Gupta CK, Chhabra P, Rajpal S. Prevalence of bronchial asthma in school children in Delhi. Journal of Asthma 1998; 35: 291-296.
3. Reddel HK, Hurd SS, FitzGerald JM. World asthma day. GINA 2014: A global asthma strategy for a global problem. International Journal of Tuberculosis and Lung Disease 2014; 18: 505-506. doi:10.5588/ijtld.14.0246
4. Ozergin Coskun Z, Celebi Erdivanlı O, Kazıkdas KC, Terzi S, Sahin U et al. High sensitization to house-dust mites in patients with allergic rhinitis in the eastern Black Sea region of Turkey: a retrospective study. American Journal of Rhinology & Allergy 2016; 30: 351-355. doi: 10.2500/ajra.2016.30.4353
5. Farrokhi S, Gheybi MK, Movahed A, Tahmasebi R, Iranpour D et al. Common aeroallergens in patients with asthma and allergic rhinitis living in southwestern part of Iran: based on skin prick test reactivity. Iranian Journal of Allergy, Asthma and Immunology 2015; 14 (2): 133.
6. Pazoki N, Ahmadi A, Mansori M, Mosavi Khorshidi SM, Onsori F et al. Prevalence of aeroallergens in patients with allergic rhinitis. Journal of Mazandaran University of Medical Sciences 2015; 25 (125): 73-80.
7. Allen M, Heinzmann A, Noguchi E, Abecasis G, Broxholme J et al. Positional cloning of a novel gene influencing asthma from chromosome 2q14. Nature Genetics 2003; 35: 258-263. doi: 10.1038/ng1256
8. Vercelli D. Discovering susceptibility genes for asthma and allergy. Nature Reviews Immunology 2008; 8: 169-182. doi: 10.1038/nri2257
9. Illi S, Depner M, Genuneit J, Horak E, Loss G et al. Protection from childhood asthma and allergy in Alpine farm environments-the GABRIEL Advanced Studies. Journal of Allergy and Clinical Immunology 2012; 129: 1470-1477.e6. doi:10.1016/j.jaci.2012.03.013
10. Marfortt DA, Josviack D, Lozano A, Cuestas E, Aguero L et al. Differences between preschoolers with asthma and allergies in urban and rural environments. Journal of Asthma 2018; 55: 470-476. doi: 10.1080/02770903.2017.1339800
11. Dey D, Mondal P, Laha A, Sarkar T, Moitra S et al. Sensitization to common aeroallergens in the atopic population of West Bengal, India: an investigation by skin prick test. International Archives of Allergy and Immunology 2019; 178: 60-65. doi: 10.1159/000492584
12. Katelaris CH, Lee BW, Potter PC, Maspero JF, Cingi C et al. Prevalence and diversity of allergic rhinitis in regions of the world beyond Europe and North America. Clinical & Experimental Allergy 2012; 42: 186-207. doi: 10.1111/j.1365- 2222.2011.03891.x
13. Dinmezel S, Ogus C, Erengin H, Cilli AO, Ozdemir T. The prevalence of asthma, allergic rhinitis, and atopy in Antalya, Turkey. Allergy & Asthma Proceedings 2005; 26: 403-409.
14. Tug T, Acik Y. Prevalence of asthma, asthma-like and allergic symptoms in the urban and rural adult population in Eastern Turkey. Asian Pacific Journal of Allergy and Immunology 2002; 20: 209-11.
15. Sakar A, Yorgancioglu A, Dinc G, Yuksel H, Celik P et al. The prevalence of asthma and allergic symptoms in Manisa, Turkey. Asian Pacific Journal of Allergy and Immunology 2006; 24: 17-25.
16. Akkurt I, Sümer H, Ozşahin SL, Gönlügür U, Ozdemir L et al. Prevalence of asthma and related symptoms in Sivas, Central Anatolia. Journal of Asthma 2003; 40: 551-556.
17. Celik G, Mungan D, Bavbek S, Sin B, Ediger D et al. The prevalence of allergic diseases and atopy in Ankara, Turkey: a two-step population-based epidemiological study. Journal of Asthma 1999; 36: 281-290.
18. Uzaslan EK, Yüksel EG, Özyardımcı N. Astma polikliniğimizde izlenmekte olan atopik bronşiyal astmalı olgularda prick, intradermal deri testleri ve rast yöntemi sonuçlarının değerlendirilmesi. Van Tıp Dergisi 1999; 6 (2): 13-18 (in Turkish).
19. Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention. Report. Fontana, WI, USA: GINA; 2018.
20. Sharma RK, Mathur Y, Chhabra G, Luhadia A, Kumar Luhadia S et al. Skin prick test, allergic rhinitis and bronchial asthma. Indian Journal of Allergy, Asthma and Immunology 2018; 32: 47-53. doi: 10.4103/ijaai.ijaai_9_18
21. Celenk S, Canitez Y, Bicakci A, Sapan N, Malyer H. An aerobiological study on pollen grains in the atmosphere of North- West Turkey. Environmental Monitoring and Assessment 2008; 158 (1-4): 365-380. doi: 10.1007/s10661-008-0590-1
22. Tham EH, Lee AJ, Bever HV. Aeroallergen sensitization and allergic disease phenotypes in Asia. Asian Pacific Journal of Allergy and Immunology 2016; 34 (3): 181-189. doi: 10.12932/ AP0770
23. Heinzerling L, Mari A, Bergmann KC, Bresciani M, Burbach GN et al. The skin prick test - European standards. Clinical and Translational Allergy 2013; 3 (1): 3. doi: 10.1186/2045-7022-3-3
24. Öztürk Ö, Tokmak A, Güçlü E, Yıldızbaş Ş, Gültekin E. Düzce’de allerjik rinitli hastalarda prick testi sonuçları. Düzce Tıp Fakültesi Dergisi 2005; 1: 11-14 (in Turkish).
25. Harmanci E, Us T, Ozdemir N, Akgun Y, Aydinli A et al. The relationship between skin prick tests and serum specific IgE which is determined by chemiluminescence method in the diagnosis of respiratory system allergies. Solunum 2000; 2: 31- 35.
26. Aydin S, Hardal U, Atli H. An analysis of skin prick test reactions in allergic rhinitis patients in Istanbul, Turkey. Asian Pacific Journal Of Allergy and Immunology 2009; 27: 19.
27. Yasan H, Aynali G, Akkuş Ö, Doğru H, Özkan M et al. Alerjik rinitten sorumlu alerjen profilinin değişimi ve semptomlarla korelasyonu. KBB- Forum 2006; 5: 158-160 (in Turkish).
28. Kalpaklioglu AF, Emekci M, Ferizli A, Misirligil Z; HouseDust Mite Working Group. A survey of acarofauna in Turkey: comparison of seven different geographic regions. Allergy & Asthma Proceedings 2004; 25: 185-90.
29. Ezeamuzie CI, Thomson MS, Al-Ali S, Dowaisan A, Khan M et al. Asthma in the desert: spectrum of the sensitizing aeroallergens. Allergy 2000; 55: 157-162.
30. Lou H, Ma S, Zhao Y, Cao F, He F et al. Sensitization patterns and minimum screening panels for aeroallergens in self-reported allergic rhinitis in China. Scientific Reports 2017; 7: 9286. doi: 10.1038/s41598-017-10111-9V
31. Saleem N, Waqar S, Shafi A. Skin prick test reactivity to common aeroallergens among allergic rhinitis patients. Journal of the College of Physicians and Surgeons Pakistan 2018; 28 (10): 766- 771.
32. Oncham S, Udomsubpayakul U, Laisuan W. Skin prick test reactivity to aeroallergens in adult allergy clinic in Thailand: a 12-year retrospective study. Asia Pacific Allergy 2018; 8 (2): e17. doi: 10.5415/apallergy.2018.8.e17
33. Guilbert A, Cox B, Bruffaerts N, Hoebeke L, Packeu A et al. Relationships between aeroallergen levels and hospital admissions for asthma in the Brussels-Capital Region: a daily time series analysis. Environmental Health 2018; 17 (1): 35. doi: 10.1186/s12940-018-0378-x
34. Van der Heide S, De Monchy JG, De Vries K, Dubois AE, Kauffman HF. Seasonal differences in airway hyperresponsiveness in asthmatic patients: relationship with allergen exposure and sensitization to house dust mites. Clinical & Experimental Allergy 1997; 27 (6): 627-633.
35. Choi IS, Koh YI, Koh JS, Lee MG. Sensitivity of the skin prick test and specificity of the serum-specific IgE test for airway responsiveness to house dust mites in asthma. Journal of Asthma 2005; 42 (3): 197-202.
36. Khazaei HA, Hashemi SR, Aghamohammadi A, Farhoudi F, Rezaei N. The study of type 1 allergy prevalence among people of South-East of Iran by skin prick test using common allergens. Iranian Journal of Allergy, Asthma and Immunology 2003; 2 (3): 165-168. doi: 02.03/ijaai.165168
37. Kumran NA, Kovancı B. Bursa İli zeytin ağaçlarında bulunan akar türleri. Bursa Uludağ Üniversitesi Ziraat Fakültesi Dergisi 2004; 18 (2): 25-34 (in Turkish).
38. Sakashita M, Hirota T, Harada M, Nakamichi R, Tsunoda T et al. Prevalence of allergic rhinitis and sensitization to common aeroallergens in a Japanese population. International Archives of Allergy and Immunology 2010; 151: 255-261.
39. Yazısız V, Yalçın AD, Afacan B, Avcı AB, Terzioğlu E. Antalya bölgesindeki allerjik rinitli hastaların değerlendirmesi. Astım Allerji İmmünoloji 2007; 5 (2): 61-67 (in Turkish).
40. Başak O, Başak S, Gültekin B, Tekin N, Söylemez A. The prevalence of allergic rhinitis in adults in Aydin, Turkey. Rhinology 2006; 4: 283-287.
41. Ceylan E, Gencer M, San Iyinen I. Distribution of aeroallergens in prick tests in patients with allergic rhinitis. Turkiye Klinikleri Journal of Medical Sciences 2006; 26: 370-374.
42. Sener O, Kim YK, Ceylan S, Ozanguc N, Yoo TJ. Comparison of skin tests to aeroallergens in Ankara and Seoul. Journal of Investigational Allergology and Clinical Immunology 2003; 13: 202-208.
43. Spieksma FTM, Frenguelli G, Nikkels AH, Mincigrucci G, Smithvis LOMJ et al. Comparative study of airborne pollen concentrations in central Italy and the Netherlands, 1982– 1985. Grana 1989; 28: 25-36. doi: 10.1080/00173138909431009