PURPOSE: Data are lacking on the association between the allergic rhinitis (AR) phenotype and sensitization to specific allergens or bronchial hyperresponsiveness (BHR) in children. We here investigated risk factors and comorbidities, including sensitization to specific allergens and BHR, for the AR phenotype by AR and its Impact on Asthma (ARIA) classification in a general population-based birth cohort study. METHODS: We enrolled 606 children aged 7 years from the Panel Study of Korean Children. The AR phenotype was assigned in accordance with the ARIA classification in children. Skin prick tests and Provocholine provocation test were performed. Risk factors and comorbidities for AR phenotypes were then analyzed. RESULTS: The prevalence of mild and moderate to severe AR in our study cohort was 37.2% and 8.8%, respectively. Recent use of analgesics or antipyretics and current cat ownership were associated with the risk of mild persistent AR. Sensitizations to Dermatophagoides Pteronyssinus (Der p), Japanese hop and cat were associated with moderate to severe persistent AR. Children with moderate to severe AR had a higher risk of current asthma and BHR compared to mild AR cases (adjusted odds ratio [aOR], 5.26; 95% confidence interval [CI], 1.77–15.62). Moderate to severe AR with allergic sensitization was associated with the highest risk of BHR (aOR, 11.77; 95% CI, 3.40–40.74). CONCLUSIONS: Moderate to severe-persistent AR is more closely related to respiratory comorbidities and sensitizations than mild AR. Stratifying the AR phenotype by ARIA classification may assist in disease management.
Allergens ; Analgesics ; Animals ; Antipyretics ; Asian Continental Ancestry Group ; Asthma ; Bronchial Hyperreactivity ; Cats ; Child ; Classification ; Cohort Studies ; Comorbidity ; Dermatophagoides pteronyssinus ; Disease Management ; Humans ; Methacholine Chloride ; Odds Ratio ; Ownership ; Parturition ; Phenotype ; Prevalence ; Rhinitis, Allergic ; Risk Factors ; Skin

Mast cells, which are major effector cells in allergic reactions, are found in the perivascular spaces of most tissues and contain pro-inflammatory and vasoactive mediators. These mediators are released after IgE receptor cross-linking induced by allergens or other stimuli, including anaphylatoxins (C3a and C5a), aggregated IgG, certain drugs, venoms, and physical stimuli (pressure and temperature changes), as well as cytokines and neuropeptides. The excess release of these mediators can cause variable allergic symptoms and signs, such as bronchospasm, itching, flushing, nausea, vomiting, diarrhea, abdominal pain, vascular instability, and anaphylaxis. Furthermore, mast cell disorders may involve either excessive proliferation of mast cells or abnormal mast cell reactivity. Mast cell disorders can be broadly divided into 3 types: primary, secondary, and idiopathic. All of these disorders present with signs and symptoms of mast cell activation and differ in severity and involvement of various organ systems. The best characterized primary disorder is mastocytosis. Systemic and cutaneous forms of the disease are well described. Secondary disorders include typical allergic diseases and some types of urticarial diseases. In this article, the biochemical characteristics of mast cells and the role of mast cells in allergic inflammation, as well as the classification, diagnosis, and management of mast cell-related disorders, will be reviewed.
Abdominal Pain ; Allergens ; Allergy and Immunology ; Anaphylatoxins ; Anaphylaxis ; Bronchial Spasm ; Classification ; Cytokines ; Diagnosis ; Diarrhea ; Flushing ; Hypersensitivity ; Immunoglobulin E ; Immunoglobulin G ; Inflammation* ; Mast Cells* ; Mastocytosis ; Nausea ; Neuropeptides ; Pruritus ; Venoms ; Vomiting

Allergic rhinitis is chronic disorder of nose which is evoked by IgE-mediated inflammation mostly triggered by contact between nasal mucosa and inhalant allergen. Allergic rhinitis can be classified according to seasonality (seasonal or perennial), continuity (intermittent or persistent), and severity (mild, moderate, or severe). Allergic rhinitis is relatively common, and the prevalence of allergic rhinitis has increased in Korea like other countries. As well as the prevalence of allergic rhinitis, the indoor and outdoor concentration of inhalant allergens and the sensitization to inhalant allergens were systematically investigated in Korea. As a result, house dust mite, pollens, fungal spores, cockroach, and animal hairs were found to be common inhalant allergens. Moreover, the concentration of tree pollens and grass pollens and sensitization to those pollens increased because of global warming, which may consequently increase the prevalence of pollen-induced allergic rhinitis. With regard to socioeconomic burden of allergic rhinitis, the direct medical cost including herbal and alternative medicine was as high as 1.78 million Korean won per year. Direct nonmedical cost as well as indirect cost including unproductivity, absenteeism, and medical cost for associated diseases such as asthma worsened the socioeconomic burden of allergic rhinitis.
Absenteeism ; Allergens ; Animals ; Asthma ; Classification* ; Cockroaches ; Complementary Therapies ; Epidemiology* ; Global Warming ; Hair ; Inflammation ; Korea ; Nasal Mucosa ; Nose ; Poaceae ; Pollen ; Prevalence ; Pyroglyphidae ; Rhinitis* ; Rhinitis, Allergic, Perennial ; Seasons ; Spores, Fungal

Allergic rhinitis is chronic disorder of nose which is evoked by IgE-mediated inflammation mostly triggered by contact between nasal mucosa and inhalant allergen. Allergic rhinitis can be classified according to seasonality (seasonal or perennial), continuity (intermittent or persistent), and severity (mild, moderate, or severe). Allergic rhinitis is relatively common, and the prevalence of allergic rhinitis has increased in Korea like other countries. As well as the prevalence of allergic rhinitis, the indoor and outdoor concentration of inhalant allergens and the sensitization to inhalant allergens were systematically investigated in Korea. As a result, house dust mite, pollens, fungal spores, cockroach, and animal hairs were found to be common inhalant allergens. Moreover, the concentration of tree pollens and grass pollens and sensitization to those pollens increased because of global warming, which may consequently increase the prevalence of pollen-induced allergic rhinitis. With regard to socioeconomic burden of allergic rhinitis, the direct medical cost including herbal and alternative medicine was as high as 1.78 million Korean won per year. Direct nonmedical cost as well as indirect cost including unproductivity, absenteeism, and medical cost for associated diseases such as asthma worsened the socioeconomic burden of allergic rhinitis.
Absenteeism ; Allergens ; Animals ; Asthma ; Classification* ; Cockroaches ; Complementary Therapies ; Epidemiology* ; Global Warming ; Hair ; Inflammation ; Korea ; Nasal Mucosa ; Nose ; Poaceae ; Pollen ; Prevalence ; Pyroglyphidae ; Rhinitis* ; Rhinitis, Allergic, Perennial ; Seasons ; Spores, Fungal

OBJECTIVE: To investigate the allergens distribution of 576 allergic rhinitis patients in Qingyang, and to provide basic epidemiologic information for the prevention and treatment of allergic rhinitis. METHOD: Skin prick test was done to all the 576 patients with allergic rhinitis with 28 kinds of allergens. RESULT: Four hundred and eighty cases (83.3%) showed positive reaction to at least one allergen of 28 allergens. The most common allergens were Magwort (73.3%), Giant Ragweed (55.0%) Tree II (51.7%), Tree I (48.3%) Dermatophagoides farinae (43.3%) and Dermatophagoides pteronyssinus (36.7%). Moreover. the positivity decreased with age. There was no difference between male and female. CONCLUSION The study shows that Magwort. Giant ragweed and tree II are the most important allergens on Qingyang district.
Adolescent ; Adult ; Aged ; Allergens ; analysis ; classification ; Animals ; Child ; Child, Preschool ; China ; Female ; Humans ; Male ; Middle Aged ; Mites ; immunology ; Pollen ; immunology ; Rhinitis, Allergic ; Rhinitis, Allergic, Perennial ; diagnosis ; immunology ; Skin Tests ; Young Adult

OBJECTIVE: To investigate the inhaled allergens spectrum of 890 allergic rhinitis patients in Shanghai, and to provide basic epidemiologic information for the prevention and treatment of allergic rhinitis. METHOD: Thirteen allergens skin prick test results of 890 allergic rhinitis patients recruited were retrospectively analyzed. RESULT: The main common inhaled allergens in allergic rhinitis patients in Shanghai were house dust mite (91.24%), dermatophagoides farinae (86.58%), tropical mite (51.98%), dog hair (15.96%). Moreover, the positive frequency was decreased with age increasing, and gender group had no obvious difference. CONCLUSION House dust mite and dermatophagoides farinae were the main allergens of allergic rhinitis patients in Shanghai. Skin prick test is helpful for the discovery of the allergens so as to provide important basis of immunotherapy.
Adolescent ; Adult ; Aged ; Allergens ; analysis ; classification ; immunology ; Animals ; Antigens, Dermatophagoides ; immunology ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Male ; Middle Aged ; Mites ; classification ; immunology ; Pyroglyphidae ; immunology ; Rhinitis, Allergic, Perennial ; epidemiology ; Skin Tests ; Young Adult

Intradermal tests were performed on 58 dogs diagnosed with atopic dermatitis from 2004~2008 at the Veterinary Medical Teaching Hospital of Konkuk University, Korea. To compare the allergen distribution observed in the present investigation to the results from other studies conducted in Korea and elsewhere, the allergens were grouped according to their kinds. There was no significant difference in gender distribution among the dogs. The most common breeds among the 58 dogs were Maltese (n = 11) and Shih-tzu (n = 11). The average age was 4.8 years. The most frequently produced a positive reaction on the intradermal tests was mold (67.3%) followed by house dust (54.5%) and house dust mites (49.1%). The present study found a low distribution of dogs allergic to various outdoor allergens compared to studies performed in other countries; this may reflect differences in living conditions for dogs living in Korea.
Allergens/classification/*immunology ; Animals ; Dermatitis, Atopic/epidemiology/immunology/*veterinary ; Dog Diseases/epidemiology/*immunology ; Dogs ; Dust/*immunology ; Female ; Fungi/*immunology ; Intradermal Tests/veterinary ; Male ; Pedigree ; Prevalence ; Pyroglyphidae/*immunology ; Republic of Korea/epidemiology

INTRODUCTIONAllergic rhinitis (AR) is a prevalent disease worldwide but is still underdiagnosed in many parts of Asia. We studied the clinical profiles of AR patients in our community based on the new ARIA classification and investigated the aetiological allergens using a skin prick test.

MATERIALS AND METHODSIn 2008, 142 newly diagnosed patients with AR were seen and underwent skin prick testing with 90 patients completing the study.

RESULTSIntermittent mild and moderate/severe AR were evident in 10% and 21.1% of the patients, while persistent mild and moderate/severe were seen in 20% and 48.9%, respectively. Rhinitis and asthma co-morbidity occurred in 28.8% with asthma incidence significantly higher in persistent AR (P = 0.002). There was no significant association between AR severity, city living and asthma co-morbidity. Nasal itchiness and sneezing were the main presenting complaints and were more common in intermittent AR (P <0.05). Sleep disturbance was associated with moderate-severe AR (P <0.05). Polypoidal mucosa was associated with asthma co-morbidity (P <0.05). Monosensitivity reaction occurred in 12.2% of patients and was associated with fungi sensitivity (P <0.05). Majority of patients were oligosensitive (52.8%) and polysensitive (34.4%) and were significantly associated with moderate-severe persistent AR (P <0.01). The highest positive skin prick reaction and the largest average wheal diameter were for the house dust mites and cat allergen (P <0.05).

CONCLUSIONOur results reflected the AR profiles in our country, which was comparable with typical profiles of the neighbouring country and other Mediterranean countries with a similar temperate climate.

Adolescent ; Adult ; Aged ; Allergens ; Animals ; Asthma ; Cats ; Female ; Fungi ; Health Status Indicators ; Humans ; Incidence ; Malaysia ; epidemiology ; Male ; Middle Aged ; Pilot Projects ; Pollen ; Prevalence ; Pyroglyphidae ; Rhinitis, Allergic, Perennial ; classification ; diagnosis ; epidemiology ; pathology ; Severity of Illness Index ; Skin Tests ; Sleep Wake Disorders ; Statistics as Topic ; Time Factors ; Young Adult

Food allergy is an adverse food reaction as a result of immune mechanisms. In a sensitized individual, food allergens activate mast cells and basophils by binding with IgE present on the cell surface, resulting in the release of chemical mediators and various cytokines to cause various clinical symptoms of food allergy. Sensitization to food allergens can occur in the gastrointestinal tract (class 1 food allergy) or as a consequence of cross reactivity to structurally homologous inhalant allergens (class 2 food allergy). The class 1 food allergens are water-soluble glycoproteins with 10-70 kD size that are resistant to heat, acid and enzymes. On the other hand, the class 2 food allergens are highly unstable and degraded by heat or enzymatic digestion. Much progress has been made in identifying and isolating food allergen. Recently cDNAs for many proteins have been isolated and recombinant proteins have been generated. These techniques make it easier to characterize each responsible food allergens. Plant food allergens are classified into families and superfamilies by their structural and functional properties. The most of plant food allergens are the cupin and prolamin superfamilies and the protein families of the plant defense system. The cupin superfamily includes allergenic seed storage proteins of 7s globulin (vicilin) and 11s globulin (legumin). 2s albumin seed storage proteins, the nonspecific lipid transfer proteins, and the cereal alpha-amylase and protease inhibitors belong to the prolamin superfamily. Profilins, heveins, and nonspecific lipid transfer proteins are present in a variety of pollens, nuts, seeds, fruits, and vegetables. These are considered as panallergens, causing a significant degree of IgE-mediated cross-reactivity. Detailed informations about the character of food allergens can be used to develop more sophisticated diagnostic methods and treatment modalities in the near future. Further knowledge of food allergens is also useful to assess the allergenicity of novel protein of genetically mo.
Allergens* ; alpha-Amylases ; Basophils ; Edible Grain ; Classification* ; Cytokines ; Digestion ; DNA, Complementary ; Food Hypersensitivity ; Fruit ; Gastrointestinal Tract ; Glycoproteins ; Hand ; Hot Temperature ; Humans ; Immunoglobulin E ; Mast Cells ; Nuts ; Plants* ; Pollen ; Profilins ; Protease Inhibitors ; Recombinant Proteins ; Seed Storage Proteins ; Vegetables

BACKGROUND AND OBJECTIVES : Allergic rhinitis has previously been classified as seasonal, perennial or occupational according to duration of exposure to allergens ; this classification, however, has posed difficulty for care providers in planning the stepwise treatment of allergic rhinitis. According to the ARIA (Allergic Rhinitis and its Impact on Asthma) workshop report, allergic rhinitis was re-classified as intermittent or persistent according to duration of symptoms, and mild or moderate-to-severe according to severity of symptoms. There has been no reports regarding the distribution of allergic rhinitis by using the new ARIA classification. We aimed to find out the distribution of allergic rhinitis according to the new ARIA classification and its usefulness in clinical use. Subjects and METHOD : A total of 502 allergic rhinitis patients were subjected to this study. They were classified under the previous classification into seasonal, perennial, and multiple. They were classified by new ARIA classification into persistent mild, persistent moderate-to-severe, intermittent mild, and intermittent moderate-to-severe. Their distribution and characteristics were analyzed. RESULTS : When classified according to previous classification, patients sensitized with perennial allergens, seasonal allergens and multi-allergens were 326 (64.9%), 63 (12.5%) and 113 (22.5%) respectively. According to the new ARIA classification, persistent mild, persistent moderate-to-severe, intermittent mild and intermittent moderate-tosevere patients were 82 (16.3%), 161 (32.1%), 159 (31.7%) and 100 (19.9%) respectively. The patients sensitized with perennial allergen were classified to persistent mild (17.5%), persistent moderate-to-severe (32.5%), intermittent mild (31.6%), intermittent moderate-to-severe (18.4%) by new ARIA classification. Half of patients with intermittent symptoms were sensitized by perennial allergen. Among the patients sensitized by only seasonal allergen, 24 (36.5%) had persistent symptoms. There were no difference in group distribution between the rhinorrhea-sneezer and blocker groups. CONCLUSION : Patient distribution by the new ARIA classification was different from the previous classification. From the point of clinicians, the new ARIA classification might be more useful for stepwise treatment and exact evaluation of allergic rhinitis patients than the previous classification.
Allergens ; Classification* ; Education ; Humans ; Rhinitis* ; Seasons