Article

GA(2)LEN skin test study II: clinical relevance of inhalant allergen sensitizations in Europe.

Department of Dermatology and Allergy, Charité Universitätsmedizin-Berlin, Berlin, Germany.
Allergy (Impact Factor: 5.88). 10/2009; 64(10):1507-15. DOI: 10.1111/j.1398-9995.2009.02089.x
Source: PubMed

ABSTRACT Skin prick testing is the standard for diagnosing IgE-mediated allergies. A positive skin prick reaction, however, does not always correlate with clinical symptoms. A large database from a Global Asthma and Allergy European Network (GA(2)LEN) study with data on clinical relevance was used to determine the clinical relevance of sensitizations against the 18 most frequent inhalant allergens in Europe. The study population consisted of patients referred to one of the 17 allergy centres in 14 European countries (n = 3034, median age = 33 years). The aim of the study was to assess the clinical relevance of positive skin prick test reactions against inhalant allergens considering the predominating type of symptoms in a pan-European population of patients presenting with suspected allergic disease.
Clinical relevance of skin prick tests was recorded with regard to patient history and optional additional tests. A putative correlation between sensitization and allergic disease was assessed using logistic regression analysis.
While an overall rate of >or=60% clinically relevant sensitizations was observed in all countries, a differential distribution of clinically relevant sensitizations was demonstrated depending on type of allergen and country where the prick test was performed. Furthermore, a significant correlation between the presence of allergic disease and the number of sensitizations was demonstrated.
This study strongly emphasizes the importance of evaluating the clinical relevance of positive skin prick tests and calls for further studies, which may, ultimately, help increase the positive predictive value of allergy testing.

0 Bookmarks
 · 
243 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The type of allergic sensitization is of central importance in the diagnosis and treatment of respiratory allergic diseases. At least 10% of the general population (and more than 50% of patients consulting for respiratory allergies) are polysensitized. Here, we review the recent literature on (i) the concepts of polysensitization, paucisensitization, co-sensitization, co-recognition, cross-reactivity, cross-sensitization, and polyallergy, (ii) the prevalence of polysensitization and (iii) the relationships between sensitization status, disease severity and treatment strategies. In molecular terms, clinical polysensitization can be divided into cross-sensitization (also known as cross-reactivity, in which the same IgE molecule binds to several allergens with common structural features) and co-sensitization (the simultaneous presence of different IgEs binding to allergens that may not necessarily have common structural features). There is a strong overall association between sensitization in skin prick tests and total IgE values but there is debate as to whether IgE thresholds are useful guides to the presence or absence of clinical symptoms in individual cases. Molecular information from component-resolved techniques appears to be of value for diagnosis and treatment decisions. Polysensitization develops over time and is a risk factor for respiratory allergy (being associated with disease severity) and therefore has clinical relevance for treatment decisions. The subterm polysensitization has been defined as polysensitization to between two and four allergens. Polyallergy is defined as clinically confirmed allergy to two or more allergens. Single-allergen grass pollen allergen immunotherapy (AIT) is safe and effective in polysensitized patients, whereas multi-allergen AIT requires more supporting evidence. Given that AIT may be more efficacious in moderate-to-severe disease than in mild disease, polysensitization could be an indication for this type of treatment. There is a need for flowcharts or decision trees for choosing the allergens for AIT in polysensitized patients and polyallergic patients.
    Clinical and translational allergy. 01/2014; 4:16.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Thermal conditions at the beginning of the year determine the timing of pollen seasons of early flowering trees. The aims of this study were to quantify the relationship between the tree pollen season start dates and the thermal conditions just before the beginning of the season and to construct models predicting the start of the pollen season in a given year. The study was performed in Krakow (Southern Poland); the pollen data of Alnus, Corylus and Betula were obtained in 1991-2012 using a volumetric method. The relationship between the tree pollen season start, calculated by the cumulated pollen grain sum method, and a 5-day running means of maximum (for Alnus and Corylus) and mean (for Betula) daily temperature was found and used in the logistic regression models. The estimation of model parameters indicated their statistically significance for all studied taxa; the odds ratio was higher in models for Betula, comparing to Alnus and Corylus. The proposed model makes the accuracy of prediction in 83.58 % of cases for Alnus, in 84.29 % of cases for Corylus and in 90.41 % of cases for Betula. In years of model verification (2011 and 2012), the season start of Alnus and Corylus was predicted more precisely in 2011, while in case of Betula, the model predictions achieved 100 % of accuracy in both years. The correctness of prediction indicated that the data used for the model arrangement fitted the models well and stressed the high efficacy of model prediction estimated using the pollen data in 1991-2010.
    Aerobiologia 01/2014; 30:307-321. · 1.33 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The composition and relative abundance of airborne pollen in urban areas of Australia and New Zealand are strongly influenced by geographical location, climate and land use. There is mounting evidence that the diversity and quality of airborne pollen is substantially modified by climate change and land-use yet there are insufficient data to project the future nature of these changes. Our study highlights the need for long-term aerobiological monitoring in Australian and New Zealand urban areas in a systematic, standardised, and sustained way, and provides a framework for targeting the most clinically significant taxa in terms of abundance, allergenic effects and public health burden.
    PLoS ONE 01/2014; 9(5):e97925. · 3.53 Impact Factor

Full-text (2 Sources)

Download
130 Downloads
Available from
May 23, 2014