Management of patients with seasonal allergic rhinitis: Diagnostic consideration of sensitization to non-frequent pollen allergens.

Autor:	Höflich C; German Environment Agency Section II 1.5 Environmental Medicine and Health Effects Assessment Berlin Germany., Balakirski G; Department of Dermatology and Allergology University Hospital RWTH Aachen Aachen Germany.; Present address: Department of Dermatology, Allergology and Dermatosurgery HELIOS University Hospital Wuppertal University of Witten/Herdecke Wuppertal Germany., Hajdu Z; Department of Otorhinolaryngology Klinikum rechts der Isar Technical University Munich Munich Germany., Baron JM; Department of Dermatology and Allergology University Hospital RWTH Aachen Aachen Germany., Fietkau K; Department of Dermatology and Allergology University Hospital RWTH Aachen Aachen Germany., Merk HF; Department of Dermatology and Allergology University Hospital RWTH Aachen Aachen Germany., Strassen U; Department of Otorhinolaryngology Klinikum rechts der Isar Technical University Munich Munich Germany., Bier H; Department of Otorhinolaryngology Klinikum rechts der Isar Technical University Munich Munich Germany., Dott W; Department for Environmental Medicine University Hospital RWTH Aachen Aachen Germany., Mücke HG; German Environment Agency Section II 1.5 Environmental Medicine and Health Effects Assessment Berlin Germany., Straff W; German Environment Agency Section II 1.5 Environmental Medicine and Health Effects Assessment Berlin Germany., Wurpts G; Department of Dermatology and Allergology University Hospital RWTH Aachen Aachen Germany., Yazdi AS; Department of Dermatology and Allergology University Hospital RWTH Aachen Aachen Germany., Chaker A; Department of Otorhinolaryngology Klinikum rechts der Isar Technical University Munich Munich Germany.; Center of Allergy and Environment (ZAUM) Technical University and Helmholtz Center Munich Munich Germany., Röseler STM; Department of Dermatology and Allergology University Hospital RWTH Aachen Aachen Germany.; Present address: Department of Pneumology, Allergology, Sleep and Respiratory Medicine Augustinians Hospital Cologne Germany.
Jazyk:	angličtina
Zdroj:	Clinical and translational allergy [Clin Transl Allergy] 2021 Oct 04; Vol. 11 (8), pp. e12058. Date of Electronic Publication: 2021 Oct 04 (Print Publication: 2021).
DOI:	10.1002/clt2.12058
Abstrakt:	Background: Diagnosis of pollen allergies is mainly based on test allergens for skin prick testing. In the minimum battery of test inhalant allergens recommended by the Global Allergy and Asthma European Network 10 pollen allergens are included. Complementary other pollen allergens may need to be considered; however, respective awareness may not always be granted. Furthermore, at least in Germany, the situation may be even more complicated by the fact that test allergens need regulatory approval. A decline in commercially available test allergens may result in a diagnostic gap regarding patients with non-frequent allergies. How many patients with non-frequent pollen allergies would be affected by this gap? The data presented here partly answer this question. Methods: The study consisted of a descriptive and an analytical part. In the descriptive part, sensitization to frequent pollen allergens (alder, hazel, birch, sweet grasses; according to the German Therapy Allergen Ordinance) and to respective non-frequent pollen allergens (cypress, Japanese cedar, ash, plane tree, olive, Bermuda grass, wall pellitory, plantain, goosefoot, mugwort, ragweed, and saltwort) was measured in adult patients with physician-diagnosed allergic rhinitis from two German federal states, namely North-Rhine Westphalia ( n  = 360) and Bavaria ( n  = 339), using skin prick testing and/or ISAC technology. Furthermore, respective regional pollen data were assessed. In the analytical part, sensitization data were correlated with each other and with anamnestic data on symptom periods. Results: Sensitization to frequent pollen allergens ranged from 45% (sIgE to Aln g 1/Alder, NRW) to 72% (prick test reactivity to birch, NRW). Sensitization to non-frequent pollen allergens ranged from 0% (sIgE to Amb a 1/ragweed, NRW) to 41% (prick test reactivity to olive, Bavaria). Sensitization data partly correlated with each other and in connection with symptom periods showed a partly similar seasonal pattern as pollen data. Conclusions: Sensitization to non-frequent pollen allergens have to be considered when examining patients with respective seasonal symptoms, and test (and respective therapy) allergens for non-frequent pollen allergies need to be available. Further prerequisites for adequate patient management would be a nationwide pollen monitoring system giving continuous pollen data and a systematic sensitization monitoring at patient level. Competing Interests: The authors declare that they have no competing interests. (© 2021 The Authors. Clinical and Translational Allergy published by John Wiley & Sons Ltd on behalf of European Academy of Allergy and Clinical Immunology.)
Databáze:	MEDLINE
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