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


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Burbach
G J
GJ
Department of Dermatology and Allergy, Charité Universitätsmedizin-Berlin, Berlin, Germany.
Heinzerling
L M
LM
Department of Dermatology and Allergy, Charité Universitätsmedizin-Berlin, Berlin, Germany.
Edenharter
G
G
Department of Dermatology and Allergy, Charité Universitätsmedizin-Berlin, Berlin, Germany.
Bachert
C
C
Department of Otorhinolaryngology, University Hospital, Ghent, Belgium.
Bindslev-Jensen
C
C
University Hospital, Allergy Centre, Odense, Denmark.
Bonini
S
S
Consiglio Nazionale delle Ricerche, Rome, Italy.
Bousquet
J
J
University Hospital, Montpellier, France.
Bousquet-Rouanet
L
L
University Hospital, Montpellier, France.
Bousquet
P J
PJ
University Hospital, Montpellier, France.
Bresciani
M
M
Consiglio Nazionale delle Ricerche, Rome, Italy.
Bruno
A
A
Consiglio Nazionale delle Ricerche, Palermo, Italy.
Canonica
G W
GW
Allergy Centre, University of Genoa, Genoa, Italy.
Darsow
U
U
Department of Dermatology and Allergy Biederstein and Division of Environmental Dermatology and Allergy Helmholtz Center, Technical University, Technische Universität, Munich, Germany.
Demoly
P
P
University Hospital, Montpellier, France.
Durham
S
S
Department of Respiratory Medicine, Royal Brompton Hospital, London, UK.
Fokkens
W J
WJ
Department of Otorhinolaryngology, Academic Medical Centre, Amsterdam, The Netherlands.
Giavi
S
S
Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University, Athens, Greece.
Gjomarkaj
M
M
Consiglio Nazionale delle Ricerche, Palermo, Italy.
Gramiccioni
C
C
Consiglio Nazionale delle Ricerche, Rome, Italy.
Haahtela
T
T
University Central Hospital, Skin and Allergy Hospital, Helsinki, Finland.
Kowalski
M L
ML
Department of Clinical Immunology and Allergy, Medical University of Lodz, Lodz, Poland.
Magyar
P
P
Allergy Centre, Semmelweis Medical University, Budapest, Hungary.
Muraközi
G
G
Allergy Centre, Semmelweis Medical University, Budapest, Hungary.
Orosz
M
M
Allergy Centre, Semmelweis Medical University, Budapest, Hungary.
Papadopoulos
N G
NG
Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University, Athens, Greece.
Röhnelt
C
C
Department of Dermatology and Allergy, Charité Universitätsmedizin-Berlin, Berlin, Germany.
Stingl
G
G
Department of Dermatology, Medical University of Vienna, Vienna, Austria.
Todo-Bom
A
A
Allergy Centre, Department of Pulmonology, Coimbra University, Coimbra, Portugal.
Von Mutius
E
E
Allergy Centre, Ludwig Maximilians University, Munich, Germany.
Wiesner
A
A
Allergy Centre, Children's University Hospital, Zurich, Switzerland.
Wöhrl
S
S
Department of Dermatology, Medical University of Vienna, Vienna, Austria.
Zuberbier
T
T
Department of Dermatology and Allergy, Charité Universitätsmedizin-Berlin, Berlin, Germany.
D000328:Adult; D000485:Allergens / Q000145:classification / Q000276:immunology; D000818:Animals; D002415:Cats; D004285:Dogs; D005060:Europe; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis / Q000276:immunology / Q000503:physiopathology; D006969:Hypersensitivity, Immediate / Q000175:diagnosis / Q000276:immunology / Q000503:physiopathology; D019570:Inhalation Exposure; D010940:Plant Proteins / Q000276:immunology; D006109:Poaceae / Q000276:immunology; D012882:Skin Tests / Q000379:methods*
D000485:Allergens; D010940:Plant Proteins