Assessment of allergen sensitization in a general population-based survey (European Community Respiratory Health Survey I).
OBJECTIVE
Exposed to a common environment, the IgE-mediated immune response differs, for instance, among sensitized subjects, some of them reacting toward one allergen (monosensitized) whereas others are sensitized to a wide array of allergens (polysensitized). However, a better phenotypic characterization is needed for epidemiologic studies. Using the data collected during the ECRHS I (European Community Respiratory Health Survey), several assessments of skin prick tests and serum-specific IgE to identify mono- and polysensitized patients were compared.


METHODS
Subjects took part in the ECRHS-I. The CAP-System was used for serum allergen-specific IgE, and allergen-coated Phazet was used for prick tests. Four allergens (Dermatophagoides pteronyssinus, cat, timothy grass, and Cladosporium) were measured using IgE and nine (the same ones plus olive pollen, birch, Alternaria, Parietaria, and ragweed) were skin tested. One to two local allergens were also tested, depending on countries.


RESULTS
Prevalence of sensitization in 11,355 subjects (34.0 [27.9-40.1] years, 49.9% men) ranged from 32.3% (four specific IgE, 19.3% mono- and 13.0% polysensitized) to 41.8% (four specific IgE combined to nine prick tests, 19.6% mono- and 22.2% polysensitized). Concordance between four specific IgE and four prick tests was weak (weighted κ 0.65 [0.64-0.66]). Concordance between seven and nine prick tests was high (weighted κ 0.99 [0.98-1.00]). Local allergens induced small changes in the prevalence of sensitization, and reclassified some subjects from mono- to polysensitized.


CONCLUSIONS
Skin tests or serum-specific IgE may be chosen to identify allergenic sensitivity, mono- and polysensitized subjects without being strictly interchangeable.
Bousquet
Philippe-Jean
PJ
National Heart and Lung Institute at Imperial College, London, UK. philippejean.bousquet@orange.fr
Castelli
Christel
C
Daures
Jean-Pierre
JP
Heinrich
Joachim
J
Hooper
Richard
R
Sunyer
Jordi
J
Wjst
Matthias
M
Jarvis
Deborah
D
Burney
Peter
P
D000328:Adult; D000485:Allergens / Q000276:immunology*; D003625:Data Collection; D005062:European Union; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology*; D008297:Male; D010641:Phenotype; D011058:Pollen / Q000009:adverse effects* / Q000276:immunology; D015995:Prevalence; D012137:Respiratory System / Q000276:immunology*; D012882:Skin Tests / Q000379:methods
D000485:Allergens; D007073:Immunoglobulin E