Effect of area of residence on patterns of aeroallergen sensitization in atopic patients.
BACKGROUND
An association with sensitization to inhaled allergens and allergic rhinitis and asthma has been established. A recent study concluded that the disparity in allergen sensitization might primarily be caused by environmental factors rather than genetic differences. The primary objective was to identify potential differences in sensitization among subjects with the same ethnicity in South India who reside in different environments.


METHODS
Five hundred forty-six patients presenting to a tertiary allergy center with allergic rhinitis and or asthma underwent evaluation using a structured questionnaire, skin-prick testing to common aeroallergens, and spirometry and were categorized according to area of residence.


RESULTS
The most common allergens causing sensitization were house-dust mite (range, 65-70%), trees (range, 52-56%), and cockroaches (range, 39-53%). There was lower risk of sensitization to cockroach allergens for subjects <21 years old living in suburban (odds ratio [OR], 0.32; 95% confidence interval [CI], 0.12-0.81) and rural environments (OR, 0.33; 95% CI, 0.11-0.96) compared with subjects <21 years old living in urban areas. There was higher risk of sensitization to fungi in subjects <21 years old living in suburban areas (OR, 1.51; 95% CI, 0.60-3.77) and rural environments (OR, 2.71; 95% CI, 0.98-7.48) compared with subjects <21 years old living in urban environments.


CONCLUSIONS
Sensitization patterns are similar in different areas of residence except in younger subjects. Sensitization to fungi was higher in younger subjects from the rural area and cockroach sensitization were higher in younger subjects from urban areas. Sensitization is an important precursor of clinical allergic disease and further studies to unravel the complex gene-environment interactions of aeroallergen sensitization in different environments are needed.
JSS Medical College, Mysore, India. mahesh1971in@yahoo.com
P A
PA
Mahesh
Ischa
I
Kummeling
D H
DH
Amrutha
Pudupakkam K
PK
Vedanthan
D000293:Adolescent; D000328:Adult; D000485:Allergens / Q000276:immunology*; D000818:Animals; D001249:Asthma / Q000209:etiology; D002648:Child; D003058:Cockroaches / Q000276:immunology; D003430:Cross-Sectional Studies; D005260:Female; D005658:Fungi / Q000276:immunology; D006801:Humans; D006967:Hypersensitivity / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D039981:Pyroglyphidae / Q000276:immunology; D012111:Residence Characteristics; D012221:Rhinitis, Allergic, Perennial / Q000209:etiology; D006255:Rhinitis, Allergic, Seasonal / Q000209:etiology; D012923:Social Class
D000485:Allergens