title: In the (sub)tropics allergic rhinitis and its impact on asthma classification of allergic rhinitis is more useful than perennial-seasonal classification.
abstract: BACKGROUND
  Two different allergic rhinitis (AR) symptom phenotype classifications exist. Treatment recommendations are based on intermittent-persistent (INT-PER) cataloging, but clinical trials still use the former seasonal AR-perennial AR (SAR-PAR) classification. This study was designed to describe how INT-PER, mild-moderate/severe and SAR-PAR of patients seen by allergists are distributed over the different climate zones in a (sub)tropical country and how these phenotypes relate to allergen sensitization patterns.
  
  
  METHODS
  Six climate zones throughout Mexico were determined, based on National Geographic Institute (Instituto Nacional de Estadística y Geografía) data. Subsequent AR patients (2-68 years old) underwent a blinded, standardized skin-prick test and filled out a validated questionnaire phenotyping AR.
  
  
  RESULTS
  Five hundred twenty-nine subjects participated in this study. In the tropical zone with 87% house-dust mite sensitization, INT (80.9%; p < 0.001) and PAR (91%; p = 0.04) were more frequent than in the subtropics. In the central high-pollen areas, there was less moderate/severe AR (65.5%; p < 0.005). Frequency of comorbid asthma showed a clear north-south gradient, from 25% in the dry north to 59% in the tropics (p < 0.005). No differences exist in AR cataloging among patients with different sensitization patterns, with two minor exceptions (more PER in tree sensitized and more PAR in mold positives; p < 0.05).
  
  
  CONCLUSIONS
  In a (sub)tropical country the SAR-PAR classification seems of limited value and bears poor relation with the INT-PER classification. INT is more frequent in the tropical zone. Because PER has been shown to relate to AR severity, clinical trials should select patients based on INT-PER combined with the severity cataloging because these make for a better treatment guide than SAR-PAR.
authors: Hospital Médica Sur, México D.F., Mexico.
authors: Désirée
authors: D
authors: Larenas-Linnemann
authors: Alexandra
authors: A
authors: Michels
authors: Hanna
authors: H
authors: Dinger
authors: Alfredo
authors: A
authors: Arias-Cruz
authors: Marichuy
authors: M
authors: Ambriz Moreno
authors: Martin
authors: M
authors: Bedolla Barajas
authors: Ruth Cerino
authors: RC
authors: Javier
authors: Maria de la Luz
authors: Mde L
authors: Cid Del Prado
authors: Manuel Alejandro
authors: MA
authors: Cruz Moreno
authors: Laura Diego
authors: LD
authors: Vergara
authors: Roberto
authors: R
authors: García Almaráz
authors: Cecilia Y
authors: CY
authors: García-Cobas
authors: Daniel Alberto
authors: DA
authors: Garcia Imperial
authors: Rosa Garcia
authors: RG
authors: Muñoz
authors: Dante
authors: D
authors: Hernandez Colín
authors: Francisco Javier
authors: FJ
authors: Linares Zapien
authors: Jorge Agustín
authors: JA
authors: Luna Pech
authors: Juan Jose
authors: JJ
authors: Matta Campos
authors: Norma
authors: N
authors: Martinez Jimenez
authors: Miguel Medina
authors: MM
authors: Avalos
authors: Alejandra
authors: A
authors: Medina Hernandez
authors: Albero Monteverde
authors: AM
authors: Maldonado
authors: Doris Nereida
authors: DN
authors: López
authors: Luis Julian
authors: LJ
authors: Pizano Nazara
authors: Emanuel Ramirez
authors: ER
authors: Sanchez
authors: José Domingo
authors: JD
authors: Ramos López
authors: Noel
authors: N
authors: Rodriguez-Pérez
authors: Pablo G
authors: PG
authors: Rodriguez Ortiz
authors: Kijawasch
authors: K
authors: Shah-Hosseini
authors: Ralph
authors: R
authors: Mösges
mesh_terms: D000293:Adolescent; D000328:Adult; D000485:Allergens / Q000276:immunology; D001249:Asthma / Q000145:classification* / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D005260:Female; D062306:Geography, Medical / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008800:Mexico; D008875:Middle Aged; D010641:Phenotype; D065631:Rhinitis, Allergic / Q000145:classification* / Q000453:epidemiology; D012621:Seasons; D014329:Tropical Climate; D055815:Young Adult
chemical_list: D000485:Allergens