title: Allergic respiratory disease: Different allergens, different symptoms.
abstract: BACKGROUND
  Spanish population is rather homogeneous in its genetic and sociocultural characteristics, but allergen sensitization shows wide geographical variations. We aimed at assessing whether sensitization to different allergens in the diverse geographical areas induced different clinical and quality-of-life characteristics in adult patients with a first-time diagnosis of rhinitis and/or asthma.
  
  
  METHODS
  Two sequential, identically designed studies were carried out to evaluate such associations (PERFILAR I and II). PERFILAR II was an extension of PERFILAR I with additional allergens being included. Both phases were epidemiological, descriptive, cross-sectional, nonintervention multicenter studies. Participants were required to have lived for at least the last 2 years in the geographical zone. Asthma control assessment was based on ACQ-5. Health-related quality of life was evaluated with validated scales for rhinitis (ESPRINT-15) and asthma (Mini-AQLQ). Skin prick tests were used to identify sensitization to involved allergens.
  
  
  RESULTS
  A total of 301 physicians recruited 2711 patients for PERFILAR I+II. Sensitization to allergens was significantly different in patients with rhinitis with/without asthma. Seasonal allergens were associated with rhinitis, a longer time to asthma development, and more severe and commonly intermittent rhinitis. HDM were associated with more common rhinitis, and Alternaria was associated with asthma. The study confirms an association of geographical areas with relevant allergens and allergic clinical picture.
  
  
  CONCLUSIONS
  Different types of aeroallergens and specific sensitization profiles are associated with different allergic clinical pictures (rhinitis with/without asthma), different clinical symptoms, and different levels of severity. This could have implications to predict later clinical course and to select appropriate management approaches.
authors.affiliation: Pneumology and Allergy Department, Clinical and Experimental Respiratory Immunoallergy, IDIBAPS, CIBERES, Hospital Clinic, Barcelona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Valero
authors.affiliation: Department of Allergy, Healthcare Research Institute IdiPAZ, CIBER de Enfermedades Respiratorias, CIBERES, Hospital Universitario La Paz, Madrid, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Quirce
authors.affiliation: Immunoallergy Department, IBSAL-Hospital Universitario de Salamanca, Salamanca, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Dávila
authors.affiliation: Allergy Department, Hospital Virgen Macarena, Sevilla, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Delgado
authors.affiliation: Department of Allergy, Healthcare Research Institute IdiPAZ, CIBER de Enfermedades Respiratorias, CIBERES, Hospital Universitario La Paz, Madrid, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Domínguez-Ortega
mesh_terms: D000485:Allergens / Q000276:immunology; D001249:Asthma / Q000175:diagnosis / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D006801:Humans; D011788:Quality of Life; D012220:Rhinitis / Q000175:diagnosis / Q000453:epidemiology*; D012882:Skin Tests; D013030:Spain / Q000453:epidemiology
chemical_list: D000485:Allergens
keywords: aeroallergen; asthma; geographical variation; rhinitis