title: The sensitization pattern differs according to rhinitis and asthma multimorbidity in adults: the EGEA study.
abstract: BACKGROUND
  Mono- and polysensitization are different IgE-mediated allergic phenotypes in children. Allergic sensitization is associated with both allergic asthma and allergic rhinitis, however, associations between the sensitization pattern and particularly polysensitization with asthma and rhinitis remains poorly studied in adults.
  
  
  OBJECTIVE
  The aim of this study was to assess how the allergic sensitization pattern associates with asthma, rhinitis and their multimorbidity.
  
  
  METHODS
  1199 adults from the EGEA study, with extensive phenotypic characterization and all data available on skin prick tests to 10 allergens, total IgE and blood eosinophils were included. Using questionnaires only, participants were classified into 6 groups: asymptomatic (no asthma, no rhinitis), non-allergic rhinitis alone, allergic rhinitis alone, asthma alone, asthma+non-allergic rhinitis and asthma+allergic rhinitis. Mono- and polysensitization were defined by a positive skin prick test to one or more than one allergen respectively.
  
  
  RESULTS
  Asymptomatic participants and those with non-allergic rhinitis alone were mostly non-sensitized (around 72%) while around 12% were polysensitized. Between 32% and 43% of participants with allergic rhinitis alone, asthma alone and asthma+non-allergic rhinitis were non-sensitized and between 37% and 46% of them were polysensitized. 65% of the participants with asthma+allergic rhinitis were polysensitized. The level of total IgE followed a similar trend to that of allergic sensitization. Eosinophils were increased in asthma, especially when associated with rhinitis. Nasal symptoms were more severe and eczema more common in participants with both asthma and allergic rhinitis than in the other groups.
  
  
  CONCLUSIONS
  Allergic sensitization and particularly polysensitization rates widely differ according to asthma and rhinitis status. This study emphasized the importance of taking into account multimorbidity between asthma and rhinitis and showed that allergic sensitization is not a dichotomic variable.
authors.affiliation: INSERM, U1168, VIMA: Aging and Chronic Diseases, Epidemiological and Public Health Approaches, Villejuif, France.|University of Versailles St-Quentin-en-Yvelines, UMR-S 1168, Montigny le Bretonneux, France.|University of Pompeu Fabra (UPF), Barcelona, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Burte
authors.affiliation: INSERM, U1168, VIMA: Aging and Chronic Diseases, Epidemiological and Public Health Approaches, Villejuif, France.|University of Versailles St-Quentin-en-Yvelines, UMR-S 1168, Montigny le Bretonneux, France.|University Hospital, Montpellier, France.
authors.forename: J
authors.initials: J
authors.lastname: Bousquet
authors.affiliation: INSERM, IAB, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Grenoble, France.|University of Grenoble Alpes, Grenoble, France.|CHU de Grenoble, Grenoble, France.
authors.forename: V
authors.initials: V
authors.lastname: Siroux
authors.affiliation: Allergology Department, Assistance Publique-Hôpitaux de Paris, Hôpital Armand-Trousseau, Paris, France.|Université Paris 6 Pierre et Marie Curie, Paris, France.
authors.forename: J
authors.initials: J
authors.lastname: Just
authors.affiliation: INSERM, U1168, VIMA: Aging and Chronic Diseases, Epidemiological and Public Health Approaches, Villejuif, France.|University of Versailles St-Quentin-en-Yvelines, UMR-S 1168, Montigny le Bretonneux, France.|University of Pompeu Fabra (UPF), Barcelona, Spain.|ISGlobal- CREAL-Centre for Research in Environmental Epidemiology, Barcelona, Spain.|CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
authors.forename: B
authors.initials: B
authors.lastname: Jacquemin
authors.affiliation: INSERM, U1168, VIMA: Aging and Chronic Diseases, Epidemiological and Public Health Approaches, Villejuif, France.|University of Versailles St-Quentin-en-Yvelines, UMR-S 1168, Montigny le Bretonneux, France.
authors.forename: R
authors.initials: R
authors.lastname: Nadif
mesh_terms: D000328:Adult; D000485:Allergens / Q000276:immunology*; D001249:Asthma / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology*; D016022:Case-Control Studies; D015897:Comorbidity; D004804:Eosinophils; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D007114:Immunization; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010641:Phenotype; D012220:Rhinitis / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology*; D012307:Risk Factors; D012720:Severity of Illness Index; D012882:Skin Tests
chemical_list: D000485:Allergens; D007073:Immunoglobulin E
keywords: allergic sensitization; asthma; monosensitization; multimorbidity; polysensitization; rhinitis