Longitudinal changes in allergen skin test reactivity in a community population sample

doi:10.1016/S0091-6749(87)80010-6

Journal of Allergy and Clinical Immunology

Volume 79, Issue 1, January 1987, Pages 16-24

https://doi.org/10.1016/S0091-6749(87)80010-6 Get rights and content

A cohort of 1333 subjects, aged 3 years and older, was followed for a mean of 8.1 years to assess changes in allergen skin test reactivity. The overall prevalence of reactivity to the five antigen mixtures was 39.1% during the initial survey and 50.7% after the follow-up period. The greatest increase in prevalence occurred among children and teenagers (22.2% and 19.5%) with only minimal increases after the age of 65 years (6.0%). No difference in prevalence between male and female subjects was apparent, either initially or at the end of the follow-up period. In-migration to the Tucson area was a major factor in determining changes in reaction prevalence. Among subjects more than 35 years of age, recent in-migrants accounted for most of the increased prevalence. Comparisons of atopy among consistent smoking groups confirmed the previous observation that smokers are less atopic than either nonsmokers or exsmokers, probably because of a self-selection process. In contrast, exsmokers were generally the most atopic, both initially and at the end of the longitudinal observation period. The high overall prevalence of allergen reactivity in this population is believed to be due in large measure to high year-round concentrations of multiple aeroallergens in the Tucson environment

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Asthma in the elderly is a health problem of growing concern. Its prevalence will increase in the next 20 years due to the rising longevity of the world population. The purpose of our work is to trace the epidemiological and clinical characteristics as well as the therapeutic difficulties of asthma in this patient population.
Retrospective study of a cohort of 112 patients aged over 65 years and presenting bronchial asthma, followed at the allergy consultation at Ibn Rochd Hospital in Casablanca over a period of 13 years.
Mean age was 67.5 years with female predominance. Family atopy was present in 41% of cases and personal atopy in 67% of cases. Fifty-two percent of patients had comorbidities, dominated by diabetes, hypertension and gastroesophageal reflux. Asthma had been present on average for 16 years. The prick-tests, performed in 34.8% of cases, were positive in 51.2%. Spirometry, performed for all patients, revealed an obstructive ventilatory disorder in 56.2% of cases. Management was based on therapeutic education and environmental control in all cases. Background treatment was prescribed in accordance with stage and level of disease control. Asthma was classified as uncontrolled in 48.2% of cases.
Asthma in the elderly is severe, often uncontrolled, and associated with comorbidities, thus posing both diagnostic and therapeutic difficulties. Its management requires patient education and understanding of the treatment regimen.
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Les allergies sont fréquemment mises en cause en pratique ophtalmologique. Ces allergies habituellement bénignes peuvent être potentiellement sévères pour la surface oculaire et avoir un retentissement important dans la vie quotidienne. Nous rapportons à travers un cas d’une kératoconjonctivite mettant en jeu 2 types d’hypersensibilités, quelques modalités thérapeutiques particulières.
Allergies are frequently implicated in ophthalmologic practice. These typically benign allergies can be potentially severe for the ocular surface and have an impact in everyday life. We relate, through a case of keratoconjunctivitis involving 2 types of hypersensitivity, the various triggers and therapeutic choices to allow a more effective treatment.
Natural history of skin prick test reactivity: A 20-year prospective study of a random population sample of children and adolescents
2017, Annals of Allergy, Asthma and Immunology
Citation Excerpt :
However, our knowledge of changes over time in reactivity and the clinical implications of sensitization to the different groups of aeroallergens (ie, pollen, fur, house dust mites, and mold) remains limited. The few longitudinal studies completed have mostly observed the study population for a period of 2 to 8 years and found that sensitization is developed through childhood and puberty12,13 and lost in late adulthood.14 The aim of the present study was, therefore, to examine the change in SPT reactivity in a random population sample of children and adolescents during a 20-year period.
Allergic reactions to airborne allergens may have important consequences for affected individuals and are believed to be unstable through life, although evidence from longitudinal studies is limited.
To assess changes in skin prick reactivity during 20 years in a random population sample of children and adolescents in relation to symptoms of rhinitis.
A total of 983 individuals, aged 7 to 17 years, were randomly selected in 1986 and invited to 4 examinations during a 20-year period. During each examination, a skin prick test was performed using common local aeroallergens (ie, birch, grass, mugwort, horse, dog, cat, house dust mite [Dermatophagoides pteronyssinus and Dermatophagoides farinae] and 2 molds [Alternaria iridis and Cladosporium herbarum]).
The prevalence of allergy to any tested allergen peaked at the ages of 13 to 23 years. Rates of sensitization were variable. In the group of individuals tested more than once (n = 592), 16% developed sensitization during the study period and 9% became desensitized. In the group of individuals tested at all 4 examinations (n = 148), 34% developed sensitization and 22% became desensitized. In the group who developed sensitization, 55% had rhinitis, 17% had asthma, and 70% had eczema. In the group who became desensitized, 30% had rhinitis, 10% had asthma, and 50% had eczema.
This 20-year prospective study found that sensitization is common, but its prevalence in individuals is also variable over time. Furthermore, through puberty and early adulthood a large number of individuals develop sensitization and a smaller number become desensitized. In addition, we found that symptoms of rhinitis rarely preceded sensitization.
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Cross-sectional studies have reported a lower prevalence of sensitization in older adults, but few longitudinal studies have examined whether this is an aging or a year-of-birth cohort effect.
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Over the 20-year follow-up, the prevalence of sensitization to at least 1 of the 3 allergens decreased from 29.4% to 24.8% (−4.6%; 95% CI, −7.0% to −2.1%). The prevalence of sensitization to house dust mite (−4.3%; 95% CI, −6.0% to −2.6%) and cat (−2.1%; 95% CI, −3.6% to −0.7%) decreased more than sensitization to grass (−0.6%; 95% CI, −2.5% to 1.3%). Age-specific prevalence of sensitization to house dust mite and cat did not differ between year-of-birth cohorts, but sensitization to grass was most prevalent in the most recent ones. Overall, total IgE levels decreased significantly (geometric mean ratio, 0.63; 95% CI, 0.58-0.68) at all ages in all year-of-birth cohorts.
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However, SPT negativity at age 5 years does not exclude the possibility of developing SPT positivity and allergic symptoms at a later age. Conversion from SPT positive to SPT negative (reversion) has been reported to be very infrequent in previous follow-up studies on healthy children21,22 but quite common in a more recent study on children in farming environment23 and in another study on children with respiratory symptoms.10 In a longitudinal study on children 8-11 years of age with a follow-up period of 3 years, atopic children living on a farm lost their SPT positivity more frequently than children in nonfarming environments.23
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^*: Supported by national Heart, Lung, and Blood Institute Specialized Center of Research Grant HL 14136

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Longitudinal changes in allergen skin test reactivity in a community population sample*

J Allergy Clin Immunol

J Allergy Clin Immunol

J Allergy Clin Immunol

The evaluation of skin tests in respiratory allergy

Acta Allergol

The incidence of immediately reacting allergy skin tests in a “normal” adult population

Ann Intern Med

Skin prick test reactivity to common allergens in Finnish adolescents

Allergy

Atopy and bronchial reactivity in Australian and Melanesian population

Clin Allergy