Aero-Allergen Sensitization in the General Population: Longitudinal Analyses of the LEAD (Lung Heart Social Body) Study

Franziska Kölli, Marie-Kathrin Breyer, Sylvia Hartl, Otto Burghuber, Emiel F M Wouters, Torben Sigsgaard, Wolfgang Pohl, Gabriele Kohlböck, Robab Breyer-Kohansal, Franziska Kölli, Marie-Kathrin Breyer, Sylvia Hartl, Otto Burghuber, Emiel F M Wouters, Torben Sigsgaard, Wolfgang Pohl, Gabriele Kohlböck, Robab Breyer-Kohansal

Abstract

Background: Monitoring of sensitization may become a non-invasive marker of impaired epithelial barrier function related to changing environmental conditions.

Objective: To longitudinally evaluate the prevalence and associated factors for positive skin prick tests (SPT) in a general population cohort.

Methods: Baseline and 4-year follow-up data from the longitudinal LEAD study are used for the current analyses. Risk factors for SPT were analyzed by multivariate binary logistic regression analyses, including residence (urban/rural), sex, socioeconomic status (SES), allergic and/or respiratory diseases, lung function testing, blood eosinophils, body composition, lifestyle habits, family history, pets in household, and exposure to tobacco smoke in childhood/adolescence (6-18 years) and adulthood (≥19 years).

Results: In total, 1439 children/adolescents and 9844 adults with valid SPTs were included in these analyses. The prevalence of sensitization at baseline was 37.6% and was higher in males in every age group, except 10-<15 years. Individuals with doctor´s diagnosed allergy, asthma or parental allergy were more likely to have a positive SPT; in adulthood, sensitization was more common in those with a high SES. A lower occurrence of sensitization was associated with the presence of a dog in the household in childhood/adolescence and with smoking in adulthood. The prevalence and intensity (number of positive SPT reactions) increased after a 4-year follow-up, especially in children/adolescents.

Conclusion: Sensitization is common in the general Austrian population and more likely in males than females. Longitudinal monitoring of sensitization in children/adolescents may identify environmental triggers related to changes in urbanization, industrialization and domestic lifestyle. ClinicalTrials.gov NCT01727518.

Keywords: adults; aero-allergens; allergy; childhood/adolescence; sensitization.

Conflict of interest statement

Prof. Dr. Sylvia Hartl reports grants from GSK, Roche, Menarini, Böhringer, Astra Zeneca, MSD, Sanofi, and Novartis for advisory board members and speakers honorarium. Prof. Dr. Wolfgang Pohl reports grants and/or personal fees from Meda, Novartis, Roche, Sanova, Astra Zeneca, Boehringer Ingelheim, Chiesi, GSK, and MedImmune, outside the submitted work. The authors declare that they have no other conflicts of interest in this work.

© 2022 Kölli et al.

Figures

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Prevalence of positive skin prick test by age and gender at baseline. *p

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Prevalence of specific SPT at baseline in childhood /adolescence vs adulthood. *p

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Prevalence of specific SPT at baseline in childhood /adolescence vs adulthood. *p

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Prevalence of each allergen in…

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Prevalence of each allergen in childhood/adolescence by gender. *p

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Prevalence of each allergen in childhood/adolescence by gender. *p

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Prevalence of each allergen in adulthood by gender. *p

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Prevalence of each allergen in adulthood by gender. *p

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Flow graph of positive skin…

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Flow graph of positive skin prick test at baseline and after a 4-year…

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Flow graph of positive skin prick test at baseline and after a 4-year follow-up period in childhood/adolescence.

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Flow graph of positive skin…

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Flow graph of positive skin prick test at baseline and after a 4-year…

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Flow graph of positive skin prick test at baseline and after a 4-year follow-up period in adulthood.
Similar articles
References
    1. Janson C, Anto J, Burney P, et al. The European community respiratory health survey: what are the main results so far? Eur Respir J. 2001;18(3):598–611. doi:10.1183/09031936.01.00205801 - DOI - PubMed
    1. Dor-Wojnarowska A, Liebhart J, Miecielica J, et al. The Impact of Sex and Age on the Prevalence of Clinically Relevant Sensitization and Asymptomatic Sensitization in the General Population. Arch Immunol Ther Exp (Warsz). 2017;65(3):253–261. doi:10.1007/s00005-016-0425-7 - DOI - PMC - PubMed
    1. Kupryś-Liphińka I, Elgalal A, Kuna P. Skin prick test with inhaled allergens in the general population of Lodz province. Pneumonol Alergol Pol. 2009;1:634. - PubMed
    1. Bjerg A, Ekerljung L, Eriksson J, et al. Increase in pollen sensitization in Swedish adults and protective effect of keeping animals in childhood. Clin Exp Allergy. 2016;46(10):1328–1336. doi:10.1111/cea.12757 - DOI - PubMed
    1. Gergen PJ, Turkeltaub PC, Kovar MG. The prevalence of allergic skin test reactivity to eight common aeroallergens in the U.S. population: results from the second National Health and Nutrition Examination Survey. J Allergy Clin Immunol. 1987;80(5):669–679. doi:10.1016/0091-6749(87)90286-7 - DOI - PubMed
Show all 52 references
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Grant support
The Austrian LEAD Study is supported by the Ludwig Boltzmann Society, the Municipal Department of Health and Environment of Vienna, the Federal State Governmental Department of Health of Lower Austria, and unrestricted scientific grants from AstraZeneca, Böhringer Ingelheim, Chiesi Pharma, Glaxo Smith Kline, Menarini Pharma, MSD, Novartis Pharma, Vivisol Health Care and Air liquide Company. None of the supporting parties had any participation in the data, nor did they contribute to the design or the content of the present manuscript.
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Figure 2
Figure 2
Prevalence of specific SPT at baseline in childhood /adolescence vs adulthood. *p

Figure 3

Prevalence of each allergen in…

Figure 3

Prevalence of each allergen in childhood/adolescence by gender. *p

Figure 3
Prevalence of each allergen in childhood/adolescence by gender. *p

Figure 4

Prevalence of each allergen in…

Figure 4

Prevalence of each allergen in adulthood by gender. *p

Figure 4
Prevalence of each allergen in adulthood by gender. *p

Figure 5

Flow graph of positive skin…

Figure 5

Flow graph of positive skin prick test at baseline and after a 4-year…

Figure 5
Flow graph of positive skin prick test at baseline and after a 4-year follow-up period in childhood/adolescence.

Figure 6

Flow graph of positive skin…

Figure 6

Flow graph of positive skin prick test at baseline and after a 4-year…

Figure 6
Flow graph of positive skin prick test at baseline and after a 4-year follow-up period in adulthood.
Similar articles
References
    1. Janson C, Anto J, Burney P, et al. The European community respiratory health survey: what are the main results so far? Eur Respir J. 2001;18(3):598–611. doi:10.1183/09031936.01.00205801 - DOI - PubMed
    1. Dor-Wojnarowska A, Liebhart J, Miecielica J, et al. The Impact of Sex and Age on the Prevalence of Clinically Relevant Sensitization and Asymptomatic Sensitization in the General Population. Arch Immunol Ther Exp (Warsz). 2017;65(3):253–261. doi:10.1007/s00005-016-0425-7 - DOI - PMC - PubMed
    1. Kupryś-Liphińka I, Elgalal A, Kuna P. Skin prick test with inhaled allergens in the general population of Lodz province. Pneumonol Alergol Pol. 2009;1:634. - PubMed
    1. Bjerg A, Ekerljung L, Eriksson J, et al. Increase in pollen sensitization in Swedish adults and protective effect of keeping animals in childhood. Clin Exp Allergy. 2016;46(10):1328–1336. doi:10.1111/cea.12757 - DOI - PubMed
    1. Gergen PJ, Turkeltaub PC, Kovar MG. The prevalence of allergic skin test reactivity to eight common aeroallergens in the U.S. population: results from the second National Health and Nutrition Examination Survey. J Allergy Clin Immunol. 1987;80(5):669–679. doi:10.1016/0091-6749(87)90286-7 - DOI - PubMed
Show all 52 references
Associated data
Related information
Grant support
The Austrian LEAD Study is supported by the Ludwig Boltzmann Society, the Municipal Department of Health and Environment of Vienna, the Federal State Governmental Department of Health of Lower Austria, and unrestricted scientific grants from AstraZeneca, Böhringer Ingelheim, Chiesi Pharma, Glaxo Smith Kline, Menarini Pharma, MSD, Novartis Pharma, Vivisol Health Care and Air liquide Company. None of the supporting parties had any participation in the data, nor did they contribute to the design or the content of the present manuscript.
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Format: AMA APA MLA NLM

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The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Unauthorized use of these marks is strictly prohibited.

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Figure 3
Figure 3
Prevalence of each allergen in childhood/adolescence by gender. *p

Figure 4

Prevalence of each allergen in…

Figure 4

Prevalence of each allergen in adulthood by gender. *p

Figure 4
Prevalence of each allergen in adulthood by gender. *p

Figure 5

Flow graph of positive skin…

Figure 5

Flow graph of positive skin prick test at baseline and after a 4-year…

Figure 5
Flow graph of positive skin prick test at baseline and after a 4-year follow-up period in childhood/adolescence.

Figure 6

Flow graph of positive skin…

Figure 6

Flow graph of positive skin prick test at baseline and after a 4-year…

Figure 6
Flow graph of positive skin prick test at baseline and after a 4-year follow-up period in adulthood.
Similar articles
References
    1. Janson C, Anto J, Burney P, et al. The European community respiratory health survey: what are the main results so far? Eur Respir J. 2001;18(3):598–611. doi:10.1183/09031936.01.00205801 - DOI - PubMed
    1. Dor-Wojnarowska A, Liebhart J, Miecielica J, et al. The Impact of Sex and Age on the Prevalence of Clinically Relevant Sensitization and Asymptomatic Sensitization in the General Population. Arch Immunol Ther Exp (Warsz). 2017;65(3):253–261. doi:10.1007/s00005-016-0425-7 - DOI - PMC - PubMed
    1. Kupryś-Liphińka I, Elgalal A, Kuna P. Skin prick test with inhaled allergens in the general population of Lodz province. Pneumonol Alergol Pol. 2009;1:634. - PubMed
    1. Bjerg A, Ekerljung L, Eriksson J, et al. Increase in pollen sensitization in Swedish adults and protective effect of keeping animals in childhood. Clin Exp Allergy. 2016;46(10):1328–1336. doi:10.1111/cea.12757 - DOI - PubMed
    1. Gergen PJ, Turkeltaub PC, Kovar MG. The prevalence of allergic skin test reactivity to eight common aeroallergens in the U.S. population: results from the second National Health and Nutrition Examination Survey. J Allergy Clin Immunol. 1987;80(5):669–679. doi:10.1016/0091-6749(87)90286-7 - DOI - PubMed
Show all 52 references
Associated data
Related information
Grant support
The Austrian LEAD Study is supported by the Ludwig Boltzmann Society, the Municipal Department of Health and Environment of Vienna, the Federal State Governmental Department of Health of Lower Austria, and unrestricted scientific grants from AstraZeneca, Böhringer Ingelheim, Chiesi Pharma, Glaxo Smith Kline, Menarini Pharma, MSD, Novartis Pharma, Vivisol Health Care and Air liquide Company. None of the supporting parties had any participation in the data, nor did they contribute to the design or the content of the present manuscript.
[x]
Cite
Copy Download .nbib
Format: AMA APA MLA NLM
Figure 4
Figure 4
Prevalence of each allergen in adulthood by gender. *p

Figure 5

Flow graph of positive skin…

Figure 5

Flow graph of positive skin prick test at baseline and after a 4-year…

Figure 5
Flow graph of positive skin prick test at baseline and after a 4-year follow-up period in childhood/adolescence.

Figure 6

Flow graph of positive skin…

Figure 6

Flow graph of positive skin prick test at baseline and after a 4-year…

Figure 6
Flow graph of positive skin prick test at baseline and after a 4-year follow-up period in adulthood.
Figure 5
Figure 5
Flow graph of positive skin prick test at baseline and after a 4-year follow-up period in childhood/adolescence.
Figure 6
Figure 6
Flow graph of positive skin prick test at baseline and after a 4-year follow-up period in adulthood.

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    1. Dor-Wojnarowska A, Liebhart J, Miecielica J, et al. The Impact of Sex and Age on the Prevalence of Clinically Relevant Sensitization and Asymptomatic Sensitization in the General Population. Arch Immunol Ther Exp (Warsz). 2017;65(3):253–261. doi:10.1007/s00005-016-0425-7
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