Trends of Sensitization to Inhalant Allergens in Korean Children Over the Last 10 Years

Abstract

Purpose: Climate and lifestyle changes increase an individual's susceptibility to various allergens and also the incidence of allergic diseases. We aimed to examine the changes in sensitization rate for aeroallergens over a 10-year period in Korean children.

Materials and methods: We retrospectively reviewed the medical records of 4493 children who visited the allergy clinic at a tertiary hospital in Korea for allergic rhinitis or asthma from January 2009 to December 2018. The serum specific immunoglobulin E (IgE) levels were measured to confirm the sensitization against Dermatophagoides farinae (D. farinae), Alternaria, weed and tree pollen mixtures, as well as cat and dog dander through ImmunoCAP test.

Results: D. farinae was the most common sensitizing aeroallergen (45.9%) during the 10-year span. The sensitization rate for tree pollen mixture (p for trend <0.001), weed pollen mixtures (p for trend <0.001), dog dander (p for trend=0.025), and cat dander (p for trend=0.003) showed ascending trends during the 10-year study period. Furthermore, the sensitization rate for multiple allergens (≥2) in 2018 increased significantly compared to that in 2009 (p for trend=0.013). Compared with children without sensitization to D. farinae, those with sensitization to D. farinae showed higher sensitization rates to other aeroallergens (p for interaction <0.001).

Conclusion: Children's sensitization rate to cat and dog dander and weed and tree pollen mixtures significantly increased during the 10-year period in Korea. Children with sensitization to D. farinae are likely to be sensitized to other aeroallergens as well.

Keywords: Allergy; aeroallergen; children; sensitization; specific IgE.

Fig. 1. Prevalence of common aeroallergen sensitization at a tertiary care hospital in Seoul, Korea.

Fig. 2. Patterns of monosensitization and multisensitization over the last 10 years. The OR of multisensitization from 2009 to 2018 significantly increased compared to that in 2009 (p for trend=0.013). Meanwhile, the OR of monosensitization significantly decreased (p for trend <0.001). OR, odds ratio.

Fig. 3. Patterns of adjusted OR (95% CI) of sensitization rate to (A) D. farinae, (B) Alternaria, (C) dog dander, (D) cat dander, (E) tree pollen, and (F) weed pollen from 2009 to 2018. Increasing trends of sensitization rate were observed in tree pollen mixture, weed pollen mixture, dog dander, and cat dander (p for trend <0.001, <0.001, 0.025, and 0.003, respectively). No significant difference was observed in the trend of sensitization to Alternaria, while the rate of sensitization to D. farinae showed a tendency to decrease (p for trend <0.001). OR, odds ratio; CI, confidence interval.

Fig. 4. Trends of adjusted OR of sensitization to (A) Alternaria, (B) dog dander, (C) cat dander, (D) tree pollen, and (E) weed pollen in terms of co-sensitization to D. farinae. The prevalence of sensitization to all allergens was higher in children with D. farinae sensitization than in those without D. farinae sensitization over the last 10 years (p for interaction <0.001, respectively). OR, odds ratio; CI, confidence interval.