Prevalence of allergen sensitization, most important allergens and factors associated with atopy in children

Authors

  • Raquel Prudente de Carvalho Baldaçara Hospital do Servidor Público Estadual de São Paulo and Universidade Federal do Tocantins
  • Maria de Fátima Marcelos Fernandes Hospital do Servidor Público Estadual de São Paulo and Universidade Federal do Tocantins
  • Leonardo Baldaçara Hospital do Servidor Público Estadual de São Paulo and Universidade Federal do Tocantins
  • Wilson Tartuce Aun Hospital do Servidor Público Estadual de São Paulo and Universidade Federal do Tocantins
  • João Ferreira de Mello Hospital do Servidor Público Estadual de São Paulo and Universidade Federal do Tocantins
  • Mario Cesar Pires Hospital do Servidor Público Estadual de São Paulo and Universidade Federal do Tocantins

Keywords:

Hypersensitivity, Child, Risk factors, Allergy and immunology, Immunologic techniques

Abstract

CONTEXT AND OBJECTIVE: Knowledge of the profile of allergen sensitization among children is important for planning preventive measures. The objective of this study was to assess the prevalence and profile of sensitization to inhaled allergens and food among children and adolescents in an outpatient population in the city of Palmas. DESIGN AND SETTING: Cross-sectional study at outpatient clinics in Palmas, Tocantins, Brazil. METHODS: Ninety-four patients aged 1-15 years who were attending two pediatric outpatient clinics were selected between September and November 2008. All of the subjects underwent clinical interviews and skin prick tests. RESULTS: A positive skin prick test was observed in 76.6% of the participants (72.3% for inhalants and 28.9% for food allergens). The most frequent allergens were Dermatophagoides pteronyssinus (34%), cat epithelium (28.7%), dog epithelium (21.3%), Dermatophagoides farinae (19.1%), Blomia tropicalis (18.1%), cow’s milk (9.6%) and grasses (9.6%). A positive skin prick test correlated with a history of atopic disease (odds ratio, OR = 5.833; P = 0.002), a family history of atopic disease (OR = 8.400; P < 0.001), maternal asthma (OR = 8.077; P = 0.048), pet exposure (OR = 3.600; P = 0.012) and cesarean delivery (OR = 3.367; P = 0.019). CONCLUSION: Dermatophagoides pteronyssinus was the most frequent aeroallergen and cow’s milk was the most prevalent food allergen. There was a positive correlation between a positive skin prick test and several factors, such as a family history of atopic disease, maternal asthma, pet exposure and cesarean delivery.

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Author Biographies

Raquel Prudente de Carvalho Baldaçara, Hospital do Servidor Público Estadual de São Paulo and Universidade Federal do Tocantins

MD, MSc. Assistant Professor in the Department of Medicine, Universidade Federal do Tocantins (UFT), Palmas, Tocantins, Brazil.

Maria de Fátima Marcelos Fernandes, Hospital do Servidor Público Estadual de São Paulo and Universidade Federal do Tocantins

MD, MSc. Head of the Diagnostic and Therapeutic Division, Department of Allergy and Immunology, Hospital do Servidor Público Estadual de São Paulo (HSPE), São Paulo, Brazil.

Leonardo Baldaçara, Hospital do Servidor Público Estadual de São Paulo and Universidade Federal do Tocantins

MD, PhD. Associate Professor in the Department of Medicine, Universidade Federal do Tocantins (UFT), Palmas, Tocantins, Brazil.

Wilson Tartuce Aun, Hospital do Servidor Público Estadual de São Paulo and Universidade Federal do Tocantins

MD. Head of the Immunology Section, Department of Allergy and Immunology, Hospital do Servidor Público Estadual de São Paulo (HSPE), São Paulo, Brazil.

João Ferreira de Mello, Hospital do Servidor Público Estadual de São Paulo and Universidade Federal do Tocantins

MD, PhD. Director of the Department of Allergy and Immunology, Hospital do Servidor Público Estadual de São Paulo (HSPE), São Paulo, Brazil.

Mario Cesar Pires, Hospital do Servidor Público Estadual de São Paulo and Universidade Federal do Tocantins

MD, PhD. Head of the Diagnostic and Therapeutic Division, Department of Dermatology, Hospital do Servidor Público Estadual de São Paulo (HSPE), São Paulo, Brazil.

References

Gendeh BS, Mujahid SH, Murad S, Rizal M. Atopic sensitization of children with rhinitis in Malaysia. Med J Malaysia. 2004;59(4):522-9.

Batllés-Garrido J, Torres-Borrego J, Rubí-Ruiz T, et al. Prevalence and factors linked to atopy in 10-and 11-year-old children in Almería, Spain. Allergol Immunopathol (Madr). 2010;38(1):13-9.

Johansson SG, Bieber T, Dahl R, et al. Revised nomenclature for allergy for global use: Report of the Nomenclature Review Committee of the World Allergy Organization, October 2003. J Allergy Clin Immunol. 2004;113(5):832-6.

Worldwide variation in prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema: ISAAC. The International Study of Asthma and Allergies in Childhood (ISAAC) Steering Committee. Lancet. 1998;351(9111):1225-32.

Solé D, Yamada E, Vana AT, et al. International Study of Asthma and Allergies in Childhood (ISAAC): prevalence of asthma and asthma- related symptoms among Brazilian schoolchildren. J Investig Allergol Clin Immunol. 2001;11(2):123-8.

Solé D, Wandalsen GF, Camelo-Nunes IC, Naspitz CK; ISAAC – Brazilian Group. Prevalence of symptoms of asthma, rhinitis, and atopic eczema among Brazilian children and adolescents identified by the International Study of Asthma and Allergies in Childhood (ISAAC) - Phase 3. J Pediatr (Rio J). 2006;82(5):341-6.

Bager P, Wohlfahrt J, Westergaard T. Caesarean delivery and risk of atopy and allergic disease: meta-analyses. Clin Exp Allergy. 2008;38(4):634-42.

Renz-Polster H, David MR, Buist AS, et al. Caesarean section delivery and the risk of allergic disorders in childhood. Clin Exp Allergy. 2005;35(11):1466-72.

Norrman G, Tomicić S, Böttcher MF, et al. Significant improvement of eczema with skin care and food elimination in small children. Acta Paediatr. 2005;94(10):1384-8.

Cole Johnson C, Ownby DR, Havstad SL, Peterson EL. Family history, dust mite exposure in early childhood, and risk for pediatric atopy and asthma. J Allergy Clin Immunol. 2004;114(1):105-10.

Laan MP, Baert MR, Bijl AM, et al. Markers for early sensitization and inflammation in relation to clinical manifestations of atopic disease up to 2 years of age in 133 high-risk children. Clin Exp Allergy. 2000;30(7):944-53.

Fasce L, Tosca MA, Baroffio M, Olcese R, Ciprandi G. Atopy in wheezing infants always starts with monosensitization. Allergy Asthma Proc. 2007;28(4):449-53.

Fuiano N, Incorvaia C, Prodam F, Procaccini DA, Bona G. Relationship between the atopy patch test and clinical expression of the disease in children with atopic eczema/dermatitis syndrome and respiratory symptoms. Ann Allergy Asthma Immunol. 2008;101(2):174-8.

Demoly P, Piette V, Daures JP. Treatment of allergic rhinitis during pregnancy. Drugs. 2003;63(17):1813-20.

Brasil. Ministério da Saúde. IBGE. Tabelas de resultados. Available from:

<http://www.ibge.gov.br/home/estatistica/populacao/censo2010/ indicadores_sociais_municipais/tabelas_pdf/tab2.pdf>. Accessed in 2012 (Dec 17).

Stein RT, Sherrill D, Morgan WJ, et al. Respiratory syncytial virus in early life and risk of wheeze and allergy by age 13 years. Lancet. 1999;354(9178):541-5.

Osterballe M, Hansen TK, Mortz CG, Bindslev-Jensen C. The clinical relevance of sensitization to pollen-related fruits and vegetables in unselected pollen-sensitized adults. Allergy. 2005;60(2):218-25.

Souza CCT, Rosário Filho NA. Perfil de aeroalérgenos intradomiciliares comuns no Brasil: revisão dos últimos 20 anos [Profile of common indoor aeroallergens in Brazil: review of the last 20 years]. Rev Bras Alergia Imunopatol. 2012;35(2):47-52.

Simpson CR, Newton J, Hippisley-Cox J, Sheikh A. Incidence and prevalence of multiple allergic disorders recorded in a national primary care database. J R Soc Med. 2008;101(11):558-63.

Patel SP, Järvelin MR, Little MP. Systematic review of worldwide variations of the prevalence of wheezing symptoms in children. Environ Health. 2008;7:57.

Heinzerling L, Frew AJ, Bindslev-Jensen C, et al. Standard skin prick testing and sensitization to inhalant allergens across Europe--a survey from the GALEN network. Allergy. 2005;60(10):1287-300.

Kidon MI, Chiang WC, Liew WK, et al. Sensitization to dust mites in children with allergic rhinitis in Singapore: does it matter if you scratch while you sneeze? Clin Exp Allergy. 2005;35(4):434-40.

Arshad SH, Tariq SM, Matthews S, Hakim E. Sensitization to common allergens and its association with allergic disorders at age 4 years: a whole population birth cohort study. Pediatrics. 2001;108(2):E33.

Arbes SJ Jr, Gergen PJ, Elliott L, Zeldin DC. Prevalences of positive skin test responses to 10 common allergens in the US population: results from the third National Health and Nutrition Examination Survey. J Allergy Clin Immunol. 2005;116(2):377-83.

Lopes MI, Miranda PJ, Sarinho E. Use of the skin prick test and specific immunoglobulin E for the diagnosis of cockroach allergy. J Pediatr (Rio J) 2006;82(3):204-9.

Taketomi EA, Sopelete MC, Moreira PFS, Vieira FAM. Doença alérgica polínica: polens alergógenos e seus principais alérgenos [Pollen allergic disease: pollens and its major allergens]. Rev Bras Otorrinolaringol. 2006;72(4):562-7.

Esteves PC, Rosário Filho NA, Trippia SG, Caleffe LG. Prevalência de rinite alérgica perene e sazonal, com sensibilização atópica ao Dermatophagoides pteronyssinus (Dp) e ao Lolium multiflorum (LOLIUM) em escolares de 13 e 14 anos e adultos de Curitiba [Prevalence of perennial and seasonal allergic rhinitis with atopic sensitization to Dermatophagoides pteronyssinus (Dp) and Lolium multiflorum (LOLIUM) in schoolchildren and adults in Curitiba]. Revista Brasileira de Alergia e Imunopatologia. 2000;23:249-59. Available from: http://www.asbai.org.br/revistas/Vol236/prev.htm. Accessed in 2012 (Dec 17).

Kalach N, Soulaines P, Imad AS, et al. Survey of prick test, total and specific age during food allergy in children. Eur Ann Allergy Clin Immunol. 2007;39(2):51-7.

Lowe AJ, Hosking CS, Bennett CM, et al. Skin prick test can identify eczematous infants at risk of asthma and allergic rhinitis. Clin Exp Allergy. 2007;37(11):1624-31.

Hofman T, Hanasz-Jarzyńska T. Food allergens as causative factors of respiratory, skin and gastrointestinal allergy confirmed by skin prick test and specific IgE and IgG4 FAST in children. Pneumonol Alergol Pol. 1992;60 Suppl 1:16-9.

Crestani E, Guerra S, Wright AL, Halonen M, Martinez FD. Parental asthma as a risk factor for the development of early skin test sensitization in children. J Allergy Clin Immunol. 2004;113(2):284-90.

Guilbert TW, Morgan WJ, Zeiger RS, et al. Atopic characteristics of children with recurrent wheezing at high risk for the development of childhood asthma. J Allergy Clin Immunol. 2004;114(6):1282-7.

Ribeiro SA, Furuyama T, Schenkman S, Jardim JR. Atopy, passive smoking, respiratory infections and asthma among children from kindergarten and elementary school. Sao Paulo Med J. 2002;120(4):109-12.

Kuyucu S, Saraçlar Y, Tuncer A, et al. Determinants of atopic sensitization in Turkish school children: effects of pre- and post-natal events and maternal atopy. Pediatr Allergy Immunol. 2004;15(1):62-71.

Mallen CD, Mottram S, Wynne-Jones G, Thomas E. Birth-related exposures and asthma and allergy in adulthood: a population- based cross-sectional study of young adults in North Staffordshire. J Asthma. 2008;45(4):309-12.

Moore DC, Elsas PX, Maximiano ES, Elsas MI. Impact of diet on the immunological microenvironment of the pregnant uterus and its relationship to allergic disease in the offspring--a review of the recent literature. Sao Paulo Med J. 2006;124(5):298-303.

Brown MA, Rad PY, Halonen MJ. Method of birth alters interferon- gamma and interleukin-12 production by cord blood mononuclear cells. Pediatr Allergy Immunol. 2003;14(2):106-11.

Naspitz CK, Solé D, Jacob CA, et al. Sensibilização a alérgenos inalantes e alimentares em crianças brasileiras atópicas, pela determinação in vitro de IgE total e específica: Projeto Alergia (PROAL) [Sensitization to inhalant and food allergens in Brazilian atopic children by in vitro total and specific IgE assay: Allergy Project -PROAL]. J Pediatr (Rio J). 2004;80(3):203-10.

Weitzman M, Gortmaker S, Walker DK, Sobol A. Maternal smoking and childhood asthma. Pediatrics. 1990;85(4):505-11.

Lee SL, Lam TH, Leung TH, et al. Foetal exposure to maternal passive smoking is associated with childhood asthma, allergic rhinitis, and eczema. ScientificWorldJournal. 2012;2012:542983.

Chong Neto HJ, Rosário NA, Tannus BG, et al. Fatores de risco para sibilância no primeiro ano de vida [Risk factors for wheezing in the first year of life]. J Pediatr (Rio J). 2008;84(6):495-502.

Ownby DR, Anderson JA. An improved prick skin-test procedure for young children. J Allergy Clin Immunol. 1982;69(6):533-5.

Murray CS, Kissen P, Craven M, et al. Cumulative exposure to indoor allergens: Association with sensitisation and respiratory symptoms in the first 3 years of life. The Journal of Allergy Clinical Immunology. 2002;109(1 Suppl 1):S177.

Dong GH, Ma YN, Ding HL, et al. Effects of housing characteristics and home environmental factors on respiratory symptoms of 10,784 elementary school children from northeast China. Respiration. 2008;76(1):82-91.

Kull I, Böhme M, Wahlgren CF, et al. Breast-feeding reduces the risk for childhood eczema. J Allergy Clin Immunol. 2005;116(3):657-61.

Snijders BE, Thijs C, Dagnelie PC, et al. Breast-feeding duration and infant atopic manifestations, by maternal allergic status, in the first 2 years of life (KOALA study). J Pediatr. 2007;151(4):347-51, 351.e1-2.

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Published

2013-09-09

How to Cite

1.
Baldaçara RP de C, Fernandes M de FM, Baldaçara L, Aun WT, Mello JF de, Pires MC. Prevalence of allergen sensitization, most important allergens and factors associated with atopy in children. Sao Paulo Med J [Internet]. 2013 Sep. 9 [cited 2025 Mar. 9];131(5):301-8. Available from: https://periodicosapm.emnuvens.com.br/spmj/article/view/1330

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