Assessment of Allergen Sensitization in a General Population-Based Survey (European Community Respiratory Health Survey I)

• Published in: Annals of epidemiology Vol. 20; no. 11; pp. 797 - 803
• Main Authors: Bousquet, Philippe-Jean, MD, PhD, Castelli, Christel, PhD, Daures, Jean-Pierre, MD, PhD, Heinrich, Joachim, PhD, Hooper, Richard, PhD, Sunyer, Jordi, MD, Wjst, Matthias, MD, Jarvis, Deborah, MD, Burney, Peter, MD, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.11.2010
• Subjects: Adult; Allergens; Allergens - immunology; Alternaria; Data Collection; ECRHS; European Union; Female; Health Status; Health Surveys; Humans; IgE; Immunoglobulin E - immunology; Internal Medicine; Male; Phenotype; Pollen - adverse effects; Pollen - immunology; Prevalence; Respiratory System - immunology; Sensitization; Skin Prick Test; Skin Tests - methods; alternaria alternata; C. herbanum; European Community Respiratory Health Survey; IgE; D. farinae; immunoglobulin E; P. judaica; ECRHS; Skin Prick Test; dermatophagoides farinae; A. alternata; parietaria judaica; Sensitization; dermatophagoides pteronyssinus; cladosporium herbanum; D. pteronyssinus
• ISSN: 1047-2797; 1873-2585
• DOI: 10.1016/j.annepidem.2010.05.012

Purpose Exposed to a common environment, the IgE-mediated immune response differs, for instance, among sensitized subjects, some of them reacting toward one allergen (monosensitized) whereas others are sensitized to a wide array of allergens (polysensitized). However, a better phenotypic characterization is needed for epidemiologic studies. Using the data collected during the ECRHS I (European Community Respiratory Health Survey), several assessments of skin prick tests and serum-specific IgE to identify mono- and polysensitized patients were compared. Methods Subjects took part in the ECRHS-I. The CAP-System was used for serum allergen-specific IgE, and allergen-coated Phazet was used for prick tests. Four allergens ( Dermatophagoides pteronyssinus , cat, timothy grass, and Cladosporium ) were measured using IgE and nine (the same ones plus olive pollen, birch, Alternaria, Parietaria , and ragweed) were skin tested. One to two local allergens were also tested, depending on countries. Results Prevalence of sensitization in 11,355 subjects (34.0 [27.9–40.1] years, 49.9% men) ranged from 32.3% (four specific IgE, 19.3% mono- and 13.0% polysensitized) to 41.8% (four specific IgE combined to nine prick tests, 19.6% mono- and 22.2% polysensitized). Concordance between four specific IgE and four prick tests was weak (weighted κ 0.65 [0.64–0.66]). Concordance between seven and nine prick tests was high (weighted κ 0.99 [0.98–1.00]). Local allergens induced small changes in the prevalence of sensitization, and reclassified some subjects from mono- to polysensitized. Conclusions Skin tests or serum-specific IgE may be chosen to identify allergenic sensitivity, mono- and polysensitized subjects without being strictly interchangeable.