Allergy Asthma Immunol Res.  2014 Sep;6(5):434-443. 10.4168/aair.2014.6.5.434.

Changes in Allergen Sensitization Over The Last 30 Years in Korea Respiratory Allergic Patients: A Single-Center

Affiliations
  • 1Division of Allergy and Immunology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. cshong@yuhs.ac
  • 2Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea.
  • 3Biomedical Research Center, Yonsei University College of Medicine, Seoul, Korea.

Abstract

PURPOSE
Determining the culprit allergen is important for the diagnosis and management of allergic diseases. The skin prick test (SPT) has been widely used to identify culprit allergens. Skin reactivity to allergens has changed due to changes in lifestyle and outdoor environments. Therefore, the aim of the present paper was to examine changes in allergen sensitization in Korea.
METHODS
We enrolled 1,135 patients with respiratory allergic diseases who were diagnosed at Severance Hospital from January 2010 to December 2011. SPTs were performed with inhalant allergens, and were compared to our previous studies of the SPTs in the 1980s and the 1990s.
RESULTS
In the 2010s, the SPT positive rate of allergic rhinitis or allergic conjunctivitis was higher than asthma without allergic rhinitis or allergic conjunctivitis. The SPT positive rate was decreased by increments of age (P value <0.01). Skin reactivity to tree pollens was significantly increased to 36.4% in the 2010s from 19.0% in the 1990s and 8.8% in the 1980s. Among tree pollens, skin reactivity to oak (4.7%->14.4%), birch (7.1%->13.6%), alder (6.3%->13.4%) and pine (2.9%->14.3%) was significantly increased in the 2010s compared with the 1990s, respectively. Current skin reactivity to grass pollens (13.9%) and weed pollens (27.0%) has significantly decreased since the 1990s (20.3%, 40.9%, respectively). Skin reactivity to house dust mites showed no difference between the 1990s (55.2%) and the 2010s (55.6%). Skin reactivity to dog (27.3%->20.7%) and cockroach (25.3%->12.3%) have significantly decreased in the 2010s in comparison with the 1990s.
CONCLUSIONS
In light of the above results, we revealed the changes in skin reactivity to inhalant allergens that have occurred in Korean allergic patients over the past three decades. Since outdoor environmental factors such as the amount of pollen, global warming and plant distribution causes the changes in skin reactivity, further study and continuous close observation will be needed.

Keyword

Change; allergen; skin test; Korea

MeSH Terms

Allergens
Alnus
Animals
Asthma
Betula
Cockroaches
Conjunctivitis, Allergic
Diagnosis
Dogs
Global Warming
Humans
Korea
Life Style
Plant Dispersal
Poaceae
Pollen
Pyroglyphidae
Rhinitis
Skin
Skin Tests
Allergens

Figure

  • Fig. 1 Skin reactivity of allergen groups for each respiratory allergic disease in the 2010s.

  • Fig. 2 Comparison of skin reactivity according to age groups in the 2010s. *Skin reactivity (%) to all allergens was decreased according to increase in age (P<00.01).

  • Fig. 3 Changes in skin reactivity to allergic diseases according to age and test period. *P<00.05 for comparison of skin reactivity (%) between the 1990s and the 2010s.

  • Fig. 4 Changes in the skin reactivity of allergen groups during the last 30 years. *P<00.05 for comparison of skin reactivity (%) between the 1980s and the 1990s. #P<00.05 for comparison of skin reactivity (%) between the 1990s and the 2010s.

  • Fig. 5 Changes in the skin reactivity of each allergen during the last 30 years. (A) Tree pollen, (B) Grass pollen, (C) Weed pollen, (D) Molds, (E) House dust mites, animal hairs and cockroach. *2010s vs 1980s (P<00.01), #1990s vs 1980s (P<00.01), $Higher value in the 1990s than the 2010s (P<00.01), &Higher value in the 2010s than the 1990s (P<00.01). Meadow gr, Meadow grass; Hop J, Humulus japonicus ; Asp fumig, Aspergillus fumigatus; D. p, Dermatophagoides pteronyssinus; D. f, Dermatophagoides farinae.

  • Fig. 6 Changes in pollen counts in the air in Korea from 1997 to 2012. The amount of oak pollen has significantly increased over the last 15 years (P=0.042).


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