Allergy Asthma Immunol Res.  2013 Mar;5(2):75-80. 10.4168/aair.2013.5.2.75.

Seasonal Specificity of Seasonal Allergens and Validation of the ARIA Classification in Korea

• Chung YJ
• Cho IK
• Lee KI
• Bae SH
• Lee JW
• Chung PS
• Mo JH

• KMID: 2260341
• DOI: http://doi.org/10.4168/aair.2013.5.2.75

Abstract

PURPOSE
In Korea, tree pollens are known to be prevalent in spring, grass pollens in summer and weed pollens in autumn. However, few studies have revealed their seasonal specificity for allergic rhinitis symptoms. An ARIA (Allergic Rhinitis and its Impact on Asthma) classification of allergic rhinitis was recently introduced and its clinical validation has not been well proved. The aim of this study was to evaluate the seasonal specificity of seasonal allergens and to validate the ARIA classification with the conventional seasonal and perennial allergic rhinitis (SAR/PAR) classification.
METHODS
Two hundred twenty six patients with allergic rhinitis were included in this study. The patients were classified according to the sensitized allergens and the ARIA classifications. A questionnaire survey was performed and the data on the seasonal symptom score, the severity of symptoms and the SNOT (sinonasal outcome test)-20 score was obtained and the data was analyzed and compared between the conventional SAR/PAR classification and the ARIA classification.
RESULTS
Seasonal pollens (tree, grass, weed) were not specific to the pollen peak season and the patients' symptoms were severe during spring and autumn regardless of the offending pollens. More than 60% of the patients with SAR showed persistent symptoms and 33% of the patients with perennial allergic rhinitis (PAR) had intermittent symptoms, showing the lack of association between the SAR/PAR/PAR+SAR classification and the ARIA classification. The ARIA classification showed better association not only with the symptomatic score, but also with the SNOT-20 score, which showed better validity than the conventional SAR/PAR classifications.
CONCLUSIONS
Seasonal pollens were not specific to their season of prevalence in terms of the severity of symptoms, and the ARIA classification showed better representation of allergic symptoms and quality of life (SNOT-20 score) than did the SAR/PAR classification.

Keyword

Seasonal allergic rhinitis; perennial allergic rhinitis; allergic rhinitis and its impact on asthma

MeSH Terms

Allergens
Humans
Korea
Poaceae
Pollen
Prevalence
Quality of Life
Rhinitis
Rhinitis, Allergic, Perennial
Rhinitis, Allergic, Seasonal
Seasons
Sensitivity and Specificity*
Surveys and Questionnaires
Allergens

Reference

1. Dykewicz MS, Fineman S. Executive Summary of Joint Task Force Practice Parameters on Diagnosis and Management of Rhinitis. Ann Allergy Asthma Immunol. 1998. 81:463–468.

2. Bauchau V, Durham SR. Epidemiological characterization of the intermittent and persistent types of allergic rhinitis. Allergy. 2005. 60:350–353.

3. Bousquet J, Van Cauwenberge P, Khaltaev N. Aria Workshop Group. World Health Organization. Allergic rhinitis and its impact on asthma. J Allergy Clin Immunol. 2001. 108:S147–S334.

4. Park HS, Chung DH, Joo YJ. Survey of airborne pollens in Seoul, Korea. J Korean Med Sci. 1994. 9:42–46.

5. Leopold D, Ferguson BJ, Piccirillo JF. Outcomes assessment. Otolaryngol Head Neck Surg. 1997. 117:S58–S68.

6. Browne JP, Hopkins C, Slack R, Cano SJ. The Sino-Nasal Outcome Test (SNOT): can we make it more clinically meaningful? Otolaryngol Head Neck Surg. 2007. 136:736–741.

7. Graif Y, Goldberg A, Tamir R, Vigiser D, Melamed S. Skin test results and self-reported symptom severity in allergic rhinitis: The role of psychological factors. Clin Exp Allergy. 2006. 36:1532–1537.

8. del Cuvillo A, Montoro J, Bartra J, Valero A, Ferrer M, Jauregui I, Dávila I, Sastre J, Mullol J. Validation of ARIA duration and severity classifications in Spanish allergic rhinitis patients - The ADRIAL cohort study. Rhinology. 2010. 48:201–205.