Pollen-induced allergic rhinitis in 1360 Italian children: Comorbidities and determinants of severity

Arianna Dondi, Salvatore Tripodi, Valentina Panetta, Riccardo Asero, Andrea Di Rienzo Businco, Annamaria Bianchi, Antonio Carlucci, Giampaolo Ricci, Federica Bellini, Nunzia Maiello, Michele Miraglia del Giudice, Tullio Frediani, Simona Sodano, Iride Dello Iacono, Francesco Macrì, Valerio Massaccesi, Carlo Caffarelli, Laura Rinaldi, Maria Francesca Patria, Elena VarinDiego Peroni, Iolanda Chinellato, Loredana Chini, Viviana Moschese, Sandra Lucarelli, Roberto Bernardini, Giuseppe Pingitore, Umberto Pelosi, Mariangela Tosca, Francesco Paravati, Stefania La Grutta, Paolo Meglio, Mauro Calvani, Mario Plebani, Paolo Maria Matricardi

Research output: Contribution to journalArticle

Abstract

Background: Pollen-induced allergic rhinoconjunctivitis (AR) is highly prevalent and rapidly evolving during childhood. General practitioners may not be fully aware of the nature and severity of symptoms experienced by patients and might underestimate the prevalence of moderate or severe disease. Thus, the relevance of early diagnosis and intervention may be overlooked. Objectives: To investigate the severity of pollen-induced AR and its determinants in Italian children referred to allergy specialists and who had never received specific immunotherapy (SIT). Methods: Children (age 4-18 yr) affected by pollen-induced AR who had never undergone SIT were recruited between May 2009 and June 2011 in 16 pediatric outpatient clinics in 14 Italian cities. Recruited children's parents answered standardized questionnaires on atopic diseases (International Study of Allergy and Asthma in Childhood, Allergic Rhinitis and its Impact on Asthma, Global Initiative for Asthma). The children underwent skin-prick test (SPT) with several airborne allergens and six food allergens. Information on socio-demographic factors, parental history of allergic diseases, education, perinatal events, breastfeeding, nutrition and environmental exposure in early life was collected through an informatics platform shared by the whole network of clinical centers (AllergyCARD™). Results: Among the 1360 recruited patients (68% males, age 10.5 ± 3.4 yr), 695 (51%) had moderate-to-severe AR, 533 (39%) asthma, and 325 (23.9%) oral allergy syndrome (OAS). Reported onset of pollen-induced AR was on average at 5.3 ± 2.8 yr, and its mean duration from onset was 5.2 ± 3.3 yr. Only 6.2% of the patients were pollen-monosensitized, and 84.9% were sensitized to ≥3 pollens. A longer AR duration was significantly associated with moderate-to-severe AR symptoms (p 0.004), asthma (p 0.030), and OAS comorbidities (p <0.001). Conclusions: This nationwide study may raise awareness of the severity of pollen-induced AR among Italian children who have never received pollen SIT. The strong association between pollen-induced AR duration and several markers of disease severity needs replication in longitudinal studies, while suggesting that countrywide initiatives for earlier diagnosis and intervention should be planned.

Original languageEnglish
Pages (from-to)742-751
Number of pages10
JournalPediatric Allergy and Immunology
Volume24
Issue number8
DOIs
Publication statusPublished - Dec 2013

Keywords

  • Allergic conjunctivitis
  • Allergic rhinitis
  • Asthma
  • Children
  • Epidemiology
  • Italy
  • Multiple pollen syndrome
  • Pan-allergens
  • Profilin

ASJC Scopus subject areas

  • Immunology and Allergy
  • Pediatrics, Perinatology, and Child Health
  • Immunology

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    Dondi, A., Tripodi, S., Panetta, V., Asero, R., Businco, A. D. R., Bianchi, A., Carlucci, A., Ricci, G., Bellini, F., Maiello, N., Miraglia del Giudice, M., Frediani, T., Sodano, S., Dello Iacono, I., Macrì, F., Massaccesi, V., Caffarelli, C., Rinaldi, L., Patria, M. F., ... Matricardi, P. M. (2013). Pollen-induced allergic rhinitis in 1360 Italian children: Comorbidities and determinants of severity. Pediatric Allergy and Immunology, 24(8), 742-751. https://doi.org/10.1111/pai.12136