TY - JOUR
T1 - Pollen-induced allergic rhinitis in 1360 Italian children
T2 - Comorbidities and determinants of severity
AU - Dondi, Arianna
AU - Tripodi, Salvatore
AU - Panetta, Valentina
AU - Asero, Riccardo
AU - Businco, Andrea Di Rienzo
AU - Bianchi, Annamaria
AU - Carlucci, Antonio
AU - Ricci, Giampaolo
AU - Bellini, Federica
AU - Maiello, Nunzia
AU - Miraglia del Giudice, Michele
AU - Frediani, Tullio
AU - Sodano, Simona
AU - Dello Iacono, Iride
AU - Macrì, Francesco
AU - Massaccesi, Valerio
AU - Caffarelli, Carlo
AU - Rinaldi, Laura
AU - Patria, Maria Francesca
AU - Varin, Elena
AU - Peroni, Diego
AU - Chinellato, Iolanda
AU - Chini, Loredana
AU - Moschese, Viviana
AU - Lucarelli, Sandra
AU - Bernardini, Roberto
AU - Pingitore, Giuseppe
AU - Pelosi, Umberto
AU - Tosca, Mariangela
AU - Paravati, Francesco
AU - La Grutta, Stefania
AU - Meglio, Paolo
AU - Calvani, Mauro
AU - Plebani, Mario
AU - Matricardi, Paolo Maria
PY - 2013/12
Y1 - 2013/12
N2 - 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.
AB - 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.
KW - Allergic conjunctivitis
KW - Allergic rhinitis
KW - Asthma
KW - Children
KW - Epidemiology
KW - Italy
KW - Multiple pollen syndrome
KW - Pan-allergens
KW - Profilin
UR - http://www.scopus.com/inward/record.url?scp=84890309691&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84890309691&partnerID=8YFLogxK
U2 - 10.1111/pai.12136
DO - 10.1111/pai.12136
M3 - Article
C2 - 24236692
AN - SCOPUS:84890309691
VL - 24
SP - 742
EP - 751
JO - Pediatric Allergy and Immunology
JF - Pediatric Allergy and Immunology
SN - 0905-6157
IS - 8
ER -