Levels of IgE sensitization drive symptom thresholds in allergic rhinitis.

Maria V Dimou,Paraskevi Xepapadaki,John Lakoumentas, Leonardos Mageiros, Xenophon Aggelidis, Maria Antonopoulou,Petros Bakakos, Sophia Βotskariova, Konstantinos Chliveros, Spyridon Chrysoulakis, Dionysios Dimas,Nikolaos Douladiris, Mina Gaga, Christos Grigoreas, Lampros Kalogiros,Michael Katotomichelakis,Evangelia Kompoti,Jannis Constantinidis, Zoi Koutsogianni,Stelios Loukides,Michael Makris,Emmanouil Manousakis, Pavlos Marangoudakis, Maria Marmara,Nikolaos Mikos, Paraskevi Mitsakou,Dimitrios Mitsias, Aris Pagalos, Vasilios Papanikolaou, Ioannis Paraskevopoulos,Constantinos Pitsios,Fotis Psarros,Nikoletta Rovina,Konstantinos Samitas, Evaggelia Stefanaki, Mina Vallianatou, Dimitrios Vourdas,Ioanna Tsiligianni, Jean Bousquet,Nikolaos G Papadopoulos

Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology(2024)

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摘要
BACKGROUND:Allergic rhinitis (AR) is a common respiratory disease encompassing a variety of phenotypes. Patients can be sensitized to 1 or more allergens. There are indications that polysensitization is associated with more severe disease. However, the extent to which the level of sensitization is associated with clinical disease variability, underlying the distinct nature of AR from AR+ conjunctivitis or AR+ asthma, is not known. OBJECTIVE:To evaluate phenotypical differences between monosensitized and polysensitized patients with AR and to quantify their symptomatic variability. METHODS:A total of 565 patients with a confirmed diagnosis of AR were included in this cross-sectional study. Of those, 155 were monosensitized and 410 were polysensitized. Interactions between sensitization levels and the reporting of different symptoms of AR and co-morbidities, disease duration, and impact were assessed. Furthermore, patients were stratified into monosensitized, oligosensitized, and polysensitized to assess whether the effect of sensitization on the phenotype was ranked. RESULTS:Polysensitized patients reported itchy eyes significantly more often (P = .001) and had a higher number of ocular (P = .005), itch-related (P = .036), and total symptoms (P = .007) than monosensitized patients. In addition, polysensitized adults and children more often reported wheeze (P = .015) and throat-clearing (P = .04), respectively. Polysensitization was associated with more burdensome AR based on a visual analog scale (P = .005). Increased sensitization level was reflected in more itchy eyes, a higher number of ocular, itch-related, and total number of symptoms, and disease burden. CONCLUSION:With an increasing number of sensitizations, patients with AR experience an increased diversity of symptoms. Multimorbidity-related symptoms increase with sensitization rank, suggesting organ-specific thresholds.
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