| 1. |
- Nwaru, Bright I, et al.
(author)
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Furry Animal Allergen Component Sensitization and Clinical Outcomes in Adult Asthma and Rhinitis
- 2019
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In: Journal of Allergy and Clinical Immunology. - : Elsevier. - 2213-2198 .- 2213-2201. ; 7:4, s. 1230-1238.e4
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Journal article (peer-reviewed)abstract
- Background: Sensitization to allergen components has been linked to asthma in children, but studies in adults are lacking.Objective: To study the relation of sensitization to furry animal allergen components to risk of asthma, rhinitis, and markers of asthma severity in adults.Methods: From the West Sweden Asthma Study, a random population-representative sample of adults aged 16 to 75 years, 2006 participants were clinically examined; 1872 were analyzed for serum IgE level to a mix of aeroallergens. Those with an IgE level of more than 0.35 kUA/L to cat, dog, or horse allergen components were analyzed for specific cat (Felis domesticus [Fel d 1, Fel d 2, and Fel d 4]), dog (Canis familiaris [Can f 1, Can f 2, Can f 3, and Can f 5]), and horse (Equus caballus [Equ c 1]) allergen components. We defined monosensitization, double sensitization, and polysensitization (>2 components) patterns and applied cluster analysis to derive distinct sensitization clusters.Results: Sensitization to each allergen component, lipocalins, each sensitization pattern, and each sensitization cluster (nonsensitized, Fel d 1–driven sensitized, and multisensitized clusters) was associated with substantial increased risk of asthma, rhinitis, concomitant asthma and rhinitis, and Asthma Control Test–controlled asthma. Fel d 1, Can f 1, Can f 2, Can f 3, polysensitization, and multisensitized cluster were further associated with increased fractional exhaled nitric oxide and eosinophil levels, but with lower PD20 methacoline (provocative dose of methacholine causing a 20% drop in FEV1) values. There was no association with asthma exacerbations, FEV1 predicted values, emergency visits or regular oral steroid use, and neutrophil levels.Conclusions: Sensitization to furry animal allergen components is an important predictor of asthma, rhinitis, and markers of asthma severity with increased blood eosinophils, fractional exhaled nitric oxide, and airway hyperreactivity.
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| 2. |
- Suzuki, Shintaro, et al.
(author)
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Characterization of sensitization to furry animal allergen components in an adult population.
- 2019
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In: Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology. - : Wiley. - 1365-2222 .- 0954-7894. ; 49:4, s. 495-505
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Journal article (peer-reviewed)abstract
- There are paucity of data on sensitization to furry animal allergen components in adults. Furry animals are major sensitizers and contributors to asthma burden in northern Europe and North America.To characterize sensitization patterns to furry animal allergen components in Swedish adults.Based on the West Sweden Asthma Study, a random population (n=1103) and an asthma sample (n=769) were tested for allergen sensitization using Phadiatop® . Those with IgE≥0.35kUA /L were tested for cat (Fel d 1, 2, and 4), dog (Can f 1, 2, 3, and 5), and horse (Equ c 1) allergen component sensitization. We defined allergen component poly-sensitization patterns, identified data-driven sensitization clusters, described component sensitization overlaps, and assessed determinants of sensitization patterns.The prevalence of allergen component sensitization ranged from 0.8% for Fel d 2 and Can f 3 to 8.9% for Fel d 1. The most common dog component was Can f 5 (3.6%); 2.1% were sensitized to Equ c 1. Those sensitized to Fel d 2 and Fel d 4 were commonly sensitized to Fel d 1. The most common dog component overlap was between Can f 1/Can f 2 and Can f 5. Mono-sensitization was 5.6%, double sensitization 1.5% and poly-sensitization 2.1%. Sensitization was always higher in the asthma than in the random sample. Three sensitization clusters were derived, namely non-sensitized (90% in random vs 66% in asthma sample); Fel d 1-driven sensitized (7% vs 19%); and multi-sensitized (3% vs 15%). Key determinants of sensitization were gender, age, raised on a farm, family history of allergy or asthma, smoking, and occupational exposure to dust or fumes.Fel d 1 and Can f 5 are the most common cat and dog components sensitization in this adult Swedish population. Mono-sensitization is more common than poly-sensitization. This detailed characterization highlights the current distribution of furry animal allergen components in Swedish adults, and their impact on clinical outcomes of asthma will be further explored.
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| 3. |
- Lötvall, Jan, 1956, et al.
(author)
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West Sweden Asthma Study: Prevalence trends over the last 18 years argue no recent increase in asthma.
- 2009
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In: Respiratory research. - : Springer Science and Business Media LLC. - 1465-993X. ; 10:1
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Journal article (peer-reviewed)abstract
- ABSTRACT: Asthma prevalence has increased over the last fifty years, but the more recent changes have not been conclusively determined. Studies in children indicate that a plateau in the prevalence of asthma may have been reached, but this has not yet been confirmed in adults. Epidemiological studies have suggested that the prevalence of asthma in adults is approximately 7-10% in different parts of the western world. We have now performed a large-scale epidemiological evaluation of the prevalence of asthma and respiratory symptoms in adults between the ages of 16-75 in West Sweden. Thirty thousand randomly chosen individuals were sent a detailed questionnaire focusing on asthma and respiratory symptoms, as well possible risk factors. Sixty-two percent of the contacted individuals responded to the questionnaire. Asthma prevalence, defined as asthma diagnosed by a physician, was 8.3%. Moreover, the prevalence of respiratory symptoms was lower compared to previous studies. The most common respiratory symptom was any wheeze (16.6%) followed by sputum production (13.3%). In comparison with studies performed 18 years ago, the prevalence of asthma has not increased, and the prevalence of most respiratory symptoms has decreased. Therefore, our data argues that the continued increase in asthma prevalence that has been observed over the last half century is over.
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| 4. |
- Rönmark, Erik P, 1981, et al.
(author)
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Different risk factor patterns for adult asthma, rhinitis and eczema : results from West Sweden Asthma Study
- 2016
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In: Clinical and Translational Allergy. - : Wiley. - 2045-7022 .- 2045-7022. ; 6
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Journal article (peer-reviewed)abstract
- BACKGROUND: Atopic diseases including asthma, rhinitis and eczema have increased in the second half of the past century. This has been well studied among children and adolescents but with the exception of asthma to a much lesser extent in adults. The adult risk factor pattern of atopic diseases, in particular of eczema, and their relation to allergic sensitization are yet to be fully elucidated. Studies among adults that have compared the risk factor pattern for these conditions in the same material are very few. The objective of this study was to compare the risk factor patterns for asthma, rhinitis and eczema in a randomly selected adult population.METHODS: A questionnaire survey on atopic diseases was dispatched by mail to 30,000 randomly selected individuals in West Sweden aged 16-75 years and 62 % participated. A subgroup of 2000 individuals was selected for clinical examinations including blood sampling for specific serum Immunoglobulin E to common airborne allergens and 1172 attended.RESULTS: The prevalence of current asthma was 11.8 %, current rhinitis 42.8 %, current eczema 13.5 and 2.3 % had all three conditions while 13.9 % had at least two conditions. No mutual risk factor was identified for all three conditions. Allergic sensitization was a strong risk factor for current asthma (OR 4.1 CI 2.7-6.3) and current rhinitis (OR 5.1 CI 3.8-6.9) but not so for current eczema. Obesity was a risk factor for current asthma and current rhinitis, while farm childhood decreased the risk for current asthma and current rhinitis. Occupational exposure to gas dust or fumes and female sex was associated with an increased risk of current asthma and current eczema.CONCLUSIONS: There are different risk factor patterns for asthma, rhinitis and eczema in adults but some risk factors are overlapping between some of the conditions. The effect of mutable risk factors should be assessed further in longitudinal studies.
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| 5. |
- Rönmark, Erik P, 1981, et al.
(author)
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Eczema among adults: prevalence, risk factors and relation to airway diseases. Results from a large-scale population survey in Sweden
- 2012
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In: British Journal of Dermatology. - : Oxford University Press (OUP). - 0007-0963 .- 1365-2133. ; 166:6, s. 1301-1308
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Journal article (peer-reviewed)abstract
- Background In contrast to asthma and rhinitis, few studies among adults investigating the prevalence and risk factors of eczema have been published. Objectives To investigate the prevalence and risk factors of eczema among adults in West Sweden. A further aim was to study the associations between asthma, rhinitis and eczema. Methods A questionnaire on respiratory health was mailed in 2008 to 30 000 randomly selected subjects in West Sweden aged 16-75 years; 62% responded. The questionnaire included questions about eczema, respiratory symptoms and diseases and their possible determinants. A subgroup of 669 subjects underwent skin prick testing against common airborne allergens. Results 'Eczema ever' was reported by 40.7% and 'current eczema' by 11.5%. Both conditions were significantly more common among women. The prevalence decreased with increasing age. The coexistence of both asthma and rhinitis with eczema was common. The main risk factors were family history of allergy and asthma. The dominant environmental risk factor was occupational exposure to gas, dust or fumes. Smoking increased the risk. Eczema was associated with urbanization, while growing up on a farm was associated with a decreased risk. Added one by one to the multivariate model, asthma, allergic rhinitis and any positive skin prick test were associated with eczema. Conclusions Eczema among adults is a common disease with more women than men having and having had eczema. Eczema is associated with other atopic diseases and with airway symptoms. Hereditary factors and exposure to gas, dust and fumes are associated with eczema.
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| 6. |
- Rönmark, Erik P, 1981, et al.
(author)
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Large scale questionnaire survey on respiratory health in Sweden: effects of late- and non-response.
- 2009
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In: Respiratory medicine. - : Elsevier BV. - 1532-3064 .- 0954-6111. ; 103:12, s. 1807-15
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Journal article (peer-reviewed)abstract
- BACKGROUND: Participation rates in epidemiologic studies conducted with postal questionnaires have steadily declined since 1970s. This can lead to an increased risk for selection bias. The aim of this study was to examine cause and effect of non-response in a large cross sectional study assessing respiratory health in western Sweden. METHODS: The study sample was 29,218. The response rate to the initial postal questionnaire was 33%. The response rates to subsequent postal reminders were 15%, 7% and 7% of eligible participants totalling a participation of 62%. Of those who did not respond to the postal survey, a random sample of 400 subjects were identified and contacted for interview by telephone. RESULTS: Non-responders did not differ significantly in prevalence of airway diseases or symptoms when compared with responders. Male sex, young age and smokers were underestimated among non-responders. No clear trends in prevalence of respiratory symptoms and report of asthma were found with delayed response to the postal survey. The proportion of smokers and men increased with increasing number of reminders. Letters reminding subjects about the study did increase the participation rate but did not alter the risk estimates. CONCLUSION: We conclude that with a response rate of 62%, our estimate of disease and symptom prevalence was not biased in this Swedish population. However, smoking was underestimated. No general trend for late-responders was seen and therefore we conclude that extrapolation of results to non-responders is not possible in our study. Causes of non-response were mainly due to circumstantial factors.
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| 7. |
- Bjerg, Anders, 1982, et al.
(author)
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Gas, dust, and fumes exposure is associated with mite sensitization and with asthma in mite-sensitized adults
- 2015
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In: Allergy. European Journal of Allergy and Clinical Immunology. - : John Wiley & Sons. - 0105-4538 .- 1398-9995. ; 70:5, s. 604-607
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Journal article (peer-reviewed)abstract
- Occupational exposure to gas, dust, and fumes (GDF) increases the risk of asthma and eczema. We investigated the role of sensitization in the association between GDF and allergic conditions. A population-based sample of 788 adults from the West Sweden Asthma Study completed questionnaires and skin prick tests. After adjustment for confounders, GDF exposure was associated with a doubled risk of sensitization to mites, but not with other allergens. Mite sensitization also modified the effect of GDF on asthma. In mite-sensitized subjects, GDF was associated with physician-diagnosed asthma, adjusted OR 2.9 (1.2-7.2), and with wheeze, OR 2.4 (1.1-5.3). In non-mite-sensitized subjects, the corresponding ORs were 1.1 (0.5-2.6) and 0.6 (0.3-1.3). GDF was independently associated with eczema regardless of mite sensitization, but not with rhinitis. These novel findings suggest that components of GDF may act as adjuvants that facilitate sensitization to mites and that mite-sensitized individuals may be especially susceptible to inhalant occupational exposures.
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| 8. |
- Pullerits, Teet, 1967, et al.
(author)
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The triad of current asthma, rhinitis and eczema is uncommon among adults: Prevalence, sensitization profiles, and risk factors
- 2021
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In: Respiratory Medicine. - : Elsevier BV. - 0954-6111 .- 1532-3064. ; 176
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Journal article (peer-reviewed)abstract
- Background Coexistence of asthma, rhinitis, and eczema has been studied in children, but data are lacking in adults. As new treatments emerge, epidemiological data on the coexistence are needed. Aims To study the prevalence of concomitant asthma, rhinitis and eczema in the general adult population and among those sensitized to aeroallergens, and to study associations between background characteristics and risks of phenotypes of asthma, rhinitis, and eczema. Methods In the West Sweden Asthma Study, phenotypes and sensitization profiles of 1103 randomly selected adults (16–75 years) were assessed. The methods included measures of serum-IgE and structured interviews on asthma, rhinitis, eczema, their associated symptoms, and relevant risk factors. Results Among all participants and in those sensitized, 2% and 6% had concomitant asthma, rhinitis, and eczema, respectively, and the condition did not differ by age or sex. Corresponding figures for asthma and rhinitis, but not eczema, was 8% and 19%, respectively. Determinants of coexistence of the three conditions were family history of asthma/allergy, body mass index, and occupational exposure to gas, dust and fumes. Allergic sensitization in those with asthma, rhinitis and eczema was found in 78%, in those with asthma and rhinitis but not eczema in 65%, in those with asthma and eczema but not rhinitis in 40%, while only 5% were sensitized among those having asthma only. Conclusions In the general adult population about 2% have concomitant asthma, rhinitis, and eczema. Of sensitized adults, about 6% has coexistence of the three conditions.
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| 9. |
- Rönmark, Erik P, 1981
(author)
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The association between eczema, asthma and rhinitis -population studies of prevalence and risk factors among adults
- 2016
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Doctoral thesis (other academic/artistic)abstract
- Background: Allergic diseases such as asthma, rhinitis and eczema have increased significantly since the middle of the past century and are now common conditions among both children and adults. The increase was observed earlier and is more evident in Westernized countries but is now also apparent in urbanized areas in developing countries. The exact cause of this increase is still not fully explored, although several partly contradicting hypotheses exist, including the hygiene hypothesis. Asthma, rhinitis and eczema are common comorbidities and allergic sensitization is commonly seen as a unifying link. Research questions: The overall aim of this thesis was to investigate the prevalence of eczema; risk factors for eczema; overlapping risk factors for asthma, rhinitis and eczema; the prevalence of allergic sensitization and the impact of allergic sensitization on these diseases in an adult population. Additional objectives included a validation of the representativeness of the recruited population. Methodology: This thesis is based on a postal survey in Västra Götaland with 18 087 responders (62%) out of a real study sample of 29 218 individuals aged 16 to 75 years. Clinical examinations including structured interviews, lung function tests, anthropometric measures, skin prick tests and assessments of specific serum Immunoglobulin E were performed in 1172 randomly selected responders. A study of non-response was carried out among non-responders to the postal survey and 211 out of the 400 randomly selected subjects were successfully contacted by phone and agreed to participate. Results: Non-responders compared to responders to the postal survey tended to be younger, smoke, have male sex and live in the metropolitan area of Gothenburg but they did not differ in prevalence of asthma, airway symptoms, eczema and rhinitis. Ever having had eczema was reported by 40.7% in the postal survey and the prevalence of current eczema was 11.5%. Eczema was more common among women and associated with respiratory symptoms, asthma and rhinitis. Allergic sensitization, obesity, female sex and occupational exposure to gas, dust or fumes were significantly and independently associated with asthma. A risk factors for rhinitis but not for eczema was obesity and allergic sensitization was strongly associated with rhinitis but less so for eczema. Risk factors for eczema but not for rhinitis were female sex and occupational exposure to gas, dust or fumes. Farm childhood was negatively associated with rhinitis and eczema but not asthma. The prevalence of sensitization to at least one common airborne allergen was 29.7%. Sensitization to birch and dog was associated with asthma while rhinitis was associated with sensitization to birch and timothy. No significant association was found between allergic sensitization and current eczema. Conclusions: We conclude that non-response had minimal effect on the outcome in our study. Eczema was more common than anticipated and associated with asthma and rhinitis. There are different risk factor patterns for asthma, rhinitis and eczema in adults. Allergic sensitization is an important risk factor for asthma and rhinitis but less so for eczema among adults. Rhinitis is mainly associated with sensitization to outdoor allergens while asthma is related to both outdoor and indoor allergens.
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