Annals of Epidemiology
Volume 20, Issue 11 , Pages 797-803, November 2010

Assessment of Allergen Sensitization in a General Population-Based Survey (European Community Respiratory Health Survey I)

  • Philippe-Jean Bousquet, MD, PhD

      Affiliations

    • National Heart and Lung Institute at Imperial College, Respiratory Epidemiology and Public Health, London, UK
    • Département Biostatistique, Epidémiologie Clinique, Santé Publique et Information Médicale, GHU Carémeau, CHU Nîmes, Nîmes, France
    • Corresponding Author InformationAddress correspondence to: Philippe-Jean Bousquet, MD, PhD, Respiratory Epidemiology and Public Health, National Heart and Lung Institute at Imperial College, Emmanuel Kaye Building, Manresa Road, London SW3 6LR, UK.
    • ,
  • Christel Castelli, PhD

      Affiliations

    • Département Biostatistique, Epidémiologie Clinique, Santé Publique et Information Médicale, GHU Carémeau, CHU Nîmes, Nîmes, France
    • ,
  • Jean-Pierre Daures, MD, PhD

      Affiliations

    • Département Biostatistique, Epidémiologie Clinique, Santé Publique et Information Médicale, GHU Carémeau, CHU Nîmes, Nîmes, France
    • ,
  • Joachim Heinrich, PhD

      Affiliations

    • Helmholtz Zentrum, Munich University, Munich, Germany
    • ,
  • Richard Hooper, PhD

      Affiliations

    • National Heart and Lung Institute at Imperial College, Respiratory Epidemiology and Public Health, London, UK
    • ,
  • Jordi Sunyer, MD

      Affiliations

    • Center de Recerca en Epidemiologia Ambiental, Institut Municipal Investigacio Medica, Barcelona, Spain
    • ,
  • Matthias Wjst, MD

      Affiliations

    • Institute of Lung Biology and Disease, Helmholtz Zentrum München, German Research Center of Environmental Health, Neuherberg/Munich, Germany
    • ,
  • Deborah Jarvis, MD

      Affiliations

    • National Heart and Lung Institute at Imperial College, Respiratory Epidemiology and Public Health, London, UK
    • ,
  • Peter Burney, MD, PhD

      Affiliations

    • National Heart and Lung Institute at Imperial College, Respiratory Epidemiology and Public Health, London, UK

Received 2 February 2010; accepted 24 May 2010. published online 12 August 2010.

Purpose

Exposed to a common environment, the IgE-mediated immune response differs, for instance, among sensitized subjects, some of them reacting toward one allergen (monosensitized) whereas others are sensitized to a wide array of allergens (polysensitized). However, a better phenotypic characterization is needed for epidemiologic studies. Using the data collected during the ECRHS I (European Community Respiratory Health Survey), several assessments of skin prick tests and serum-specific IgE to identify mono- and polysensitized patients were compared.

Methods

Subjects took part in the ECRHS-I. The CAP-System was used for serum allergen-specific IgE, and allergen-coated Phazet was used for prick tests. Four allergens (Dermatophagoides pteronyssinus, cat, timothy grass, and Cladosporium) were measured using IgE and nine (the same ones plus olive pollen, birch, Alternaria, Parietaria, and ragweed) were skin tested. One to two local allergens were also tested, depending on countries.

Results

Prevalence of sensitization in 11,355 subjects (34.0 [27.9–40.1] years, 49.9% men) ranged from 32.3% (four specific IgE, 19.3% mono- and 13.0% polysensitized) to 41.8% (four specific IgE combined to nine prick tests, 19.6% mono- and 22.2% polysensitized). Concordance between four specific IgE and four prick tests was weak (weighted κ 0.65 [0.64–0.66]). Concordance between seven and nine prick tests was high (weighted κ 0.99 [0.98–1.00]). Local allergens induced small changes in the prevalence of sensitization, and reclassified some subjects from mono- to polysensitized.

Conclusions

Skin tests or serum-specific IgE may be chosen to identify allergenic sensitivity, mono- and polysensitized subjects without being strictly interchangeable.

Key Words: IgE, Skin Prick Test, Sensitization, ECRHS

Selected Abbreviations and Acronyms: IgE, immunoglobulin E, A. alternata, alternaria alternata, C. herbanum, cladosporium herbanum, D. pteronyssinus, dermatophagoides pteronyssinus, D. farinae, dermatophagoides farinae, ECRHS, European Community Respiratory Health Survey, P. judaica, parietaria judaica

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PII: S1047-2797(10)00126-2

doi:10.1016/j.annepidem.2010.05.012

Annals of Epidemiology
Volume 20, Issue 11 , Pages 797-803, November 2010

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