Journal List > J Rhinol > v.25(2) > 1109240

Park, Kim, Kim, Lee, Koo, Kim, Kim, Kim, Kim, Kim, Kim, Kim, Kim, Rha, Roh, Park, Shin, Lim, Lee, Lee, Lee, Kim, and Cho: The Relationship between the Causative Allergens of Allergic Diseases and Environments in Korea Over a 8-Year-Period: Based on Skin Prick Test from 2006 to 2015

Abstract

Background and Objectives:

The present study evaluated the results of skin prick test using 55 allergens at 20 centers in the Republic of Korea in 2006, 2010, and 2014-2015. The aim was to assess changes in the positive rate of allergens according to temporal, regional, and environmental factors.

Materials and Method:

In total, 20 hospitals were selected based on the population distribution in the Republic of Korea. A skin prick test panel comprising 55 aeroallergens was distributed to 18 hospitals for this prospective study. The 2006 and 2010 skin prick test results were collected and analyzed retrospectively from 20 hospitals, while the 2014/2015 skin prick test results (from June 2014 to May 2015) were collected prospectively from 18 hospitals.

Results:

A total of 14,897 SPT test results were analyzed: 4,319 in 2006, 7,431 in 2010, and 1,852 in 2014/2015. The overall rate of skin prick test positivity to more than two allergens was significantly higher in males than females. The positive rates of alder pollens and birch, oak and ragweed pollen positivity were increased in older patients. Several positive rates were increased according to the temperature in spring. The positive rates for beech pollen, birch pollen, hazel pollen, oak pollen, Tyrophagus putrescentiae, mugwort, cat, Acarus siro, Lepidoglyphus destructor and Tyrophagus putrescentiae were significantly increased, while those of Cult rye pollen and dandelion were significantly decreased over the three test periods. The overall positive rate for allergens in Jeju province varied significantly from Seoul and other cities. Conclusion: Change in the positive rate of multiple aeroallergens was evaluated in the Republic of Korea over time. Our findings can be used to recommend aeroallergens suitable for inclusion in skin prick test panels in the Republic of Korea and will facilitate further investigation of changes in the patterns of allergic diseases.

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Table 1.
Demographic characteristics of the study population
  Total 2006 2010 2014+2015 p-value
Subjects, number 14897 4319 7431 3147  
Sex
  Male 8,720 (58.54) 2,544 (58.90) 4,324 (58.19) 1,852 (58.85) 0.6921
  Female 6,177 (41.46) 1,775 (41.10) 3,107 (41.81) 1,295 (41.15)  
Age, years
  Mean±SD 36.38±18.29 33.25±17.82 37.55±18.41 37.94±18.11 <0.0001∗
  Median (min-max) 35.00 (2.00-93.00) 32.00 (2.00-90.00) 36.00 (3.00-93.00) 36.00 (3.00-82.00)  
  <20 3,385 (22.72) 1,240 (28.71) 1,548 (20.83) 597 (18.97)  
  ≥20-<40 5,164 (34.66) 1,490 (34.50) 2,554 (34.37) 1,120 (35.59) <0.0001
  ≥40–59 4,499 (30.20) 1,218 (28.20) 2,288 (30.79) 993 (31.55)  
  ≥60 1,849 (12.41) 371 (8.59) 1,041 (14.01) 437 (13.89)  

Data are presented as n (%) or means±SD. Statistical analysis was carried out using a chi-square test or ANOVA (followed by post hoc Bonferroni correction). Significant difference between ∗: 2006 vs. 2010 and †: 2006 vs. 2014+2015 by post hoc analysis

Table 2.
Summary of mean temperatures in each season
  Spring Summer Fall Winter
1st tertile
  N 1,190 1,261 1,255 1,297
  Mean (sd) 5.25 (1.21) 22.71 (0.87) 7.70 (1.42) -2.60 (1.56)
  Median (range) 5.10 (-3.20-7.90) 23.10 (17.20-23.80) 8.40 (-4.20-10.60) -2.60 (-7.60—0.90)
2nd tertile
  N 1,174 1,178 1,229 1,245
  Mean (sd) 10.68 (1.55) 25.23 (0.59) 15.16 (1.87) 0.13 (0.52)
  Median (range) 10.00 (8.00-13.50) 25.20 (23.90-26.00) 15.10 (10.80-17.90) 0.00 (-0.80-1.20)
3rd tertile
  N 1,182 1,332 1,285 1,269
  Mean (sd) 17.72 (1.20) 26.91 (0.75) 21.40 (1.31) 2.59 (1.56)

Median (range) 17.35 (13.60-20.70) 26.70 (26.10-29.30) 21.60 (18.20-24.90) 2.10 (1.30-26.00)

Table 3.
Comparison of allergens positive rate according to temperature tertile
  Spring
1st tertile (<8˚C) 2nd tertile (≥8-<13.6) 3rd tertile (≥13.6) p value for trend
Pollen
Alder pollens
  2006 13/331 (3.93) 6/298 (2.01) 16/308 (5.19) 0.4206
  2010 31/662 (4.68) 37/646 (5.73) 51/610 (8.36) 0.0069
  2014+2015 5/197 (2.54) 12/230 (5.22) 34/264 (12.88) <0.0001
  p value for trend 0.5812 0.0576 0.0011  
  Overall 49/1190 (4.12) 55/1174 (4.68) 101/1182 (8.54) <0.0001
Beech pollen
  2006 8/289 (2.77) 8/269 (2.97) 15/275 (5.45) 0.0942
  2010 30/650 (4.62) 26/635 (4.09) 46/605 (7.60) 0.0213
  2014+2015 7/197 (3.55) 15/230 (6.52) 31/264 (11.74) 0.0009
  p value for trend 0.5354 0.0555 0.0075  
  Overall 45/1136 (3.96) 49/1134 (4.32) 92/1144 (8.04) <0.0001
Birch pollen
  2006 13/331 (3.93) 6/298 (2.01) 20/308 (6.49) 0.1148
  2010 37/662 (5.59) 40/646 (6.19) 57/610 (9.34) 0.0093
  2014+2015 9/197 (4.57) 16/230 (6.96) 37/264 (14.02) 0.0003
  p value for trend 0.5907 0.0079 0.0026  
  Overall 59/1190 (4.96) 62/1174 (5.28) 114/1182 (9.64) <0.0001
Table 4.
Distribution of subjects who are SPT-positive to two or more allergens
  Total 2006 2010 2014+2015 p-value
Subjects, number 14,897 4,319 7,431 3,147  
Number of positive allergens
  1 1,265 (8.49) 380 (8.80) 602 (8.10) 283 (8.99) 0.9161
  ≥2 6,313 (42.38) 1,841 (42.63) 2,974 (40.02) 1,498 (47.60) 0.0003

Data are numbers (%). P-values were calculated using the Cochran-Armitage trend test

Table 5.
Top 15 aeroallergens in 2006, 2010, and 2014
Rank 2006 2010 2014-2015
1 D_pteronyssinus (37.07) D_farinae (32.4) D_farinae (37.89)
2 D_farinae (34.96) D_pteronyssinus (32.4) D_pteronyssinus (36.58)
3 Mugwort (8.34) Cat (8.38) Mugwort (10.99)
4 Cat (6.46) Tyrophagus (7.74) Birch (7.83)
5 Oak (5.67) Birch (7.51) Tyrophagus (7.83)
6 Dog hair (5.35) Mugwort (7.3) Cat (7.50)
7 Alder (5.23) Oak (6.89) Acarus siro (6.91)
8 Cockroach (5.09) Walnut (6.84) Oak (6.84)
9 Ragweed (4.75) Dog hair (6.81) Hazel (6.45)
10 Birch (4.51) Cockroach (6.72) Beech (6.18)
11 Dandelion (4.47) Alder (6.67) Cockroach (G) (5.92)
12 Beech (4.28) Beech (5.53) Alder (5.66)
13 Hazel (4.03) Ragweed (5.48) Ragweed (5.00)
14 Tyrophagus (3.92) Hazel (5.24) Leidoglyphus (4.8)
15 Willow (2.96) Acarus siro (4.17) Dog hair (4.18)
Table 6.
SPT positivity according to gender
  Male Female p-value∗
Subjects, number
Positive allergens=1
  2006 (n=4319) 236 (9.28) 144 (8.11) 0.1839
  2010 (n=7431) 367 (8.49) 235 (7.56) 0.1499
  2014+2015 (n=3147) 164 (8.86) 119 (9.19) 0.7473
  Overall (n=14897) 767 (8.80) 498 (8.06) 0.1135
p for trend 0.5508 0.3609  
Positive allergens ≥2
  2006 (n=4319) 1,168 (45.91) 673 (37.92) <0.0001
  2010 (n=7431) 1,864 (43.11) 1,110 (35.73) <0.0001
  2014+2015 (n=3147) 933 (50.38) 565 (43.63) 0.0002
  Overall (n=14897) 3,965 (45.47) 2,348 (38.01) <0.0001
p for trend 0.0152 0.0053  

Data are numbers (%). p-values were calculated using the ∗: chi-square test and †: Cochran-Armitage trend test

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