Children who suffer from allergic rhinitis (AR) Triggered by pollen – or “AR pollen” – are at substantial risk of disease persistence for at least 2 decades, according to recent findings.1
Several studies cited by the investigators of these new findings indicate that the prevalence of AR tends to increase with age in children and that it can persist for several years, with limited information on remission. In adult individuals, remission rates vary but can reach 36% over an extended period.2.3
The new long-term study examining pollen-AR was led by Magnus Lindqvist, from the Solna Department of Immunology and Allergy at Karolinska Institutet and Karolinska University Hospital in Stockholm, Sweden.
“The aim of this study was to investigate the natural history of pollen-induced AR (AR-pollen) by prospectively following the same individuals over 20 years, including the transition from childhood to young adulthood, in this which concerns the prevalence, persistence and remission of the disease. and the development of asthma,” Lindqvist and colleagues wrote.
The team’s research was titled Barn/Children Allergi/Allergy Milieu Stockholm Epidemiologic Study Cohort (BAMSE) and was a population-based birth cohort study consisting of 4,089 children born in Stockholm between 1994 and 1996.
Investigators recruited children at a median age of 2 months and then followed them through several different allergy-related questionnaires. At 4 separate time points – ages 4, 8, 16 and 24 – the team invited subjects who had completed questionnaires for clinical follow-up assessments, including blood samples for sIgE testing.
Their research evaluated all subjects who had sIgE test results and completed questionnaire information related to symptoms of asthma, AR, and allergen immunotherapy (AIT) treatment at the specified ages. Ultimately, 1,137 subjects were retained.
They screened the blood samples for levels of allergen-specific IgE (sIgE) in response to inhaled allergens using ‘Phadiatop’, which is a combination of common inhaled allergens including grass, birch, mugwort, mold, dogs, cats, horses, and house dust mites. For their research, sera with a positive Phadiatop result, defined as sIgE levels ≥0.35 kUA/L, were further analyzed to determine sIgE reactivity to airborne allergens included in the sIgE screening process. team.
Pollen-AR was characterized by investigators as exhibiting symptoms including a runny nose, itchy or stuffy nose, sneezing, and itchy or watery eyes when subjects were exposed to a combination of birch pollen and/ or grasses. It was also characterized by subjects with IgE levels ≥0.35 kUA/L from grass and/or birch.
The research team showed that about 75 percent of children who reported suffering from RA-pollen before the age of 4 or 8 persisted in their condition until age 24, and about 30 % of them were shown to have developed cases of asthma.
The team found that the likelihood of subjects having persistent pollen AR was substantial, even when pollen-specific IgE levels were found to be quite low. They also noted that the highest cure rate of subjects’ pollen-AR occurred between ages 16 and 24, with approximately 21.5% of them reporting remission during this period.
Despite these results, investigators reported that the majority of subjects remained sensitized to pollen. They added that this period also marked the time when pollen-specific IgE levels stopped increasing, noting that the estimated annual incidence of pollen-AR had declined by 1.5% to 0.8% per year on average. .
“We can conclude that children with pollen-AR are at high risk of persistent disease for at least 20 years and that childhood through adolescence appears to be the most dynamic period of disease progression,” they said. -they write. “Our results further highlight the close cross-sectional and longitudinal relationship between awareness, AR and asthma.”
- Lindqvist, M, Leth-Møller, KB, Linneberg, A et al. Natural evolution of pollen-induced allergic rhinitis from childhood to adulthood: a 20-year follow-up. Allergy. 2023; 00:1-9. doi:10.1111/all.15927.
- Heldin J, Malinovschi A, Johannessen A et al. Clinical remission of asthma and allergic rhinitis – in a longitudinal population study. J Allergy to asthma. 2022; 15:1569-1578.
- Gough H, Grabenhenrich L, Reich A et al. Allergic multimorbidity of asthma, rhinitis and eczema over 20 years in the German MAS birth cohort. Immunol against pediatric allergies. 2015 ; 26(5): 431-437.
