Temporal Patterns of Allergen Sensitisation in the General Population: The LEAD Study

Area of Science:

• Immunology
• Epidemiology
• Allergy Research

Background:

• Allergic sensitization is often considered a lifelong, stable condition.
• Emerging evidence suggests allergic sensitization may change over an individual's lifespan.

Purpose of the Study:

• To provide longitudinal data on allergic sensitization patterns in a general population.
• To identify factors associated with changes in allergic sensitization over time.

Main Methods:

• Longitudinal assessment of aeroallergen sensitization using repeated skin prick tests (SPT) in the Austrian population.
• Characterization of sensitization patterns: stable non-sensitized, stable sensitized, new-onset, resolution, and fluctuating.
• Analysis of demographic, metabolic, behavioral, environmental, and immunological factors across different age groups.

Main Results:

• Over 5000 individuals showed varied sensitization patterns: 54.4% stable non-sensitized, 30.6% stable sensitized, 5.6% resolution, 4.8% new-onset, and 4.6% fluctuating.
• New-onset sensitization was more common in <18 years, fluctuating in 18-60 years, and resolution in ≥60 years.
• Stable sensitization linked to parental allergy and eosinophils; fluctuation associated with adiposity and environmental exposures.

Conclusions:

• Allergic sensitization is dynamic, not a fixed trait, with significant temporal variation.
• Resolution and fluctuation of sensitization occur across all ages, with new sensitization possible in adulthood.
• Findings suggest allergic sensitization is a modifiable phenotype influenced by age, environment, and lifestyle.