Association of Cat Sensitization With Comorbid Asthma in Patients With Allergic Rhinitis: A Real-World Study

The prevalence of allergic rhinitis (AR) and asthma (AS) comorbidity (AR + AS) is increasing and is associated with severe allergic symptoms. The impact of cat dander sensitization on AR + AS remains unclear.

In this retrospective study, 1154 patients with AR alone and 213 patients with AR + AS were enrolled at the Third Affiliated Hospital of Sun Yat-Sen University from January 2021 to February 2024. Allergens in serum were measured using UniCAP system. Multivariate logistic regression was performed to assess risk factors of AR + AS.

Although family history of AR and AS, VAS (> 3), polysensitization, cat ownership, cat sIgE level, and age < 18 were associated with AR + AS, cat dander sensitization remained the prominent factor (OR = 3.743, p < 0.001). The positive rate of cat dander was higher in AR + AS group than AR alone group (25.4% vs. 10.5%, p < 0.001). The prevalence of AR + AS was the highest in the HDM+Cat+ group (33.8%). Moreover, the prevalence of cat-sensitized AR + AS increased from 14.3% to 37.3% with elevated HDM sIgE levels. Co-sensitization of HDM and cat dander (OR = 3.244, p = 0.036) and the cat ownership among cat-sensitized patients (OR = 5.531, p < 0.001) were associated with AR + AS. However, in children, cat sensitization without ownership was associated with AR + AS, whereas this was not observed in adults.

Cat sensitization is associated with AR + AS. Co-sensitization to HDM and cat dander and cat ownership further increase the prevalence of AR + AS among the cat-sensitized patients. Early detection of cat dander component sensitization may help identify at-risk individuals and optimize management of AR + AS.