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Allergen skin test reactivities among asthmatic Thai children
A Kongpanichkul1, P Vichyanond, M Tuchinda
1Department of Pediatrics, Nakornpathom Hospital, Thailand.
Insights
In Thai children with asthma, skin prick tests revealed high sensitization rates to common allergens. House dust mites, specifically Dermatophagoides pteronyssinus and Dermatophagoides farinae, were identified as the primary triggers.
Area of Science:
- Pediatric Allergy and Immunology
- Respiratory Medicine
- Clinical Immunology
Background:
- Asthma is a prevalent chronic respiratory disease in children, often exacerbated by allergic sensitization.
- Identifying specific aeroallergens is crucial for effective asthma management and environmental control strategies.
- Understanding local allergen prevalence in pediatric populations informs targeted diagnostic and therapeutic approaches.
Purpose of the Study:
- To determine the prevalence of sensitization to 14 common aeroallergens in asthmatic children in Thailand.
- To identify the most significant allergens contributing to allergic sensitization in this pediatric cohort.
- To correlate allergen sensitization with asthma severity and patient demographics.
Main Methods:
- A cross-sectional study involving 100 asthmatic children (aged 0-16 years) attending a pediatric allergy clinic.
- Skin prick tests were performed using 14 selected local aeroallergens, including house dust mites, cockroaches, pollens, molds, and animal danders.
- Allergen sensitization was defined by a mean wheal diameter of ≥3 mm at 20 minutes post-prick.
Main Results:
- A high overall sensitization rate was observed, with 74% of children showing positive reactions to at least one allergen.
- The most prevalent sensitizing allergens were house dust mites: Dermatophagoides pteronyssinus (67%) and Dermatophagoides farinae (62%).
- Other significant allergens included American cockroach (44%) and shrimp (14%). Wheal size to D. pteronyssinus did not correlate with age.
Conclusions:
- House dust mites are the predominant allergens responsible for sensitization in asthmatic children in Thailand.
- Cockroach and shrimp allergens also contribute significantly to allergic sensitization in this population.
- Findings underscore the importance of house dust mite avoidance and targeted allergen immunotherapy in managing pediatric asthma in the region.
Abstract:
Skin prick tests with 14 selected local aeroallergens were performed on 100 asthmatic children aged 0-16 years attending the Pediatric Allergy Clinic, Faculty of Medicine, Siriraj Hospital. The 14 allergens included Dermatophagoides farinae, Dermatophagoides pteronyssinus, American cockroach (Periplaneta americana), Johnson grass (Sorghum halopense), Cladosporium clarosporoides, Alternaria tenuis, Penicillium mix, Aspergillus mix, cat dander, dog dander, milk, egg white, soy and shrimp. Positive skin test reactivity was defined as a mean wheal diameter > or = 3 mm at the 20 minute reading. There were 68 males and 32 females. Their ages were between 0-2 years (n = 1), 2-5 years (n = 19), 5-10 years (n = 49) and 10-16 years (n = 31). Of all the subjects, 22 were classified as having mild asthma, 74 with moderate asthma and 4 with severe asthma. At least one skin prick test was positive in 74 subjects (74%) and two positive tests in 66 subjects (66%). The prevalence of sensitization to various allergens was as follows; Dermatophagoides pteronyssinus 67%, Dermatophagoides farinae 62%, American cockroach 44%, shrimp 14%, Johnson grass 14%, cat dander 10%, Alternaria 7%, Cladosporium 7%, dog dander 5%, soy 4%, Penicillium 3%, Aspergillus 2%, milk 2% and egg white 1%. The wheal size to Dermatophagoides pteronyssinus did not correlate with age. In this group of asthmatic Thai children, house dust mites are the most important allergen causing sensitization.