Trends in aeroallergen sensitization in Germany – An analysis of 2919 serological data sets of a university ENT department

Abstract

Background: Recently, population-based birth-cohort studies provided an insight into the allergic march during childhood.

Aims: Our study aimed to investigate sensitization pattern until advanced age.

Patients and methods: Demographic, clinical and serological characteristics of 2919 patients with positive allergen-specific IgE between 1999 and 2019 were analyzed. We performed subgroup analysis of various age-groups and different years of birth to distinguish between age-dependent changes and birth-cohort-effects.

Results: Since 1999, the proportion of sensitized children has significantly increased. The prevalence of sIgE towards most allergens reached its peak in adolescence or young adulthood. Only to mites, the highest rate of sensitization was found in childhood. With further aging, the prevalence of sIgE significantly decreased in most sensitizations. Only to Fagales, the highest rate of sensitization was observed among patients >65 years. The year-of-birth analysis proved the above-mentioned changes to be age-dependent. Further, it revealed various sensitization trends from older to younger generations.

Conclusions and significance: The increased proportion of children with sensitization during the last 20 years outlines the allergy epidemic. Probably due to immunosenescence, the aeroallergen sensitization rates decreased with aging, except for Fagales. Over time, different aeroallergens gained or lost relevance, potentially due to environmental and life-style changes.

Chinese abstract

背景：最近, 以人群为基础的出生队列研究提供了对一个关于儿童期过敏的深入了解。

目的：本研究旨在探讨一直持续至老年的致敏模式。

患者与方法：分析1999-2019年间2919例过敏原特异性IgE阳性患者的人口学、临床及血清学特征。我们对不同年龄组和不同出生年份进行了亚组分析, 以区分年龄依赖性变化和出生队列效应。

结果：自1999年以来, 儿童致敏率明显上升。大多数过敏原的sIgE患病率在青春期或青年期达到高峰。在儿童期, 致敏率最高的只有螨虫。随着年龄的增长, 在大多数致敏作用中, sIgE的患病率显著降低。65岁以上的患者仅对Fagales的致敏率最高。出生年份分析证明上述变化与年龄有关。此外, 它还揭示了从老一代到年轻一代的各种致敏趋势。

结论与意义：近20年来, 儿童致敏率的增加反映了过敏的蔓延。可能是由于免疫衰老, 除Fagales外, 空气过敏原的致敏率随年龄增长而降低。随着时间的推移, 不同的空气过敏原获得或失去相关性, 可能是由于环境和生活方式的变化。

Keywords:

• Aeroallergen
• sensitization
• longitudinal pattern
• immunosenescence
• birth-cohort-effect

Compliance with ethical standards

Statements of human rights

The present study has been performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. An approval by the appropriate institutional research ethics committee was not necessary due to the retrospective character of the study on completely anonymized data.

Informed consent

All patients registered in our database provided written informed consent concerning the use of their anonymized data for scientific purpose.

Disclosure statement

No potential conflict of interest was reported by the author(s).