Serum Albumin as a Cross-Reactive Component in Furry Animals May Be Related to the Allergic Symptoms of Patients with Rhinitis

Figures & data

Figure 1 Research cohort recruitment flowchart. Patients who were clinically confirmed to have allergic rhinitis were screened for cat and dog allergen sensitivities, and a questionnaire about demographic information and visual analog scores (VASs) was given to each patient. After obtaining informed consent from all patients, serum samples from patients were used to further examine the sensitization profiles to common furry animals and cat/dog components.

Abbreviations: Can f, Canis familiaris; Fel d, Felis domesticus.

Table 1 Demographic Characteristics of the Participants

	Total Cohort	Dog-Sensitized Only	Cat-Sensitized Only	Dog and Cat Double-Sensitized	P value*
N	211	55	75	81	-
Sex, n (%)
Male	85 (40.28)	35 (63.64)	43 (57.33)	48 (59.26)	0.765
Female	126 (59.72)	20 (36.36)	32 (42.67)	33 (40.74)
Age, n (%)
Median (IQR)	14 (6, 24)	10 (6, 18)	13 (9, 24)	9 (5, 26)	0.062
<18 years	142 (67.30)	41 (74.55)	46 (61.33)	55 (67.90)	0.281
≥18 years	69 (32.70)	14 (25.44)	29 (38.67)	26 (32.10)
Diagnosis, n (%)
Allergy rhinitis	70 (40.28)	17 (30.91)	23 (30.67)	30 (37.04)	0.642
Allergy rhinitis with asthma	141 (66.82)	38 (69.09)	52 (69.33)	51 (62.96)
VAS score, median (IQR)
Symptom	3.56 (3.00, 4.28)	3.33 (2.56, 4.00)	3.44 (2.89, 3.94)	4.00 (3.33, 4.56)	<0.001
Life of quality	5.25 (4.25, 5.75)	4.50 (3.25, 5.50)	5.25 (4.38, 5.75)	5.50 (4.75, 6.00)	<0.001

Notes: Proportions were compared between the groups using chi-squared test (χ²), and for nonparametric quantitative data, the Kruskal–Wallis H-test was used for comparison between groups. *P value refers to the comparison among the three groups of dog-sensitized only, cat-sensitized only, dog and cat double-sensitized. If the difference between groups is statistically significant, use bold fonts.

Abbreviation: VAS, visual analog scale.

Figure 2 Distribution of positive rates of the components (A) and other furry animal crude extracts (B) in dog-sensitized only, cat-sensitized only and both dog and cat double-sensitized patients. Kruskal–Wallis H-test was used to compare the proportion differences between multiple groups. The color shades refers to the percentage of sIgE class 1–5.

Abbreviations: Can f, Canis familiaris; Fel d, Felis domesticus.

Figure 3 Hierarchical cluster (A) and optimal scale analysis (B) of the connection between components and furry animal crude extracts. Hierarchical clustering analysis, also known as hierarchical cluster analysis, is an algorithm that organizes similar objects into groups called clusters. Optimal scale analysis is a ‘dimensional reduction’ analytical method. Using specific immunoglobulin E levels as categorical variables, the closer the two points of the allergens were, the higher the correlation between the two factors.

Abbreviations: Can f, Canis familiaris; Fel d, Felis domesticus.

Figure 4 Plot Venn diagrams for serum albumin (A), lipocalin (B), among the three proteins (C), and three proteins link to the extracts from five furry animals (D–F). Core represents the number and proportion of cases where all components are positive.

Table 2 The Sensitization Profile of Crude Extracts and Components of Furry Animals Based on the 3 Proteins Sensitization

Allergens	Serum Albumin, %		OR^§	P value^†	Lipocalin, %		OR^†	P value^‡	Prostatic Kallikrein, %		OR^†	P value^‡
	Positive	Negative			Positive	Negative			Positive	Negative
Can f	88.46	61.08	1.45	0.006	80.85	59.76	1.35	0.008	91.67	60.96	1.50	0.003
Can f 1	65.38	12.43	5.26	0.000	–	–	–	–	41.67	16.04	2.60	0.005
Can f 2	30.77	4.32	7.12	0.000	–	–	–	–	25.00	5.35	4.68	0.004
Can f 3	–	–	–	–	25.53	3.66	6.98	0.000	16.67	7.49	2.23	0.131
Can f 4	19.23	6.49	2.96	0.042	–	–	–	–	25.00	5.88	4.25	0.006
Can f 5	19.23	10.27	1.87	0.188	25.53	7.32	3.49	0.001	–	–		–
Fel d	96.15	70.81	1.36	0.006	65.96	76.22	0.87	0.158	62.50	75.40	0.83	0.175
Fel d 1	50.00	72.97	0.69	0.017	48.94	76.22	0.64	0.001	50.00	72.73	0.69	0.022
Fel d 2	–	–	–	–	36.17	5.49	6.59	0.000	20.83	11.23	1.86	0.188
Pigeon	0.00	1.08	0.00	1.000	0.00	1.22	0.00	1.000	0.00	1.07	0.00	1.000
Chichen	11.54	2.16	5.34	0.042	4.26	3.05	1.40	0.653	4.17	3.21	1.30	0.576
Sheep	73.08	2.70	27.04	0.000	27.66	6.71	4.12	0.000	25.00	9.63	2.60	0.038
Rat	65.38	4.32	15.12	0.000	23.40	8.54	2.74	0.005	12.50	11.76	1.06	1.000
Mouse	73.08	0.00	+∞	0.000	27.66	3.66	7.56	0.000	20.83	7.49	2.78	0.048
Goose	0.00	0.54	0.00	1.000	0.00	0.61	0.00	1.000	0.00	0.53	0.00	1.000
Cow	69.23	6.49	10.67	0.000	21.28	12.20	1.74	0.116	20.83	13.37	1.56	0.351
Horse	57.69	2.70	21.35	0.000	25.53	4.88	5.23	0.000	25.00	7.49	3.34	0.015

Notes: ^†OR is the rate of the positive group divided by the rate of the negative group, which is used to indicate the strength of the association between protein positive and the corresponding allergen. ^‡P value is a significant indicator of the difference between the proportions of the positive group and the negative group, and proportions were compared between the groups using chi-squared test (χ²). If the difference between groups is statistically significant, use bold fonts.“–” in the table indicates that the component belongs to this type of protein. Serum albumin positive means Can f 3 and or Fel d 2 sensitized. Lipocalin positive means one or more of Can f 1, Can f 2 and Can f 4 sensitized. Prostatic kallikrein positive means Can f 5 positive.

Abbreviations: VAS, visual analog scale; Can f, Canis familiaris; Fel d, Felis domesticus.

Figure 5(A, B) Differences in VAS scores for symptoms and quality of life in patients with rhinitis. VAS- visual analog scale for serum albumin positive patients means Can f 3 and/or Fel d 2 sensitized. Positive lipocalin indicates sensitization to one or more of Can f 1, Can f 2 and Can f 4 allergens. Prostatic kallikrein positivity is defined as Can f 5 positivity. Mann-Whitney U test was used to compare the distribution difference between the two groups, and P <0.05 was considered statistically significant.