1. In the (sub)tropics allergic rhinitis and its impact on asthma classification of allergic rhinitis is more useful than perennial-seasonal classification
- Author
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Albero Monteverde Maldonado, Martin Bedolla Barajas, Cecilia Yvonne García-Cobas, Hanna Dinger, Laura Diego Vergara, Ralph Mösges, Doris Nereida López, Noel Rodríguez-Pérez, Manuel Alejandro Cruz Moreno, Alfredo Arias-Cruz, Juan Jose Matta Campos, Rosa Muñoz, Désirée Larenas-Linnemann, José Domingo Ramos López, Miguel Medina Avalos, Jorge Agustín Luna Pech, Emanuel Ramirez Sanchez, Roberto García Almaráz, Maria de la Luz Cid Del Prado, Kijawasch Shah-Hosseini, Pablo G Rodriguez Ortiz, Francisco Javier Linares Zapien, Ruth Cerino Javier, Marichuy Ambriz Moreno, Norma Martinez Jimenez, Alexandra Michels, Dante Hernandez Colín, Luis Julian Pizano Nazara, Daniel Alberto Garcia Imperial, and Alejandra Medina Hernandez
- Subjects
Adult ,Male ,medicine.medical_specialty ,Perennial plant ,Adolescent ,MEDLINE ,Subtropics ,Young Adult ,Internal medicine ,Tropical climate ,medicine ,Immunology and Allergy ,Humans ,Young adult ,Geography, Medical ,Child ,Mexico ,Asthma ,Tropical Climate ,business.industry ,Disease progression ,General Medicine ,Allergens ,Middle Aged ,medicine.disease ,Rhinitis, Allergic ,Clinical trial ,Phenotype ,Otorhinolaryngology ,Child, Preschool ,Disease Progression ,Female ,Seasons ,business - Abstract
BackgroundTwo different allergic rhinitis (AR) symptom phenotype classifications exist. Treatment recommendations are based on intermittent–persistent (INT-PER) cataloging, but clinical trials still use the former seasonal AR–perennial AR (SAR-PAR) classification. This study was designed to describe how INT-PER, mild–moderate/severe and SAR-PAR of patients seen by allergists are distributed over the different climate zones in a (subtropical country and how these phenotypes relate to allergen sensitization patterns.MethodsSix climate zones throughout Mexico were determined, based on National Geographic Institute (Instituto Nacional de Estadística y Geografía) data. Subsequent AR patients (2–68 years old) underwent a blinded, standardized skin-prick test and filled out a validated questionnaire phenotyping AR.ResultsFive hundred twenty-nine subjects participated in this study. In the tropical zone with 87% house-dust mite sensitization, INT (80.9%; p < 0.001) and PAR (91%; p = 0.04) were more frequent than in the subtropics. In the central high-pollen areas, there was less moderate/severe AR (65.5%; p < 0.005). Frequency of comorbid asthma showed a clear no -south gradient, from 25% in the dry north to 59% in the tropics (p < 0.005). No differences exist in AR cataloging among patients with different sensitization patterns, with two minor exceptions (more PER in tree sensitized and more PAR in mold positives; p < 0.05).ConclusionIn a (sub)tropical country the SAR-PAR classification seems of limited value and bears poor relation with the INT-PER classification. INT is more frequent in the tropical zone. Because PER has been shown to relate to AR severity, clinical trials should select patients based on INT-PER combined with the severity cataloging because these make for a better treatment guide than SAR-PAR.
- Published
- 2014