Department of Internal Medicine, Seoul National University College of Medicine, Korea.
Ann Allergy Asthma Immunol. 2011 Oct;107(4):344-52. doi: 10.1016/j.anai.2011.07.012. Epub 2011 Aug 11.
The allergen skin prick test is the most representative diagnostic test for atopy, but its use has been limited because of the belief that skin reactivity decreases with aging.
To investigate skin reactivity and influencing factors in the elderly population.
This cross-sectional analysis included 854 subjects (aged ≥65 years) who participated in the Korean Longitudinal Study on Health and Aging cohort (September 2005 to August 2006) and underwent allergen skin prick tests. Skin prick tests were performed with 1 mg/mL of histamine and a panel of 12 aeroallergens that are common in Korea. The wheal diameters were measured and compared to identify the factors associated with skin reactivity.
Older age and female sex were associated with reduced histamine skin reactivity in elderly subjects. This age-related decrease was apparent only among women, the reasons for which were not identified. In contrast to histamine, wheal response size induced by 2 major allergens, Dermatophagoides pteronyssinus and Dermatophagoides farinae, did not show sex differences and did not decrease with age among the subjects showing allergen-induced wheal size greater than 0 mm.
This analysis demonstrates that age and sex can independently influence histamine skin reactivity among the elderly population. The allergen-induced wheal sizes did not decrease with age. The discrepancy between histamine and allergen skin reactivity may warrant further evaluation to redefine the cutoff value for the determination of a positive skin test result in elderly subjects.
过敏原皮肤点刺试验是最具代表性的变应性诊断试验，但由于认为皮肤反应性随年龄增长而降低，其应用受到限制。
调查老年人的皮肤反应性及其影响因素。
本横断面分析纳入了 854 名（年龄≥65 岁）参加韩国健康老龄化纵向研究队列的受试者（2005 年 9 月至 2006 年 8 月），并进行了过敏原皮肤点刺试验。皮肤点刺试验使用 1mg/mL 组织胺和一组 12 种常见于韩国的气传过敏原进行。测量风团直径并进行比较，以确定与皮肤反应性相关的因素。
在老年受试者中，年龄较大和女性与组织胺皮肤反应性降低相关。这种与年龄相关的下降仅见于女性，但原因尚不清楚。与组织胺不同，在表现出过敏原诱导的风团大小大于 0mm 的受试者中，2 种主要过敏原（屋尘螨和粉尘螨）诱导的风团反应大小没有性别差异，且不随年龄而降低。
本分析表明，年龄和性别可以独立影响老年人群的组织胺皮肤反应性。过敏原诱导的风团大小不随年龄而降低。组织胺和过敏原皮肤反应性之间的差异可能需要进一步评估，以重新定义老年受试者中阳性皮肤试验结果的判定值。
