Department of Dermatology and Allergy Centre, Odense Research Centre for Anaphylaxis (ORCA), Odense University Hospital, University of Southern Denmark, Odense, Denmark.
Institute of Clinical research, University of Southern Denmark, Odense, Denmark.
Allergy. 2019 Feb;74(2):308-317. doi: 10.1111/all.13630. Epub 2018 Nov 8.
While much is known on childhood atopic diseases, knowledge about persistence of atopic diseases from childhood to adulthood is limited. We therefore aimed to study the clinical course of atopic diseases and type I sensitization prospectively in an unselected cohort of adolescents followed into adulthood.
A cohort of unselected 8th-grade school children (mean age 14 years) established in 1995 and followed up in 2010 were evaluated with questionnaire, clinical examination, skin prick tests and measurements of specific IgE.
The lifetime prevalence of atopic diseases was high and increased significantly from adolescence (31%) to adulthood (57%); particularly allergic rhinitis increased with an incidence rate of 17.5/1000 person-years. Childhood predictors for adult allergic rhinitis were atopic dermatitis, asthma and asymptomatic sensitization to pollen and house dust mite. Among those with asymptomatic sensitization in adolescence, 53%-78% developed allergic rhinitis in adulthood. Furthermore, type I sensitization increased significantly from adolescence to adulthood mostly due to increased sensitization to pollen. Type I sensitization was found mainly in those with allergic rhinitis. A high number of adults had oral allergy symptoms due to the high number of birch pollen allergic individuals.
Persistence of atopic diseases in adulthood is common, and a high proportion of the adult population is sensitized giving a high prevalence of allergic rhinitis. Many with asymptomatic sensitization in adolescence will develop allergic rhinitis in adult life. The focus should be on prevention of atopic diseases and sensitization already in childhood.
虽然我们对儿童特应性疾病有很多了解，但对特应性疾病从儿童期到成年期的持续性知之甚少。因此，我们旨在研究未选择的青少年队列中特应性疾病和 I 型致敏的临床病程，前瞻性地随访至成年期。
我们对 1995 年建立的未选择的 8 年级学生队列（平均年龄 14 岁）进行了评估，采用问卷调查、临床检查、皮肤点刺试验和特异性 IgE 测量。
特应性疾病的终身患病率很高，从青少年期（31%）到成年期（57%）显著增加；特别是过敏性鼻炎的发病率为 17.5/1000 人年。儿童期特应性皮炎、哮喘和对花粉及屋尘螨无症状致敏是成年期过敏性鼻炎的预测因素。在青少年期无症状致敏的人群中，53%-78%在成年期发展为过敏性鼻炎。此外，I 型致敏从青少年期到成年期显著增加，主要是由于对花粉的致敏增加。I 型致敏主要见于过敏性鼻炎患者。由于桦树花粉过敏者数量众多，许多成年人有口腔过敏症状。
特应性疾病在成年期持续存在较为常见，且成年人群中 I 型致敏的比例较高，导致过敏性鼻炎的患病率较高。许多在青少年期无症状致敏的人在成年期会发展为过敏性鼻炎。重点应放在预防儿童时期的特应性疾病和致敏。
