Background: To assess the prevalence of allergic sensitization and to analyze patterns of sensitization to common inhalant and food allergens in a nationwide representative sample of children and adolescents in Germany. Methods: Data were collected from 2003 to 2006 within the KiGGS, the national Health Interview and Examination Survey covering a representative sample of 17,641 children and adolescents in Germany. Immunoglobulin E (IgE) antibodies to 20 specific allergens (11 inhalant and 9 food allergens) were quantitatively measured in a subsample of 12,988 KiGGS participants aged 3-17 years using the ImmunoCAP system. Serum concentrations ≥0.35 kU/l indicate sensitized participants. An exploratory factor analysis was performed in order to identify sensitization patterns. Results: Sensitization to at least 1 of the 20 tested allergens was detected in 40.2% [95% confidence interval (CI) 39.0-41.4] of the participants. The highest sensitization prevalences were found for pollen from Timothy grass (22.7%; 21.5-23.9) and rye (21.2%; 20.0-22.4). Sensitization was more prevalent in boys than in girls and prevalence increased generally with increasing age. We identified seven sensitization groups, namely (in descending order of magnitude) ‘Timothy grass/rye', ‘house-dust mites', ‘food/mugwort', ‘birch/apple', ‘animals', ‘cow's milk/egg white' and ‘moulds'. Conclusions: Allergic sensitization is common in German children and adolescents. The fact that sensitization potentially leads to clinically relevant allergic diseases stresses the public health relevance of this topic. Whether the grouping reflects the propensity for persons to be sensitized to multiple allergens within a group, or whether it is due to IgE cross-reactivity between different allergens of similar structure is still being discussed.

Keywords:
Allergic sensitization, Immunoglobulin E cross-reactivity, Children and adolescents
1.
Arshad SH, Tariq SM, Matthews S, Hakim E: Sensitization to common allergens and its association with allergic disorders at age 4 years: a whole population birth cohort study. Pediatrics 2001;108:E33.
2.
Illi S, von Mutius E, Lau S, Nickel R, Niggemann B, Sommerfeld C, Wahn U: The pattern of atopic sensitization is associated with the development of asthma in childhood. J Allergy Clin Immunol 2001;108:709-714.
3.
Kellberger J, Dressel H, Vogelberg C, Leupold W, Windstetter D, Weinmayr G, Genuneit J, Heumann C, Nowak D, von Mutius E, Radon K: Prediction of the incidence and persistence of allergic rhinitis in adolescence: a prospective cohort study. J Allergy Clin Immunol 2012;129:397-402.
4.
Kjaer HF, Eller E, Andersen KE, Host A, Bindslev-Jensen C: The association between early sensitization patterns and subsequent allergic disease. The DARC birth cohort study. Pediatr Allergy Immunol 2009;20:726-734.
5.
Kurukulaaratchy RJ, Matthews S, Arshad SH: Defining childhood atopic phenotypes to investigate the association of atopic sensitization with allergic disease. Allergy 2005;60:1280-1286.
6.
Salo PM, Calatroni A, Gergen PJ, Hoppin JA, Sever ML, Jaramillo R, Arbes SJ Jr., Zeldin DC: Allergy-related outcomes in relation to serum IgE: results from the National Health and Nutrition Examination Survey 2005-2006. J Allergy Clin Immunol 2011;127:1226-1235.
7.
Burbach GJ, Heinzerling LM, Edenharter G, Bachert C, Bindslev-Jensen C, Bonini S, Bousquet J, Bousquet-Rouanet L, Bousquet PJ, Bresciani M, Bruno A, Canonica GW, Darsow U, Demoly P, Durham S, Fokkens WJ, Giavi S, Gjomarkaj M, Gramiccioni C, Haahtela T, Kowalski ML, Magyar P, Murakozi G, Orosz M, Papadopoulos NG, Rohnelt C, Stingl G, Todo-Bom A, von Mutius E, Wiesner A, Wohrl S, Zuberbier T: GA(2)LEN skin test study II: clinical relevance of inhalant allergen sensitizations in Europe. Allergy 2009;64:1507-1515.
8.
Heinzerling LM, Burbach GJ, Edenharter G, Bachert C, Bindslev-Jensen C, Bonini S, Bousquet J, Bousquet-Rouanet L, Bousquet PJ, Bresciani M, Bruno A, Burney P, Canonica GW, Darsow U, Demoly P, Durham S, Fokkens WJ, Giavi S, Gjomarkaj M, Gramiccioni C, Haahtela T, Kowalski ML, Magyar P, Murakozi G, Orosz M, Papadopoulos NG, Rohnelt C, Stingl G, Todo-Bom A, von Mutius E, Wiesner A, Wohrl S, Zuberbier T: GA(2)LEN skin test study I: GA(2)LEN harmonization of skin prick testing: novel sensitization patterns for inhalant allergens in Europe. Allergy 2009;64:1498-1506.
9.
Majkowska-Wojciechowska B, Pelka J, Korzon L, Kozlowska A, Kaczala M, Jarzebska M, Gwardys T, Kowalski ML: Prevalence of allergy, patterns of allergic sensitization and allergy risk factors in rural and urban children. Allergy 2007;62:1044-1050.
10.
Rönmark E, Bjerg A, Perzanowski M, Platts-Mills T, Lundbäck B: Major increase in allergic sensitization in schoolchildren from 1996 to 2006 in northern Sweden. J Allergy Clin Immunol 2009;124:357-363.
11.
Matricardi PM, Bockelbrink A, Keil T, Grüber C, Niggemann B, Hamelmann E, Wahn U, Lau S: Dynamic evolution of serum immunoglobulin E to airborne allergens throughout childhood: results from the Multi-Centre Allergy Study birth cohort. Clin Exp Allergy 2009;39:1551-1557.
12.
Calatroni A, Arbes SJ, Gergen PJ, Mitchell HE, Zeldin DC: Classification of 19 allergen-specific IgE antibodies tested in NHANES 2005-2006. J Allergy Clin Immunol 2009;123:S193.
13.
Hölling H, Kamtsiuris P, Lange M, Thierfelder W, Thamm M, Schlack R: The German Health Interview and Examination Survey for Children and Adolescents (KiGGS): study management and conduct of fieldwork. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2007;50:557-566.
14.
Kamtsiuris P, Lange M, Schaffrath Rosario A: The German Health Interview and Examination Survey for Children and Adolescents (KiGGS): sample design, response and nonresponse analysis. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2007;50:547-556.
15.
Kurth B-M, Kamtsiuris P, Hölling H, Schlaud M, Dölle R, Ellert U, Kahl H, Knopf H, Lange M, Mensink GB, Neuhauser H, Rosario AS, Scheidt-Nave C, Schenk L, Schlack R, Stolzenberg H, Thamm M, Thierfelder W, Wolf U: The challenge of comprehensively mapping children's health in a nation-wide health survey: design of the German KiGGS-Study. BMC Public Health 2008;8:196.
16.
Hill T, Lewicki P: Statistics: Methods and Applications. A Comprehensive Reference for Science, Industry, and Data Mining. http://www.statsoft.com/textbook (accessed January 2012).
17.
Field A: Discovering Statistics Using SPSS. London, SAGE Publications Ltd., 2009, pp 627-682.
18.
Ismail K: Unravelling factor analysis. Evid Based Ment Health 2008;11:99-102.
20.
Braun-Fahrlander C, Gassner M, Grize L, Takken-Sahli K, Neu U, Stricker T, Varonier HS, Wuthrich B, Sennhauser FH, Swiss Study on Childhood Allergy and Respiratory symptoms, Air Pollution (SCARPOL) team: No further increase in asthma, hay fever and atopic sensitisation in adolescents living in Switzerland. Eur Respir J 2004;23:407-413.
21.
Mortz CG, Lauritsen JM, Andersen KE, Bindslev-Jensen C: Type I sensitization in adolescents: prevalence and association with atopic dermatitis. The Odense Adolescence Cohort Study on Atopic Diseases and Dermatitis (TOACS). Acta Derm Venereol 2003;83:194-201.
22.
Toelle BG, Ng K, Belousova E, Salome CM, Peat JK, Marks GB: Prevalence of asthma and allergy in schoolchildren in Belmont, Australia: three cross-sectional surveys over 20 years. BMJ 2004;328:386-387.
23.
Kim J, Hahm MI, Lee SY, Kim WK, Chae Y, Park YM, Han MY, Lee KJ, Kwon HJ, Jung JA, Kim SY, Ahn K: Sensitization to aeroallergens in Korean children: a population-based study in 2010. J Korean Med Sci 2011;26:1165-1172.
24.
Stapel SO, Kleine-Tebbe J: Allergy testing in the laboratory; in Kay AB, Kaplan AP, Bousquet J, Holt PG (eds): Allergy and Allergic Diseases. Oxford, Wiley-Blackwell, 2009, pp 1346-1367.
25.
Burastero SE: Pollen-cross allergenicity mediated by panallergens: a clue to the patho-genesis of multiple sensitizations. Inflamm Allergy Drug Targets 2006;5:203-209.
26.
Soeria-Atmadja D, Onell A, Kober A, Matsson P, Gustafsson MG, Hammerling U: Multivariate statistical analysis of large-scale IgE antibody measurements reveals allergen extract relationships in sensitized individuals. J Allergy Clin Immunol 2007;120:1433-1440.
27.
Borres MP, Ebisawa M, Eigenmann PA: Use of allergen components begins a new era in pediatric allergology. Pediatr Allergy Immunol 2011;22:454-461.
28.
Scala E, Alessandri C, Bernardi ML, Ferrara R, Palazzo P, Pomponi D, Quaratino D, Rasi C, Zaffiro A, Zennaro D, Mari A: Cross-sectional survey on immunoglobulin E reactivity in 23,077 subjects using an allergenic molecule-based microarray detection system. Clin Exp Allergy 2010;40:911-921.
29.
Melioli G, Marcomini L, Agazzi A, Bazurro G, Tosca M, Rossi GA, Minale P, Rossi R, Reggiardo G, Canonica GW, Passalacqua G: The IgE repertoire in children and adolescents resolved at component level: a cross-sectional study. Pediatr Allergy Immunol 2012;23:433-440.
© 2013 S. Karger AG, Basel
2013
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.