These authors jointly led the project.
Allergic airway diseases in a tropical urban environment are driven by dominant mono-specific sensitization against house dust mites
Article first published online: 24 JAN 2014
© 2014 The Authors. Allergy published by John Wiley & Sons Ltd.
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
Volume 69, Issue 4, pages 501–509, April 2014
How to Cite
Allergic airway diseases in a tropical urban environment are driven by dominant mono-specific sensitization against house dust mites. Allergy 2014; 69: 501–509., , , , , , , , .
Edited by: Wytske Fokkens
- Issue published online: 5 MAR 2014
- Article first published online: 24 JAN 2014
- Manuscript Accepted: 19 DEC 2013
- Singapore Immunology Network. Grant Numbers: SIgN-06-006, SIgN-08-020, SIgN-10-029
- National Medical Research Council. Grant Number: NMRC/1150/2008
- Biomedical Research Council
- Agency for Science, Technology and Research (A*STAR)
- National University of Singapore
- immunoglobulin E;
Southeast Asian populations are increasingly affected by allergic airway diseases. Etiology and specific causes, however, are still unknown. The aim of this study is therefore to identify allergens and risk factors for the high prevalence of allergic airway disease in the tropical urban environment.
Symptoms of allergic rhinitis (AR), asthma, and allergic dermatitis were recorded in two independent cohorts of 576 and 7373 ethnic Chinese individuals living in Singapore. Reactivity against common allergens was determined by skin prick tests (SPT); specific immunoglobulin E (sIgE) titers against 12 common allergens, as well as total serum IgE (tIgE), were measured in the smaller cohort.
Immunoglobulin E sensitization was almost exclusively directed against house dust mite (HDM) allergens. More than 80% of individuals were HDM-sIgE positive. Of these, less than 30% also had sIgE for other allergens, and similarly, few of the HDM-sIgE-negative individuals reacted to other allergens. Titers for HDM-sIgE were 8–30 times higher than other non-HDM allergen titers and correlated directly with total serum tIgE levels. Migrants from nontropical countries typically arrived with low or undetectable HDM-sIgE but developed substantial titers in a time-dependent fashion. Importantly, prolonged stay in Singapore also resulted in the manifestation of AR and asthma symptoms, contributing to some of the highest national prevalence rates worldwide.
In a tropical urban environment, the allergic response is dominated by a single allergen class. The mono-specific IgE sensitization against HDM translates into increased prevalence of allergic airway diseases, which now impact a large proportion of the population in Singapore.