Sensitizations to aeroallergens in Israel: Prevalences and profiles
Main Article Content
Keywords
aeroallergen, Israel, Middle East, sensitization, skin prick test
Abstract
Background: Most of the literature on aeroallergen sensitization have been generated in North America and Western Europe.
Objectives: To determine aeroallergen sensitization prevalences and patterns among patients with physician-diagnosed allergic rhinitis (AR) in Israel.
Methods: We conducted a retrospective, observational study of sensitization to 20 aeroallergen extracts in skin prick tests (SPTs) among consecutive pediatric and adult patients with AR attending the allergy clinic at Emek Medical Center (Afula, Israel) and an affiliated regional outpatient clinic (Nazareth, Israel) from 2021 to 2023.
Results: A total of 1993 patients (547 females, 27.4%) were included (median [range] age: 24 [6–82]). The five allergens or groups of allergens with the highest SPT positivity rates were house dust mite (HDM: Dermatophagoides pteronyssinus and D. farinae; 74.8%), tree pollens (44.3%), olive pollen (34.1%), grass pollens (25.6%), and cat dander (22.6%). Of the 1993 patients, 947 (47.5%) had a positive SPT for just one of the 20 tested extracts. Patients sensitized to cat dander were significantly (12-fold) more likely to be sensitized to dog dander and vice versa. Patients living in an urban environment were more likely to be sensitized to cypress pollen (19.3% vs. 12.0% in a nonurban environment; p = 0.002, chi-squared test) and pellitory pollen (21.6% vs. 15.1%, respectively; p = 0.010, chi-squared test). Our suggestion is that in the Middle East, patients with symptoms of AR can be effectively screened with a standard “European” panel of allergen extracts for SPTs (such as that suggested by the Global Allergy and Asthma European Network [GA2LEN] organization), plus Johnson grass, Bermuda grass, and oak and eucalyptus pollen extracts.
References
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3 Goronfolah L. Aeroallergens, atopy and allergic rhinitis in the Middle East. Eur Ann Allergy Clin Immunol. 2016;48(1):5–21.
4 Katelaris CH, Lee BW, Potter PC, Maspero JF, Cingi C, Lopatin A, et al. Prevalence and diversity of allergic rhinitis in regions of the world beyond Europe and North America. Clin Exp Allergy. 2012;42(2):186–207. 10.1111/j.1365-2222.2011.03891.x
5 Savoure M, Bousquet J, Jaakkola JJK, Jaakkola MS, Jacquemin B, Nadif R. Worldwide prevalence of rhinitis in adults: A review of definitions and temporal evolution. Clin Transl Allergy. 2022;12(3):e12130. 10.1002/clt2.12130
6 Graif Y, Garty BZ, Livne I, Green MS, Shohat T. Prevalence and risk factors for allergic rhinitis and atopic eczema among schoolchildren in Israel: Results from a national study. Ann Allergy Asthma Immunol. 2004;92(2):245–9. 10.1016/S1081-1206(10)61555-4
7 Romano-Zelekha O, Graif Y, Garty BZ, Livne I, Green MS, Shohat T. Trends in the prevalence of asthma symptoms and allergic diseases in Israeli adolescents: Results from a national survey 2003 and comparison with 1997. J Asthma. 2007;44(5):365–9. 10.1080/02770900701363983
8 Shahar E, Lorber M. Prevalence of self-reported allergic conditions in an adult population in Israel. Isr Med Assoc J. 2001;3(3):190–3.
9 Alsowaidi S, Abdulle A, Shehab A, Zuberbier T, Bernsen R. Allergic rhinitis: Prevalence and possible risk factors in a Gulf Arab population. Allergy. 2010;65(2):208–12. 10.1111/j.1398-9995.2009.02123.x
10 Mansouritorghabeh H, Jabbari-Azad F, Sankian M, Varasteh A, Farid-Hosseini R. The most common allergenic tree pollen grains in the Middle East: A narrative review. Iran J Med Sci. 2019;44(2):87–98.
11 El Sharif N, Douwes J, Hoet PH, Doekes G, Nemery B. Concentrations of domestic mite and pet allergens and endotoxin in Palestine. Allergy. 2004;59(6):623–31. 10.1111/j.1398-9995.2004.00441.x
12 El-Sharif N, Douwes J, Hoet P, Nemery B. Childhood asthma and indoor aeroallergens and endotoxin in Palestine: A case-control study. J Asthma. 2006;43(3):241–7. 10.1080/02770900600567122
13 Teplitsky V, Mumcuoglu KY, Babai I, Dalal I, Cohen R, Tanay A. House dust mites on skin, clothes, and bedding of atopic dermatitis patients. Int J Dermatol. 2008;47(8):790–5. 10.1111/j.1365-4632.2008.03657.x
14 Waibel KH. Allergic rhinitis in the Middle East. Mil Med. 2005;170(12):1026–8. 10.7205/MILMED.170.12.1026
15 Zeldin Y, Kidon MI, Magen E, Bibi H, Cohen A, Waisel Y, et al. Impact of specific allergen sensitization on the prevalence of asthma in patients with allergic rhinitis from adjacent distinct geographic areas. Ann Allergy Asthma Immunol. 2008;101(1):30–4. 10.1016/S1081-1206(10)60831-9
16 Waisel Y, Eshel A, Keynan N, Langgut D. Ambrosia: A new impending disaster for the Israeli allergic population. Isr Med Assoc J. 2008;10(12):856–7.
17 Kivity S, Sade K, Abu-Arisha F, Lerman Y, Kivity S. Epidemiology of bronchial asthma and chronic rhinitis in schoolchildren of different ethnic origins from two neighboring towns in Israel. Pediatr Pulmonol. 2001;32(3):217–21. 10.1002/ppul.1111
18 Shohat T, Golan G, Tamir R, Green MS, Livne I, Davidson Y, et al. Prevalence of asthma in 13–14 yr-old schoolchildren across Israel. Eur Respir J. 2000;15(4):725–9. 10.1034/j.1399-3003.2000.15d16.x
19 Shohat T, Green MS, Davidson Y, Livne I, Tamir R, Garty BZ. Differences in the prevalence of asthma and current wheeze between Jews and Arabs: Results from a national survey of schoolchildren in Israel. Ann Allergy Asthma Immunol. 2002;89(4):386–92. 10.1016/S1081-1206(10)62040-6
20 Graif Y, Goldberg A, Tamir R, Vigiser D, Melamed S. Skin test results and self-reported symptom severity in allergic rhinitis: The role of psychological factors. Clin Exp Allergy. 2006;36(12):1532–7. 10.1111/j.1365-2222.2006.02589.x
21 Sade K, Roitman D, Kivity S. Sensitization to dermatophagoides, blomia tropicalis, and other mites in atopic patients. J Asthma. 2010;47(8):849–52. 10.3109/02770903.2010.506683
22 Zeldin Y, Weiler Z, Magen E, Tiosano L, Kidon MI. Safety and efficacy of allergen immunotherapy in the treatment of allergic rhinitis and asthma in real life. Isr Med Assoc J. 2008;10(12):869–72.
23 Heinzerling L, Mari A, Bergmann KC, Bresciani M, Burbach G, Darsow U, et al. The skin prick test–European standards. Clin Transl Allergy. 2013;3(1):3. 10.1186/2045-7022-3-3
24 Geller-Bernstein C, Etzioni A. Pediatric allergy and immunology in Israel. Pediatr Allergy Immunol. 2013;24(2):187–94. 10.1111/pai.12044
25 Graif Y, Yigla M, Tov N, Kramer MR. Value of a negative aeroallergen skin-prick test result in the diagnosis of asthma in young adults: Correlative study with methacholine challenge testing. Chest. 2002;122(3):821–5. 10.1378/chest.122.3.821
26 Kornizky Y, Topilsky M, Fireman E, Kivity S, Kivity S. Specific IgE antibodies to aeroallergens and food among Israelis. Ann Allergy Asthma Immunol. 1999;83(2):149–52. 10.1016/S1081-1206(10)62627-0
27 Til-Perez G, Carnevale C, Sarria-Echegaray PL, Arancibia-Tagle D, Chugo-Gordillo S, Tomas-Barberan MD. Sensitization profile in patients with respiratory allergic diseases: Differences between conventional and molecular diagnosis (a cross-sectional study). Clin Mol Allergy. 2019;17:8. 10.1186/s12948-019-0112-4
28 Almogren A. Airway allergy and skin reactivity to aeroallergens in Riyadh. Saudi Med J. 2009;30(3):392–6.
29 Al-Dowaisan A, Fakim N, Khan MR, Arifhodzic N, Panicker R, Hanoon A, et al. Salsola pollen as a predominant cause of respiratory allergies in Kuwait. Ann Allergy Asthma Immunol. 2004;92(2):262–7. 10.1016/S1081-1206(10)61558-X
30 Al-Ghamdi BR, Omer FM, Awadalla NJ, Mahfouz AA. Specific aeroallergen sensitization associated with current rhinitis among adults in southwestern Saudi Arabia. Medicine (Baltimore). 2022;101(35):e30384. 10.1097/MD.0000000000030384
31 Zahraldin K, Chandra P, Tuffaha A, Ehlayel M. Sensitization to common allergens among children with asthma and allergic rhinitis in Qatar. J Asthma Allergy. 2021;14:287–92. 10.2147/JAA.S295228
32 Thalappil S, Ibrahim T, Shibu S, Mobayed H, Al-Nesf M. Aeroallergens sensitization pattern in atopic patients in Qatar: A retrospective study. Qatar Med J. 2023;2023(2):2. 10.5339/qmj.2023.sqac.2
33 Bibi H, Shoseyov D, Feigenbaum D, Nir P, Shiachi R, Scharff S, et al. Comparison of positive allergy skin tests among asthmatic children from rural and urban areas living within small geographic area. Ann Allergy Asthma Immunol. 2002;88(4):416–20. 10.1016/S1081-1206(10)62374-5
34 Rached E, Brooks DB. Water governance in the Middle East and North Africa: An unfinished agenda. In: Tortajada C, Biswas A, editors. Improving water policy and governance. London: Routledge; 2011.
35 Israeli Ministry of Agriculture. The Ministry of Agriculture publishes Israel’s dog statistics for 2019. [Internet]. 2020 [Accessed on November 25, 2024]. Available from: https://www.gov.il/en/pages/seker-klavim-2019.
36 The Jerusalem Post. On International Cat Day, Israel’s 2 million street cats remain a crisis. [Internet]. 2021 [Accessed on November 25th, 2024]. Available from: https://www.jpost.com/israel-news/on-international-cat-day-israels-2-million-street-cats-remain-a-crisis-676180.
37 Reininger R, Varga EM, Zach M, Balic N, Lindemeier AD, Swoboda I, et al. Detection of an allergen in dog dander that cross-reacts with the major cat allergen, Fel d 1. Clin Exp Allergy. 2007;37(1):116–24. 10.1111/j.1365-2222.2006.02611.x
38 Ukleja-Sokolowska N, Gawronska-Ukleja E, Zbikowska-Gotz M, Socha E, Lis K, Sokolowski L, et al. Analysis of feline and canine allergen components in patients sensitized to pets. Allergy Asthma Clin Immunol. 2016;12:61. 10.1186/s13223-016-0167-4
39 Bousquet J, Heinzerling L, Bachert C, Papadopoulos NG, Bousquet PJ, Burney PG, et al. Practical guide to skin prick tests in allergy to aeroallergens. Allergy. 2012;67(1):18–24.
40 Burbach GJ, Heinzerling LM, Edenharter G, Bachert C, Bindslev-Jensen C, Bonini S, et al. GA(2)LEN skin test study II: clinical relevance of inhalant allergen sensitizations in Europe. Allergy. 2009;64(10):1507–15. 10.1111/j.1398-9995.2009.02089.x
41 Heinzerling LM, Burbach GJ, Edenharter G, Bachert C, Bindslev-Jensen C, Bonini S, et al. 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(10):1498–506. 10.1111/j.1398-9995.2009.02093.x
42 Newson RB, van Ree R, Forsberg B, Janson C, Lotvall J, Dahlen SE, et al. Geographical variation in the prevalence of sensitization to common aeroallergens in adults: the GA(2) LEN survey. Allergy. 2014;69(5):643–51. 10.1111/all.12397
43 Calderon MA, Cox L, Casale TB, Moingeon P, Demoly P. Multiple-allergen and single-allergen immunotherapy strategies in polysensitized patients: looking at the published evidence. J Allergy Clin Immunol. 2012;129(4):929–34. 10.1016/j.jaci.2011.11.019
44 Demoly P, Passalacqua G, Pfaar O, Sastre J, Wahn U. Management of the polyallergic patient with allergy immunotherapy: a practice-based approach. Allergy Asthma Clin Immunol. 2016;12:2. 10.1186/s13223-015-0109-6
45 Bedard A, Sofiev M, Arnavielhe S, Anto JM, Garcia-Aymerich J, Thibaudon M, et al. Interactions between air pollution and pollen season for rhinitis using mobile technology: A MASK-POLLAR study. J Allergy Clin Immunol Pract. 2020;8(3):1063–73 e4. 10.1016/j.jaip.2019.11.022
46 Berger M, Bastl M, Bouchal J, Dirr L, Berger U. The influence of air pollution on pollen allergy sufferers. Allergol Select. 2021;5:345–8. 10.5414/ALX02284E
47 Rosario CS, Urrutia-Pereira M, Murrieta-Aguttes M, D’Amato G, Chong-Silva DC, Godoi RHM, et al. Air pollution and rhinitis. Front Allergy. 2024;5:1387525. 10.3389/falgy.2024.1387525
48 Bosch-Cano F, Bernard N, Sudre B, Gillet F, Thibaudon M, Richard H, et al. Human exposure to allergenic pollens: A comparison between urban and rural areas. Environ Res. 2011;111(5):619–25. 10.1016/j.envres.2011.04.001
49 Priftis KN, Anthracopoulos MB, Nikolaou-Papanagiotou A, Matziou V, Paliatsos AG, Tzavelas G, et al. Increased sensitization in urban vs. rural environment—rural protection or an urban living effect? Pediatr Allergy Immunol. 2007;18(3): 209–16. 10.1111/j.1399-3038.2006.00514.x
50 Priftis KN, Anthracopoulos MB, Paliatsos AG, Tzavelas G, Nikolaou-Papanagiotou A, Douridas P, et al. Different effects of urban and rural environments in the respiratory status of Greek schoolchildren. Respir Med. 2007;101(1):98–106. 10.1016/j.rmed.2006.04.008
51 Tizek L, Redlinger E, Ring J, Eyerich K, Biedermann T, Zink A. Urban vs rural–Prevalence of self-reported allergies in various occupational and regional settings. World Allergy Organ J. 2022;15(1):100625. 10.1016/j.waojou.2022.100625
2 Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens WJ, Togias A, et al. Allergic rhinitis and its impact on asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen). Allergy. 2008;63(Suppl 86):8–160.
3 Goronfolah L. Aeroallergens, atopy and allergic rhinitis in the Middle East. Eur Ann Allergy Clin Immunol. 2016;48(1):5–21.
4 Katelaris CH, Lee BW, Potter PC, Maspero JF, Cingi C, Lopatin A, et al. Prevalence and diversity of allergic rhinitis in regions of the world beyond Europe and North America. Clin Exp Allergy. 2012;42(2):186–207. 10.1111/j.1365-2222.2011.03891.x
5 Savoure M, Bousquet J, Jaakkola JJK, Jaakkola MS, Jacquemin B, Nadif R. Worldwide prevalence of rhinitis in adults: A review of definitions and temporal evolution. Clin Transl Allergy. 2022;12(3):e12130. 10.1002/clt2.12130
6 Graif Y, Garty BZ, Livne I, Green MS, Shohat T. Prevalence and risk factors for allergic rhinitis and atopic eczema among schoolchildren in Israel: Results from a national study. Ann Allergy Asthma Immunol. 2004;92(2):245–9. 10.1016/S1081-1206(10)61555-4
7 Romano-Zelekha O, Graif Y, Garty BZ, Livne I, Green MS, Shohat T. Trends in the prevalence of asthma symptoms and allergic diseases in Israeli adolescents: Results from a national survey 2003 and comparison with 1997. J Asthma. 2007;44(5):365–9. 10.1080/02770900701363983
8 Shahar E, Lorber M. Prevalence of self-reported allergic conditions in an adult population in Israel. Isr Med Assoc J. 2001;3(3):190–3.
9 Alsowaidi S, Abdulle A, Shehab A, Zuberbier T, Bernsen R. Allergic rhinitis: Prevalence and possible risk factors in a Gulf Arab population. Allergy. 2010;65(2):208–12. 10.1111/j.1398-9995.2009.02123.x
10 Mansouritorghabeh H, Jabbari-Azad F, Sankian M, Varasteh A, Farid-Hosseini R. The most common allergenic tree pollen grains in the Middle East: A narrative review. Iran J Med Sci. 2019;44(2):87–98.
11 El Sharif N, Douwes J, Hoet PH, Doekes G, Nemery B. Concentrations of domestic mite and pet allergens and endotoxin in Palestine. Allergy. 2004;59(6):623–31. 10.1111/j.1398-9995.2004.00441.x
12 El-Sharif N, Douwes J, Hoet P, Nemery B. Childhood asthma and indoor aeroallergens and endotoxin in Palestine: A case-control study. J Asthma. 2006;43(3):241–7. 10.1080/02770900600567122
13 Teplitsky V, Mumcuoglu KY, Babai I, Dalal I, Cohen R, Tanay A. House dust mites on skin, clothes, and bedding of atopic dermatitis patients. Int J Dermatol. 2008;47(8):790–5. 10.1111/j.1365-4632.2008.03657.x
14 Waibel KH. Allergic rhinitis in the Middle East. Mil Med. 2005;170(12):1026–8. 10.7205/MILMED.170.12.1026
15 Zeldin Y, Kidon MI, Magen E, Bibi H, Cohen A, Waisel Y, et al. Impact of specific allergen sensitization on the prevalence of asthma in patients with allergic rhinitis from adjacent distinct geographic areas. Ann Allergy Asthma Immunol. 2008;101(1):30–4. 10.1016/S1081-1206(10)60831-9
16 Waisel Y, Eshel A, Keynan N, Langgut D. Ambrosia: A new impending disaster for the Israeli allergic population. Isr Med Assoc J. 2008;10(12):856–7.
17 Kivity S, Sade K, Abu-Arisha F, Lerman Y, Kivity S. Epidemiology of bronchial asthma and chronic rhinitis in schoolchildren of different ethnic origins from two neighboring towns in Israel. Pediatr Pulmonol. 2001;32(3):217–21. 10.1002/ppul.1111
18 Shohat T, Golan G, Tamir R, Green MS, Livne I, Davidson Y, et al. Prevalence of asthma in 13–14 yr-old schoolchildren across Israel. Eur Respir J. 2000;15(4):725–9. 10.1034/j.1399-3003.2000.15d16.x
19 Shohat T, Green MS, Davidson Y, Livne I, Tamir R, Garty BZ. Differences in the prevalence of asthma and current wheeze between Jews and Arabs: Results from a national survey of schoolchildren in Israel. Ann Allergy Asthma Immunol. 2002;89(4):386–92. 10.1016/S1081-1206(10)62040-6
20 Graif Y, Goldberg A, Tamir R, Vigiser D, Melamed S. Skin test results and self-reported symptom severity in allergic rhinitis: The role of psychological factors. Clin Exp Allergy. 2006;36(12):1532–7. 10.1111/j.1365-2222.2006.02589.x
21 Sade K, Roitman D, Kivity S. Sensitization to dermatophagoides, blomia tropicalis, and other mites in atopic patients. J Asthma. 2010;47(8):849–52. 10.3109/02770903.2010.506683
22 Zeldin Y, Weiler Z, Magen E, Tiosano L, Kidon MI. Safety and efficacy of allergen immunotherapy in the treatment of allergic rhinitis and asthma in real life. Isr Med Assoc J. 2008;10(12):869–72.
23 Heinzerling L, Mari A, Bergmann KC, Bresciani M, Burbach G, Darsow U, et al. The skin prick test–European standards. Clin Transl Allergy. 2013;3(1):3. 10.1186/2045-7022-3-3
24 Geller-Bernstein C, Etzioni A. Pediatric allergy and immunology in Israel. Pediatr Allergy Immunol. 2013;24(2):187–94. 10.1111/pai.12044
25 Graif Y, Yigla M, Tov N, Kramer MR. Value of a negative aeroallergen skin-prick test result in the diagnosis of asthma in young adults: Correlative study with methacholine challenge testing. Chest. 2002;122(3):821–5. 10.1378/chest.122.3.821
26 Kornizky Y, Topilsky M, Fireman E, Kivity S, Kivity S. Specific IgE antibodies to aeroallergens and food among Israelis. Ann Allergy Asthma Immunol. 1999;83(2):149–52. 10.1016/S1081-1206(10)62627-0
27 Til-Perez G, Carnevale C, Sarria-Echegaray PL, Arancibia-Tagle D, Chugo-Gordillo S, Tomas-Barberan MD. Sensitization profile in patients with respiratory allergic diseases: Differences between conventional and molecular diagnosis (a cross-sectional study). Clin Mol Allergy. 2019;17:8. 10.1186/s12948-019-0112-4
28 Almogren A. Airway allergy and skin reactivity to aeroallergens in Riyadh. Saudi Med J. 2009;30(3):392–6.
29 Al-Dowaisan A, Fakim N, Khan MR, Arifhodzic N, Panicker R, Hanoon A, et al. Salsola pollen as a predominant cause of respiratory allergies in Kuwait. Ann Allergy Asthma Immunol. 2004;92(2):262–7. 10.1016/S1081-1206(10)61558-X
30 Al-Ghamdi BR, Omer FM, Awadalla NJ, Mahfouz AA. Specific aeroallergen sensitization associated with current rhinitis among adults in southwestern Saudi Arabia. Medicine (Baltimore). 2022;101(35):e30384. 10.1097/MD.0000000000030384
31 Zahraldin K, Chandra P, Tuffaha A, Ehlayel M. Sensitization to common allergens among children with asthma and allergic rhinitis in Qatar. J Asthma Allergy. 2021;14:287–92. 10.2147/JAA.S295228
32 Thalappil S, Ibrahim T, Shibu S, Mobayed H, Al-Nesf M. Aeroallergens sensitization pattern in atopic patients in Qatar: A retrospective study. Qatar Med J. 2023;2023(2):2. 10.5339/qmj.2023.sqac.2
33 Bibi H, Shoseyov D, Feigenbaum D, Nir P, Shiachi R, Scharff S, et al. Comparison of positive allergy skin tests among asthmatic children from rural and urban areas living within small geographic area. Ann Allergy Asthma Immunol. 2002;88(4):416–20. 10.1016/S1081-1206(10)62374-5
34 Rached E, Brooks DB. Water governance in the Middle East and North Africa: An unfinished agenda. In: Tortajada C, Biswas A, editors. Improving water policy and governance. London: Routledge; 2011.
35 Israeli Ministry of Agriculture. The Ministry of Agriculture publishes Israel’s dog statistics for 2019. [Internet]. 2020 [Accessed on November 25, 2024]. Available from: https://www.gov.il/en/pages/seker-klavim-2019.
36 The Jerusalem Post. On International Cat Day, Israel’s 2 million street cats remain a crisis. [Internet]. 2021 [Accessed on November 25th, 2024]. Available from: https://www.jpost.com/israel-news/on-international-cat-day-israels-2-million-street-cats-remain-a-crisis-676180.
37 Reininger R, Varga EM, Zach M, Balic N, Lindemeier AD, Swoboda I, et al. Detection of an allergen in dog dander that cross-reacts with the major cat allergen, Fel d 1. Clin Exp Allergy. 2007;37(1):116–24. 10.1111/j.1365-2222.2006.02611.x
38 Ukleja-Sokolowska N, Gawronska-Ukleja E, Zbikowska-Gotz M, Socha E, Lis K, Sokolowski L, et al. Analysis of feline and canine allergen components in patients sensitized to pets. Allergy Asthma Clin Immunol. 2016;12:61. 10.1186/s13223-016-0167-4
39 Bousquet J, Heinzerling L, Bachert C, Papadopoulos NG, Bousquet PJ, Burney PG, et al. Practical guide to skin prick tests in allergy to aeroallergens. Allergy. 2012;67(1):18–24.
40 Burbach GJ, Heinzerling LM, Edenharter G, Bachert C, Bindslev-Jensen C, Bonini S, et al. GA(2)LEN skin test study II: clinical relevance of inhalant allergen sensitizations in Europe. Allergy. 2009;64(10):1507–15. 10.1111/j.1398-9995.2009.02089.x
41 Heinzerling LM, Burbach GJ, Edenharter G, Bachert C, Bindslev-Jensen C, Bonini S, et al. 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(10):1498–506. 10.1111/j.1398-9995.2009.02093.x
42 Newson RB, van Ree R, Forsberg B, Janson C, Lotvall J, Dahlen SE, et al. Geographical variation in the prevalence of sensitization to common aeroallergens in adults: the GA(2) LEN survey. Allergy. 2014;69(5):643–51. 10.1111/all.12397
43 Calderon MA, Cox L, Casale TB, Moingeon P, Demoly P. Multiple-allergen and single-allergen immunotherapy strategies in polysensitized patients: looking at the published evidence. J Allergy Clin Immunol. 2012;129(4):929–34. 10.1016/j.jaci.2011.11.019
44 Demoly P, Passalacqua G, Pfaar O, Sastre J, Wahn U. Management of the polyallergic patient with allergy immunotherapy: a practice-based approach. Allergy Asthma Clin Immunol. 2016;12:2. 10.1186/s13223-015-0109-6
45 Bedard A, Sofiev M, Arnavielhe S, Anto JM, Garcia-Aymerich J, Thibaudon M, et al. Interactions between air pollution and pollen season for rhinitis using mobile technology: A MASK-POLLAR study. J Allergy Clin Immunol Pract. 2020;8(3):1063–73 e4. 10.1016/j.jaip.2019.11.022
46 Berger M, Bastl M, Bouchal J, Dirr L, Berger U. The influence of air pollution on pollen allergy sufferers. Allergol Select. 2021;5:345–8. 10.5414/ALX02284E
47 Rosario CS, Urrutia-Pereira M, Murrieta-Aguttes M, D’Amato G, Chong-Silva DC, Godoi RHM, et al. Air pollution and rhinitis. Front Allergy. 2024;5:1387525. 10.3389/falgy.2024.1387525
48 Bosch-Cano F, Bernard N, Sudre B, Gillet F, Thibaudon M, Richard H, et al. Human exposure to allergenic pollens: A comparison between urban and rural areas. Environ Res. 2011;111(5):619–25. 10.1016/j.envres.2011.04.001
49 Priftis KN, Anthracopoulos MB, Nikolaou-Papanagiotou A, Matziou V, Paliatsos AG, Tzavelas G, et al. Increased sensitization in urban vs. rural environment—rural protection or an urban living effect? Pediatr Allergy Immunol. 2007;18(3): 209–16. 10.1111/j.1399-3038.2006.00514.x
50 Priftis KN, Anthracopoulos MB, Paliatsos AG, Tzavelas G, Nikolaou-Papanagiotou A, Douridas P, et al. Different effects of urban and rural environments in the respiratory status of Greek schoolchildren. Respir Med. 2007;101(1):98–106. 10.1016/j.rmed.2006.04.008
51 Tizek L, Redlinger E, Ring J, Eyerich K, Biedermann T, Zink A. Urban vs rural–Prevalence of self-reported allergies in various occupational and regional settings. World Allergy Organ J. 2022;15(1):100625. 10.1016/j.waojou.2022.100625
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Rottem, M., Noujedat, M., & Awni, Y. (2025). Sensitizations to aeroallergens in Israel: Prevalences and profiles. Allergologia Et Immunopathologia, 53(4), 101–111. https://doi.org/10.15586/aei.v53i4.1335
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Original Articles
How to Cite
Rottem, M., Noujedat, M., & Awni, Y. (2025). Sensitizations to aeroallergens in Israel: Prevalences and profiles. Allergologia Et Immunopathologia, 53(4), 101–111. https://doi.org/10.15586/aei.v53i4.1335