Analysis Of Specific IgE Of Food Allergen In Patients With Seasonal Allergic Rhinitis

Objective:The inhalant allergens of seasonal allergic rhinitis(SAR)mainly include pollen,fungi and so on.Studies have suggested that allergen homology exisits between specific pollen and plant-based foods,which may cause cross-hypersensitivity reactions and lead to the coexistence of SAR and food allergy.Based on this,this study retrospectively analyzed the results of allergen serum specific Ig E(sIgE)to characterize allergen sensitization status in patients with SAR and food allergy,so as to provide a reference for the etiological diagnosis and treatment of clinical patients.Methods:A total of 892 patients who were clinically diagnosed as SAR and underwent allergen serum sIgE testing in our outpatient department of otolaryngology-head and neck surgery from March 2021 to September 2022 were enrolled in this study.Among them,there were 416 SAR patients whose serum sIgE were positive for allergens(including inhalation and food allergens).The general data of 416 patients with SAR were collected.The total symptom score(TSS)and visual analogue scale(VAS)were used to guide the patients to score according to their self-feeling in nearly a week.Microsoft Excel 2019 and the statistical software SPSS 26.0 and Graphpad Prism 9.5were used to analyze the data.The counting data were expressed in terms of rate(%),and chi-square test was used for inter-group comparison.The measurement data conforming to the normal distribution were expressed as mean±standard deviation((?)±s),and the t-test was used for the comparison between groups.The measurement data that didn’t conform to the normal distribution were expressed by median and interquartile range,and the nonparametric test was used for the comparison between groups.The difference was considered statistically significant at P<0.05.Results:Among the 416 SAR patients with positive allergens,378 cases(90.87%)were positive for inhalant allergens,162 cases(38.94%)were positive for food allergens,and124 cases(29.81%)were double positive for inhalant and food allergens.The positive rates of inhalant allergens were the highest in SAR patients,followed by food allergens,and the positive rates of dual allergens were the lowest.There was a statistically significant difference in age among the three groups(P<0.05),while the differences in TSS and VAS scores were not statistically significant(P>0.05).The top 5 detection rates of inhalant allergens were mugwort,common ragweed,white birch,house dust mite/dermatophagoides farinae and platanus acerifolia,and the top 5 detection rates of food allergens were strawberry,peach,wheat flour,apple and egg.The positive rates of partial inhalant and food allergens were significantly different between the juvenile and adult groups(P<0.05).There was no significant difference in the positive rate of inhalant allergens in SAR patients of different genders(P>0.05),while the positive rates of apple(X~2=4.045,P<0.05)and peach(X~2=6.549,P<0.05)in male were significantly higher than those in female.The overall concentration grading of allergens was mainly classified as grade 1～2.The concentration grading of some allergens,such as mugwort,platanus acerifolia pollen,strawberry,apple,was mainly grade 3～4.These allergens had high sensitization rates and high serum sIgE concentrations,which may lead to severe anaphylaxis.SAR patients were often accompanied by multiple food sensitization.The positive rates of food allergens from high to low were strawberry,peach,wheat flour,apple and egg.Common plant food triggers included Rosaceae,Gramineae,Betulaceae,Leguminosae,Bromeliaceae,and Anacardiaceae.Spearman correlation analysis showed that the sIgE level of white birch pollen was positively correlated with that of apple(rs=0.449,P=0.041),peach(rs=0.569,P=0.009)and strawberry(rs=0.440,P=0.046);the sIgE level of mugwort was positively correlated with that of peach(rs=0.403,P=0.037).Conclusion:1.Inhalant allergens and food allergens are important pathogenic factors of SAR.The positive rates of some allergens have statistical significance in different age and sex.2.There is no significant difference in TSS and VAS scores among SAR patients with positive inhalation allergens,food allergens,and dual inhalation and food allergens.It is suggested that the presence or absence of food allergen sensitization does not affect the subjective perception of allergic symptoms in SAR patients.3.The sIgE concentration of white birch pollen is positively correlated with that of apple,peach and strawberry.The sIgE concentration of mugwort is positively correlated with that of peach.It is suggested that pollen may be co-sensitized with plant food.4.SAR patients are often accompanied by multiple food allergies,and allergen detection is of great clinical significance in predicting allergic process and in the diagnosis and treatment of SAR.