The Link between Uncontrolled Asthma and Sensitization to Inhalant Allergens: Evidence from Jeddah, Saudi Arabia

Abstract

Background: For optimal asthma control, current guidelines recommend the assessment of allergy phenotype. This study investigates the relationship between asthma control and sensitization to inhalant allergens. Methods: A cross-sectional study was conducted over a one year period since January 2011. Asthmatics were sequentially selected from allergy clinic at King Abdulaziz University Hospital in Jeddah. Evaluation of asthma control was based on GINA guideline. Assessment of the sensitization towards inhalant allergens was measured in-vivo by wheal size and number of positive reactions on the standard skin prick test (SPT). SPSS was used to analyse any statistical correlation. Results: A total of 110 asthmatics with a mean age of 34 ± 14 years were included, 63.6% being females. Asthma was predominantly uncontrolled in 68 cases (61.8%), partly controlled in 26 cases (23.6%) and controlled in 16 cases (14.5%). SPT to common inhalant allergens was positive in 76 asthmatics (77.6%); of which 54 (55.1%) were uncontrolled, 13 (13.3%) partly controlled and only 9 (9.2%) were controlled asthmatics. The predominant allergens were Dermatophagoides pteronyssinus in 57 cases (54.8%), Dermatophagoides farinae in 49 cases (47.1%), cat epithelia in 35 cases (33.7%) and cockroach in 23 cases (22.1%). Uncontrolled asthma was correlated significantly with positive SPT (p=0.038). Conclusions: More than half of the uncontrolled asthmatics population is sensitized to indoor inhalant allergens. This clinically favours the assessment of allergic status in any asthmatic, whose symptoms are not controlled. This is one of the early studies exploring the potential link between asthma control and sensitization to inhalant allergens.