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Natural course of pollen-induced allergic rhinitis from childhood to adulthood: a 20-year follow-up
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  • Magnus Lindqvist,
  • Katja Leth-Møller,
  • Allan Linneberg,
  • Inger Kull,
  • Anna Bergstrom,
  • Antonios Georgellis,
  • Magnus Borres,
  • Agneta Ekebom,
  • Marianne van Hage,
  • Erik Melén,
  • Marit Westman
Magnus Lindqvist
Karolinska Institutet Institutionen for medicin Solna

Corresponding Author:[email protected]

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Katja Leth-Møller
Frederiksberg Hospital Center for Klinisk Forskning og Forebyggelse
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Allan Linneberg
Frederiksberg Hospital Center for Klinisk Forskning og Forebyggelse
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Inger Kull
Karolinska Institutet Institutionen for klinisk forskning och utbildning Sodersjukhuset
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Anna Bergstrom
Karolinska Institutet Institutet for miljomedicin
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Antonios Georgellis
Karolinska Institutet Institutet for miljomedicin
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Magnus Borres
Uppsala universitet Institutionen for kvinnors och barns halsa
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Agneta Ekebom
Naturhistoriska riksmuseet
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Marianne van Hage
Karolinska Institutet Institutionen for medicin Solna
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Erik Melén
Karolinska Institutet Institutionen for klinisk forskning och utbildning Sodersjukhuset
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Marit Westman
Karolinska Institutet Institutionen for medicin Solna
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Abstract

Background Allergic rhinitis (AR) is one of the most common chronic diseases worldwide. There are limited prospective long-term data regarding persistency and remission of AR. The objective of this study was to investigate the natural course of pollen-induced AR (pollen-AR) over 20 years, from childhood into early adulthood. Methods Data from 1137 subjects in the Barn/Children Allergi/Allergy Milieu Stockholm Epidemiologic birth cohort (BAMSE) with a completed questionnaire regarding symptoms, asthma, treatment with allergen immunotherapy (AIT) and results of allergen-specific IgE for inhalant allergens at 4, 8, 16 and 24 years were analysed. Pollen-AR was defined as sneezing, runny, itchy, or blocked nose; and itchy or watery eyes when exposed to birch and/or grass pollen in combination with allergen-specific IgE ≥0.35kU A/l to birch and/or grass. Results Approximately 75% of children with pollen-AR at 4 or 8 years had persistent disease up to 24 years, and 30% developed asthma. The probability of persistency was high already at low levels of pollen-specific IgE. The highest rate of remission from pollen-AR was seen between 16 and 24 years (21.5%), however the majority remained sensitized. This period was also when pollen-specific IgE-levels stopped increasing and the average estimated annual incidence of pollen-AR decreased from 1.5% to 0.8% per year. Conclusion Children with pollen-AR are at high risk of persistent disease for at least 20 years. Childhood up to adolescence seems to be the most dynamic period of AR progression. Our findings underline the close cross-sectional and longitudinal relationship between sensitization, AR, and asthma.
02 Jul 2023Submitted to Allergy
03 Jul 2023Submission Checks Completed
03 Jul 2023Assigned to Editor
03 Jul 2023Review(s) Completed, Editorial Evaluation Pending
06 Jul 2023Reviewer(s) Assigned
22 Jul 2023Editorial Decision: Revise Minor
13 Sep 20231st Revision Received
13 Sep 2023Submission Checks Completed
13 Sep 2023Assigned to Editor
13 Sep 2023Review(s) Completed, Editorial Evaluation Pending
18 Sep 2023Reviewer(s) Assigned
25 Sep 2023Editorial Decision: Accept