Asthma, rhinitis, and skin test reactivity to aeroallergens in families ofasthmatic subjects in Anqing, China

In industrialized countries with a Western lifestyle, sensitization to pere nnial aeroallergens is strongly associated with asthma, whereas sensitizati on to seasonal aeroallergens is closely related to allergic rhinitis. Littl e is known, however, about the relation between skin test reactivity to aer oallergens and either asthma or rhinitis in mainland China. We studied 10,0 09 members of 2,544 families in Anqing (China) that were selected on the ba sis of physician-diagnosed asthma in at least two siblings. Generalized est imating equations were employed to study the association between skin test reactivity to aeroallergens and either asthma or rhinitis. After adjustment for age, sex, intensity of smoking, skin test reactivity to other aeroalle rgens, and household correlations, sensitization to dust mite was an indepe ndent predictor of both asthma (OR = 1.3, 95% CI = 1.1 to 1.5, p = 0.008) a nd rhinitis (OR = 1.3, 95% CI = 1.0 to 1.8, p = 0.04). Sensitization to mol d was significantly associated with asthma (OR = 1.6, 95% CI = 1.1 to 2.3, p = 0.008), and sensitization to silk was an independent predictor of rhini tis (OR = 1.5, 95% CI = 1.1 to 2.2, p = 0.02). Although 46.9% of the study participants were sensitized to at least one allergen, only 3.5% of study s ubjects reported nasal symptoms consistent with rhinitis. Among asthmatic s ubjects, 6.2% reported nasal symptoms. Whereas sensitization to perennial a eroallergens was associated with asthma among families of asthmatic subject s in rural China, sensitization to silk was the strongest predictor of rhin itis in this population. Our findings also suggest that allergic rhinitis i s far less common among asthmatic subjects in rural China than in asthmatic subjects in industrialized countries with a Western lifestyle.