Which factors determine the course of allergic rhinitis over puberty?

Published Online: September 19, 2011

Allergic rhinitis (AR), commonly known as hay fever, is one of the most common diseases in children and adults and has been reported to affect between 9% and 42% of populations. Hereditary as well as environmental and lifestyle factors have been reported to play a role for the development of this disease. Even though it usually begins in childhood or adolescence, the course over puberty and the risk factors involved during this significant time have so far not been analyzed in detail.

As described in a current article in The Journal of Allergy and Clinical Immunology (JACI), Kellberger et al. examined these factors using data from the Study on Occupational Allergy Risks (SOLAR), which is the first follow-up of German participants of the International Study of Asthma and Allergies in Childhood (ISAAC) Phase II. Risk factors for new-onset and persistence of AR from the ages of 9-11 years (ISAAC Phase II) to the ages of 15-18 years (SOLAR) were analyzed to improve the prediction of the course of disease over puberty. Medical information as well as questionnaire data were available for analysis.

A positive skin prick test response in childhood to mixed tree pollen or mixed grass pollen showed to be the most important determinant for new-onset as well as persistence of AR over puberty. A positive skin prick test response to house dust mites, cat or mold (i.e. indoor allergens) in childhood as well as parental history of asthma and female sex were additional risk factors for new-onset of AR. Having been breast-fed exclusively for at least two months, however, was protective against development of AR over puberty.

The course of AR from childhood until adolescence can be well predicted using risk factors that can be easily determined in childhood. Sensitization to outdoor allergens (tree and grass pollen) seems to be of greater importance for the course of the disease than sensitization to indoor allergens. These findings might help pediatricians in advising patients.


The Journal of Allergy and Clinical Immunology (JACI) is the official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.
Key words: Allergic rhinitis, disease prediction, adolescence, cohort study

AAAAI - American Academy of Allergy Asthma & Immunology