Histamine and allergen skin reactivity in the elderly population: results from the Korean Longitudinal Study on Health and Aging

Ann Allergy Asthma Immunol. 2011 Oct;107(4):344-52. doi: 10.1016/j.anai.2011.07.012. Epub 2011 Aug 11.

Abstract

Background: The allergen skin prick test is the most representative diagnostic test for atopy, but its use has been limited because of the belief that skin reactivity decreases with aging.

Objective: To investigate skin reactivity and influencing factors in the elderly population.

Methods: This cross-sectional analysis included 854 subjects (aged ≥65 years) who participated in the Korean Longitudinal Study on Health and Aging cohort (September 2005 to August 2006) and underwent allergen skin prick tests. Skin prick tests were performed with 1 mg/mL of histamine and a panel of 12 aeroallergens that are common in Korea. The wheal diameters were measured and compared to identify the factors associated with skin reactivity.

Results: Older age and female sex were associated with reduced histamine skin reactivity in elderly subjects. This age-related decrease was apparent only among women, the reasons for which were not identified. In contrast to histamine, wheal response size induced by 2 major allergens, Dermatophagoides pteronyssinus and Dermatophagoides farinae, did not show sex differences and did not decrease with age among the subjects showing allergen-induced wheal size greater than 0 mm.

Conclusions: This analysis demonstrates that age and sex can independently influence histamine skin reactivity among the elderly population. The allergen-induced wheal sizes did not decrease with age. The discrepancy between histamine and allergen skin reactivity may warrant further evaluation to redefine the cutoff value for the determination of a positive skin test result in elderly subjects.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Allergens / immunology*
  • Cohort Studies
  • Cross-Sectional Studies
  • Female
  • Histamine / immunology*
  • Humans
  • Hypersensitivity / diagnosis
  • Hypersensitivity / immunology*
  • Logistic Models
  • Longitudinal Studies
  • Male
  • Multivariate Analysis
  • Republic of Korea
  • Sex Factors
  • Skin Tests / methods*
  • Skin Tests / standards
  • Surveys and Questionnaires

Substances

  • Allergens
  • Histamine