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A meta-analysis of sensitization to the most common aeroallergens in a Middle Eastern region: an overview of the main molecular allergens

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Abstract

The prevalence of sensitization to aeroallergens in communities is incomprehensible. We aimed to assess the prevalence of sensitization to common aeroallergens according to the reliable studies performed in different cities of Iran. Literature review was performed by the inclusion of data sources such as PubMed, Web of Science, Google Scholar, ProQuest, Scopus, Iran Medex, and Magiran. All studies determining the prevalence of indoor and outdoor common aeroallergens were included in this review. STATA 14 and metaprop command were used for meta-analysis of data. Random pooled estimate (ES) (pooled prevalence), 95% confidence interval (95% CI), and p value were calculated. Forty-two reliable studies were included in this study. The random pooled estimate (ES) (pooled prevalence) of positive family history of allergy and positive specific IgE (in vivo tests and/or in vitro) to at least one allergen was 69% (95% CI 64–74%) and 74% (95% CI 66–81%), respectively. The pooled prevalence for weeds, trees, and grasses as outdoor allergens was 57% (95% CI 46–68%), 43% (95% CI 33–52%), and 41% (95% CI 32–50%), respectively. Salsola kali (S. kali) and Cynodon dactylon were the most prevalent weeds and grass allergens being found in 56% (95% CI 45–66%) and 40% (95% CI 29–52%) of sensitized patients, respectively. Meta-analysis of indoor allergens revealed that 27% (95% CI 14–43%), 38% (95% CI 21–57%), 21% (95% CI 16–26%), and 16% (95% CI 10–24%) of allergic patients were sensitized to mold, house dust mite (HDM), cockroach, and cat allergens, respectively. The results of the current meta-analysis revealed that S. kali is the most common aeroallergens in southwestern and northeastern areas as well as the capital city (Tehran) of Iran, while allergic patients living in northern and southern coastal areas of Iran were more prone to suffer from HDM sensitization.

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Acknowledgements

We highly appreciate Dr. Kimia Gohari for her kind collaboration in this work.

Funding

This study was supported by a grant from Tehran University of Medical Sciences. None of the authors has direct or indirect commercial financial incentive associating with publishing the article, and no funding agreement limits our ability to complete and publish the study.

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Corresponding authors

Correspondence to Zahra Pourpak or Adriano Mari.

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Ethical approval

The protocol of this systematic review was approved by the Research committee and Ethics Committee of Immunology, Asthma, and Allergy Research Institute and approved and registered by Tehran University of Medical Sciences (No: 31266).

Appendix

Appendix

Aeroallergens

Kingdom

Order

Family

Genus

Species

Common name

Outdoor

Weeds

Plantae

Caryophyllales

Amaranthaceae

Salsola

kali

Russian Thistle/Saltwort

Plantae

Caryophyllales

Amaranthaceae

Chenopodium

album

Lamb’s quarter/White goosefoot

Plantae

Caryophyllales

Amaranthaceae

Amaranthus

retroflexus

Pigweed

Plantae

Caryophyllales

Amaranthaceae

Amaranthus

palmeri

Careless weed

Plantae

Caryophyllales

Chenopodiaceae 

Kochia

scoparia

Burning Bush

Plantae

Asterales

Asteraceae 

Artemisia

vulgaris or douglasiana

Mugwort

Plantae

Lamiales

Plantaginaceae

Plantago

lanceolata

Plantain

Plantae

Asterales

Asteraceae

Leucanthemum

vulgare

Oxeye daisy

Plantae

Rosales

Urticaceae

Urtica

dioica

Nettle

Plantae

Asterales

Asteraceae

Taraxacum

Officinale

Dandelion

Plantae

Caryophyllales

Polygonaceae

Rumex

acetosella

Sheep’s Sorrel

Plantae

Asterales

Asteraceae

Xanthium

strumarium

Cocklebur

Plantae

Fabales

Fabaceae 

Medicago

sativa

Alfalfa

Plantae

Asterales

Asteraceae

Solidago

spp.

Goldenrod

Plantae

Rosales

Rhamnaceae 

Ceanothus

spp.

Redroot

Grasses

Plantae

Poales

Poacea

Cynodon

dactylon

Bermuda Grass

Plantae

Poales

Poacea

Lolium

perenne

Rye grass

Plantae

Poales

Poacea

Phleum

pratense

Timothy grass

Plantae

Poales

Poacea

Festuca

pratensis

Meadow fescue

Plantae

Poales

Poaceae

Poa

pratensis

Kentucky blue grass or Meadow grass

Plantae

Poales

Poaceae

Sorghum

halepense

Johnson grass

Plantae

Poales

Poaceae

Holcus

lanatus

Velvet grass or Yorkshire Fog

Plantae

Poales

Poaceae

Dactylis

glomerata

Orchard grass or cocksfoot

Plantae

Poales

Poaceae

Anthoxanthum

odoratum

Sweet vernal grass

Plantae

Poales

Poaceae

Agrostis

spp.

Bent grass

Plantae

Poales

Poaceae

  

Oat grass

Plantae

Poales

Poaceae

Avena

spp.

Wild oat

Plantae

Poales

Poaceae

Bromus

spp.

Bromus

Plantae

Poales

Poaceae

Agrostis

spp.

Redtop

Trees

Plantae

Lamiales

Oleaceae

Fraxinus

excelsior or americana

Ash

Plantae

Pinales

Cupressaceae

Cupressus

Arizonica, sempervirens

Cypress

Plantae

Proteales

Platanaceae

Platanus

Orientalis acerifolia

Plane tree or sycamore

Plantae

Lamiales

Oleaceae

OLea

europea

Olive

Plantae

Fabales

Fabaceae 

Prosopis

juliflora

Mesquite

Plantae

Myrtales

Myrtaceae 

Eucalyptus

globules

Eucalyptus

Plantae

Fagales

Fagaceae 

Fagus

spp.

Beech

Plantae

 

Pinaceae 

  

Cedar

Plantae

Fagales

Betulaceae

Alnus

spp.

Alder

Plantae

 

Adoxaceae

  

Elder

Plantae

Fagales

Betulaceae

Betula

spp.

Birch

Plantae

Fagales

Fagaceae 

Quercus

spp.

Oak

Plantae

Fagales

Betulaceae

Corylus

spp.

Hazel

Plantae

Malpighiales

Salicaceae

Poplus

alba

Poplar

Plantae

Rosales

Ulmaceae 

Ulmus

spp.

Elm

Plantae

Malpighiales

Salicaceae 

Salix

spp.

Willow

Plantae

Malpighiales

Salicaceae 

Populus

deltoids

Cottonwood

Plantae

Sapindales

Simaroubaceae 

Ailanthus

altissima

Tree of heaven

Plantae

Fabales

Fabaceae 

Acacia

longifolia

Common Acacia

Plantae

Pinales

Cupressaceae 

Juniperus

ashei

Juniper

Plantae

Pinales

Pinaceae 

Pinus

spp.

Lodgepole pine

Plantae

Sapindales

Sapindaceae 

Acer

spp.

Maple

Plantae

Sapindales

Sapindaceae 

Aesculus

spp.

Horse chestnuts

Plantae

Fabales

Fabaceae 

Rubinia

pseudoacacia

False acacias

Plantae

Malvales

Malvaceae

Tilia

spp.

Limes

Plantae

Myrtales

Myrtaceae

Eucalyptus

spp.

Red river

Plantae

Fagales

Juglandaceae

Carya

spp.

Shagbark hickory

Plantae

Saxifragales

Altingiaceae

Liquidambar

spp.

Sweetgum

Mold

Fungi

Eurotiales

Trichocomaceae

Aspergillus

Fumigates/niger

 

Fungi

Pleosporales

Pleosporaceae

Alternaria

alternata

 

Indoor and outdoor

 

Fungi

Capnodiales

Davidiellaceae

Cephalosporium

Acremonium/Herbarium

 

Fungi

Eurotiales

Trichocomaceae

Penicillium

spp.

 

Fungi

Saccharomycetales

Saccharomycetaceae

Candida

Albicans

 

Fungi

Pleosporales

Pleosporaceae

Bipolaris

spp.

 

Indoor

HDM

Animalia

Sarcoptiformes

Pyroglyphidae

Dermatophagoides

farinae

 

Animalia

Sarcoptiformes

Pyroglyphidae

Dermatophagoides

pteronyssinus

 

Cockroach

Animalia

Blattodea

Ectobiidae

Blattella

germanica

German Cockroach

Animalia

Blattodea

Blattidae

Periplaneta

americana

American cockroach

Cat

Animalia

Carnivora

Felidae

Felis

Catus/domesticus

 

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Shokouhi Shoormasti, R., Sabetkish, N., Kazemnejad, A. et al. A meta-analysis of sensitization to the most common aeroallergens in a Middle Eastern region: an overview of the main molecular allergens. Aerobiologia 35, 383–409 (2019). https://doi.org/10.1007/s10453-019-09586-y

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