The Prevalence Rate of Atopic and Non-Atopic Asthma and Some Related Factors among Patients Referred to Asthma and Allergy Clinic



Background: The prevalence of asthma and allergic diseases in the world has increased in recent decades, and it
is necessary to identify allergens in different regions. The aim of this study was to evaluate the frequency of
allergens in patients with atopic and non-atopic asthma in Dazyani Asthma and Allergy Clinic, Gorgan City, Iran
in 2020.
Methods: This cross-sectional descriptive study was performed on 96 children with asthma aged 1 to 16 years.
Diagnosis of asthma was based on the patient's clinical signs, life-saving medications used, activity limitation
established, and pulmonary function tests. Accordingly, the definitive diagnosis of asthma was a 15% increase in
forced expiratory volume-1 (FEV1) after inhalation of 2 puffs of salbutamol. Children were divided into two
groups of atopic and non-atopic based on experiments. In this study, if immunoglobulin E (IgE) levels were high
and Prick test was positive, they were in the atopic group, otherwise they were in the non-atopic group. Serum
levels of eosinophils and immunoglobulin E were analyzed by type of asthma and severity of asthma.
Finding: Among the studied children, 54.17% had atopic and 45.83% non-atopic phenotype. A total of 71.78% of
children with asthma were at least allergic to one of the allergens tested. There were also significant relationships
between the severity of asthma and being atopic, immunoglobulin E, and eosinophil count.
Conclusion: Asthma is more severe in children with atopic asthma than non-atopic asthma. The mean of
immunoglobulin E and eosinophils in atopic asthma is higher than non-atopic. Immunoglobulin E and eosinophil
levels are also directly related to the severity of asthma.


Jameson JL, Fauci AS, Kasper DL, Hauser SL, Longo DL, Loscalzo J. Harrison's principles of internal medicine. 12th ed. New York, NY: McGraw-Hill Education; 2018.
Nazari Z, Ghaffari J, Ghaffari N, Ahangarkani F. A review on hypersensitivity reactions to fungal aeroallergens in patients with allergic disorders in Iran. Curr Med Mycol 2019; 5(1): 42-7.
Voskamp AL, Kormelink TG, van Wijk RG, Hiemstra PS, Taube C, de Jong EC, et al. Modulating local airway immune responses to treat allergic asthma: lessons from experimental models and human studies. Semin Immunopathol 2020; 42(1): 95-110.
Woods JT, Walter RJ, Houle MC, Barber BS, Morris MJ. The effect of deployment on pulmonary function in military personnel with asthma. Mil Med 2022; 187(1-2): e116-e121.
Lin TY, Poon AH, Hamid Q. Asthma phenotypes and endotypes. Curr Opin Pulm Med 2013; 19(1): 18-23.
Jesus JPV, Lima-Matos AS, Almeida PCA, Lima VB, Mello LM, Souza-Machado A, et al. Obesity and asthma: Clinical and laboratory characterization of a common combination. J Bras Pneumol 2018; 44(3): 207-12.
Teifoori F, Shams-Ghahfarokhi M, Postigo I, Razzaghi-Abyaneh M, Eslamifar A, Gutierrez A, et al. Identification of the main allergen sensitizers in an Iran asthmatic population by molecular diagnosis. Allergy Asthma Clin Immunol 2014; 10(1): 41.
Zare Marzouni H, Akrami R, Shalilian M, Kalani N, Noori Ahmad Abadi M, Kooti W. Investigating the prevalence, determining the effects of immunologic sensitization and clinical symptoms related to allergens existing in Khuzestan province. J Fasa Univ Med Sci 2016; 6(1): 96-105. [In Persian].
Su YT, Yang YN, Li YC, Tsai CC, Chen LM, Lin YC, et al. Age-dependent distribution of the atopic phenotype and allergen sensitization among asthmatic children in southern Taiwan. Asian Pac J Allergy Immunol 2016; 34(3): 206-11.
Morgan BW, Siddharthan T, Grigsby MR, Pollard SL, Kalyesubula R, Wise RA, et al. Asthma and allergic disorders in Uganda: A population-based study across urban and rural settings. J Allergy Clin Immunol Pract 2018; 6(5): 1580-7.
Timm S, Frydenberg M, Janson C, Campbell B, Forsberg B, Gislason T, et al. The urban-rural gradient in asthma: A population-based study in Northern Europe. Int J Environ Res Public Health 2015; 13(1): 93.
Miele CH, Gaviola C, Wise RA, Gilman RH, Jaganath D, Miranda JJ, et al. Urbanization but not biomass fuel smoke exposure is associated with asthma prevalence in four resource-limited settings. A106. Epidemiology and risk factors of asthma: from the crib to adulthood. American Thoracic Society; 2016. p. A2782.
Gerday S, Schleich F, Henket M, Paulus V, Guissard F, Louis R. Comparison of demographic, functional and inflammatory features between atopic and non atopic asthmatics. Retrospective study on a large cohort of patients. Eur Respir J 2020; 56(suppl 64): 3317.
Dharmage SC, Perret JL, Custovic A. Epidemiology of asthma in children and adults. Front Pediatr 2019; 7: 246.
Oddy WH. Breastfeeding, childhood asthma, and allergic disease. Ann Nutr Metab 2017; 70(Suppl 2): 26-36.
Moghtaderi M, Hosseini TS, Farjadian S. Sensitization to common allergens among patients with allergies in major Iranian cities: A systematic review and meta-analysis. Epidemiol Health 2017; 39: e2017007.
Celakovska J, Ettlerova K, Ettler K, Bukac J. Food allergy, asthma bronchiale, and rhinitis in atopic dermatitis patients with total immunoglobulin E under and above 200 IU/ml. Food Agric Immunol 2015; 26(5): 671-81.
Carroll WD, Lenney W, Child F, Strange RC, Jones PW, Whyte MK, et al. Asthma severity and atopy: How clear is the relationship? Arch Dis Child 2006; 91(5): 405-9.
Berti A, Volcheck GW, Cornec D, Smyth RJ, Specks U, Keogh KA. Severe/uncontrolled asthma and overall survival in atopic patients with eosinophilic granulomatosis with polyangiitis. Respir Med 2018; 142: 66-72.
Kumar RM, Pajanivel R, Koteeswaran G, Menon SK, Charles PM. Correlation of total serum immunoglobulin E level, sputum, and peripheral eosinophil count in assessing the clinical severity in bronchial asthma. Lung India 2017; 34(3): 256-61.
Snehalatha G, Begum A, Raju N, Ravi Kumar N. A study on correlation of serum IgE levels with diagnosis and severity of asthma in children. Int J Contemp Pediatr 2018; 5(6): 2240-3.
Ahmed M, Chohan M, Abbas K, Shamim S. Correlation of serum immunoglobulin e levels with asthma severity in children (2-12 years) presenting to a tertiary care hospital. Khyber Med Univ J 2018; 10(4): 212-16.