Characterising the allergen landscape in paediatric allergic rhinitis and/or asthma

Objective To characterise the allergen sensitisation profile and its demographic, seasonal and laboratory associations in children with allergic rhinitis (AR) and/or asthma in Guangdong, China. Methods We retrospectively reviewed the records of children diagnosed with AR and/or asthma from January 2020 to December 2023. Serum allergen-specific Immunoglobulin E (IgE) measurements were used to identify allergens. Sensitisation patterns and their relationships with age, sex, season of visit, peripheral-blood cell counts and immune markers were assessed with χ² tests and Spearman correlation. Results A total of 8080 children (median age, 7.0 years; 69.0% boys) were included; 89.1% had AR, 7.5% asthma and 3.4% both conditions. Overall, 76.5% were sensitised to inhalant allergens, 18.3% to food allergens and 5.2% to other allergens. Dermatophagoides farinae (93.2 %) and Dermatophagoides pteronyssinus (88.3 %) were the dominant inhalant allergens, whereas egg (14.2 %) and milk (11.9 %) prevailed among foods. Dual sensitisation was most common (67.6 %). Inhalant sensitisation peaked in summer (79.8 %), whereas food sensitisation was highest in spring (6.8 %). Inhalant‐allergen positivity increased with age, while food‐allergen positivity declined (p<0.001). Seventeen of 18 allergens displayed significant sex differences. Total IgE correlated positively with most inhalant and food allergens but negatively with egg allergen (p<0.05); neutrophil percentage showed similar positive correlations with several allergens. Allergen sensitisation correlates with impaired lung function and elevated airway inflammation. Conclusion House-dust mites are the principal sensitising allergens in children with AR and/or asthma in Guangdong, followed by egg and milk. Sensitisation patterns are modulated by season, age and sex, underscoring the necessity for region- and age-specific preventive and therapeutic strategies in paediatric allergic disease management.