Abdulrahman Al-Frayh

Cladosporium and respiratory allergy: Diagnostic implications in Saudi Arabia

An allergological study to evaluate allergenicity to Cladosporium, Burkard 7-Day Volumetric Spore Trap and Personal Volumetric air sampler (viable mode) were employed to conduct air sampling for 12 months in three regions of Saudi Arabia. The study was extended for a continuous 3rd year at one site. Skin prick testing (SPT) was also conducted on 605 allergic individuals using commercial extracts of C. herbarum. Cladosporium emerged to be the most prevalent genus in the outdoor environment constituting up to 25% of all fungal spores in the dry region and 37.1 and 41.2% in two coastal cities respectively. Amongst the species C. sphaerospermum, C. macrocarpum, C. cladosporioides and C. herbarum were noted. Maximum hourly concentrations up to 14 × 103 m−3 were recorded in coastal region during winter months. Morning concentrations were higher at both city sites compared to afternoon concentration. SPT result revealed an overall 19.67% positive reactions with majority showing mild reactions.

Seasonal Periodicities of Fungal Allergens in the Atmosphere of Riyadh

Aerobiological studies to evaluate allergenic fungal spores in the atmosphere of Riyadh were conducted using Burkard volumetric 7-day recording spore trap and culture plate techniques from November...

Human sensitization to Prosopis juliflora antigen in Saudi Arabia.

BACKGROUND Allergenicity to Prosopis juliflora pollen antigen has been reported from only a few countries, including the US, South Africa, India and Kuwait. In some parts of Saudi Arabia, species of Prosopis have been introduced by the millions as roadside ornamentation. There appear to be four flowering seasons during which pollen grains float in all directions. However, the role of Prosopis pollen as the sensitizing and/or triggering agent of allergic asthma and/or rhinitis in the Kingdom has never been evaluated. PATIENTS AND METHODS A total of 473 allergic patients suffering from bronchial asthma in four different geographical regions (Abha, Qassim, Hofuf and Gizan), and attending allergy clinics and chest disease centers of university and Ministry of Health hospitals in the region were tested for immediate hypersensitivity reaction to Prosopis juliflora allergens. Airborne pollen grains at one center were also studied for one full year, using volumetric sampling techniques. RESULTS A total of 76.1% patients in Qassim, 37.5% in Gizan, 29% in Abha and 11% in Hofuf reacted positively to Prosopis antigen. Multiple sensitivities to other pollen antigens were detected in all patients. The level of airborne Prosopis pollen detected in Gizan exceeded 90 grains m -3 of air. CONCLUSION In view of the documented evidence of Prosopis-involved allergenicity, the role of Prosopis pollen as a sensitizing factor in Saudi Arabia has been confirmed. However, the cause of elicitation of symptoms in many multiple sensitive patients, together with the question of cross-reactivities, needs thorough and detailed investigation. In vitro confirmation of all positive results is also required to incriminate Prosopis as one of the major allergens in parts of Saudi Arabia.

AIRBORNE ALTERNARIA SPORES: POTENTIAL ALLERGIC SENSITIZERS IN SAUDI ARABIA

BACKGROUND In order to investigate the role of airborne Alternaria spp. in the sensitization of individuals having respiratory allergy symptoms, particularly bronchial asthma, an aerobiologic and clinical (diagnostic) study was conducted at several centers in Saudi Arabia. MATERIALS AND METHODS Airborne Alternaria spores were studied at four different centers in Riyadh, Jeddah and Al-Khobar, including three years at one site. Skin prick tests (SPT) were conducted on a total of 616 allergic individuals attending allergy clinics at six different hospitals in Abha, Qassim, Gizan, Jeddah, Hofuf and Makkah regions. RESULTS Alternaria spores constituted between 1.9%-9.6% of the total fungal air spora, and the maximum concentration exceeded 5x10 2 spores per m3 of air in Jeddah, followed by 4.9x102 spores per m3 in Al-Khobar. Mean weekly and monthly concentration of Alternaria fluctuated, reaching up to 150 spores per m 3 and 60 spores per m 3, respectively. Quantitative regional variations were also recorded. IgE-mediated SPT reactivities conducted on allergic patients resulted in an overall 21.6% positive reactions, showing mild, moderate and strong wheal and erythema. CONCLUSION The findings reveal that Alternaria spores are prevalent as a major component in the outdoor environment of the Kingdom, with peaks in April and October. The overall 21.6% positive SPT reactions indicate the sensitization level or cross-reactive sensitivity to Alternaria allergens. The study suggests that airborne Alternaria can be a potential allergic sensitizer in susceptible individuals and can be a risk factor in sensitized individuals with symptoms of bronchial asthma and allergic rhinitis in the Kingdom of Saudi Arabia.

A comparative study of immediate skin test reactivity to inhalant allergens in asthmatic children of two different regions in Saudi Arabia.

The skin test reactivities to various inhalant allergens in asthmatic children from two different regions in Saudi Arabia were compared. One hundred-twenty subjects each from the Central and Western regions, representing different environmental features, were selected. Prick test reactivity to 24 common allergens were analyzed and compared. Seventy-one (59.2%) patients from Riyadh (Central region) showed positive skin reactions to one or more allergens, while 87 (72.5%) reacted positively to different allergens from Makkah (Western region). The distribution of skin test sensitivity revealed striking differences in the two groups. The most prominent were reactions to the house dust mite (D. farinae) which amounted to 56.3% and to fungal allergens, 31.3% in asthmatics from the Western region, while reactions to the same allergens in subjects from the Central region were 10% and 5.8%, respectively. Similarly, marked variations were noted with pollen grain allergens with 9.3% in Central region and 15.4% in the Western region. The study indicates the presence of different allergen profiles in the two regions and suggests the influence of climatic and environmental factors and their impact on sensitization of susceptible subjects.

Infant Feeding Practices in Riyadh, Saudi Arabia

ABSTRACT Infant-feeding patterns were studied in 6,623 randomly selected Saudi families living in Riyadh. The 4,796 infants studied were under 1 year of age and were fed with breast milk plus bottl...

Fungal Allergens in the Atmosphere of Riyadh: A Preliminary Communication

ABSTRACT Aerobiological studies to identify and quantify airborne fungal allergens in Riyadh, Saudi Arabia, were conducted using Burkard volumetric spore trap and gravity-settle plate techniques. H...

House dust mite allergens in Saudi Arabia: Regional variations and immune response.

In order to assess the causative extrinsic allergic factor(s) in school-age children diagnosed as having bronchial asthma and allergic rhinitis, and to qualitatively and quantitatively evaluate the presence of house dust mites (HDMs) in the homes of these children in Saudi Arabia, a study analyzing mite contents in 165 samples collected from patientsâ indoor environment was conducted. The dust samples were collected from four regions of Saudi Arabia, showing variation in their geography and climate. Immunochemical assays were performed using ALK reagents by ELISA technique. A total of 462 children were also tested using skin prick test (SPT) method for IgE-mediated reactions to HDMs. The samples from the Central dry region revealed a very low amount of the potent house dust mites (Dermatophagoides pteronyssinus and D. farinae, the two dominant species in various parts of the world). The samples from the Southern mountainous region contained a very high concentration of Der p I (84,000 ng/g of dust), while the Western coastal region showed a high concentration of Der f I (up to 22,000 ng/g). The mid-Western agricultural region did not exhibit any significant level of either Der p I or Der f I. The maximum level of D. pteronyssinus detected in the Central dry region was 106 ng/g of dust. The data exhibit both qualitative and quantitative variations of HDMs in the three regions and may be attributed to variation in geography and climate, particularly humidity of the regions, which vary significantly. Riyadh in the Central region is considered to have low humidity (<40%), while humidity in the Western coastal region, Jeddah, and the Southern region of Abha is comparatively higher, which helps house dust mites thrive. SPT results in these regions with house dust mite allergens (in addition to other common inhalant allergens) also revealed a considerable number of IgE-mediated reactions, consistent with the frequency of house dust mites in the region. Though more data are being accumulated on the subject to conduct a statistical comparison and more skin tests are underway in the Southern region, the study suggests the presence of at least two HDMs as well as qualitative diversity and quantitative variation of house dust mites in Saudi Arabia. The study also indicates, with a considerable number of IgE-mediated reactions, the possible influence of mites in the allergic manifestations of many patients, which is not only common, but increasing in parts of the country.

Airborne Ganoderma basidiospores in a country with desert environment

Aerobiological studies to identify Ganoderma basidiospores were conducted using Burkard Volumetric 7-Day Recording Sampler (Burkard Manufacturing Co. Ltd., England) at three separate cities in Saudi Arabia. At one site, Jizan, close to the coast of Red Sea, up to 17% of all basidiospores counted were identified as Ganoderma spp. while less than 1% Ganoderma spp. were identified at the two non-coastal sites. A clear seasonal pattern from late autumn to early summer (October-March) with a peak in December was recorded at Jizan and the maximum concentration of Ganoderma basidiospores reached 1.9×103 m−3 in December followed by 1.2×103 m−3 in January. The diurnal pattern of Ganoderma spore concentrations, when averaged over the year had late-evening maxima (a nocturnal pattern). However, other sites that showed low concentrations of Ganoderma basidiospores did not exhibit any peak or a high maximal level. The study demonstrates that even in a desert environment, airborne activities of Ganoderma basidiospores can be recorded. The impact of Ganoderma on asthmatic patients, particularly in such environments, needs to be investigated.

Bronchial asthma and wheeze in a desert country.

A cross-sectional, population-based study was conducted among school children (3300), aged 7–12 years, in the Kingdom of Saudi Arabia, during the period January, 1988–February, 1990. The aim of the study was to investigate the association between asthma, allergic rhinitis, wheeze and eczema among Saudi school children. The relationship between pet-ownership and respiratory allergy was also studied. Detailed information was collected about wheeze and asthma in 3041 children and history of asthma and allergic rhinitis in their parents. The population sample had a high prevalence rate of diagnosed asthma (6.8%), history of wheeze (10.5%), allergic rhinitis (17.9%), and eczema (10.8%). Allergic rhinitis was the most frequently seen respiratory illness when compared to other respiratory symptoms. The prevalence rate of asthma, allergic rhinitis and eczema among parents reflected the same pattern as that seen in the children. Prevalence rate for asthma in children with pets is twice that of children without pets (OR:2.4; 95%, Cl:1.8–3.1). The odds of having chronic cough (OR:3.9; 95%, Cl:2.8–5.2), chronic wheeze (OR:4.2; 95%, 3.3–5.4), allergic rhinitis (OR:8.0; 95% Cl:6.3–10.3) and eczema (OR:2.8:95 Cl:2.1–3.7) was higher in children with pets than in children without pets. The present study revealed that petownership was associated with increased respiratory symptoms.