Distributional Characteristics Analysis of Aeroallergens Among Children With Allergic Respiratory Diseases in Sichuan Province,China

Distributional Characteristics Analysis of Aeroallergens Among Children With Allergic Respiratory Diseases in Sichuan Province,China | Authorea try { document.documentElement.classList.add('js'); } catch (e) { } var _gaq = _gaq || []; _gaq.push(['_setAccount', 'G-8VDV14Y67G']); _gaq.push(['_trackPageview']); (function() { var ga = document.createElement('script'); ga.type = 'text/javascript'; ga.async = true; ga.src = ('https:' == document.location.protocol ? 'https://ssl' : 'http://www') + '.google-analytics.com/ga.js'; var s = document.getElementsByTagName('script')[0]; s.parentNode.insertBefore(ga, s); })(); Skip to main content Preprints Collections Wiley Open Research IET Open Research Ecological Society of Japan All Collections About About Authorea FAQs Contact Us Quick Search anywhere Search for preprint articles, keywords, etc. Search Search ADVANCED SEARCH SCROLL This is a preprint and has not been peer reviewed. Data may be preliminary. 30 October 2025 V1 Latest version Share on Distributional Characteristics Analysis of Aeroallergens Among Children With Allergic Respiratory Diseases in Sichuan Province,China Authors : Ling Liao 0009-0003-1039-914X , Lamei Liu , Qi Wang 0000-0001-9252-9013 , and Shujing Gao [email protected] Authors Info & Affiliations https://doi.org/10.22541/au.176180772.20813967/v1 Published Frontiers in Pediatrics Version of record Peer review timeline 233 views 119 downloads Contents Abstract 1 INTRODUCTION 2 METHODS 3 RESULTS 4 DISCUSSION 5 CONCLUSION Information & Authors Metrics & Citations View Options References Figures Tables Media Share Abstract Objective: Analysis of the prevalence and distribution patterns of aeroallergens in Children with respiratory allergic diseases in Sichuan province based on skin prick test (SPT) results. Methods: This retrospective cross-sectional study included 7,880 pediatric patients with atopic diseases in outpatient department of West China Second University Hospital between January 2023 and December 2024. All patients completed standardized SPT. Results: Among the 7,880 pediatric patients, 48.6% showed positive results on SPT, the positive rate of SPT in boys was much higher than in girls ( P < 0.01) .The top three allergens ranked by sensitization rates in (SPT) were as follows: Dermatophagoides pteronyssinus (Der.p ), Dermatophagoides farinae ( Der.f ), and house dust. Among the 3,826 patients with a positive SPT result, the majority of patients (86.5%) were sensitized to two or more allergens. Most allergens exhibited the highest positive rates in the Sichuan Basin. With increasing age, the positive rates for inhalant allergens showed an upward trend except cat dander and feathers. Across all age groups, the three most frequently detected allergens were Der.f , Der.p , and house dust, also exhibited the highest positive rates among all disease group. Preschool children had the lowest overall positive. Conclusion: Der.p and Der.f are the predominant airborne allergens, followed by house dust, animal dander, and cockroaches. Sensitization rates, number and characteristics to inhalant allergens vary across different genders, age groups, medical conditions, geographic regions, and climates. Distributional Characteristics Analysis of Aeroallergens Among Children With Allergic Respiratory Diseases in Sichuan Province,China Ling Liao 1,2 , RN, M.M. Lamei Liu 1,2 , RN, M.M. Qi Wang 1,2 , RN, M.M. Shujing Gao 1,2,* , RN. 1 Department of Pediatric Respiratory and Immunology Nursing, West China Second University Hospital, Sichuan University 2 Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China *Correspondence Shujing Gao, West China Second University Hospital, Sichuan University, 20 Section 3, Renmin Nan Lu Road, Chengdu, Sichuan 610041, China. Email: [email protected] Abstract Objective: Analysis of the prevalence and distribution patterns of aeroallergens in Children with respiratory allergic diseases in Sichuan province based on skin prick test (SPT) results. Methods: This retrospective cross-sectional study included 7,880 pediatric patients with atopic diseases in outpatient department of West China Second University Hospital between January 2023 and December 2024. All patients completed standardized SPT. Results: Among the 7,880 pediatric patients, 48.6% showed positive results on SPT, the positive rate of SPT in boys was much higher than in girls ( P < 0.01) .The top three allergens ranked by sensitization rates in (SPT) were as follows: Dermatophagoides pteronyssinus (Der.p ), Dermatophagoides farinae ( Der.f ), and house dust. Among the 3,826 patients with a positive SPT result, the majority of patients (86.5%) were sensitized to two or more allergens. Most allergens exhibited the highest positive rates in the Sichuan Basin. With increasing age, the positive rates for inhalant allergens showed an upward trend except cat dander and feathers. Across all age groups, the three most frequently detected allergens were Der.f , Der.p , and house dust, also exhibited the highest positive rates among all disease group. Preschool children had the lowest overall positive. Conclusion: Der.p and Der.f are the predominant airborne allergens, followed by house dust, animal dander, and cockroaches. Sensitization rates, number and characteristics to inhalant allergens vary across different genders, age groups, medical conditions, geographic regions, and climates. KEYWORDS Aeroallergens, Allergic Respiratory, Children, Skin Prick Test Key Message This large-scale retrospective study of 7,880 children with respiratory allergic diseases in Sichuan Province revealed that Dermatophagoides pteronyssinus and Dermatophagoides farinae were the predominant aeroallergens, followed by house dust. The majority of sensitized children exhibited multiple allergen sensitization, and the overall positive rates increased with age. These findings emphasize the regional dominance of mite sensitization and the influence of local climate and geography on pediatric allergic disease patterns. 1 INTRODUCTION Allergic diseases encompass a group of immune-mediated hypersensitivity disorders elicited upon exposure to specific allergens via contact, ingestion, or inhalation. 1 These conditions can affect multiple organ systems, with the respiratory tract, skin, and gastrointestinal tract being the most frequently involved. In addition to substantially compromising quality of life, allergic diseases impose significant economic burdens on both families and healthcare systems and, in severe instances, can be life-threatening. 2 Due to their chronic nature and high recurrence rate, they pose a substantial and escalating challenge to global public health. Respiratory allergies represent the most common form of allergic disorders, with allergic rhinitis (AR) and asthma (AS) being the two predominant manifestations, especially in pediatric populations. Epidemiological studies indicate that the global prevalence of AR in children is approaching 40%. 3 In China, the prevalence of AR among children reached 18.46% in 2021 and continues to exhibit a steady increase. 4 According to the Global Burden of Disease (GBD) database, around 97.5 million children worldwide were affected by asthma in 2021, including 9.4 million cases in China. 5 The prevalence of asthma among children in major Chinese urban areas has also risen significantly, with cumulative incidence increasing from 1.09% to 3.02% over the past three decades. Repeated nationwide surveys consistently corroborate this upward trend in childhood asthma. 6-8 Furthermore, AR and AS are closely interrelated: AR is widely recognized as a significant risk factor for the development of AS, and epidemiological data reveal substantial comorbidity between the two conditions. It is estimated that approximately 30% of patients with rhinitis eventually progress to asthma, while up to 80% of those with persistent asthma also present with rhinitis. 9 Allergens, also referred to as antigens, serve both pathogenic and triggering functions in respiratory allergic diseases. Sensitization to inhaled allergens represents a critical determinant in the development of airway disorders. 10,11 Upon re-exposure to sensitizing allergens, inflammatory mediators such as histamine are released, initiating a cascade of allergic responses that include bronchospasm and mucosal edema. 12 Extensive research has demonstrated that sensitization profiles exhibit considerable geographic, climatic, and seasonal variation, reflecting the extensive diversity of inhalant allergens. 13-15 China encompasses a vast geographical area with extensive latitudinal coverage, complex topography, and marked climatic variations across regions. However, updated data on sensitization patterns to inhalant allergens among the pediatric population in Sichuan Province remain scarce. The skin prick test (SPT), a standard diagnostic procedure for detecting specific IgE-mediated sensitization, provides a rapid and reliable method for allergen screening. 16 It is especially useful in patients with allergic rhinitis and asthma for identifying causative allergens, thus supporting the development of personalized avoidance strategies and guiding specific immunotherapy. Therefore, this study aims to investigate the prevalence and sensitization profiles of inhalant allergens among children by employing a large-scale SPT. It further seeks to analyze variations in sensitization across demographic characteristics, allergic disease subtypes, and geographical and climatic factors, thereby providing a scientific basis for the early prevention and management of pediatric respiratory allergic diseases in the region. 2 METHODS 2.1 Study Participants This retrospective cross-sectional study enrolled pediatric patients with respiratory conditions who attended the outpatient department of West China Second University Hospital between January 2023 and December 2024. The inclusion criteria were as follows: (1) diagnosis of allergic rhinitis (AR) or asthma, established according to the Chinese Guideline for Diagnosis and Treatment of Allergic Rhinitis and the Guideline for the Diagnosis and Optimal Management of Asthma in Children (2016), respectively; (2) age between 0 and 18 years, with skin prick testing performed; and (3) availability of complete medical records, including age, sex, home address, diagnosis, clinical history, and SPT results. Patients were excluded if they met any of the following criteria: (1) severe dysfunction of major organs (e.g., heart, liver, or kidneys); (2) autoimmune diseases or immunodeficiency disorders; (3) immune dysfunction resulting from prolonged use of corticosteroids or immunosuppressants; or (4) discontinuation of oral antihistamines or topical corticosteroids for less than one week prior to testing. 2.2 Data Collection Eligible cases were identified from the electronic medical record system.Relevant patient information was extracted, and a structured database was constructed following a process of dual-entry verification, collation, and integration. All data were recoded to ensure anonymity, completeness, and accuracy. Patients were categorized into three age groups: early childhood (0–6 years), school-aged (7–12 years), and adolescent (13–18 years). They were also classified by clinical diagnosis into the following groups: allergic rhinitis (AR), asthma (AS), and comorbid asthma with allergic rhinitis (AS+AR). 2.3 Skin Prick Test It was performed by a trained operator under the supervision of a respiratory physician, following a standardized protocol. The volar forearm was cleansed with 75% ethanol or normal saline and allowed to air-dry. Subsequently, a positive control (histamine), a negative control (saline), and a panel of allergen extracts were applied. A sterile lancet was held at a 90-degree angle to the skin and used to prick through each droplet with a quick, firm motion, maintaining contact for approximately one second to ensure epidermal penetration. A new, single-use lancet was employed for each allergen to prevent cross-contamination. Patients or their guardians were instructed to keep the forearm extended with the palm facing upward during a 15–20 minute observation period. The skin index (SI) was calculated as the mean wheal diameter of the allergen divided by the mean wheal diameter of the histamine positive control. Sensitization levels were graded as follows: SI = 0 (negative); Level 1 (0 < SI < 0.5, ”+”); Level 2 (0.5 ≤ SI < 1.0, ”++”); Level 3 (1.0 ≤ SI < 2.0, ”+++”); Level 4 (SI ≥ 2.0, ”++++”). A reaction of ”+++” or ”++++” was considered strongly positive. The allergen panel comprised ten common inhalant allergens: Dermatophagoides farinae ( Der.f ), Dermatophagoides pteronyssinus ( Der.p ), Cat dander, Dog hair, Cockroach, Penicillium , Japanese hop , House dust, Artemisia , and Feather. Multiple sensitization was defined as a positive skin reaction to two or more distinct allergens. 2.4 Statistics Statistical analyses were conducted using SPSS Statistics(version 27.0; IBM Corp). Categorical variables are expressed as numbers and percentages. Group comparisons for categorical data were performed using the Chi-square test, with Fisher’s exact test applied when expected cell frequencies were below 5. The Bonferroni method was employed to adjust for multiple comparisons. A two-sided p-value of < 0.05 was defined as the threshold for statistical significance. 2.5 Ethical considerations The study protocol was approved by the Ethics Committee of West China Second University Hospital, Sichuan University (Approval No. 2025-IRB-249). Due to the retrospective nature of the study and anonymization of patient data, the need for written informed consent was waived. 3 RESULTS 3.1 Participant Characteristics Between January 2023 and December 2024, a total of 7,880 patients (6.4 ± 2.9 years) were enrolled in this study. The cohort comprised 4,956 boys (62.9%, 6.5 ± 2.9 years) and 2,924 girls (37.1%, 6.2 ± 2.8 years). Based on clinical diagnosis, 5,475 patients (69.5%) were identified with allergic rhinitis (AR), 1,103 (14.0%) with asthma (AS), 723 (9.2%) with comorbid asthma and AR (AS and AR), and 579 (7.3%) with non-respiratory allergic diseases (Table 1) . Of these, 3,826 patients (48.6%) exhibited a positive skin reaction to at least one allergen, while a family history of allergic disease was reported by only 109 patients (1.4%) (Table 1) . The top three allergens with the highest proportions in both SPT sensitization rates and strong positive reactions were Der.p , Der.f , and house dust (Table 2) . 3.2 Differences of Allergic Sensitizations Among Different Groups Gender Differences: the overall SPT positivity rate was significantly higher in boys (50.2%) than in girls (45.9%, P < 0.01) (Table 1) . Boys also showed significantly higher sensitization rates to Der.p , Der.f , house dust, and Artemisia . In addition, male patients had a higher frequency of strongly positive reactions (grade “+++” or “++++”) to Der.p and Der.f compared to females. No significant gender differences were observed for the other six inhalant allergens (Table 3 and Figure 1B) . Furthermore, boys exhibited a significantly higher proportion of polysensitization to three or more allergens than girls ( P < 0.01) (Figure 2B). Age-Related Patterns: boys outnumbered girls across all three age groups (P < 0.01). And the differences in total sensitization rates with significant differences among age strata ( P < 0.01) (Table 1) . Sensitization rates to most aeroallergens increased progressively with age, except for cat dander and feather mix. The three allergens with the highest sensitization rates across age groups were Der.p (36.2%, 49.5%, and 53.0%), Der.f (36.9%, 50.0%, and 51.8%), and house dust (11.9%, 21.0%, and 22.7%). Statistically significant differences in sensitization rates were observed among age groups for these allergens (Figure 1C) . With respect to the number of sensitizing allergens, school-aged children had a significantly higher rate of polysensitization than preschool children. Moreover, the proportion of adolescents sensitized to three or more or five or more allergens was higher than that in the preschool group (Figure 2C) . Disease-Specific Profiles: male patients predominated in all three clinical disease groups, and significant differences in SPT positive rates were observed among the groups (P < 0.01) (Table 1) Significant differences in sensitization rates to eight aeroallergens were observed in the three disease groups, with the exception of Penicillium and feather mix. The three most common aeroallergens in terms of positive rates were Der.p, Der.f and house dust (Table 3) . Except for dog hair and cockroach, both the AR and AR with AS groups exhibited significantly higher rates of strongly positive reactions to the remaining six allergens compared to the AS group (P < 0.05) (Figure 1D) . When comparing the number of allergens to which children were sensitized, significant differences (P < 0.05) were observed in both mono- and polysensitization rates among the disease groups. Consistent with the overall sensitization and strongly positive reaction patterns, children with AR or AR with AS comprised a higher proportion of all sensitized cases than those with AS alone (Figure 2D) . 3.3 Geographical and Climatic Characteristics A total of 7,880 pediatric patients were classified into three groups based on their residential region: the Sichuan Basin, the southern Sichuan mountainous area, and the northern Sichuan plateau. No significant differences in sex distribution were found. The overall sensitization rate was significantly higher in the Sichuan Basin, which is predominantly plains, compared to the other two regions (Table 1) . While sensitization rates to Penicillium and feather mix did not differ significantly, statistically significant differences ( P < 0.05) were observed for the other eight aeroallergens across the three geographical regions. Expect for Japanese hop and Artemisia , which showed the highest sensitization rates in the northwestern Sichuan plateau, others exhibited the highest positive rates in the Sichuan Basin (Table 3) . Based on the visit dates from January 2023 to December 2024, participants were categorized into four seasonal groups: spring (March–May), summer (June–August), autumn (September–November), and winter (December–February). No significant differences in sex distribution were observed. However, significant seasonal variations were detected in the positive rates for inhalant allergens (Table 1) . Notably, the pattern of seasonal differences in allergen sensitization closely resembled that observed across geographical regions: no significant seasonal variations were found for Penicillium or feather mix, whereas the remaining eight allergens showed statistically significant ( P < 0.05) differences in sensitization rates across seasons. The positive rates for Der.f , Der.p , and house dust were highest in summer, followed by autumn, and lowest in spring and winter. In contrast, sensitization rates to dog hair, cat dander, and Japanese hop peaked in spring, were moderately high in winter, and lowest in summer and autumn (Table 3) . 4 DISCUSSION Globally recognized as a priority public health issue,allergic diseases are garnering increasing attention due to their high prevalence, recurrent nature, challenges in treatment, and often suboptimal clinical outcomes. Pediatric allergic disorders—primarily allergic rhinitis, asthma, eczema, and food allergies—have emerged as leading chronic conditions affecting children. Early identification and timely intervention are essential to mitigate their physical and psychological effects, and ensure healthy growth and development during childhood. 17-19 The onset of allergic symptoms and the rate of allergen sensitization are closely associated with allergen exposure. 20 Variations in lifestyle and environmental conditions contribute to distinct regional patterns of allergen distribution. To characterize the profile of respiratory allergens among children in Sichuan Province, we retrospectively analyzed SPT results from 7,880 pediatric patients. Based on overall SPT positivity rates, the most common sensitizing allergens in this population were Der.p and Der.f. This pattern is consistent with reports from other Asian countries, including Thailand, Malaysia, and Indonesia 21-24 as well as with studies conducted in multiple Chinese regions such as Beijing, Guangdong, Chongqing, and Hunan. 25-30 Dust mites, as thermophilic and hygrophilic organisms, thrive in domestic environments such as bedding, sofas, carpets, and plush toys. Their growth and reproduction are favored by ambient temperatures between 32–36°C and relative humidity above 50%. Sichuan Province (97°21′–108°12′ E, 26°03′–34°19′ N), covers 486,000 km² with a population exceeding 84 million and an urbanization rate of 58.4%, exhibits a climate characterized by high precipitation, frequent rainfall, limited annual sunshine (only 1,000–1,600 hours). Its basin-enclosed topography further restricts moisture dispersion, resulting in a consistently high relative humidity of 60%–80% throughout the year. These conditions create an nearly ideal environment for dust mite survival and proliferation. The proportion of strongly positive SPT reactions was 58.5%, with reactions to Der.p , Der.f , and house dust collectively accounting for 52.5% of these. This suggests heightened sensitivity to dust mite allergens among the studied population, likely attributable to the persistently humid and enclosed climate of the Sichuan Basin, consistent with observations in other high-humidity regions such as Fujian and the Greater Minnan area. 31,32 Furthermore, 86.5% of sensitized patients exhibited reactivity to multiple allergens individuals are sensitized to two or more allergens. 30,33 Aeroallergens demonstrate distinct spatial, and a finding consistent with previous studies indicating that most allergic seasonal distributions shaped by climatic and topographical factors. In this study, the detection rate of house dust mites peaked during summer, aligning with Sichuan’s hot and humid climatic conditions. In contrast, sensitization rates to pet allergens were highest in spring, likely associated with seasonal molting patterns. During spring and winter, increased shedding elevates the environmental load of dander, salivary proteins, and sebaceous secretions, thereby raising allergen levels compared to summer and autumn. Sichuan Province spans a vast and topographically diverse region, characterized by a general west-high, east-low relief, making it one of China’s most geographically complex areas. It can be broadly divided into three regions: the Sichuan Basin, the Southern Sichuan Mountains, and the Northwestern Sichuan Plateau. Sensitization rates to Der.p, Der.f , house dust, and pet dander were highest in the basin region. The eastern Sichuan Basin is the most densely populated and economically developed part of the province. Its subtropical monsoon humid climate and favorable living conditions provide an ideal environment for dust mite proliferation, while higher rates of pet ownership further contribute to allergen accumulation. In contrast, high sensitization rates to Japanese hop and Artemisia were observed in the Western Sichuan Plateau. This high-altitude alpine region experiences a cold climate with significant temperature variations. River valleys are relatively dry and warm, while the plateau remains cold and humid. Artemisia species are commonly distributed across alpine meadows and slopes, whereas Japanese hop thrives in moist riparian zones and valley wetlands. The widespread growth of these plants, combined with abundant wind resources that facilitate pollen dispersal, explains the higher pollen-related sensitization rates in this region compared to the other two areas. Our study also investigated the influence of gender, age, and clinical diagnosis on sensitization patterns. With respect to gender, boys exhibited significantly higher SPT positive rates than girls across study groups. Strongly positive reactions to both dust mite species and house dust, as well as polysensitization, were significantly more frequent in boys, suggesting a heightened susceptibility to inhalant allergens in girls. While this finding contrasts with studies reporting a greater predisposition to allergic diseases in females, 34,35 it aligns with previous reports from Zhejiang, Changzhou, and Henan in China. 28,30,36 .Furthermore, a survey conducted over a decade ago also documented gender differences in allergen sensitization, with stronger IgE-mediated sensitization observed in males. 37 The influence of sex hormones on immune maturation and allergic responses may partly explain these disparities, as clinical manifestations tend to become more pronounced in boys after adolescence. 38-40 Further research is warranted to clarify the mechanistic basis of gender-specific sensitization patterns in respiratory allergic diseases. Age-stratified analysis revealed that sensitization rates to most inhalant allergens increased with age, a trend consistent with previous reports. 41,42 Preschool children exhibited the lowest overall SPT positive, though dust mites remained the predominant allergen across all age groups. Adolescents and school-aged children showed higher sensitization rates to pet dander and outdoor pollen compared to preschoolers. Several factors may explain these patterns. Infants and toddlers (aged 0–3 years), who accounted for 16.1% of the preschool cohort, are often initially sensitized to food allergens due to immature immune and digestive systems. 43 Additionally, their still-developing immune responses may function at a relatively lower capacity. From a childcare perspective, many parents limit close contact between young children and household pets to reduce infection risks, and restricted outdoor activity further decreases exposure to environmental allergens such as pollen. We also observed that mono-sensitization was most common in preschool children, whereas polysensitization (≥5 allergens) peaked during adolescence. Clinical evidence suggests that some children who are mono-sensitized in early life may progress to multiple sensitization as they grow older, 30 a process potentially linked to the maturation of immune tolerance mechanisms. These findings underscore the importance of age-specific strategies for the prevention and management of allergic diseases in children. Allergen sensitization plays a critical role in the initiation and progression of allergic diseases. In this study, the overall rate of allergen sensitization was significantly higher in patients with AR and those with comorbid AR and asthma than in patients with AS alone. This trend was particularly pronounced in the AR-only group and is consistent with findings reported from Chongqing, another major metropolitan area in southwestern China. 27 An anatomical and functional explanation may underlie this pattern: as the first point of contact with inhaled air, the nasal mucosa is directly and repeatedly exposed to aeroallergens—unlike the lower airways, which are better protected. 44 By contrast, studies from northern China, suggest that the pathophysiology of comorbid asthma and rhinitis may involve distinct or amplified mechanisms compared to either condition alone. 29,30 These regional differences may be influenced by northern China’s drier, colder climate and higher concentrations of outdoor pollen, which can aggravate mucosal irritation and airway hyperresponsiveness. Further large-scale clinical studies are needed to clarify these geographic variations. Notably, multiple allergen sensitization was significantly more common in AR than in AS alone. In line with the “one airway, one disease” concept, patients with AR have nearly a fourfold increased risk of developing asthma compared to non-AR individuals. 9,45 Previous studies have further confirmed that AR substantially elevates the risk of asthma, particularly in children with polysensitization. 46,47 Therefore, controlling AR progression and alleviating its symptoms are essential for asthma prevention. These findings also highlight the inadequacy of monotherapy for such patients and underscore the need for combined, sensitization profile-guided specific immunotherapy. 5 CONCLUSION This study provides a comprehensive analysis of the distribution and variation of aeroallergens among children with respiratory allergic diseases in Sichuan Province, across multiple variables including gender, age, disease type, geographical environment, and seasonal variation. The results identified house dust mites ( Dermatophagoides farinae and Dermatophagoides pteronyssinus ) as the predominant inhalant allergens, while house dust, pet dander, and cockroach also demonstrated notable sensitization rates. In contrast, pollen-related sensitization was largely restricted to the western Sichuan plateau. Both the prevalence of sensitization and the frequency of polysensitization increased with age. Compared to other respiratory allergic conditions, children with allergic rhinitis (AR) exhibited the highest SPT positive rate and the most pronounced gender disparities. It is noteworthy that Penicillium and feather mix did not emerge as prominent sensitizers across any demographic or clinical categories. This raises questions regarding their inclusion in routine inhalant allergen SPT panels for the pediatric population in Sichuan, an issue that merits evaluation in future investigations.Based on the present findings, the local pediatric allergen spectrum can be more clearly defined, providing a basis for precise clinical diagnosis, personalized immunotherapy, and targeted regional public health interventions. This study has several limitations. First, its single-center, retrospective design may affect the generalizability of the findings. However, as a nationally designated children’s medical center, the study site provided a large sample covering all pediatric age groups, which strengthens its regional representativeness. Second, the inclusion of only ten allergens may limit the comprehensiveness of the sensitization profile described. Finally, the study did not examine the relationship between sensitization characteristics and clinical disease severity, nor did it perform a detailed correlation between SPT wheal sizes and serum-specific immunoglobulin E (sIgE) levels. Future studies should therefore incorporate broader allergen panels and integrate clinical severity metrics with in vitro immunological measures to better characterize the sensitization-disease relationship. AUTHOR CONTRIBUTIONS Ling Liao: Conceptualization; methodology; data curation; formal analysis; writing – original draft; writing – review and editing Lamei Liu: Data curation; writing – review and editing. Qi Wang: Data curation; writing – review and editing. Shujing Gao: Conceptualization; supervision; methodology; writing – review and editing. ACKNOWLEDGEMENTS None. FUNDING INFORMATION This study received no external funding. CONFLICT OF INTEREST STATEMENT All authors declare that there are no conflicts of interest. REFERENCES 1. 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Table 1 Characteristics of participants Variable Number (n = 7,880) Percentage ( % ) SPT positive n (%) X 2 P Gender 13.9 ＜ 0.01 # Male 4956 62.9 2488 (50.2) Female 2924 37.1 1341 (45.9) Age(years) 143.952 ＜ 0.01 # 0–6 4495 57.0 1921 (42.7) 7–12 3134 39.8 1762 (56.2) 13–18 251 3.2 146 (58.2) Disease 1407.739 ＜ 0.01 # Allergic rhinitis 5475 69.5 3526 (64.4) Asthma 1103 14.0 54 (4.9) Asthma with allergic rhinitis 723 9.2 249 (34.4) Non-respiratory allergy 579 7.3 Region 303.293 ＜ 0.01 # Sichuan Basin 7310 92.8 3752 (51.3) Mountainous regions of southern Sichuan 386 4.9 48 (12.4) Plateau areas of northern Sichuan 184 2.3 29 (15.8) Season 26.334 ＜ 0.01 # Spring 1662 21.1 779 (46.9) Summer 2852 36.2 1470 (51.5) Autumn 2081 26.4 1023 (49.2) Winter 1285 16.3 557 (43.3) Family history of allergies (n = 3,826 patients) Positive 109 2.9 Negative 3717 97.1 Table 2 Positive rates and distribution of various allergens in skin prick test in patients. Allergen Types Skin Prick Test Positive Number Strong Positve Number ­ + ++ +++ ++++ N % N % Der.p 4524 247 1034 1591 484 3356 42.6 2075 26.3 Der.f 4569 363 1085 1476 387 3311 42.0 1863 23.6 House dust 6627 404 648 189 12 1253 15.9 201 2.6 Cat dander 7392 162 238 80 8 488 6.2 88 1.1 Dog hair 7413 154 217 91 5 467 5.9 96 1.2 Cockroach 7460 159 214 44 3 420 5.3 47 0.6 Japanese hop 7486 101 137 100 56 394 5.0 156 2.0 Artemisia 7676 62 78 51 13 204 2.6 64 0.8 Penicillium 7802 35 31 10 2 78 1.0 12 0.2 Feather 7833 16 26 5 0 47 0.6 5 0.1 Der.p, Dermatophagoides pteronyssinus, Der.f, Dermatophagoides farinae Table 3 Comparison of sensitized allergens between different groups. Parameters Der.f Der.p House dust Cat dander Dog hair Cockroach Japanese hop Artemisia Penicillium Feather Gender male 2136 (43.1) 2182 (44.0) 823 (16.6) 326 (6.6) 298 (6.0) 272 (5.5) 263 (5.3) 142 (2.9) 53 (1.1) 26 (0.5) famale 1175 (40.2) 1174 (40.2) 430 (14.7) 162 (5.5) 169 (5.8) 148 (5.1) 131 (4.5) 62 (2.1) 25 (0.9) 21 (0.7) P 0.011 * 0.001 # 0.026 * 0.065 0.672 0.415 0.104 0.044 * 0.353 0.281 Diseases AR 3074 (56.1) 3089 (56.4) 1156 (21.1) 439 (8.0) 415 (7.6) 388 (7.1) 348 (6.4) 180 (3.3) 65 (1.2) 42 (0.8) AS 38(3.4) 48(4.4) 16(1.5) 12(1.1) 12(1.1) 6(0.5) 4(0.4) 3(0.3) 5(0.5) 2(0.2) AR+AS 199 (27.5) 219 (30.3) 81 (11.2) 37 (5.1) 40 (5.5) 26 (3.6) 42 (5.8) 21 (2.9) 8 (1.1) 3 (0.4) P ＜0.01 # ＜0.01 # ＜0.01 # ＜0.01 # ＜0.01 # ＜0.01 # ＜0.01 # ＜0.01 # 0.096 0.061 Geographic regions. Basin 3259 (44.6) 3304 (45.2) 1236 (16.9) 475 (6.5) 459 (6.3) 412 (5.6) 374 (5.1) 185 (2.5) 76 (1.0) 46 (0.6) Mountain 35(9.1) 36(9.3) 14(3.6) 6(1.6) 5(1.3) 6(1.6) 8(2.1) 8(2.1) 2(0.5) 0(0.0) Plateau 17(9.2) 16(8.7) 3(1.6) 7(3.8) 3(1.6) 2(1.1) 12(6.5) 11(6.0) 0(0.0) 1(0.5) P ＜0.01 # ＜0.01 # ＜0.01 # ＜0.01 # ＜0.01 # ＜0.01 # 0.018 * 0.012 * 0.329 0.275 Seasons Spring 629 (37.8) 656 (39.5) 89 (5.4) 154 (9.3) 134 (8.1) 48 (2.9) 128 (7.7) 55 (3.3) 10 (0.6) 9 (0.5) Summer 1302 (45.7) 1335 (46.8) 799 (28.0) 150 (5.3) 155 (5.4) 58 (2.0) 109 (3.8) 43 (1.5) 33 (1.2) 14 (0.5) Autumn 893 (42.9) 894 (43.0) 310 (14.9) 89 (4.3) 82 (3.9) 268 (12.9) 84 (4.0) 61 (2.9) 26 (1.2) 17 (0.8) Winter 487 (37.9) 471 (36.7) 55 (4.3) 95 (7.4) 96 (7.5) 46 (3.6) 73 (5.7) 45 (3.5) 9 (0.7) 7 (0.5) P ＜0.01 # ＜0.01 # ＜0.01 # ＜0.01 # ＜0.01 # ＜0.01 # 0.018 * 0.012 * 0.117 0.497 Der.p, Dermatophagoides pteronyssinus, Der.f, Dermatophagoides farinae Data are presented as number (percentage). * P < 0.05. # P < 0.01. Figure 1 Allergic sensitizations in patients. (A) Prevalence of different kinds of allergens. (B) Comparison of strongly positive rates for allergens in different gender groups. (C) Comparison of prevalence for allergens in different age groups.* P < 0.05. # P < 0.01. a: Compared between 0–6 years group and 7–12 years group. b: Compared between 7–12 years group and 13–18 years group. c: Compared between 0–6 years group and 13–18 years group. (D) Comparison of strongly positive rates for allergens in different disease groups. * P < 0.05. # P < 0.01. a: Compared between AR group and asthma group. b: Compared between asthma group and AR combined with asthma group. c: Compared between AR group and AR combined with asthma group. Der.p, Dermatophagoides pteronyssinus, Der.f, Dermatophagoides farinae Figure 2 Sensitization to different number of positive allergens in different groups. (A) The number of people in different number of positive allergens in all person (B) The number of positive allergens in different genders.* P < 0.05. (C) The number of positive allergens in different ages.* P < 0.05. # P < 0.01. a: Compared between 0–6 years group and 7–12 years group. b: Compared between 7–12 years group and 13–18 years group. c: Compared between 0–6 years group and 13–18 years group. (C) The number of positive allergens in different diseases.* P < 0.05. # P < 0.01. a: Compared between AR group and asthma group. b: Compared between asthma group and AR combined with asthma group. c: Compared between AR group and AR combined with asthma group. Information & Authors Information Version history V1 Version 1 30 October 2025 Peer review timeline Published Frontiers in Pediatrics Version of Record 18 May 2026 Published Copyright This work is licensed under a Non Exclusive No Reuse License. Authors Affiliations Ling Liao 0009-0003-1039-914X West China Second University Hospital Sichuan University View all articles by this author Lamei Liu West China Second University Hospital Sichuan University View all articles by this author Qi Wang 0000-0001-9252-9013 West China Second University Hospital Sichuan University View all articles by this author Shujing Gao [email protected] West China Second University Hospital Sichuan University View all articles by this author Metrics & Citations Metrics Article Usage 233 views 119 downloads .FvxKWukQNSOunydq8rnd { width: 100px; } Citations Download citation Ling Liao, Lamei Liu, Qi Wang, et al. Distributional Characteristics Analysis of Aeroallergens Among Children With Allergic Respiratory Diseases in Sichuan Province,China. Authorea . 30 October 2025. DOI: https://doi.org/10.22541/au.176180772.20813967/v1 If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. 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