Article

Association of pediatric asthma severity with exposure to common household dust allergens

Yale Center for Perinatal, Pediatric and Environmental Epidemiology, Department of Epidemiology and Public Health, Yale University School of Medicine, One Church Street, 6th Floor, New Haven, CT 06510, USA.
Environmental Research (Impact Factor: 4.37). 06/2009; 109(6):768-74. DOI: 10.1016/j.envres.2009.04.010
Source: PubMed

ABSTRACT

Reducing exposure to household dust inhalant allergens has been proposed as one strategy to reduce asthma.
To examine the dose-response relationships and health impact of five common household dust allergens on disease severity, quantified using both symptom frequency and medication use, in atopic and non-atopic asthmatic children.
Asthmatic children (N=300) aged 4-12 years were followed for 1 year. Household dust samples from two indoor locations were analyzed for allergens including dust mite (Der p 1, Der f 1), cat (Fel d 1), dog (Can f 1), cockroach (Bla g 1). Daily symptoms and medication use were collected in monthly telephone interviews. Annual disease severity was examined in models including allergens, specific IgE sensitivity and adjusted for age, gender, atopy, ethnicity, and mother's education.
Der p 1 house dust mite allergen concentration of 2.0 microg/g or more from the main room and the child's bed was related to increased asthma severity independent of allergic status (respectively, OR 2.93, 95% CI 1.37, 6.30 for 2.0-10.0 microg/g and OR 2.55 95% CI 1.13, 5.73 for 10.0 microg/g). Higher pet allergen levels were associated with greater asthma severity, but only for those sensitized (cat OR 2.41 95% CI 1.19, 4.89; dog OR 2.06 95% CI 1.01, 4.22).
Higher levels of Der p 1 and pet allergens were associated with asthma severity, but Der p 1 remained an independent risk factor after accounting for pet allergens and regardless of Der p 1 specific IgE status.

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    • "Moreover, HDM sensitization is a major risk factor for asthma (Platts-Mills et al. 2011; Shek et al. 2010; Trakultivakorn et al. 2002). IgE responses to allergens from HDMs can significantly contribute to the total serum IgE which influences asthma pathogenesis and severity (Erwin et al. 2007; Gent et al. 2009]. Increased eosinophils in peripheral blood and airway secretion are vital features of asthma, and its severity. "

    Full-text · Article · Dec 2013
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    • "Moreover, HDM sensitization is a major risk factor for asthma (Platts-Mills et al. 2011; Shek et al. 2010; Trakultivakorn et al. 2002). IgE responses to allergens from HDMs can significantly contribute to the total serum IgE which influences asthma pathogenesis and severity (Erwin et al. 2007; Gent et al. 2009]. Increased eosinophils in peripheral blood and airway secretion are vital features of asthma, and its severity. "

    Full-text · Article · Dec 2013
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    • "We collected house dust for HDM allergen analysis at only one point of time in various seasons. However, previous studies have reported that Der p 1 and Der f 1 concentrations in children's mattress dust are highly stable, indicating that a single measurement of HDM levels in house dust could be a good indication of exposure to HDM during a 1-yr period (29, 30). We also tried to overcome this limitation by evaluating the severity on the same day of the dust collection, not on the day of subject enrollment. "
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    ABSTRACT: We attempted to investigate the correlation between the severity of atopic dermatitis (AD) in children and the indoor level of house dust mite (HDM) allergens. Ninety-five patients (31.1 ± 19.5 months of age) with AD were enrolled in this study, and serum specific IgE against Dermatophagoides pteronyssinus and D. farinae was measured. The severity of AD was assessed using the visual analogue scale on the same day of house dust collection. Living rooms and mattresses where the child usually slept were vacuumed for 2 minutes and concentrations of Der f 1 were measured by enzyme-linked immunosorbent assay. The skin symptoms were more severe in patients with Der f 1 concentrations in living room > 2 µg/g dust than ≤ 2 µg/g dust (P = 0.018). This difference was noted in AD patients without sensitization to HDM (P = 0.004), but not in patients with sensitization. There was no difference in symptom severity according to Der f 1 concentrations in mattresses (P = 0.062). The severity of skin symptoms is associated with indoor concentrations of HDM in children with AD, and it is likely to act as nonspecific irritants as well as allergens in AD skin lesions.
    Full-text · Article · Jan 2013 · Journal of Korean medical science
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