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Häufigkeit von Sensibilisierungen und Allergien durch Hausstaubmilben. ALLERGO JOURNAL 2022. [DOI: 10.1007/s15007-022-5636-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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2
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Balkissou AD, Poka-Mayap V, Massongo M, Djenabou A, Endale-Mangamba LM, Olomo EJ, Boulleys-Nana JR, Diffo-Sonkoue L, Adidigue-Ndiome R, Alexandra AJE, Haman-Wabi AB, Adama S, Iddi-Faical A, Pefura-Yone EW. Prevalence and determinants of current asthma in Cameroon. Respir Med Res 2020; 78:100783. [PMID: 32841816 DOI: 10.1016/j.resmer.2020.100783] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 07/25/2020] [Accepted: 07/25/2020] [Indexed: 12/19/2022]
Abstract
INTRODUCTION The prevalence of asthma varies from one country to another due to differences in ethnicity, socio-economics status, environmental and climatic risk factors. The aim of this study was to determine the prevalence and determinants of current asthma in Cameroonian adults. MATERIAL AND METHODS Data from 4 cross-sectional community-based studies from 2014 to 2018 were analyzed. Participants aged 19 years and above were selected through multilevel stratified random sampling methods across 2 urban areas, 2 semi-urban areas and 1 rural area. Current asthma was defined as "wheezing in the last 12 months in a subject with self-reported asthma or having used drugs for asthma treatment". Logistic regression was used to investigate the determinants of current asthma. RESULTS A total of 10,707 adults [median age (interquartile range)=36 (26-52) years, 44.5% of men] were definitively enrolled in the study. The overall prevalence [95% confidence interval (CI)] of current asthma was 3.9% (3.5-4.3)%. Determinants [odd's ratio (OR), (95%CI)] of current asthma were: Sudanese ethnicity [1.9(1.4-2.7)], rural area [1.5(1.1-2.1)], urban area [1.6(1.2-2.2)], past history of pneumonia [1.9(1.1-3.4)], allergic rhino-conjunctivitis [6.5(4.7-8.9)], atopic eczema [2.3(1.5-3.6)], body mass index (BMI)≥40kg/m2 [1.9(1.0-3.4)] and BMI<18kg/m2 [1.8(1.2-2.9)]. CONCLUSION The prevalence of current asthma is close to the low value of the Sub-Saharan African range. Sudanese ethnicity, rural area, urban area, history of pneumonia, allergic disease, severe obesity and underweight were determinants of current asthma in Cameroon. More research is surely warranted to understand the mechanisms underlying the association of asthma with Sudanese ethnicity.
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Affiliation(s)
- A D Balkissou
- Faculty of Medicine and Biomedical Sciences of Garoua, University of Ngaoundéré, Garoua, Cameroon; Hôpital Jamot de Yaounde, Yaoundé, Cameroon.
| | | | - M Massongo
- Hôpital Jamot de Yaounde, Yaoundé, Cameroon; Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - A Djenabou
- Hôpital Jamot de Yaounde, Yaoundé, Cameroon
| | - L-M Endale-Mangamba
- Hôpital Laquintinie de Douala, Douala, Cameroon; Faculty of Medicine and Pharmaceutical Sciences of Douala, Douala, Cameroon
| | - E J Olomo
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | | | - L Diffo-Sonkoue
- Institut Supérieur de Technologie Médicale, Yaoundé, Cameroon
| | | | - A J E Alexandra
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - A B Haman-Wabi
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - S Adama
- Institut Supérieur de Technologie Médicale, Yaoundé, Cameroon
| | - A Iddi-Faical
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - E W Pefura-Yone
- Hôpital Jamot de Yaounde, Yaoundé, Cameroon; Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
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Spann K, Snape N, Baturcam E, Fantino E. The Impact of Early-Life Exposure to Air-borne Environmental Insults on the Function of the Airway Epithelium in Asthma. Ann Glob Health 2018; 82:28-40. [PMID: 27325066 DOI: 10.1016/j.aogh.2016.01.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
The airway epithelium is both a physical barrier protecting the airways from environmental insults and a significant component of the innate immune response. There is growing evidence that exposure of the airway epithelium to environmental insults in early life may lead to permanent changes in structure and function that underlie the development of asthma. Here we review the current published evidence concerning the link between asthma and epithelial damage within the airways and identify gaps in knowledge for future studies.
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Affiliation(s)
- Kirsten Spann
- School of Biomedical Sciences, Queensland University of Technology, Queensland, Australia.
| | - Natale Snape
- Children's Health Research Centre, University of Queensland, Queensland, Australia
| | - Engin Baturcam
- Children's Health Research Centre, University of Queensland, Queensland, Australia
| | - Emmanuelle Fantino
- Children's Health Research Centre, University of Queensland, Queensland, Australia
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Lowe AJ, Angelica B, Su J, Lodge CJ, Hill DJ, Erbas B, Bennett CM, Gurrin LC, Axelrad C, Abramson MJ, Allen KJ, Dharmage SC. Age at onset and persistence of eczema are related to subsequent risk of asthma and hay fever from birth to 18 years of age. Pediatr Allergy Immunol 2017; 28:384-390. [PMID: 28301056 DOI: 10.1111/pai.12714] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/13/2017] [Indexed: 02/05/2023]
Abstract
BACKGROUND Few studies have simultaneously addressed the importance of age of onset and persistence of eczema for the subsequent development of asthma and hay fever, particularly into early adulthood. METHODS A high-risk birth cohort was recruited comprising 620 infants, who were then followed up frequently until 2 years of age, annually from age 3 to 7, then at 12 and 18 years, to document any episodes of eczema, current asthma, and hay fever. The generalized estimation equation technique was used to examine asthma and hay fever outcomes at 6 (n = 325), 12 (n = 248) and 18 (n = 240) years, when there was consistency of associations across the follow-ups. RESULTS Very early-onset persistent (onset <6 months, still present from 2 to 5 years) eczema was related to current asthma (adjusted OR = 3.2 [95% CI = 1.7-6.1]), as was very early-onset remitting eczema (onset <6 months but not present from 2-5 years, OR = 2.7, 95% CI = 1.0-7.2) and early-onset persistent eczema (onset from 6-24 months, OR = 2.3, 95% CI = 1.2-4.7). Late-onset eczema (commenced from 2-5 years) was associated with increased risk of asthma at 12 years (OR = 3.0, 95% CI=1.1-8.2) but not at age 6 years. Only very early-onset persistent eczema was associated with increased risk of hay fever (aOR = 2.4, 95% CI = 1.4-4.1). CONCLUSION AND CLINICAL RELEVANCE Eczema which commences in early infancy and persists into toddler years is strongly associated with asthma, and to a lesser extent hay fever, in high-risk children. If these associations are causal, prevention of early-life eczema might reduce the risk of respiratory allergy.
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Affiliation(s)
- Adrian J Lowe
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Vic., Australia.,Murdoch Childrens Research Institute, Melbourne, Vic., Australia
| | - Bianca Angelica
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Vic., Australia
| | - John Su
- Murdoch Childrens Research Institute, Melbourne, Vic., Australia.,Monash University, Eastern Health, Melbourne, Vic., Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Vic., Australia
| | - Caroline J Lodge
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Vic., Australia.,Murdoch Childrens Research Institute, Melbourne, Vic., Australia
| | - David J Hill
- Murdoch Childrens Research Institute, Melbourne, Vic., Australia
| | - Bircan Erbas
- School of Psychology and Public Health, La Trobe University, Melbourne, Vic., Australia
| | - Catherine M Bennett
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Vic., Australia.,Centre for Population Health Research, Deakin University, Melbourne, Vic., Australia
| | - Lyle C Gurrin
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Vic., Australia
| | | | - Michael J Abramson
- Department of Epidemiology & Preventive Medicine, Monash University, Melbourne, Vic., Australia
| | - Katrina J Allen
- Murdoch Childrens Research Institute, Melbourne, Vic., Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Vic., Australia
| | - Shyamali C Dharmage
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Vic., Australia.,Murdoch Childrens Research Institute, Melbourne, Vic., Australia
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Alduraywish SA, Standl M, Lodge CJ, Abramson MJ, Allen KJ, Erbas B, von Berg A, Heinrich J, Lowe AJ, Dharmage SC. Is there a march from early food sensitization to later childhood allergic airway disease? Results from two prospective birth cohort studies. Pediatr Allergy Immunol 2017; 28:30-37. [PMID: 27590890 DOI: 10.1111/pai.12651] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/01/2016] [Indexed: 01/22/2023]
Abstract
BACKGROUND The march from early aeroallergen sensitization to subsequent respiratory allergy is well established, but it is unclear whether early life food sensitization precedes and further increases risk of allergic airway disease. OBJECTIVE To assess the association between food sensitization in the first 2 years of life and subsequent asthma and allergic rhinitis by age 10-12 years. METHODS We used data from two independent cohorts: the high-risk Melbourne Atopic Cohort Study (MACS) (n = 620) and the population-based LISAplus (n = 3094). Food sensitization was assessed at 6, 12, and 24 months in MACS and 24 months in LISAplus. Multiple logistic regressions were used to estimate associations between sensitization to food only, aeroallergen only, or both and allergic airway disease. RESULTS When compared to non-sensitized children, sensitization to food only at 12 months in MACS and 24 months in LISAplus was associated with increased risk of current asthma (aOR = 2.2; 95% CI 1.1, 4.6 in MACS and aOR = 4.9; 2.4, 10.1 in LISAplus). Similar results were seen for allergic rhinitis. Additionally, cosensitization to food and aeroallergen in both cohorts at any tested point was a stronger predictor of asthma (at 24 months, aOR = 8.3; 3.7, 18.8 in MACS and aOR = 14.4; 5.0, 41.6 in LISAplus) and allergic rhinitis (at 24 months, aOR = 3.9; 1.9, 8.1 in MACS and aOR = 7.6; 3.0, 19.6 in LISAplus). CONCLUSIONS In both cohorts, food sensitization (with or without aeroallergen sensitization) in the first two years of life increased the risk of subsequent asthma and allergic rhinitis. These findings support the role of early life food sensitization in the atopic march and suggest trials to prevent early onset have the potential to reduce the development of allergic airways disease.
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Affiliation(s)
- Shatha A Alduraywish
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Vic., Australia.,Department of Family and Community Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Marie Standl
- Institute of Epidemiology I, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - Caroline J Lodge
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Vic., Australia
| | - Michael J Abramson
- School of Public Health & Preventive Medicine, Monash University, Melbourne, Vic., Australia
| | - Katrina J Allen
- Murdoch Children's Research Institute, Department of Paediatrics, University of Melbourne, Royal Childrens' Hospital, Melbourne, Vic., Australia
| | - Bircan Erbas
- School of Psychology and Public Health, La Trobe University, Melbourne, Vic., Australia
| | - Andrea von Berg
- Marien-Hospital Wesel, Department of Pediatrics, Research Institute, Wesel, Germany
| | - Joachim Heinrich
- Institute of Epidemiology I, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany.,Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine Unit, Paediatric Environmental Epidemiology, WHO Collaboration Centre for Occupational Health, University Hospital Munich, Munich, Germany
| | - Adrian J Lowe
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Vic., Australia.,Murdoch Children's Research Institute, Department of Paediatrics, University of Melbourne, Royal Childrens' Hospital, Melbourne, Vic., Australia
| | - Shyamali C Dharmage
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Vic., Australia.,Murdoch Children's Research Institute, Department of Paediatrics, University of Melbourne, Royal Childrens' Hospital, Melbourne, Vic., Australia
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Nishikawa K, Fujimura T, Ota Y, Abe T, ElRamlawy KG, Nakano M, Takado T, Uenishi A, Kawazoe H, Sekoguchi Y, Tanaka A, Ono K, Kawamoto S. Exposure to positively- and negatively-charged plasma cluster ions impairs IgE-binding capacity of indoor cat and fungal allergens. World Allergy Organ J 2016; 9:27. [PMID: 27660668 PMCID: PMC5011831 DOI: 10.1186/s40413-016-0118-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 08/03/2016] [Indexed: 11/12/2022] Open
Abstract
Background Environmental control to reduce the amount of allergens in a living place is thought to be important to avoid sensitization to airborne allergens. However, efficacy of environmental control on inactivation of airborne allergens is not fully investigated. We have previously reported that positively- and negatively-charged plasma cluster ions (PC-ions) reduce the IgE-binding capacity of crude allergens from Japanese cedar pollen as important seasonal airborne allergens. Cat (Felis domesticus) and fungus (Aspergillus fumigatus) are also important sources of common airborne allergens in living spaces throughout the year, and early sensitization with those allergens is considered to be a risk factor for future development of allergic rhinitis, pollinosis and asthma. The aim of this study is to examine whether the PC-ions reduce the IgE-binding capacity of a cat major allergen (Fel d 1) and fungal allergens in an experimental condition. Methods Fel d 1, crude fungal extract, or a fungal major allergen Asp f 1, was treated with PC-ions for 6 h in an experimental cylindrical apparatus. Sham-treated allergens were prepared in the same experimental apparatus without generation of PC-ions. The degradation of the PC-ions-treated Fel d 1 was analyzed by SDS-PAGE, and the IgE-binding capacity of the PC-ions-treated allergens was analyzed by ELISA inhibition assay. Results Exposure of Fel d 1, crude fungal extract and Asp f 1 to PC-ions significantly decreased protein content of Fel d 1 or Asp f 1, respectively. SDS-PAGE analysis suggested that the decreased Fel d 1 content upon exposure with PC-ions was attributable to protein degradation. ELISA inhibition indicated that the PC-ions treatment significantly impaired IgE-binding capacities of Fel d 1, crude fungal allergens, and Asp f 1 compared to sham treatment. Discussion Our data suggest that treatment with PC-ions not only reduce indoor cat and fungal allergens, but also impair their allergenicity. Conclusion These results suggest that environmental control with PC-ions is useful for inactivation of indoor cat and fungal allergens.
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Affiliation(s)
- Kazuo Nishikawa
- Hiroshima Research Center for Healthy Aging (HiHA), Department of Molecular Biotechnology, Graduate School of Advanced Sciences of Matter, Hiroshima University, 1-3-1 Kagamiyama, Higashi-Hiroshima, Hiroshima 730-8530 Japan
| | - Takashi Fujimura
- Hiroshima Research Center for Healthy Aging (HiHA), Department of Molecular Biotechnology, Graduate School of Advanced Sciences of Matter, Hiroshima University, 1-3-1 Kagamiyama, Higashi-Hiroshima, Hiroshima 730-8530 Japan
| | - Yasuhiro Ota
- Hiroshima Research Center for Healthy Aging (HiHA), Department of Molecular Biotechnology, Graduate School of Advanced Sciences of Matter, Hiroshima University, 1-3-1 Kagamiyama, Higashi-Hiroshima, Hiroshima 730-8530 Japan
| | - Takuya Abe
- Hiroshima Research Center for Healthy Aging (HiHA), Department of Molecular Biotechnology, Graduate School of Advanced Sciences of Matter, Hiroshima University, 1-3-1 Kagamiyama, Higashi-Hiroshima, Hiroshima 730-8530 Japan
| | - Kareem Gamal ElRamlawy
- Hiroshima Research Center for Healthy Aging (HiHA), Department of Molecular Biotechnology, Graduate School of Advanced Sciences of Matter, Hiroshima University, 1-3-1 Kagamiyama, Higashi-Hiroshima, Hiroshima 730-8530 Japan
| | - Miyako Nakano
- Hiroshima Research Center for Healthy Aging (HiHA), Department of Molecular Biotechnology, Graduate School of Advanced Sciences of Matter, Hiroshima University, 1-3-1 Kagamiyama, Higashi-Hiroshima, Hiroshima 730-8530 Japan
| | - Tomoaki Takado
- Engineering Department III, Plasma cluster Equipment Division, Health and Environment Systems Group, SHARP Corporation, Osaka, Japan
| | - Akira Uenishi
- Engineering Department III, Plasma cluster Equipment Division, Health and Environment Systems Group, SHARP Corporation, Osaka, Japan
| | - Hidechika Kawazoe
- Engineering Department III, Plasma cluster Equipment Division, Health and Environment Systems Group, SHARP Corporation, Osaka, Japan
| | - Yoshinori Sekoguchi
- Engineering Department III, Plasma cluster Equipment Division, Health and Environment Systems Group, SHARP Corporation, Osaka, Japan
| | - Akihiko Tanaka
- Division of Allergology and Respiratory Medicine, Department of Medicine, Showa University, Tokyo, Japan
| | - Kazuhisa Ono
- Hiroshima Research Center for Healthy Aging (HiHA), Department of Molecular Biotechnology, Graduate School of Advanced Sciences of Matter, Hiroshima University, 1-3-1 Kagamiyama, Higashi-Hiroshima, Hiroshima 730-8530 Japan.,Department of Food Sciences and Biotechnology, Faculty of Life Sciences, Hiroshima Institute of Technology, Hiroshima, Japan
| | - Seiji Kawamoto
- Hiroshima Research Center for Healthy Aging (HiHA), Department of Molecular Biotechnology, Graduate School of Advanced Sciences of Matter, Hiroshima University, 1-3-1 Kagamiyama, Higashi-Hiroshima, Hiroshima 730-8530 Japan
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Luzak A, Flexeder C, von Berg A, Berdel D, Klümper C, Koletzko S, Bauer CP, Heinrich J, Nowak D, Schulz H. Relation of lung function and current inhalant allergen-specific immunoglobulin E concentrations in adolescents (GINIplus cohort). Ann Allergy Asthma Immunol 2015. [PMID: 26195441 DOI: 10.1016/j.anai.2015.06.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND The prevalence of allergen sensitization reaches up to 46.6% in 14- to 17-year-old German adolescents. Polysensitization is strongly associated with a higher risk of allergic rhinitis or asthma. Whether or how sensitization also is related to lung function remains uncertain. OBJECTIVE To assess whether sensitization to common inhalant allergens is associated with lung function in adolescents after stratification by allergic respiratory disease. METHODS In total, 1,719 15-year-old participants of the German Infant Study on the Influence of Nutrition Intervention plus Air Pollution and Genetics on Allergy Development (GINIplus) birth cohort provided valid spirometric indices, including forced expiratory volume in 1 second, forced vital capacity (FVC), forced expiratory flow rate at 25% to 75% of the FVC, and specific immunoglobulin E (IgE) screening test to 8 inhalant allergens (ImmunoCAP). Complete information on allergic rhinitis and asthma status was available for 1,128 subjects. Associations between lung function parameters and sensitization, classified into 4 groups (no sensitization to polysensitization) were analyzed using adjusted linear regression models. RESULTS Among participants, 21.1% (n = 347) had allergic rhinitis, 10.1% (n = 119) had asthma, and 46.4% (n = 798) had a positive screening test to inhalant allergens. Prevalences were consistently higher in boys. The percentage of subjects with rhinitis or asthma increased from 5.8% in non-sensitized subjects (n = 620) to 69.4% in polysensitized subjects (n = 144). Sensitization was not associated with any spirometric parameter considered in subjects with allergic rhinitis, asthma, or neither disease. CONCLUSION Although allergen-specific IgE concentrations can contribute to the identification of subjects at higher risk for allergic rhinitis and asthma, sensitization to inhalant allergens is not related to impaired spirometric lung parameters within the different allergic respiratory disease subgroups.
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Affiliation(s)
- Agnes Luzak
- Institute of Epidemiology I, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Claudia Flexeder
- Institute of Epidemiology I, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Andrea von Berg
- Research Institute, Department of Pediatrics, Marien-Hospital Wesel, Wesel, Germany
| | - Dietrich Berdel
- Research Institute, Department of Pediatrics, Marien-Hospital Wesel, Wesel, Germany
| | - Claudia Klümper
- IUF Leibniz Research Institute for Environmental Medicine and Medical Faculty, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany
| | - Sibylle Koletzko
- Dr von Hauner Children's Hospital, Ludwig Maximilians University of Munich, Munich, Germany
| | - Carl-Peter Bauer
- Department of Pediatrics, Technical University of Munich, Munich, Germany
| | - Joachim Heinrich
- Institute of Epidemiology I, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany; Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research, Munich, Germany
| | - Dennis Nowak
- Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research, Munich, Germany; Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital of Munich (LMU), Munich, Germany
| | - Holger Schulz
- Institute of Epidemiology I, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany; Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research, Munich, Germany.
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Baldacci S, Maio S, Cerrai S, Sarno G, Baïz N, Simoni M, Annesi-Maesano I, Viegi G. Allergy and asthma: Effects of the exposure to particulate matter and biological allergens. Respir Med 2015; 109:1089-104. [PMID: 26073963 DOI: 10.1016/j.rmed.2015.05.017] [Citation(s) in RCA: 153] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 05/08/2015] [Accepted: 05/19/2015] [Indexed: 10/23/2022]
Abstract
The prevalence of asthma and allergies including atopy has increased during the past decades, particularly in westernized countries. The rapid rise in the prevalence of such diseases cannot be explained by genetic factors alone. Rapid urbanization and industrialization throughout the world have increased air pollution and population exposures, so that most epidemiologic studies are focusing on possible links between air pollution and respiratory diseases. Furthermore, a growing body of evidence shows that chemical air pollution may interact with airborne allergens enhancing the risk of atopic sensitization and exacerbation of symptoms in sensitized subjects. These phenomena are supported by current in vitro and animal studies showing that the combined exposure to air pollutants and allergens may have a synergistic or additive effect on asthma and allergies, although there is an insufficient evidence about this link at the population level. Further research is needed in order to elucidate the mechanisms by which pollutants and biological allergens induce damage in exposed subjects. The abatement of the main risk factors for asthma and allergic diseases may achieve huge health benefits. Thus, it is important to raise awareness of respiratory allergies as serious chronic diseases which place a heavy burden on patients and on society as a whole.
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Affiliation(s)
- S Baldacci
- Pulmonary Environmental Epidemiology Unit, Institute of Clinical Physiology, CNR, Pisa, Italy.
| | - S Maio
- Pulmonary Environmental Epidemiology Unit, Institute of Clinical Physiology, CNR, Pisa, Italy
| | - S Cerrai
- Pulmonary Environmental Epidemiology Unit, Institute of Clinical Physiology, CNR, Pisa, Italy
| | - G Sarno
- Pulmonary Environmental Epidemiology Unit, Institute of Clinical Physiology, CNR, Pisa, Italy
| | - N Baïz
- Sorbonne Universités, UPMC Univ Paris 06, UMR-S 1136, Institute Pierre Louis of Epidémiology and Public Health, Epidemiology of Allergic and Respiratory Diseases Department, Paris, France; INSERM, UMR-S 1136, IPLESP, EPAR Department, Paris, France
| | - M Simoni
- Pulmonary Environmental Epidemiology Unit, Institute of Clinical Physiology, CNR, Pisa, Italy
| | - I Annesi-Maesano
- Sorbonne Universités, UPMC Univ Paris 06, UMR-S 1136, Institute Pierre Louis of Epidémiology and Public Health, Epidemiology of Allergic and Respiratory Diseases Department, Paris, France; INSERM, UMR-S 1136, IPLESP, EPAR Department, Paris, France
| | - G Viegi
- Pulmonary Environmental Epidemiology Unit, Institute of Clinical Physiology, CNR, Pisa, Italy
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Codispoti CD, LeMasters GK, Levin L, Reponen T, Ryan PH, Biagini Myers JM, Villareal M, Burkle J, Evans S, Lockey JE, Khurana Hershey GK, Bernstein DI. Traffic pollution is associated with early childhood aeroallergen sensitization. Ann Allergy Asthma Immunol 2014; 114:126-33. [PMID: 25499550 DOI: 10.1016/j.anai.2014.10.020] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Revised: 10/08/2014] [Accepted: 10/28/2014] [Indexed: 01/08/2023]
Abstract
BACKGROUND No large, prospective, epidemiologic study has investigated the association between diesel exhaust particle (DEP) exposure and early aeroallergen sensitization and allergic rhinitis (AR) at 4 years of age. OBJECTIVE To determine how exposure to traffic exhaust during infancy is associated with aeroallergen sensitization and AR at 4 years of age and the predictive utility of the wheal area at 1 to 3 years of age on AR at 4 years of age. METHODS Infants born to aeroallergen sensitized parents were evaluated annually with skin prick tests to 15 aeroallergens with measurement of wheal areas. At 4 years of age, AR was defined as at least one positive aeroallergen skin prick test result and the presence of sneezing and a runny nose without a cold or flu. Infant (DEP) exposure was estimated using data from 27 air sampling monitors and a land use regression model. RESULTS Complete data were available for 634 children at 4 years of age. Prevalence of AR increased annually from 6.9% to 21.9%. A positive trend was observed for high DEP exposure and aeroallergen sensitization at 2 and 3 years of age (odds ratio, 1.40; 95% confidence interval, 0.97-2.0) and (odds ratio, 1.35; 95% confidence interval, 0.98-1.85) but not with AR. At 2 years of age, every 1-mm(2) increase in the wheal area of timothy and Alternaria significantly increased the odds of AR at 4 years of age. At 3 years of age, every 1-mm(2) increase in the wheal area of fescue, dog, and Penicillium significantly increased the odds of AR at 4 years of age. CONCLUSION DEP exposure enhances the risk of early aeroallergen sensitization. Aeroallergen wheal area at 2 and 3 years of age is associated with AR at 4 years of age.
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Affiliation(s)
- Christopher D Codispoti
- Department of Internal Medicine, Division of Immunology/Allergy, University of Cincinnati, Cincinnati, Ohio; Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio; Division of Immunology, Microbiology, and Allergy, Rush University Medical Center, Chicago, Illinois.
| | - Grace K LeMasters
- Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio
| | - Linda Levin
- Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio
| | - Tiina Reponen
- Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio
| | - Patrick H Ryan
- Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio; Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Jocelyn M Biagini Myers
- Division of Asthma Research, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Manuel Villareal
- Department of Internal Medicine, Division of Immunology/Allergy, University of Cincinnati, Cincinnati, Ohio
| | - Jeff Burkle
- Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio
| | - Sherry Evans
- Department of Internal Medicine, Division of Immunology/Allergy, University of Cincinnati, Cincinnati, Ohio
| | - James E Lockey
- Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio
| | | | - David I Bernstein
- Department of Internal Medicine, Division of Immunology/Allergy, University of Cincinnati, Cincinnati, Ohio
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10
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Carsin AE, Zock JP, Jarvis D, Basagaña X, Heinrich J, Toren K, Janson C, Anto JM, Sunyer J. Serum total immunoglobulin E is a surrogate of atopy in adult-onset asthma: a longitudinal study. Int Arch Allergy Immunol 2012. [PMID: 23183370 DOI: 10.1159/000342464] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Studies have shown that serum total immunoglobulin E (IgE) levels are higher in asthmatics. However, the role of the serum total IgE level, independently from atopy, in adult asthma is not understood. We studied the associations between serum total IgE, the number of sensitizations and the sum of specific IgEs and new-onset asthma using longitudinal data from the European Community Respiratory Health Survey. METHODS Serum total and specific IgE to 4 common inhalant allergens were measured at baseline in 9,175 participants, with a follow-up of 9 years. Individuals with asthma history and/or asthma symptoms were excluded. Atopy was defined as the presence of at least one specific IgE ≥0.35 kU/l. Total and specific IgEs were regressed against new-onset asthma using multivariate logistic regression with a random intercept for the study centre. RESULTS Two hundred and ninety-seven participants had developed asthma during follow-up (incidence rate 5.7 per 1,000 person-years). A 10% higher level of total IgE was associated with a 12% increased risk of new-onset asthma (p = 0.005). However, after adjustment for the number of positive specific IgEs [odds ratio (OR) for multiple sensitization 1.74, 95% confidence interval (CI) 1.05–2.88] and the sum of allergenspecific IgEs (OR 1.18, 95% CI 1.00–1.40), the association between total IgE and asthma disappeared (OR 1.00, 95% CI 0.91–1.10). Seventeen percent of new-onset asthma cases could be attributed to atopy, and this estimate was not largely modified when the total IgE level was simultaneously taken into account. CONCLUSIONS After taking into account the number and intensity of 4 specific IgEs, the serum total IgE level was not associated with new-onset asthma in adults.
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Affiliation(s)
- Anne-Elie Carsin
- Centre for Research in Environmental Epidemiology, Barcelona, Spain.
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11
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Lung dendritic cell developmental programming, environmental stimuli, and asthma in early periods of life. J Allergy (Cairo) 2012; 2012:176468. [PMID: 23209481 PMCID: PMC3503332 DOI: 10.1155/2012/176468] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2012] [Revised: 09/29/2012] [Accepted: 09/30/2012] [Indexed: 12/22/2022] Open
Abstract
Dendritic cells (DCs) are important cells of our innate immune system. Their role is critical in inducing adaptive immunity, tolerance, or allergic response in peripheral organs—lung and skin. The lung DCs are not developed prenatally before birth. The DCs develop after birth presumably during the first year of life; exposures to any foreign antigen or infectious organisms during this period can significantly affect DC developmental programming and generation of distinct DC phenotypes and functions. These changes can have both short-term and long-term health effects which may be very relevant in childhood asthma and predisposition for a persistent response in adulthood. An understanding of DC development at molecular and cellular levels can help in protecting neonates and infants against problematic environmental exposures and developmental immunotoxicity. This knowledge can eventually help in designing novel pharmacological modulators to skew the DC characteristics and immune responses to benefit the host across a lifetime.
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12
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Health impacts of air pollution: a life course approach for examining predictors of respiratory health in adulthood. Ann Epidemiol 2012; 22:239-49. [PMID: 22463842 DOI: 10.1016/j.annepidem.2012.02.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2011] [Revised: 01/27/2012] [Accepted: 02/03/2012] [Indexed: 11/23/2022]
Abstract
PURPOSE This research applies a life course health development framework to examine the impacts of childhood exposure to air pollution on respiratory health in adulthood. METHODS This prospective cohort study uses data collected from children originally studied in the 1970/1980s, including exposure to air pollution, indoor exposures, sociodemographic variables, and health outcomes data. Thirty years later, a self-administered questionnaire was used to collect data from adulthood on health status, occupational and residential histories, socioeconomic status, and lifestyle. RESULTS Overall, 29% of respondents were diagnosed with at least one respiratory condition and 24% have persistent respiratory symptoms in adulthood. Significant neighborhood differences in exposure variables and adulthood health outcomes were found. Predictors of adulthood respiratory health include asthma diagnosis or chest illness in childhood, parental record of respiratory symptoms, other medical diagnosis in adulthood, fair/poor self-perceived health, smoking/exposure to smoking, and residing in a property built before 1950. Results suggest that exposure to ambient total suspended particulates in childhood is preventative for diagnosis with at least one respiratory condition in adulthood. CONCLUSION Findings suggest that long-term childhood exposure to air pollution does not predict respiratory conditions and symptoms in adulthood. However, respiratory health in childhood predicts adulthood respiratory health, thus suggesting that the health impacts of any exposures that impact respiratory health during critical or sensitive times in childhood are long term.
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13
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Hatzler L, Panetta V, Lau S, Wagner P, Bergmann RL, Illi S, Bergmann KE, Keil T, Hofmaier S, Rohrbach A, Bauer CP, Hoffman U, Forster J, Zepp F, Schuster A, Wahn U, Matricardi PM. Molecular spreading and predictive value of preclinical IgE response to Phleum pratense in children with hay fever. J Allergy Clin Immunol 2012; 130:894-901.e5. [PMID: 22841010 DOI: 10.1016/j.jaci.2012.05.053] [Citation(s) in RCA: 179] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2012] [Revised: 05/24/2012] [Accepted: 05/30/2012] [Indexed: 01/03/2023]
Abstract
BACKGROUND IgE sensitization against grass pollen is a cause of seasonal allergic rhinitis. OBJECTIVE We sought to investigate the evolution at the molecular level and the preclinical predictive value of IgE responses against grass pollen. METHODS The German Multicentre Allergy Study examined a birth cohort born in 1990. A questionnaire was administered yearly, and blood samples were collected at 1, 2, 3, 5, 6, 7, 10, and 13 years of age. Grass pollen-related seasonal allergic rhinitis (SARg) was diagnosed according to nasal symptoms in June/July. Serum IgE antibodies to Phleum pratense extract and 8 P pratense molecules were tested with immune-enzymatic singleplex and multiplex assays, respectively. RESULTS One hundred seventy-seven of the 820 examined children had SARg. A weak monomolecular/oligomolecular IgE response to P pratense was observed very frequently before SARg onset. These initial IgE responses increased in concentration and molecular complexity during the preclinical and clinical process. A typical progression of IgE sensitization was observed: Phl p 1 (initiator in >75% of cases); then Phl p 4 and Phl p 5; then Phl p 2, Phl p 6, and Phl p 11; and then Phl p 12 and Phl p 7. At age 3 years, IgE sensitization predicted SARg by age 12 years (positive predictive value, 68% [95% CI, 50% to 82%]; negative predictive value, 84% [95% CI, 80% to 87%]). At this preclinical prediction time, the number of recognized molecules and the serum levels of IgE to P pratense were significantly lower than at 3 or more years after SARg onset. CONCLUSIONS The IgE response against grass pollen molecules can start years before disease onset as a weak monosensitization or oligosensitization phenomenon. It can increase in serum concentration and complexity through a "molecular spreading" process during preclinical and early clinical disease stages. Testing IgE sensitization at a preclinical stage facilitates prediction of seasonal allergic rhinitis at its molecular monosensitization or oligosensitization stage.
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Affiliation(s)
- Laura Hatzler
- Department of Paediatric Pneumology and Immunology, Charité University Medical Centre, Berlin, Germany
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14
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Abstract
Animal dander is a common cause of allergic rhinitis and allergic asthma in patients. In this regard, cats and dogs represent major causes of allergy to animal dander. In first line, the therapeutic options include the elimination of the pet from the patient's home as a (secondary) preventive step. However, avoidance of temporary contacts or indirect exposure to cat dander is often difficult, since cat-allergens are widely distributed even in non-cat-keeping households. In general, conventional pharmacologic therapy does not thoroughly prevent allergic symptoms. Therefore, allergen-specific immunotherapy (SIT) represents an important therapeutic option. This article highlights the current standards and further developments of SIT for cat-allergic patients.
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15
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Kellberger J, Dressel H, Vogelberg C, Leupold W, Windstetter D, Weinmayr G, Genuneit J, Heumann C, Nowak D, von Mutius E, Radon K. Prediction of the incidence and persistence of allergic rhinitis in adolescence: a prospective cohort study. J Allergy Clin Immunol 2011; 129:397-402, 402.e1-3. [PMID: 21924762 DOI: 10.1016/j.jaci.2011.08.016] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2011] [Revised: 08/05/2011] [Accepted: 08/19/2011] [Indexed: 12/28/2022]
Abstract
BACKGROUND Predictive models have rarely been used in allergy research and practice. However, they might support physicians in advising patients. OBJECTIVE The aim of this study was to create predictive models for the incidence and persistence of allergic rhinitis (AR) during adolescence. METHODS A prospective population-based cohort study was conducted starting at age 9 to 11 years. Potential risk factors for atopic diseases obtained at baseline in 2810 subjects were used to create predictive logistic regression models for the incidence and persistence of physician-diagnosed AR with current symptoms at age 15 to 18 years. RESULTS Positive skin prick test responses to outdoor allergens at baseline were the most important determinant for both the incidence and persistence of AR until follow-up. For the incidence of AR, positive skin prick test responses to indoor allergens, parental history of asthma, female sex, and not having been breast-fed exclusively for 2 or more months were additional statistically significant independent risk factors. Depending on the number of risk factors present, the probability of the incidence of AR increased from 2% (no risk factors present) to 72% (full model; 95% CI, 58% to 85%). The probability of persistence of AR ranged from 33% (no risk factors present) to 83% (full model; 95% CI, 70% to 97%). CONCLUSION The course of AR over puberty can be predicted using risk factors that are easy to determine in childhood. Sensitization to outdoor allergens seems to play a much greater role for disease development than sensitization to indoor allergens. This might help pediatricians in advising patients.
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Affiliation(s)
- Jessica Kellberger
- Occupational and Environmental Epidemiology & Net Teaching Unit, Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital of Munich (LMU), Munich, Germany.
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16
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Antó JM, Sunyer J, Basagaña X, Garcia-Esteban R, Cerveri I, de Marco R, Heinrich J, Janson C, Jarvis D, Kogevinas M, Kuenzli N, Leynaert B, Svanes C, Wjst M, Gislason T, Burney P. Risk factors of new-onset asthma in adults: a population-based international cohort study. Allergy 2010; 65:1021-30. [PMID: 20132157 DOI: 10.1111/j.1398-9995.2009.02301.x] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND The occurrence of new-onset asthma during adulthood is common, but there is insufficient understanding of its determinants including the role of atopy. OBJECTIVE To assess the risk factors for the development of new-onset asthma in middle-aged adults and to compare them according to atopy. METHODS A longitudinal analysis of 9175 young adults who participated in two surveys of the European Community Respiratory Health Survey (ECRHS) conducted 9 years apart. FINDINGS We observed 179 cases of new-onset asthma among 4588 participants who were free of asthma and reported at the beginning of the follow-up that they had never had asthma (4.5 per 1000 person-years). In a logistic regression, the following risk factors were found to increase the risk of new-onset asthma: female gender (OR: 1.97; 95% confidence interval (CI): 1.38, 2.81), bronchial hyperresponsiveness (3.25; 2.19, 4.83), atopy (1.55; 1.08, 2.21), FEV(1) < 100 % predicted (1.87; 1.34, 2.62), nasal allergy (1.98;1.39,2.84) and maternal asthma (1.91; 1.13; 3.21). Obesity, respiratory infections in early life and high-risk occupations increased the risk of new-onset asthma although we had limited power to confirm their role. Among the atopics, total IgE and sensitization to cat were independently related to the risk of new-onset asthma. The proportion of new-onset asthma attributable to atopy varied from 12% to 21%. CONCLUSION Adults reporting that they had never had asthma were at a substantial risk of new-onset asthma as a result of multiple independent risk factors including lung function. Atopy explains a small proportion of new-onset adult asthma.
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Affiliation(s)
- J M Antó
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona.
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17
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Saarne T, Grönlund H, Kull I, Almqvist C, Wickman M, van Hage M. Cat sensitization identified by recombinant Fel d 1 several years before symptoms--results from the BAMSE cohort. Pediatr Allergy Immunol 2010; 21:277-83. [PMID: 20003163 DOI: 10.1111/j.1399-3038.2009.00894.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Exposure to cat is one of the most important causes of allergic disease. The objective of this study was to investigate IgE reactivity to the recombinant major cat allergen, rFel d 1, as an early marker of cat sensitization. Based on questionnaires, 144 children with allergic symptoms due to cat, or where such symptoms were suspected, were selected from the birth cohort BAMSE and allocated into three study groups. Blood samples taken at age 4 and 8 yrs were analysed for IgE to rFel d 1 and cat dander extract (CDE) by quantitative ELISA (cut-off limit 0.037 kU(A)/l) and the ImmunoCAP System (cut-off limit 0.35 kU(A)/l), respectively. At 4 yrs, 25/33 children with certain allergic symptoms to cat had IgE to both rFel d 1 and CDE, while 14/42 of those suspecting symptoms at 4 had IgE to rFel d 1 and 9/42 to CDE. In a group developing symptoms after 4 yrs, 60/69 had IgE to rFel d 1 and 57/69 to CDE at 8, while 33/69 had IgE to rFel d 1 already at 4 and 26/69 to CDE. This was the only one of the three study groups where a significant increase in the IgE levels to rFel d 1 was found from 4 to 8 yrs (p < 0.001), even when only children with IgE to rFel d 1 already at 4 were included (p < 0.001). We show that the single major cat allergen rFel d 1 is at least as good as CDE in the diagnosis of cat allergy in childhood. With a sensitive rFel d 1 assay cat sensitization can be detected several years before symptoms to cat are reported.
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Affiliation(s)
- Tiiu Saarne
- Department of Medicine, Clinical Immunology and Allergy Unit, Karolinska Institutet and University Hospital, Stockholm, Sweden
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18
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Schäfer T, Stieger B, Polzius R, Krauspe A. Associations between cat keeping, allergen exposure, allergic sensitization and atopic diseases: results from the Children of Lübeck Allergy and Environment Study (KLAUS). Pediatr Allergy Immunol 2009; 20:353-7. [PMID: 19538356 DOI: 10.1111/j.1399-3038.2008.00806.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The role of cat keeping on the promotion of allergies is discussed controversially. We investigated the associations between cat keeping, allergen exposure, allergic sensitization and atopic diseases in pre-school children. A total of 606 children (5- to 6-yr old) were studied in the course of the mandatory school entrance examination. Information on doctor diagnosed asthma and allergic rhinitis, pet keeping and confounders was obtained by questionnaire. The prevalence of atopic eczema was determined by dermatological examination, allergic sensitization was assessed by skin prick test, and the allergen exposure to cat allergen Fel d 1 was measured by a commercial wipe test. Cats were present in 16% of the households and results of the exposure categories (0-III) on cat allergen were 47.2%, 25.5%, 24.3% and 3.0% respectively. The prevalence of cat keeping increased significantly with exposure categories from 0.5% to 61.5% (p(trend) < 0.001). Children (6.3%) were sensitized to cat allergen and sensitization rates increased also significantly with exposure categories from 3.0% to 15.4% (p(trend) < 0.001). Children (9.3%) were diagnosed with atopic eczema and a positive history of asthma/rhinitis was given in 3.6% and 3.9% respectively. Sensitization to cat was associated with atopic eczema (23.3% vs. 7.4%; OR(adj.)= 3.8, CI: 1.4-10.8), asthma (12.5% vs. 3.7%; OR(adj.)= 4.9, CI: 1.1-21.2), allergic rhinitis (6.9% vs. 2.7%; OR(adj.)= 3.1, CI: 0.7-15.2) and any atopic disease (43.5% vs. 16.3%; OR(adj.)= 3.8, CI: 1.5-9.5). The data suggest a promoting effect of cat keeping for atopic diseases.
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Affiliation(s)
- Torsten Schäfer
- Institute of Social Medicine, Medical University Lübeck, Lübeck, Germany.
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