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McSharry C, Vesper S, Wymer L, Howieson S, Chaudhuri R, Wright GR, Thomson NC. Decreased FEV1 % in asthmatic adults in Scottish homes with high Environmental Relative Moldiness Index values. Clin Exp Allergy 2015; 45:902-907. [PMID: 25580663 PMCID: PMC7162076 DOI: 10.1111/cea.12482] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Revised: 11/18/2014] [Accepted: 11/21/2014] [Indexed: 02/06/2023]
Abstract
BACKGROUND Exposures to indoor biological contaminants have been implicated in asthma's aetiology but their effect on lung function is not well quantified. OBJECTIVE The aim of this cross-sectional study of non-smoking, asthmatic adults in Scotland was to determine the correlation between the results from a standard spirometry test, forced expiratory volume in one-second percent (FEV1 %), and quantitative estimates of some biological exposures. METHODS A population (n = 55) of non-smoking, adult asthmatics in Scotland was included in this study and each completed a questionnaire that allowed the determination of the Asthma Control Questionnaire scores (ACQ) and St. George's Respiratory Questionnaire scores (SGRQ), as well as corticosteroid use. Spirometry testing was completed and the pre-bronchodilator FEV1 % value calculated. At about the same time, floor dust samples were collected in the living room and in the bedroom. These dust samples were analysed for mould contamination, as described by the Environmental Relative Moldiness Index (ERMI) values and by (1, 3)-β-D-glucan concentrations, for endotoxin, and for dust mite, cat, and dog allergen concentrations. The asthmatics' FEV1 % values were tested for correlation (Pearson) to questionnaire-based estimates of health. Also, each biological exposure was tested for correlation (Pearson) to the FEV1 % values. RESULTS FEV1 % results were correlated with ACQ scores (ρ -0.586, P < 0.001), SGRQ scores (ρ -0.313, P = 0.020), and weakly with corticosteroid use (ρ -0.221, P = 0.105). The ERMI values in the homes (average 5.3) were significantly correlated with FEV1 % values (ρ -0.378, P = 0.004). There was no correlation between FEV1 % and concentrations of endotoxin, (1, 3)-β-D-glucan, or any of the allergens. CONCLUSION AND CLINICAL RELEVANCE Although these results do not prove that mould exposures caused the deficit in lung function observed in this study, it might be advisable for asthmatics to avoid high ERMI environments.
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Affiliation(s)
- C McSharry
- Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK
| | - S Vesper
- National Exposure Research Laboratory, United States Environmental Protection Agency, Cincinnati, OH, USA
| | - L Wymer
- National Exposure Research Laboratory, United States Environmental Protection Agency, Cincinnati, OH, USA
| | - S Howieson
- Department of Architecture and Building Science, University of Strathclyde, Glasgow, Glasgow, UK
| | - R Chaudhuri
- Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK
| | - G R Wright
- Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK
| | - N C Thomson
- Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK
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Kim HJ, Kang MH, Park HM. Common allergens of atopic dermatitis in dogs: comparative findings based on intradermal tests. J Vet Sci 2011; 12:287-90. [PMID: 21897103 PMCID: PMC3165159 DOI: 10.4142/jvs.2011.12.3.287] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Intradermal tests were performed on 58 dogs diagnosed with atopic dermatitis from 2004~2008 at the Veterinary Medical Teaching Hospital of Konkuk University, Korea. To compare the allergen distribution observed in the present investigation to the results from other studies conducted in Korea and elsewhere, the allergens were grouped according to their kinds. There was no significant difference in gender distribution among the dogs. The most common breeds among the 58 dogs were Maltese (n = 11) and Shih-tzu (n = 11). The average age was 4.8 years. The most frequently produced a positive reaction on the intradermal tests was mold (67.3%) followed by house dust (54.5%) and house dust mites (49.1%). The present study found a low distribution of dogs allergic to various outdoor allergens compared to studies performed in other countries; this may reflect differences in living conditions for dogs living in Korea.
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Affiliation(s)
- Ha-Jung Kim
- BK21 Basic & Diagnostic Veterinary Specialist Program for Animal Diseases and Department of Veterinary Internal Medicine, College of Veterinary Medicine, Konkuk University, Seoul 143-701, Korea
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Jung JW, Choi JC, Shin JW, Kim JY, Park IW, Choi BW. Clinical characteristics according to sensitized allergens in adult korean patients with bronchial asthma. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2010; 2:102-7. [PMID: 20358023 PMCID: PMC2846732 DOI: 10.4168/aair.2010.2.2.102] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2009] [Accepted: 12/16/2009] [Indexed: 11/20/2022]
Abstract
Purpose Allergic sensitization is a risk factor for the development of bronchial asthma. This study was conducted to investigate clinical manifestations according to sensitized allergens in adult Korean patients with bronchial asthma. Methods In total, 523 adult patients who were diagnosed with bronchial asthma between March 2002 and March 2008 were included in the study. All patients underwent skin prick tests for approximately 45 allergens or a specific IgE test. Sensitized allergens were grouped into the following categories: house dust mites, fungus, pollen, and animal dander. Atopy was defined as a positive skin prick test response or the presence of a specific IgE to one or more allergens. Results Of the 523 patients, 295 (56%) were sensitized to one or more allergens. A younger median age, greater proportion of males, higher eosinophil counts, and higher total IgE levels were observed in the atopic asthma group compared to the non-atopic asthma group. The PC20 value was negatively correlated with eosinophil counts and total IgE in the atopic asthma group. In the subgroup analysis, patients sensitized to Cladosporium showed poorer pulmonary function and a higher response to bronchodilators. In addition, patients sensitized to Alternaria showed severer bronchial hyperresponsiveness than non-atopic patients with asthma. Finally, a gradual increase in the number of sensitized allergens was noted with increasing age, eosinophil counts, and total IgE levels. Conclusions We suggest the need for identifying the existence of atopy and exact offending allergens at the time of asthma diagnosis, since significant differences in sex, age, blood test results, and lung function were observed according to atopy and sensitized allergens.
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Affiliation(s)
- Jae Woo Jung
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
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Respiratory Health and Allergy Among Young Farmers and Non-Farming Rural Males in Denmark. J Agromedicine 2008. [DOI: 10.1300/j096v04n01_09] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Anthracopoulos MB, Mantzouranis E, Paliatsos AG, Tzavelas G, Lagona E, Nicolaidou P, Priftis KN. Different effects of sensitization to mites and pollens on asthma symptoms and spirometric indices in children: a population-based cohort study. Ann Allergy Asthma Immunol 2007; 99:122-9. [PMID: 17718099 DOI: 10.1016/s1081-1206(10)60635-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND We have previously shown that long-term exposure of children to a highly polluted urban compared with a rural environment is associated with subclinical airway narrowing and increased prevalence of atopy. OBJECTIVE To test the hypothesis that sensitization to indoor perennial, compared with seasonal, aeroallergens has distinct effects on asthma symptoms and/or spirometric indices. METHODS We evaluated the respiratory health of 478 and 342 children aged 8 to 10 years living in an urban and a rural area, respectively, during a period of 8 years. Children were evaluated by parental questionnaire in 3 phases, 1995 to 1996 (phase 1), 1999 to 2000 (phase 2), and 2003 to 2004 (phase 3), and by spirometry and skin prick testing to 9 common local aeroallergens in phases 1 and 2. RESULTS Sensitization to pollens was associated with current wheezing in phase 1 of the study (odds ratio [OR], 3.36; 95% confidence interval [CI], 1.71 to 6.62; P < .001) but not with spirometric indices. Sensitization to mites was negatively associated with forced expiratory volume in 1 second (95% CI, -7.26 to -0.90; P = .01) and forced expiratory flow at 50% of forced vital capacity (95% CI, -10.80 to -1.33; P = .01) in study phase 1 but not in phase 2. CONCLUSIONS Our results indicate that sensitization to mites is associated with insidious involvement of large and small airways, whereas sensitization to pollens is associated with childhood wheezing at the age of 8 to 10 years. Subsequent loss of these associations implies that risk factors other than allergy influence airway disease at a later age.
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VOLUME 4, NUMBERS 1 AND 2. J Agromedicine 2005. [DOI: 10.1300/j096v09n02_14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Choi SY, Sohn MH, Yum HY, Kwon BC, Kim KE. Correlation between inhalant allergen-specific IgE and pulmonary function in children with asthma. Pediatr Pulmonol 2005; 39:150-5. [PMID: 15633201 DOI: 10.1002/ppul.20163] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Sensitization to aeroallergens is associated with diminished lung function in adults. Little has been studied on the relationship between the inhalant allergen-specific IgE and pulmonary function in asthmatic children. This study was focused on four major inhalant allergens found in Korea, including Dermatophagoides pteronyssinus (Der p.), Dermatophagoides farinae (Der f.), and Alternaria- and German cockroach-specific IgEs, with evaluation of pulmonary function in relation to the amount of allergens. The parents or legal guardians of participants enrolled in this study gave informed consent. Fifty-five asthmatic patients and 48 nonasthmatic children were included. The amounts of specific IgE for the four specified inhalant allergens were determined by employing the CAP system FEIA. Forced expiratory volume in 1 sec (FEV(1))/forced vital capacity (FVC), FEV(1), and forced expiratory flow between 25% and 75% of FVC (FEF(25-75)) of subjects were evaluated through pulmonary function tests. In the asthmatic group, FEV(1), FEV(1)/FVC, and FEF(25-75) were significantly reduced (P < 0.05): reduction in FEV(1) (r = -0.44) and FEF(25-75) (r = -0.33) in association with the Der f.-specific allergen, and reduction in FEV(1) (r = -0.37) and FEF(25-75) (r = -0.34) in association with the Der p.-specific allergen, were observed. However, there was no significant correlation with German cockroach and Alternaria allergen. In the control group, no significant correlation was detectable between the allergen-specific IgE titers and the results of pulmonary function tests. In asthmatic patients, Der p.- and Der f.-specific IgEs, and not German cockroach and Alternaria, seem to play a considerable role in reduced pulmonary function among asthmatic children.
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Affiliation(s)
- Sung-Yon Choi
- Department of Pediatrics and Allergy Institute, Yonsei University College of Medicine, Seoul, Korea
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8
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Langley SJ, Goldthorpe S, Craven M, Morris J, Woodcock A, Custovic A. Exposure and sensitization to indoor allergens: association with lung function, bronchial reactivity, and exhaled nitric oxide measures in asthma. J Allergy Clin Immunol 2003; 112:362-8. [PMID: 12897743 DOI: 10.1067/mai.2003.1654] [Citation(s) in RCA: 139] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND Exposure to high levels of allergens in sensitized asthmatic patients causes worsening of pulmonary function in experimental studies. Chronic exposure to lower, naturally occurring levels of allergens might increase the severity of asthma. OBJECTIVE We sought to study the associations between sensitization and exposure to common indoor allergens (dust mite, cat, and dog) in the home on pulmonary function, exhaled nitric oxide (eNO), and airway reactivity in asthmatic patients. METHODS Dust samples were collected from the living room carpet and mattress of 311 subject's homes, and Der p 1, Fel d 1, and Can f 1 concentrations were measured by using ELISAs. Spirometry, nonspecific bronchial reactivity, and eNO were measured. RESULTS Subjects both sensitized and exposed to high levels of sensitizing allergen had significantly lower FEV(1) percent predicted values (mean, 83.7% vs 89.3%; mean difference, 5.6%; 95% CI, 0.6%-10.6%; P =.03), higher eNO values (geometric mean [GM], 12.8 vs 8.7 ppb; GM ratio, 0.7; 95% CI, 0.5-0.8; P =.001), and more severe airways reactivity (PD(20) GM, 0.25 vs 0.73 mg; GM ratio, 2.9; 95% CI, 1.6-5.0; P <.001) compared with subjects not sensitized and exposed. No significant effect of the interaction between sensitization and exposure was found for FEV(1) percent predicted and eNO values. However, there was a significant effect of the interaction between sensitization and exposure to any allergen (P =.05) and between sensitization and exposure to cat allergen (P =.04) for nonspecific bronchial reactivity. CONCLUSION Asthmatic subjects who are exposed in their homes to allergens to which they are sensitized have a more severe form of the disease.
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Affiliation(s)
- Stephen J Langley
- North West Lung Centre, Wythenshawe Hospital, Manchester, United Kingdom
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Jaén A, Sunyer J, Basagaña X, Chinn S, Zock JP, Antó JM, Burney P. Specific sensitization to common allergens and pulmonary function in the European Community Respiratory Health Survey. Clin Exp Allergy 2002; 32:1713-9. [PMID: 12653161 DOI: 10.1046/j.1365-2222.2002.01539.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The role of atopy in the evolution to chronic obstructive disease remains controversial. AIM We aimed to assess the association between individual sensitization to common allergens and lung function. METHOD We analysed data from 12,687 subjects aged 20 to 44 years, from 34 centres in 15 countries participating in the European Community Respiratory Health Survey (ECRHS). Participants performed a blood test, lung function test, methacholine challenge, and answered an administered questionnaire. The relationships between specific IgE, FEV1 and FEV1/FVC ratio were assessed for each study centre stratified by sex, followed by random effects meta-analysis. RESULTS Asthmatics sensitized to house dust mite had a lower FEV1 (-119 mL in women and -112 mL in men) and FEV1/FVC ratio (-1.95%, and -2.48%) than asthmatics without sensitization. Asthmatics sensitized to cat had a lower FEV1 (statistically significant for women only) and a lower FEV1/FVC ratio. Asthmatic women sensitized to grass had a lower FEV1 and a lower ratio, and those sensitized to Cladosporium had a lower FEV1. A weak association was found with sensitization to cat and to Cladosporium among non-asthmatic women, which disappeared after adjusting for BHR. CONCLUSION We conclude that atopy was related to a lower lung function, which was only apparent among asthmatics. This relationship was explained by specific sensitization to cat and to house dust mite, the latter being homogeneous across areas.
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Affiliation(s)
- A Jaén
- Respiratory and Environmental Health Research Unit, Institut Municipal d'Investigació Mèdica (IMIM), Barcelona, Spain.
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10
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Lin YC, Su HJ, Hsiue TR, Lee CH, Chen CW, Guo YL. Levels of house dust mite-specific IgE and cockroach-specific IgE and their association with lower pulmonary function in Taiwanese children. Chest 2002; 121:347-53. [PMID: 11834642 DOI: 10.1378/chest.121.2.347] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
OBJECTIVE Sensitization to an aeroallergen is known to diminish pulmonary function in young children and adults; however, it remains unclear whether it produces similar effects in adolescents. This study, therefore, examined the relationship between serum allergen-specific IgE levels and pulmonary function in adolescents. DESIGN Middle-school children were invited for a physician's evaluation and pulmonary function test when not experiencing an asthma attack and for the determination of serum levels of specific IgE to common allergens. SETTING National Cheng Kung University Hospital, Taiwan. SUBJECTS Middle-school children in southern Taiwan, who had completed both a nationally administered Chinese version of the International Study of Asthma and Allergies in Childhood questionnaire and a pulmonary function test in October 1996. RESULTS Forty-two then currently asthmatic children, 38 children with asthma in remission (no reported attack for > 12 months), and 69 children without asthma completed the study. Children with asthma had a significantly lower adjusted forced expiratory flow between 25% and 75% of FVC (FEF(25-75%)) and FEV(1)/FVC than children without asthma. A greater percentage of children with asthma were more sensitized to Dermatophagoides pteronyssinus (Der p), Dermatophagoides farinae (Der f), and German cockroach but not cat dander or dog dander. Children with asthma with Der f-specific IgE > 100 IU/mL, or cockroach-specific IgE > 0.7 IU/mL showed lower pulmonary function. No such association was found in children without asthma. CONCLUSION Our findings suggest that sensitization to Der f and German cockroach was a critical factor for the lower pulmonary function observed in middle-school children with asthma.
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Affiliation(s)
- Ying-Chu Lin
- Department of Environmental and Occupational Health, National Cheng Kung University Hospital, Tainan, Taiwan
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Affiliation(s)
- P Cabrera Navarro
- Servicio de Neumología. Hospital Universitario de Gran Canaria Dr. Negrín. Las Palmas de Gran Canaria.
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Abstract
The importance of allergies and allergens in the development and persistence of asthma is suggested by 3 lines of evidence. First, a number of epidemiologic studies demonstrate that sensitization to indoor allergens and the spores of the outdoor seasonal fungus Alternaria is a risk factor for the development of asthma in both children and adults. Sensitivity to pollens, on the other hand, rarely constitutes a risk for asthma but does constitute a risk for seasonal allergic rhinitis. Second, several studies, again in both children and adults, have demonstrated that, in persons sensitive to indoor allergens, the severity of asthma symptoms will vary with the level of exposure. Third, the elimination of exposure to house-dust mites has produced a remarkable reversal of asthma in sensitive children and adults. Not only have symptoms and pulmonary function improved, but there has also been evidence of a reduction in airway inflammation and hyperresponsiveness. Taken together, these studies make a strong argument for the importance of allergy and allergen exposure as aggravating factors in asthma in both children and adults and reinforce the importance of the identification and treatment of these allergen sensitivities. (J Allergy Clin Immunol 2000;105:S628-32.)
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Affiliation(s)
- H S Nelson
- Department of Medicine, National Jewish Medical and Research Center, and the University of Colorado Health Sciences Center, Denver, USA
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Weiss ST. Atopy as a risk factor for chronic obstructive pulmonary disease: epidemiological evidence. Am J Respir Crit Care Med 2000; 162:S134-6. [PMID: 10988168 DOI: 10.1164/ajrccm.162.supplement_2.ras-16] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- S T Weiss
- Channing Laboratory, Brigham and Women's Hospital, Boston, Massachusetts, USA.
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Nelson HS. The importance of allergens in the development of asthma and the persistence of symptoms. J Allergy Clin Immunol 2000; 105:S628-32. [PMID: 10856169 DOI: 10.1067/mai.2000.106154] [Citation(s) in RCA: 68] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The importance of allergies and allergens in the development and persistence of asthma is suggested by 3 lines of evidence. First, a number of epidemiologic studies demonstrate that sensitization to indoor allergens and the spores of the outdoor seasonal fungus Alternaria is a risk factor for the development of asthma in both children and adults. Sensitivity to pollens, on the other hand, rarely constitutes a risk for asthma but does constitute a risk for seasonal allergic rhinitis. Second, several studies, again in both children and adults, have demonstrated that, in persons sensitive to indoor allergens, the severity of asthma symptoms will vary with the level of exposure. Third, the elimination of exposure to house-dust mites has produced a remarkable reversal of asthma in sensitive children and adults. Not only have symptoms and pulmonary function improved, but there has also been evidence of a reduction in airway inflammation and hyperresponsiveness. Taken together, these studies make a strong argument for the importance of allergy and allergen exposure as aggravating factors in asthma in both children and adults and reinforce the importance of the identification and treatment of these allergen sensitivities.
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Affiliation(s)
- H S Nelson
- Department of Medicine, National Jewish Medical, Denver, CO 80206, USA
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Kusunoki T, Hosoi S, Asai K, Harazaki M, Furusho K. Relationships between atopy and lung function: results from a sample of one hundred medical students in Japan. Ann Allergy Asthma Immunol 1999; 83:343-7. [PMID: 10541428 DOI: 10.1016/s1081-1206(10)62676-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The prevalence of allergic diseases has been increasing dramatically and several studies have shown that atopy is related to asthmatic symptoms and bronchial hyperresponsiveness. OBJECTIVE To observe the relationships between atopic status and asthmatic predisposition (obstructive change in lung function) in apparently healthy young adults in Japan. METHODS A sample of 100 healthy Japanese medical students were subjected to a skin prick test for 11 common aeroallergens and food allergens, and their spirometric lung function was measured. RESULTS Surprisingly, 90% of them showed a positive prick test result for at least one of the 11 allergens tested, and 59% of them showed allergic responses to more than three allergens. The positive rate for Dermatophagoidesfarinae (Der) was the highest (71.0%), followed by house dust (57.0%), Dactylois gloinerata (42.0%), Cryptomeria gromerata (Cry) (40.0%), and cat fur (39.0%). Furthermore, there was no statistical difference in the positive rates for Der and Cry between groups with and without either the present illness or past history of any of the three major allergic diseases: bronchial asthma (BA), atopic dermatitis (AD), or allergic rhinitis (AR). Compared with the positive rates for these aeroallergens, those for food allergens were much lower (4% to 9%). Several lung function parameters, including the levels of FEV1% and %V50 which reflect obstructive pulmonary changes, showed significant negative correlation to the number of skin prick test-positive allergens. The same correlation was observed for groups without either the present illness or past history of BA. CONCLUSION These data suggest that those who are multi-allergic tend to feature subclinical asthma-like changes in their lung functions. Further studies are needed to determine whether this multi-allergic status can lead to future onset of asthma or other allergic diseases.
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MESH Headings
- Adult
- Allergens
- Animals
- Cats
- Dermatitis, Atopic/epidemiology
- Dermatitis, Atopic/etiology
- Dermatitis, Atopic/physiopathology
- Dust/adverse effects
- Female
- Food Hypersensitivity/epidemiology
- Food Hypersensitivity/etiology
- Food Hypersensitivity/physiopathology
- Forced Expiratory Volume
- Fungi/immunology
- Humans
- Hypersensitivity, Immediate/epidemiology
- Hypersensitivity, Immediate/physiopathology
- Japan/epidemiology
- Lung/physiopathology
- Male
- Pollen/immunology
- Respiratory Function Tests
- Respiratory Hypersensitivity/epidemiology
- Respiratory Hypersensitivity/etiology
- Respiratory Hypersensitivity/physiopathology
- Rhinitis, Allergic, Seasonal/epidemiology
- Rhinitis, Allergic, Seasonal/etiology
- Rhinitis, Allergic, Seasonal/physiopathology
- Skin Tests
- Students, Medical
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Affiliation(s)
- T Kusunoki
- Department of Pediatrics, Kyoto University, Japan
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Nelson HS, Szefler SJ, Jacobs J, Huss K, Shapiro G, Sternberg AL. The relationships among environmental allergen sensitization, allergen exposure, pulmonary function, and bronchial hyperresponsiveness in the Childhood Asthma Management Program. J Allergy Clin Immunol 1999; 104:775-85. [PMID: 10518821 DOI: 10.1016/s0091-6749(99)70287-3] [Citation(s) in RCA: 153] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Sensitivity and exposure to indoor allergens constitutes a risk factor for the development and persistence of asthma in children. OBJECTIVE Our purpose was to evaluate the relationship between sensitivity and exposure to inhalant allergens and lung function and bronchial responsiveness in a group of children (n = 1041) aged 8.9 +/- 2.1 years with mild to moderate asthma enrolled in the Childhood Asthma Management Program (CAMP). METHODS With use of the extensive CAMP baseline cross-sectional data on spirometry, bronchial responsiveness, allergen sensitivities, and household allergen levels, the relationship of sensitization and exposure to allergens to lung function and methacholine sensitivity was evaluated. Children who enrolled in CAMP stopped all antiasthma medication except rescue use of albuterol and prednisone for exacerbations during the 5- to 16-week screening period. During the last 2 of these weeks they underwent spirometry and methacholine challenge. Indoor allergen exposures were determined from questionnaires completed by the parent. Household levels of indoor allergens (mite, cat, dog, cockroach, mold) were determined on house dust samples. Allergen sensitivity was determined by percutaneous skin testing with a standard battery of allergens plus locally important pollen and fungal spores. Lung function and bronchial hyperresponsiveness were compared for children sensitive and not sensitive to both indoor and outdoor allergens on skin testing and, if sensitive, for exposed and not exposed to the allergens to which they were positive on skin testing. RESULTS There was a strong direct correlation between increased sensitivity to inhaled methacholine and skin test sensitivity to tree, weed, Alternaria, cat, dog, and indoor molds. When the relationship was examined by stepwise regression, the skin test sensitivities showing the strongest associations with the concentration of methacholine that caused a 20% fall in FEV(1) were dog (P =.003), Alternaria (P =.01), and cat (P =.05). Children sensitive to any one of the aeroallergens tested were compared for the presence or absence of exposure to that allergen at the time that the methacholine challenge was performed. Those who were sensitive and exposed to weed and cat had greater methacholine sensitivity than those similarly sensitive but not exposed (P =.003 and P =.02, respectively). CONCLUSIONS Sensitivity to dog or cat dander or Alternaria by skin testing was associated with increased bronchial responsiveness but not decreased lung function in children with mild to moderate asthma. These findings support the important role that sensitization to certain allergens plays in modulating bronchial responsiveness.
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Affiliation(s)
- H S Nelson
- National Jewish Medical and Research Center, Denver, Colo. 80206, USA
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van der Heide S, Dubois AE, Kauffman HF, de Monchy JG. Allergy to mites: relation to lung function and airway hyperresponsiveness. Allergy 1999; 53:104-7. [PMID: 10096820 DOI: 10.1111/j.1398-9995.1998.tb05009.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Exposure to house-dust-mite allergens is an important cause of allergic reactions in sensitized patients. In community-based studies, sensitization to house-dust mites, as ascertained by a positive skin test or by an increased allergen-specific IgE level in serum, is associated with both diminished lung function and enhanced airway hyperresponsiveness. Sensitization to house-dust mites is an independent risk factor for the development of asthma, especially in areas which favor the growth of house-dust mites. In studies with asthmatic patients, however, the relationship between sensitization to mites and lung function or airway hyperresponsiveness is less clear. The selection of asthmatic individuals (with sensitization to other inhalant allergens) and the use of medication such as inhaled steroids may interfere with the demonstration of a possible association between mite allergy and lung function or airway hyperresponsiveness in asthmatic patients.
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Affiliation(s)
- S van der Heide
- Department of Allergology, Clinic for Internal Medicine, University Hospital, Groningen, The Netherlands.
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