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164 Allergen transfer chamber: A new method for testing allergen barriers
J ALLERGY CLIN IMMUNOL VOLUME 97, NUMBER 1, PART3
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House Dust Mite Allergens in Mattresses. A Cross S e c t i o n a l A n a l y s i s in a T e m p e r a t e C o s t a l A r e a . H Mosbeeh MD PhD, M Steensen MD, C Veegerbv BS, L Ponlsen PhD, JH Heinig MD, C J0hnsen MD, Copenhagen. Denmark. Risk levels for sensitisation have been described for the house dust mite Dermatophagoides pteronyssinus - but only with respect to the group 1 allergen. The group 2 allergen seems to be important as well, but the occurrence of this and the group 1 allergens from D. farinae and D. microceras are less well described. We have examined dust from mattresses of 92 adults from a representative sample of the general population in an urban area. Concentration of group 1 allergens were measured by an ELISA technique. An IRMA method was applied for Dermatophagoides group 2 allergens. All participants were skin prick tested and their housing and cleaning standards were recorded. Concentrations of Der p 1, Der f 1, Der m 1 and Der 2 allergens were 0.2 (0-133), 0.7 (0-102), 0.03 (0-6.9) and 132.3 (16250) #g/g dust (median and 5-95 % CI). The age of the mattresses correlated with the allergen concentrations, but neither the occurrence of a positive skin test reaction to Dermatophagoides, the age of the house or the reported cleaning and ventilation habits seemed to have any influence. Concentration of Der p 1 and Der f I did not correlate, indicating different needs for these species. Der 1 and Der 2 allergens occurred together, however Der 2 allergens dominated and in a considerate number of cases house dust mite allergen exposure would have been underestimated if only Der p 1 had been looked for.
Impact of an individual teaching program on e n v i r o n m e n t a l c o n t r o l in m o d e r a t e to s e v e r e a s t h m a t i c s .
J C8i6. P Robichaud. H Boutin. A Filion. M Lavall~e. M K r a u s k v . M R o u l e a u . J L Malo. A Cartier. LP B o u l e t , Quebec and Montreal, Canada. Obieetives: To determine the influence of an individualized asthma education program (IAEP) on the avoidance of asthma triggers. ~ : A prospective randomized control trial of 1 year duration. Patients: 149 patients with moderate to severe asthma from 3 tertiary care hospitals: I/3 were randomized in group C (control-group) and 2/3 in the educated group (group E). Main outcome measures: Smoking habits, house dust mite preventive measures, willingness to cease exposure to eats and dogs. Methods: After participation to our IAEP, current smokers were given explanations with regard to the negative influence smoking could have on their asthma. In subjects sensitized to eat, dog and house dust mites (HDM) (positive skin prick test-induration > 3ram), the influence of exposure to these allergens on airway responsiveness was explained and subjects were encouraged to adopt measures to decrease that exposure. Results: Few subjects stopped smoking one year after the IAEP (one in group C and 2 in group E). Most of the subjects sensitized to HDM adopted the recommendations given by the educator (26 subjects out of 37 in group E in comparison with 0 out of 21 in group C (P < 0.0001)). Among those sensitized to cats or dogs (group C,',16 group E=32) 6 out 16 in group C and 5 out of 32 in group E no longer had a pet at home by the end of the study. Conclusions: Our IAEP was able to motivate patients in adhering to HDM avoiding measures. Smoking habits and exposure to pets were not influenced by the one year intervention.
Abstracts
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Clinical study o f bedding covers in mite-allergic asthmatic patients. J Bimbaum MD. F de Blav MD. E Paty MD, J Just ~f13, G Pauli MD, D Vervloet MD. D Charpin MD, Marseille, France. The study was designed to assess the climcal efficacy of bedding covers in house dust mite respiratory allergy. TMrty one astlunadc padents with house dust mite allergy, aged between %dO years, participated in a 24-weck study. Asthma had to be unstable with at least nocturual or diunh'd attacks, or variability of peak flow measurements, or B2 agonist intake ,almost d;dly Patients had to be exposed to mite allergens (Acarex test ++ or +++) and to receive maintenance and-itfflmmnatory treatment. After a four-week run-in period when astlunatic symptoms mid peak flow measitrements were recorded daily in diary cards, patients were randomly allocated to receive either active (Intcrvent, WL Gore and Associates, UK) or placebo mattress, duvet mid pillow covers. Then, they reex)rded their symptoms, treatment, peak flow measuremcns, one week every month during 6 months. At baseline aud after 12 weeks and 24 weeks, specific lgE against lnite, mctacholine challenge were realized, and mattress and floor samples were obtained by vacuuming for measurement of mite-group I allergen level. At baseline, the two groups were comparable on severity of asth,na and mean level of allergens. There was a sigifificant decrease of grou1) I allergen in mattress and floor (p<0.0001) mid IgEs level (p=0.03) in the active group compared to the placebo group. Symptoms, peak flow measurements relnained unchanged. Variations in bronchial reactivity to metacholinc was similar in both groups. In conclnsiou, allergen avoidance by "Intervent covers" is effective. However, in tiffs group of moderate asdunatic patients, it did not i,nprove allergic asduna.
Allergen Transfer Chamber: A new Method for Testing Allergen Barriers. JH Ransom MD. Tm~eka. Kansas. IF Halsey PhD Lenexa. KS _ Fabrics capable of excluding allergens are an integral part of current dust mite control methods. Using a novel dual chamber device, a reference dust containing a known quantity of allergen is loaded into one chamber. The fabric barrier to be tested is placed over the chamber and connected to an identical chamber. The device is rotated overnight, and the amount of allergen transferred across the barrier is determined by immunoassay using a standard technique. Samples of common bedsheets as well as fabrics sold for their proposed allergen excluding ability were tested. Results were as follows: Material Mite allergen (threadcount) (Nanograms transferred) Unwashed 5X 20X Cotton 130 19.5 16.3 4.0 Cotton 180 7.8 5.0 5.0 Cotton 200 <3.9 5.5 <3.9 Cotton 250 <3.9 <3.9 4.9 AG Microfibril <3.9 <3.9 <3.9 ACP Stretchable <3.9 <3.9 <3.9 Negative control <3.9 NA NA Positive control 2647 NA NA CONCLUSIONS: The dual chamber test system permits accurate and reproducible assessment of the antigen permeability ol fabrics and of the effects of washing, allowing such tests to be performed in the laboratory.
161
162
House Dust Mite Allergens in Mattresses. A Cross S e c t i o n a l A n a l y s i s in a T e m p e r a t e C o s t a l A r e a . H Mosbeeh MD PhD, M Steensen MD, C Veegerbv BS, L Ponlsen PhD, JH Heinig MD, C J0hnsen MD, Copenhagen. Denmark. Risk levels for sensitisation have been described for the house dust mite Dermatophagoides pteronyssinus - but only with respect to the group 1 allergen. The group 2 allergen seems to be important as well, but the occurrence of this and the group 1 allergens from D. farinae and D. microceras are less well described. We have examined dust from mattresses of 92 adults from a representative sample of the general population in an urban area. Concentration of group 1 allergens were measured by an ELISA technique. An IRMA method was applied for Dermatophagoides group 2 allergens. All participants were skin prick tested and their housing and cleaning standards were recorded. Concentrations of Der p 1, Der f 1, Der m 1 and Der 2 allergens were 0.2 (0-133), 0.7 (0-102), 0.03 (0-6.9) and 132.3 (16250) #g/g dust (median and 5-95 % CI). The age of the mattresses correlated with the allergen concentrations, but neither the occurrence of a positive skin test reaction to Dermatophagoides, the age of the house or the reported cleaning and ventilation habits seemed to have any influence. Concentration of Der p 1 and Der f I did not correlate, indicating different needs for these species. Der 1 and Der 2 allergens occurred together, however Der 2 allergens dominated and in a considerate number of cases house dust mite allergen exposure would have been underestimated if only Der p 1 had been looked for.
Impact of an individual teaching program on e n v i r o n m e n t a l c o n t r o l in m o d e r a t e to s e v e r e a s t h m a t i c s .
J C8i6. P Robichaud. H Boutin. A Filion. M Lavall~e. M K r a u s k v . M R o u l e a u . J L Malo. A Cartier. LP B o u l e t , Quebec and Montreal, Canada. Obieetives: To determine the influence of an individualized asthma education program (IAEP) on the avoidance of asthma triggers. ~ : A prospective randomized control trial of 1 year duration. Patients: 149 patients with moderate to severe asthma from 3 tertiary care hospitals: I/3 were randomized in group C (control-group) and 2/3 in the educated group (group E). Main outcome measures: Smoking habits, house dust mite preventive measures, willingness to cease exposure to eats and dogs. Methods: After participation to our IAEP, current smokers were given explanations with regard to the negative influence smoking could have on their asthma. In subjects sensitized to eat, dog and house dust mites (HDM) (positive skin prick test-induration > 3ram), the influence of exposure to these allergens on airway responsiveness was explained and subjects were encouraged to adopt measures to decrease that exposure. Results: Few subjects stopped smoking one year after the IAEP (one in group C and 2 in group E). Most of the subjects sensitized to HDM adopted the recommendations given by the educator (26 subjects out of 37 in group E in comparison with 0 out of 21 in group C (P < 0.0001)). Among those sensitized to cats or dogs (group C,',16 group E=32) 6 out 16 in group C and 5 out of 32 in group E no longer had a pet at home by the end of the study. Conclusions: Our IAEP was able to motivate patients in adhering to HDM avoiding measures. Smoking habits and exposure to pets were not influenced by the one year intervention.
Abstracts
163
164
223
Clinical study o f bedding covers in mite-allergic asthmatic patients. J Bimbaum MD. F de Blav MD. E Paty MD, J Just ~f13, G Pauli MD, D Vervloet MD. D Charpin MD, Marseille, France. The study was designed to assess the climcal efficacy of bedding covers in house dust mite respiratory allergy. TMrty one astlunadc padents with house dust mite allergy, aged between %dO years, participated in a 24-weck study. Asthma had to be unstable with at least nocturual or diunh'd attacks, or variability of peak flow measurements, or B2 agonist intake ,almost d;dly Patients had to be exposed to mite allergens (Acarex test ++ or +++) and to receive maintenance and-itfflmmnatory treatment. After a four-week run-in period when astlunatic symptoms mid peak flow measitrements were recorded daily in diary cards, patients were randomly allocated to receive either active (Intcrvent, WL Gore and Associates, UK) or placebo mattress, duvet mid pillow covers. Then, they reex)rded their symptoms, treatment, peak flow measuremcns, one week every month during 6 months. At baseline aud after 12 weeks and 24 weeks, specific lgE against lnite, mctacholine challenge were realized, and mattress and floor samples were obtained by vacuuming for measurement of mite-group I allergen level. At baseline, the two groups were comparable on severity of asth,na and mean level of allergens. There was a sigifificant decrease of grou1) I allergen in mattress and floor (p<0.0001) mid IgEs level (p=0.03) in the active group compared to the placebo group. Symptoms, peak flow measurements relnained unchanged. Variations in bronchial reactivity to metacholinc was similar in both groups. In conclnsiou, allergen avoidance by "Intervent covers" is effective. However, in tiffs group of moderate asdunatic patients, it did not i,nprove allergic asduna.
Allergen Transfer Chamber: A new Method for Testing Allergen Barriers. JH Ransom MD. Tm~eka. Kansas. IF Halsey PhD Lenexa. KS _ Fabrics capable of excluding allergens are an integral part of current dust mite control methods. Using a novel dual chamber device, a reference dust containing a known quantity of allergen is loaded into one chamber. The fabric barrier to be tested is placed over the chamber and connected to an identical chamber. The device is rotated overnight, and the amount of allergen transferred across the barrier is determined by immunoassay using a standard technique. Samples of common bedsheets as well as fabrics sold for their proposed allergen excluding ability were tested. Results were as follows: Material Mite allergen (threadcount) (Nanograms transferred) Unwashed 5X 20X Cotton 130 19.5 16.3 4.0 Cotton 180 7.8 5.0 5.0 Cotton 200 <3.9 5.5 <3.9 Cotton 250 <3.9 <3.9 4.9 AG Microfibril <3.9 <3.9 <3.9 ACP Stretchable <3.9 <3.9 <3.9 Negative control <3.9 NA NA Positive control 2647 NA NA CONCLUSIONS: The dual chamber test system permits accurate and reproducible assessment of the antigen permeability ol fabrics and of the effects of washing, allowing such tests to be performed in the laboratory.