- Email: [email protected]
Cockroach Allergen Reduction by Extermination Alone in Low-Income, Urban Homes-A Randomized Control Trial
Abstracts S157
J ALLERGY CLIN IMMUNOL VOLUME 119, NUMBER 1
High Environmental Tobacco Smoke Exposure and Presence of IL4 Polymorphism (C-589T) Increases Risk of Infant Wheezing: the Cincinnati Childhood Allergy and Air Pollution Study (CCAAPS) A. M. Smith1, D. I. Bernstein1, G. K. LeMasters2, N. L. Huey3, G. K. Khurana Hershey3; 1University of Cincinnati, Department of Internal Medicine, Cincinnati, OH, 2University of Cincinnati, Department of Environmental Health, Cincinnati, OH, 3Cincinnati Children’s Hospital Center for Translational Research in Allergy and Asthma, Cincinnati, OH. RATIONALE: Children exposed to environmental tobacco smoke (ETS) have increased asthma exacerbations. IL4 C-589Tand IL13 C-1112T SNPs are associated with enhanced function of respective cytokines and with asthma phenotypes. Increased IL4 and IL13 levels reported in smokers suggest a potential for gene*environment interaction. The purpose of this study was to determine if infants exposed to ETS and with IL4 or IL13 gene polymorphisms were at increased risk of infantile wheezing. METHODS: A prospective birth cohort of 758 infants born to atopic parents was evaluated annually by a detailed medical and environmental questionnaire, physical examination, and skin prick testing to a panel of 15 aeroallergens, milk, and egg. DNA samples were genotyped for IL4 C-589T and IL13 C-1112T polymorphisms. The relationship of ETS exposure and genotype with the outcome of wheezing without a cold was analyzed with multiple logistic regression. Odds ratios (OR) and 95% confidence intervals (CI) were calculated. RESULTS: The mean age of infants at time of SPT was 13.462.2 months. The overall prevalence of sensitization was 28.6%. The overall prevalence of wheezing without a cold was 26.2%. Analysis of the genotypes was stratified by race since the racially diverse study population was not in Hardy-Weinberg equilibrium. The interaction of exposure to high levels of ETS and the CT/TT genotypes for IL4 C-589T was independently associated with wheezing (OR: 10.84; 95% CI: 1.12-104.64) in AfricanAmerican infants (n5146). CONCLUSIONS: In infants at high risk for atopy, the interaction of ETS and IL4 C-589T is associated with wheezing without a cold during infancy. Funding: NIEHS Grants ES10957 and ES11170 and NIAID Grant T32AI60515-02
617
BASE a Major Cat Allergen S. E. O’Neil, W. Smith, T. K. Heinrich, B. J. Hales, W. R. Thomas; Telethon Institute for Child Health Research, West Perth, AUSTRALIA. RATIONALE: While cats are known to produce at least 10 allergenic proteins, only Fel d 1 has been extensively characterised. Recent studies have shown that some cat-allergic subjects have high-IgE binding to Fel d 1 but for many patients the titre is low. METHODS: A cat mandibular cDNA library was screened by immunoassay with human cat allergic sera. A polypeptide from an IgE binding clone was expressed in Escherichia coli and purified by chromatography. The IgE reactivity was determined by dissociation enhanced lanthanide fluorescence immunoassay (DELFIA). RESULTS: A cDNA from an IgE-reactive clone isolated from the mandibular library encoded a protein with a predicted molecular mass of 26kDa. It had high sequence identity with breast cancer and salivary gland expression gene (BASE) protein and the major Equ c 4 and 5 latherin horse allergens. The recombinant polypeptide bound IgE in over 50% of 31 sera from subjects with cat allergy. The importance of the BASE allergen was shown by the finding that the DELFIA assay showed higher IgE reactivity than Fel d 1 for 55% of subjects with binding to BASE. CONCLUSIONS: The high IgE reactivity of BASE highlights the importance of determining the allergenicity of the full spectrum of cat allergens. Its high IgE binding, compared to Fel d 1, shows its importance in allergic sensitisation to cats. Funding: National Health and Medical Research Council of Australia
618
Cockroach Allergen Reduction by Extermination Alone in Low-Income, Urban Homes-A Randomized Control Trial M. L. Sever1, S. J. Arbes, Jr.1 D. C. Zeldin1, C. Schal2, R. G. Santangelo2, J. C. Gore2, B. Vaughn3, H. Mitchell3; 1NIEHS, Research Triangle Park, NC, 2NCSU, Raleigh, NC, 3Rho, Inc., Chapel HIll, NC. RATIONALE: We previously reported significant reductions in cockroach allergen (Bla g 1) concentrations in cockroach-infested urban homes after extermination alone. The objectives of this study were to confirm that previous finding and compare extermination performed by entomologists and commercial companies. METHODS: This 3-arm randomized controlled trial enrolled 60 cockroach-infested homes. Homes were randomly assigned to either a control group or one of two treatment groups and followed for 1 year. Treatment 1 received insecticide bait placement by staff from the Entomology Department at North Carolina State University. Treatment 2 homes received extermination from 1 of 4 randomly assigned commercial pest control companies. Vacuumed dust sampling and cockroach trapping were conducted at 0, 6 and 12 months. Dust samples were collected from kitchen, living room, and bedroom floors, and the bedroom bed, and were analyzed by ELISA. RESULTS: Relative to control, Treatment 1 homes showed a significant 12-month reduction in Bla g 1 at all sampled sites except the bedroom floor. From baseline to month 12, geometric mean Bla g 1 concentrations (U/g) decreased from 64.2 to 5.6 in the kitchen, 10.6 to 1.1 in the living room, 10.7 to 1.9 in the bedroom floor and 3.6 to 2.3 in the bed. Treatment 2 homes showed no significant 12-month reductions relative to control. CONCLUSIONS: Significant reductions in Bla g 1 can be achieved by extermination alone in cockroach-infested homes; however, the magnitude of the reduction is dependent on the effectiveness of cockroach control.
619
Wheezing Severe Rhinovirus Illnesses During Infancy Predict Childhood Asthma at Age 6 Years K. A. Roberg1, K. T. Sullivan-Dillie2, M. D. Evans2, T. E. Pappas2, E. L. Anderson2, K. M. Hanson2, D. F. DaSilva2, C. J. Tisler2, L. E. P. Salazar2, R. E. Gangnon2, J. E. Gern2, R. F. Lemanske, Jr.2; 1University of Wisconsin School of Medicine and Public Health Madison, WI, 2UW School of Medicine and Public Health, Madison, WI. RATIONALE: We previously reported that rhinovirus (RV) wheezing illnesses in the first year of life increased the risk for recurrent wheezing by age 3 years. These findings suggest that RV illnesses might also influence the development of asthma later on in childhood. METHODS: Nasal lavage specimens collected during infancy at study visits and symptomatic illnesses from children enrolled in the Childhood Origins of ASThma (COAST) project were analyzed by culture and RTPCR for respiratory viruses. Respiratory tract symptoms were characterized for severity and the presence/absence of wheezing. Children were evaluated for asthma at age 6 years. RESULTS: Children who had a wheezing RV illness during infancy (n541) were significantly more likely to be diagnosed with asthma at age 6 than children who did not (n5214) (54% vs. 23%, p50.0002). Non-wheezing illnesses with RV predicted risk of recurrent wheeze at age 3 yrs (29% vs. 15%, p50.01), but not asthma at age 6 (24% vs. 22%, p50.75). The occurrence of an RSV wheezing illness during infancy (n547) was not significantly associated with asthma diagnosis at age 6 (38% vs. 26%, p50.13). There was a non-significant trend between non-RV/non-RSV wheezing illnesses in infancy (n544) and asthma (39% vs. 26%, p50.13). CONCLUSIONS: Of the viral etiologies most frequently associated with moderate to severe wheezing illnesses during infancy, RV infections are most significantly associated with the subsequent development of childhood asthma. Furthermore, the risk of asthma at age 6 appears to be linked to RV illnesses involving the lower respiratory tract, and not the upper respiratory tract. Funding: NIH grants M01 RR03186, R01 HL61879, and P01 HL70831
SUNDAY
616
J ALLERGY CLIN IMMUNOL VOLUME 119, NUMBER 1
High Environmental Tobacco Smoke Exposure and Presence of IL4 Polymorphism (C-589T) Increases Risk of Infant Wheezing: the Cincinnati Childhood Allergy and Air Pollution Study (CCAAPS) A. M. Smith1, D. I. Bernstein1, G. K. LeMasters2, N. L. Huey3, G. K. Khurana Hershey3; 1University of Cincinnati, Department of Internal Medicine, Cincinnati, OH, 2University of Cincinnati, Department of Environmental Health, Cincinnati, OH, 3Cincinnati Children’s Hospital Center for Translational Research in Allergy and Asthma, Cincinnati, OH. RATIONALE: Children exposed to environmental tobacco smoke (ETS) have increased asthma exacerbations. IL4 C-589Tand IL13 C-1112T SNPs are associated with enhanced function of respective cytokines and with asthma phenotypes. Increased IL4 and IL13 levels reported in smokers suggest a potential for gene*environment interaction. The purpose of this study was to determine if infants exposed to ETS and with IL4 or IL13 gene polymorphisms were at increased risk of infantile wheezing. METHODS: A prospective birth cohort of 758 infants born to atopic parents was evaluated annually by a detailed medical and environmental questionnaire, physical examination, and skin prick testing to a panel of 15 aeroallergens, milk, and egg. DNA samples were genotyped for IL4 C-589T and IL13 C-1112T polymorphisms. The relationship of ETS exposure and genotype with the outcome of wheezing without a cold was analyzed with multiple logistic regression. Odds ratios (OR) and 95% confidence intervals (CI) were calculated. RESULTS: The mean age of infants at time of SPT was 13.462.2 months. The overall prevalence of sensitization was 28.6%. The overall prevalence of wheezing without a cold was 26.2%. Analysis of the genotypes was stratified by race since the racially diverse study population was not in Hardy-Weinberg equilibrium. The interaction of exposure to high levels of ETS and the CT/TT genotypes for IL4 C-589T was independently associated with wheezing (OR: 10.84; 95% CI: 1.12-104.64) in AfricanAmerican infants (n5146). CONCLUSIONS: In infants at high risk for atopy, the interaction of ETS and IL4 C-589T is associated with wheezing without a cold during infancy. Funding: NIEHS Grants ES10957 and ES11170 and NIAID Grant T32AI60515-02
617
BASE a Major Cat Allergen S. E. O’Neil, W. Smith, T. K. Heinrich, B. J. Hales, W. R. Thomas; Telethon Institute for Child Health Research, West Perth, AUSTRALIA. RATIONALE: While cats are known to produce at least 10 allergenic proteins, only Fel d 1 has been extensively characterised. Recent studies have shown that some cat-allergic subjects have high-IgE binding to Fel d 1 but for many patients the titre is low. METHODS: A cat mandibular cDNA library was screened by immunoassay with human cat allergic sera. A polypeptide from an IgE binding clone was expressed in Escherichia coli and purified by chromatography. The IgE reactivity was determined by dissociation enhanced lanthanide fluorescence immunoassay (DELFIA). RESULTS: A cDNA from an IgE-reactive clone isolated from the mandibular library encoded a protein with a predicted molecular mass of 26kDa. It had high sequence identity with breast cancer and salivary gland expression gene (BASE) protein and the major Equ c 4 and 5 latherin horse allergens. The recombinant polypeptide bound IgE in over 50% of 31 sera from subjects with cat allergy. The importance of the BASE allergen was shown by the finding that the DELFIA assay showed higher IgE reactivity than Fel d 1 for 55% of subjects with binding to BASE. CONCLUSIONS: The high IgE reactivity of BASE highlights the importance of determining the allergenicity of the full spectrum of cat allergens. Its high IgE binding, compared to Fel d 1, shows its importance in allergic sensitisation to cats. Funding: National Health and Medical Research Council of Australia
618
Cockroach Allergen Reduction by Extermination Alone in Low-Income, Urban Homes-A Randomized Control Trial M. L. Sever1, S. J. Arbes, Jr.1 D. C. Zeldin1, C. Schal2, R. G. Santangelo2, J. C. Gore2, B. Vaughn3, H. Mitchell3; 1NIEHS, Research Triangle Park, NC, 2NCSU, Raleigh, NC, 3Rho, Inc., Chapel HIll, NC. RATIONALE: We previously reported significant reductions in cockroach allergen (Bla g 1) concentrations in cockroach-infested urban homes after extermination alone. The objectives of this study were to confirm that previous finding and compare extermination performed by entomologists and commercial companies. METHODS: This 3-arm randomized controlled trial enrolled 60 cockroach-infested homes. Homes were randomly assigned to either a control group or one of two treatment groups and followed for 1 year. Treatment 1 received insecticide bait placement by staff from the Entomology Department at North Carolina State University. Treatment 2 homes received extermination from 1 of 4 randomly assigned commercial pest control companies. Vacuumed dust sampling and cockroach trapping were conducted at 0, 6 and 12 months. Dust samples were collected from kitchen, living room, and bedroom floors, and the bedroom bed, and were analyzed by ELISA. RESULTS: Relative to control, Treatment 1 homes showed a significant 12-month reduction in Bla g 1 at all sampled sites except the bedroom floor. From baseline to month 12, geometric mean Bla g 1 concentrations (U/g) decreased from 64.2 to 5.6 in the kitchen, 10.6 to 1.1 in the living room, 10.7 to 1.9 in the bedroom floor and 3.6 to 2.3 in the bed. Treatment 2 homes showed no significant 12-month reductions relative to control. CONCLUSIONS: Significant reductions in Bla g 1 can be achieved by extermination alone in cockroach-infested homes; however, the magnitude of the reduction is dependent on the effectiveness of cockroach control.
619
Wheezing Severe Rhinovirus Illnesses During Infancy Predict Childhood Asthma at Age 6 Years K. A. Roberg1, K. T. Sullivan-Dillie2, M. D. Evans2, T. E. Pappas2, E. L. Anderson2, K. M. Hanson2, D. F. DaSilva2, C. J. Tisler2, L. E. P. Salazar2, R. E. Gangnon2, J. E. Gern2, R. F. Lemanske, Jr.2; 1University of Wisconsin School of Medicine and Public Health Madison, WI, 2UW School of Medicine and Public Health, Madison, WI. RATIONALE: We previously reported that rhinovirus (RV) wheezing illnesses in the first year of life increased the risk for recurrent wheezing by age 3 years. These findings suggest that RV illnesses might also influence the development of asthma later on in childhood. METHODS: Nasal lavage specimens collected during infancy at study visits and symptomatic illnesses from children enrolled in the Childhood Origins of ASThma (COAST) project were analyzed by culture and RTPCR for respiratory viruses. Respiratory tract symptoms were characterized for severity and the presence/absence of wheezing. Children were evaluated for asthma at age 6 years. RESULTS: Children who had a wheezing RV illness during infancy (n541) were significantly more likely to be diagnosed with asthma at age 6 than children who did not (n5214) (54% vs. 23%, p50.0002). Non-wheezing illnesses with RV predicted risk of recurrent wheeze at age 3 yrs (29% vs. 15%, p50.01), but not asthma at age 6 (24% vs. 22%, p50.75). The occurrence of an RSV wheezing illness during infancy (n547) was not significantly associated with asthma diagnosis at age 6 (38% vs. 26%, p50.13). There was a non-significant trend between non-RV/non-RSV wheezing illnesses in infancy (n544) and asthma (39% vs. 26%, p50.13). CONCLUSIONS: Of the viral etiologies most frequently associated with moderate to severe wheezing illnesses during infancy, RV infections are most significantly associated with the subsequent development of childhood asthma. Furthermore, the risk of asthma at age 6 appears to be linked to RV illnesses involving the lower respiratory tract, and not the upper respiratory tract. Funding: NIH grants M01 RR03186, R01 HL61879, and P01 HL70831
SUNDAY
616