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Differences in mite specific IgE between asthmatic parents and their offspring are large
Abstracts S169
J ALLERGY CLIN IMMUNOL VOLUME 115, NUMBER 2
674
Increment of IgE Production in Obese Children
K. Matsuda, H. Tani, Y. Okamatsu, Y. Sakaguchi, K. Kimura, T. Matsuishi; Department of Pediatrics, Kurume university school of medicine, Kurume ciry, Fukuoka, JAPAN. RATIONALE: Recently there has been a significant worldwide increase in the prevalence of allergic disorders and obesity in children; however, the mechanisms of this possible association have rarely been explored. We examine the relationship between the degree of obesity and allergic factors and their symptoms in children. METHODS: Body mass index (BMI) measurement and blood test (including serum IgE levels, peripheral eosinophils counts and serum Leptin levels) were performed in 37 (17 female, 20 male; mean age 9.3years) obese subjects and in 34 (13 female, 21 male; mean age 9.8years) non-obese subjects. Clinical information regarding their histories of allergic disorder were collected from clinical charts. RESULTS: The obese subjects had significantly higher serum IgE levels than did non-obese subjects (obese: 817.4+ 369.2 IU/ml, non-obese: 227.4+65.4 IU/ml, p<0.01), although no significant differences regarding the prevalence of allergic disorders (i.e., bronchial asthma, atopic dermatitis) (11 of the 37 obese subjects and 11 of the 34 non-obese subjects) or peripheral eosinophils counts (obese: 5.2+0.6 %, non-obese: 3.9+0.8 %, p=0.19) were seen between 2 groups. The obese subjects had significantly higher Leptin levels than did non-obese subjects (obese: 24.4+ 1.9 ng/ml, non-obese: 10.6+1.8ng/ml, p<0.001). A significant correlation was observed between Leptin levels and IgE in all subjects who had allergic disorder (r=0.75; p<0.0001).
CONCLUSIONS: Incremental IgE production was observed in obese children, and their high Leptin levels may correlate with the up-regulation of IgE. The present our results may partly explain why obesity is the risk factor in the future development of asthma. Funding: kurume university
675
Body Mass Index and Its Effects on Clinical Control of Asthma
J. B. Saxena, K. Kwong, C. Jones; Allergy and Immunology, Los Angeles County +University of Southern California, Los Angeles, CA. RATIONALE: To determine whether there is an association between body mass index and the time to achieve clinical control of asthma and the ability to maintain clinical control of asthma METHODS: The study population consisted of children aged 2-18 living in the Los Angeles area as part of the Pediatric Asthma Disease Management Program (PADMAP). The inclusion criteria for the group were as follows: age 2-18 years old, entered program between January 1, 1998 June 30, 2003, persistent asthmatic, greater than or equal to two visits in the program and control status reported at visit 2, and vital data available to determine BMI percentile. RESULTS: Obesity (BMI > 95%) did not impact the pattern of control observed for persistent cases over the course of six visits (p >0.05 at each 1 visit) By their second visit to the Breathmobile, nearly /2 of the patients had achieved clinical control of their asthma. The estimated percent of children reaching clinical control was not impacted by their BMI percentile score (p = 0.94) Adjusting for severity did not alter this finding (p= 0.75) CONCLUSIONS: The results reveal that in an inner city pediatric asthmatic population given optimal asthma controller therapy, body mass index percentile was not a factor in achieving or maintaining control of asthma symptoms. The time required to achieve control of asthma symptoms and to maintain asthma control was not statistically different when compared to obese and non-obese asthmatics. Funding: University of Southern California
Differences in Mite Specific IgE Between Asthmatic Parents and Their Offspring Are Large P. B. Williams; Allergy & Immunology, Children’s Mercy Hospital, KC, Olathe, KS. RATIONALE: Numerous reports indicate that the incidence of allergies are increasing in modern societies. Questions arise as to whether this is due to improved reporting methods, growing patient awareness, use of better tests, or is actually due to environmental or lifestyle changes. While studying the genetics of asthma, a rather large difference was noted in the levels of specific IgE (s-IgE) to mites in asthmatic parents versus their offspring which is reported herein. METHODS: Families with at least one parent having reversible airway disease were recruited and all members were testing using the Pharmacia CAP system for levels of specific IgE to several common allergens including those from the dust mite Dermatophagoides farinase (DF). The cohort cosisted of 666 parents with 797 offspring (n=1458). RESULTS: Three hundred and two (45.3%) of the parents and 479 (60.1%) of the siblings demonstrated specific IgE to DF (positive cutoff > 0.35 KUa/L). When quantitative specific IgE levels in the parents versus their offspring were investigated very large differences were noted between these groups. In the sensitized parents the average s-IgE to DF was 14.8 KUa/L while that in the children was 51.7 KUa/L. This number represents a minimum as only 10% of the parents had levels of sIgE>100 while 42% of their children had levels exceeding 100 KUa/L. CONCLUSIONS: These data represent very large objective increases in s-IgE levels between parents and their offspring with respect to DF which supports the fact that allergies are increasing. Possible explanations include enhanced exposure or changing lifestyle factors.
676
MONDAY
Anti-Helminth Treatment Lead to a Reduction on Asthma Severity M. Medeiros, Jr.1,2, M. C. F. Almeida1, A. A. Cruz1, J. P. Figueiredo1, R. R. Oliveira1, L. M. Alcantara3, C. B. Aquino1, E. M. Carvalho1, M. I. Araujo1; 1Servico de Imunologia, Universidade Federal da Bahia, Brazil, Salvador, Bahia, Brazil, BRAZIL, 2Instituto de Investigação em Imunologia/CNPq, Brazil, Salvador, BRAZIL, 3Faculdade de Farmacia, Universidade Federal da Bahia, Brazil, Salvador, Bahia, Brazil, BRAZIL. RATIONALE: Helminthic infections reduce asthma severity. This prospective study evaluates the influence of anti-helminth treatment on the asthma severity in asthmatics living in a polyhelminthic endemic area, in Brazil. METHODS: Fifty-five subjects aged between 6 and 40 years infected with S. mansoni and other helminths were selected for this study (group I). Another 21 asthmatic subjects aged between 6 and 40 years, infected with other helminths, except S. mansoni (group II). Asthma severity was evaluated using scores obtained by a questionnaire to access the severity, physical exams, and pulmonary function tests. The evaluations were performed in the beginning of the study (D0) and every 3 months thereafter (D1, D2, D3 and D4), for a year. Subjects from group I were treated with Mebendazole and Praziquantel, while subjects from group II received Mebendazole, immediately after first evaluation on D0. RESULTS: At D0 all of the subjects from group I and II had mild asthma. However, when we compare the score of asthma at D0 with D1, D2 and D3 there was an increase in the asthma severity in asthmatics from both, group I and group II (p<0,005). Twelve months after treatment, there was a decrease in asthma severity in subjects from group I - they returned to the basal levels, while subjects from group II maintained the symptoms of asthma. CONCLUSIONS: Our data show that anti-helminth treatment of asthmatic subjects living in a polyhelminthic endemic area leads to an increase in asthma symptoms. Helminthic infection through regulatory mechanisms could modulate the asthma inflammatory response. Funding: NHI Grant # D43 TW 06216; Fogarty EIDG# D43 TW00919;FAPESB
673
J ALLERGY CLIN IMMUNOL VOLUME 115, NUMBER 2
674
Increment of IgE Production in Obese Children
K. Matsuda, H. Tani, Y. Okamatsu, Y. Sakaguchi, K. Kimura, T. Matsuishi; Department of Pediatrics, Kurume university school of medicine, Kurume ciry, Fukuoka, JAPAN. RATIONALE: Recently there has been a significant worldwide increase in the prevalence of allergic disorders and obesity in children; however, the mechanisms of this possible association have rarely been explored. We examine the relationship between the degree of obesity and allergic factors and their symptoms in children. METHODS: Body mass index (BMI) measurement and blood test (including serum IgE levels, peripheral eosinophils counts and serum Leptin levels) were performed in 37 (17 female, 20 male; mean age 9.3years) obese subjects and in 34 (13 female, 21 male; mean age 9.8years) non-obese subjects. Clinical information regarding their histories of allergic disorder were collected from clinical charts. RESULTS: The obese subjects had significantly higher serum IgE levels than did non-obese subjects (obese: 817.4+ 369.2 IU/ml, non-obese: 227.4+65.4 IU/ml, p<0.01), although no significant differences regarding the prevalence of allergic disorders (i.e., bronchial asthma, atopic dermatitis) (11 of the 37 obese subjects and 11 of the 34 non-obese subjects) or peripheral eosinophils counts (obese: 5.2+0.6 %, non-obese: 3.9+0.8 %, p=0.19) were seen between 2 groups. The obese subjects had significantly higher Leptin levels than did non-obese subjects (obese: 24.4+ 1.9 ng/ml, non-obese: 10.6+1.8ng/ml, p<0.001). A significant correlation was observed between Leptin levels and IgE in all subjects who had allergic disorder (r=0.75; p<0.0001).
CONCLUSIONS: Incremental IgE production was observed in obese children, and their high Leptin levels may correlate with the up-regulation of IgE. The present our results may partly explain why obesity is the risk factor in the future development of asthma. Funding: kurume university
675
Body Mass Index and Its Effects on Clinical Control of Asthma
J. B. Saxena, K. Kwong, C. Jones; Allergy and Immunology, Los Angeles County +University of Southern California, Los Angeles, CA. RATIONALE: To determine whether there is an association between body mass index and the time to achieve clinical control of asthma and the ability to maintain clinical control of asthma METHODS: The study population consisted of children aged 2-18 living in the Los Angeles area as part of the Pediatric Asthma Disease Management Program (PADMAP). The inclusion criteria for the group were as follows: age 2-18 years old, entered program between January 1, 1998 June 30, 2003, persistent asthmatic, greater than or equal to two visits in the program and control status reported at visit 2, and vital data available to determine BMI percentile. RESULTS: Obesity (BMI > 95%) did not impact the pattern of control observed for persistent cases over the course of six visits (p >0.05 at each 1 visit) By their second visit to the Breathmobile, nearly /2 of the patients had achieved clinical control of their asthma. The estimated percent of children reaching clinical control was not impacted by their BMI percentile score (p = 0.94) Adjusting for severity did not alter this finding (p= 0.75) CONCLUSIONS: The results reveal that in an inner city pediatric asthmatic population given optimal asthma controller therapy, body mass index percentile was not a factor in achieving or maintaining control of asthma symptoms. The time required to achieve control of asthma symptoms and to maintain asthma control was not statistically different when compared to obese and non-obese asthmatics. Funding: University of Southern California
Differences in Mite Specific IgE Between Asthmatic Parents and Their Offspring Are Large P. B. Williams; Allergy & Immunology, Children’s Mercy Hospital, KC, Olathe, KS. RATIONALE: Numerous reports indicate that the incidence of allergies are increasing in modern societies. Questions arise as to whether this is due to improved reporting methods, growing patient awareness, use of better tests, or is actually due to environmental or lifestyle changes. While studying the genetics of asthma, a rather large difference was noted in the levels of specific IgE (s-IgE) to mites in asthmatic parents versus their offspring which is reported herein. METHODS: Families with at least one parent having reversible airway disease were recruited and all members were testing using the Pharmacia CAP system for levels of specific IgE to several common allergens including those from the dust mite Dermatophagoides farinase (DF). The cohort cosisted of 666 parents with 797 offspring (n=1458). RESULTS: Three hundred and two (45.3%) of the parents and 479 (60.1%) of the siblings demonstrated specific IgE to DF (positive cutoff > 0.35 KUa/L). When quantitative specific IgE levels in the parents versus their offspring were investigated very large differences were noted between these groups. In the sensitized parents the average s-IgE to DF was 14.8 KUa/L while that in the children was 51.7 KUa/L. This number represents a minimum as only 10% of the parents had levels of sIgE>100 while 42% of their children had levels exceeding 100 KUa/L. CONCLUSIONS: These data represent very large objective increases in s-IgE levels between parents and their offspring with respect to DF which supports the fact that allergies are increasing. Possible explanations include enhanced exposure or changing lifestyle factors.
676
MONDAY
Anti-Helminth Treatment Lead to a Reduction on Asthma Severity M. Medeiros, Jr.1,2, M. C. F. Almeida1, A. A. Cruz1, J. P. Figueiredo1, R. R. Oliveira1, L. M. Alcantara3, C. B. Aquino1, E. M. Carvalho1, M. I. Araujo1; 1Servico de Imunologia, Universidade Federal da Bahia, Brazil, Salvador, Bahia, Brazil, BRAZIL, 2Instituto de Investigação em Imunologia/CNPq, Brazil, Salvador, BRAZIL, 3Faculdade de Farmacia, Universidade Federal da Bahia, Brazil, Salvador, Bahia, Brazil, BRAZIL. RATIONALE: Helminthic infections reduce asthma severity. This prospective study evaluates the influence of anti-helminth treatment on the asthma severity in asthmatics living in a polyhelminthic endemic area, in Brazil. METHODS: Fifty-five subjects aged between 6 and 40 years infected with S. mansoni and other helminths were selected for this study (group I). Another 21 asthmatic subjects aged between 6 and 40 years, infected with other helminths, except S. mansoni (group II). Asthma severity was evaluated using scores obtained by a questionnaire to access the severity, physical exams, and pulmonary function tests. The evaluations were performed in the beginning of the study (D0) and every 3 months thereafter (D1, D2, D3 and D4), for a year. Subjects from group I were treated with Mebendazole and Praziquantel, while subjects from group II received Mebendazole, immediately after first evaluation on D0. RESULTS: At D0 all of the subjects from group I and II had mild asthma. However, when we compare the score of asthma at D0 with D1, D2 and D3 there was an increase in the asthma severity in asthmatics from both, group I and group II (p<0,005). Twelve months after treatment, there was a decrease in asthma severity in subjects from group I - they returned to the basal levels, while subjects from group II maintained the symptoms of asthma. CONCLUSIONS: Our data show that anti-helminth treatment of asthmatic subjects living in a polyhelminthic endemic area leads to an increase in asthma symptoms. Helminthic infection through regulatory mechanisms could modulate the asthma inflammatory response. Funding: NHI Grant # D43 TW 06216; Fogarty EIDG# D43 TW00919;FAPESB
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