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Prevelence of Indoor Allergens in Kansas City Schools
Abstracts S171
J ALLERGY CLIN IMMUNOL VOLUME 123, NUMBER 2
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Children With Asthma And No URTI, More Commonly Have Rhinovirus In Their Exhaled Breath, Than In Mucous E. R. Tovey1, D. S. Y. Ng2, S. Stelzer-Braid3, W. D. Rawlinson3, B. G. Oliver2; 1Woolcock Institute of Medical Research, Glebe SYDNEY, Australia, 2University of Sydney, SYDNEY, Australia, 3SEALS, Prince of Wales Hospital, SYDNEY, Australia. RATIONALE: Rhinovirus (RV) URTIs are commonly associated with asthma exacerbations. Recent data suggests RV may be persistent in the airways of children and adults with asthma. METHODS: Children with or without asthma, either with or without URTIs, had exhaled RV aerosols sampled using a novel sampling mask plus nasal mucous collected. Virus was detected by PCR. URTI was established by questionnaire. RESULTS: % 1ve RV was detected in samples as follows Asthma 1ve, URTI 1ve, (n 5 62): mucous 34%, exhaled 37% Asthma 1ve, URTI 2ve, (n 5 54): mucous 2%, exhaled 39% Asthma 2ve, URTI 1ve, (n 5 42): mucous 12%, exhaled 12% Asthma 2ve, URTI 2ve, (n 5 29): mucous 0%, exhaled 0% CONCLUSIONS: Many children with asthma who do not have symptoms of URTIs may have persistent RV infections in their lower airways only, which can be detected in their exhaled breath, but not in nasal mucous. Whether the carriage of these quiescent infections is influenced by anti-inflammatory medications and affects clinical outcomes requires exploration.
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Cigarette Smoke Impaired Antiviral Responses of Airway Epithelial Cells to dsRNA are Associated with Upregulation of Glucocorticoid Induced Leucine Zipper (GILZ) R. U. Lee1,2, J. Eddleston3,4, J. Herschbach3, B. L. Zuraw2,4; 1Scripps Clinic, San Diego, CA, 2VA San Diego Healthcare, San Diego, CA, 3Veterans Medical Research Foundation, La Jolla, CA, 4University of California, San Diego, La Jolla, CA. RATIONALE: Since exposure to cigarette smoke (CS) is associated with increased risk of respiratory viral infections and has been show to dampen the innate immune response in airway cells to LPS and cytokines, we assessed the effect of CS exposure on the response of airway epithelial cells to dsRNA (a surrogate for viral infection) as well as its effect on the expression of the anti-inflammatory protein GILZ. METHODS: CS extract was generated by bubbling smoke from 2 reference cigarettes through DMSO. BEAS-2B cells were treated with CSE or control DMSO, diluted 1:1000, for 20 hours, then stimulated with Poly IC (2mcg/ml). 4 hours later IRF-3 phosphorylation was assessed by immunoblotting, while 6 hours later CXCL10 mRNA levels were assessed by quantitative real-time PCR. GILZ protein levels were assessed by immunoblotting total cell lysates from BEAS-2B cells incubated with CS extract. RESULTS: CS increased the expression of GILZ while diminishing the effect of dsRNA on the activation of IRF-3 in BEAS-2B cells. In addition, Poly-IC induced CXCL-10 mRNAwas reduced by 41% after pre-treatment with CS. CONCLUSIONS: CS induces GILZ and attenuates innate antiviral mechanisms in airway epithelial cells. Therefore, GILZ may be involved in the impaired response to viral infections in CS exposed individuals.
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Prevelence of Indoor Allergens in Kansas City Schools T. A. Lupoli, L. Gard, K. Kennedy, F. Pacheco, C. E. Ciaccio, C. Barnes, J. Portnoy; Children’s Mercy Hospital, Kansas City, MO. RATIONALE: Dust mite, cockroach, and penicillium are common perennial indoor allergens. Sensitization and exposure to these allergens are associated with significant asthma morbidity. The following was performed to study the prevalence of dust mite, cockroach, and penicillium allergens in Kansas City schools. METHODS: Seven schools from two school districts were recruited from the greater Kansas City area. Dust vacuum samples were collected from school libraries, classrooms, administrative offices, and common areas (hallways and gymnasiums). A total of 85 indoor school areas were sampled during January and February 2007. Dust mite, cockroach, and penicillium concentrations were enumerated using a whole body antigen assay. Pearson Correlation was determined for dust mite, roach, and penicillium using SSPS statistical software. RESULTS: Mean dust mite concentrations were highest in classrooms (72.73 micrograms/gram), while mean cockroach concentrations were elevated in administrative areas (73.35 mcg/g). The mean penicillium concentration ranged from 3.94 to 8.19 mcg/g across the various indoor locations sampled. The prevalence of dust mite was seen to correlelate significantly with cockroach and penicillium in schools. CONCLUSIONS: Dust mite and cockroach are prevalent indoor school allergens that can be up to 18 times the concentration of penicillium in the sampled rooms. Consideration should be given to reducing indoor allergen levels in schools as well as homes. Further research is needed to determine whether reducing allergen levels in schools effectively reduces asthma morbidity in children.
655
Exhaled NO Among 7-Year-Old Children Who Attended Head Start in New York City M. S. Perzanowski, A. Divjan, R. B. Mellins, S. M. Canfield, M. J. Rosa, G. L. Chew, A. G. Rundle, I. F. Goldstein, J. S. Jacobson; Columbia University, New York, NY. RATIONALE: Fractional Exhaled Nitric Oxide (FENO) has been proposed as a marker for airway inflammation in cohort studies of asthma. METHODS: As part of a longitudinal study of risk factors for childhood asthma, children recruited in NYC Head Start centers at age 4 years were brought to a clinic for offline FENO and lung function testing at age 7. Children with specific IgE to dust mite, cockroach, mouse or cat allergens (>0.35 IU/ml) at age 7 were considered seroatopic. RESULTS: Of 149 participating children, 106 had complete questionnaire data, achieved a valid FENO test and had not taken medication on the day of the test that might have lowered their FENO. The 30 children with a report of wheeze in the previous 12 months had higher FENO concentrations than the 76 without (means 18.3 vs. 13.3 ppb, p 5 0.030). In a multivariable logistic regression model adjusting for seroatopy and FEV1% predicted, FENO was significantly associated with current wheeze (p 5 0.044). FENO at age 7 years was positively associated with domestic ETS exposure at age 4 years (b 5 0.28, p 5 0.005) but inversely associated with ETS exposure at the time of the test (age 7) (b 5 -0.23, p 5 0.020). CONCLUSIONS: Given its association with current wheeze, independent of seroatopy and lung function, FENO may be a valid and convenient outcome measure for inner-city cohort studies of asthma. The positive association of ETS exposure at age 4 with eNO at age 7 suggests a long-term detrimental effect of ETS exposure on the airway of young children.
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J ALLERGY CLIN IMMUNOL VOLUME 123, NUMBER 2
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ET R
AC
TE D
Children With Asthma And No URTI, More Commonly Have Rhinovirus In Their Exhaled Breath, Than In Mucous E. R. Tovey1, D. S. Y. Ng2, S. Stelzer-Braid3, W. D. Rawlinson3, B. G. Oliver2; 1Woolcock Institute of Medical Research, Glebe SYDNEY, Australia, 2University of Sydney, SYDNEY, Australia, 3SEALS, Prince of Wales Hospital, SYDNEY, Australia. RATIONALE: Rhinovirus (RV) URTIs are commonly associated with asthma exacerbations. Recent data suggests RV may be persistent in the airways of children and adults with asthma. METHODS: Children with or without asthma, either with or without URTIs, had exhaled RV aerosols sampled using a novel sampling mask plus nasal mucous collected. Virus was detected by PCR. URTI was established by questionnaire. RESULTS: % 1ve RV was detected in samples as follows Asthma 1ve, URTI 1ve, (n 5 62): mucous 34%, exhaled 37% Asthma 1ve, URTI 2ve, (n 5 54): mucous 2%, exhaled 39% Asthma 2ve, URTI 1ve, (n 5 42): mucous 12%, exhaled 12% Asthma 2ve, URTI 2ve, (n 5 29): mucous 0%, exhaled 0% CONCLUSIONS: Many children with asthma who do not have symptoms of URTIs may have persistent RV infections in their lower airways only, which can be detected in their exhaled breath, but not in nasal mucous. Whether the carriage of these quiescent infections is influenced by anti-inflammatory medications and affects clinical outcomes requires exploration.
653
Cigarette Smoke Impaired Antiviral Responses of Airway Epithelial Cells to dsRNA are Associated with Upregulation of Glucocorticoid Induced Leucine Zipper (GILZ) R. U. Lee1,2, J. Eddleston3,4, J. Herschbach3, B. L. Zuraw2,4; 1Scripps Clinic, San Diego, CA, 2VA San Diego Healthcare, San Diego, CA, 3Veterans Medical Research Foundation, La Jolla, CA, 4University of California, San Diego, La Jolla, CA. RATIONALE: Since exposure to cigarette smoke (CS) is associated with increased risk of respiratory viral infections and has been show to dampen the innate immune response in airway cells to LPS and cytokines, we assessed the effect of CS exposure on the response of airway epithelial cells to dsRNA (a surrogate for viral infection) as well as its effect on the expression of the anti-inflammatory protein GILZ. METHODS: CS extract was generated by bubbling smoke from 2 reference cigarettes through DMSO. BEAS-2B cells were treated with CSE or control DMSO, diluted 1:1000, for 20 hours, then stimulated with Poly IC (2mcg/ml). 4 hours later IRF-3 phosphorylation was assessed by immunoblotting, while 6 hours later CXCL10 mRNA levels were assessed by quantitative real-time PCR. GILZ protein levels were assessed by immunoblotting total cell lysates from BEAS-2B cells incubated with CS extract. RESULTS: CS increased the expression of GILZ while diminishing the effect of dsRNA on the activation of IRF-3 in BEAS-2B cells. In addition, Poly-IC induced CXCL-10 mRNAwas reduced by 41% after pre-treatment with CS. CONCLUSIONS: CS induces GILZ and attenuates innate antiviral mechanisms in airway epithelial cells. Therefore, GILZ may be involved in the impaired response to viral infections in CS exposed individuals.
654
Prevelence of Indoor Allergens in Kansas City Schools T. A. Lupoli, L. Gard, K. Kennedy, F. Pacheco, C. E. Ciaccio, C. Barnes, J. Portnoy; Children’s Mercy Hospital, Kansas City, MO. RATIONALE: Dust mite, cockroach, and penicillium are common perennial indoor allergens. Sensitization and exposure to these allergens are associated with significant asthma morbidity. The following was performed to study the prevalence of dust mite, cockroach, and penicillium allergens in Kansas City schools. METHODS: Seven schools from two school districts were recruited from the greater Kansas City area. Dust vacuum samples were collected from school libraries, classrooms, administrative offices, and common areas (hallways and gymnasiums). A total of 85 indoor school areas were sampled during January and February 2007. Dust mite, cockroach, and penicillium concentrations were enumerated using a whole body antigen assay. Pearson Correlation was determined for dust mite, roach, and penicillium using SSPS statistical software. RESULTS: Mean dust mite concentrations were highest in classrooms (72.73 micrograms/gram), while mean cockroach concentrations were elevated in administrative areas (73.35 mcg/g). The mean penicillium concentration ranged from 3.94 to 8.19 mcg/g across the various indoor locations sampled. The prevalence of dust mite was seen to correlelate significantly with cockroach and penicillium in schools. CONCLUSIONS: Dust mite and cockroach are prevalent indoor school allergens that can be up to 18 times the concentration of penicillium in the sampled rooms. Consideration should be given to reducing indoor allergen levels in schools as well as homes. Further research is needed to determine whether reducing allergen levels in schools effectively reduces asthma morbidity in children.
655
Exhaled NO Among 7-Year-Old Children Who Attended Head Start in New York City M. S. Perzanowski, A. Divjan, R. B. Mellins, S. M. Canfield, M. J. Rosa, G. L. Chew, A. G. Rundle, I. F. Goldstein, J. S. Jacobson; Columbia University, New York, NY. RATIONALE: Fractional Exhaled Nitric Oxide (FENO) has been proposed as a marker for airway inflammation in cohort studies of asthma. METHODS: As part of a longitudinal study of risk factors for childhood asthma, children recruited in NYC Head Start centers at age 4 years were brought to a clinic for offline FENO and lung function testing at age 7. Children with specific IgE to dust mite, cockroach, mouse or cat allergens (>0.35 IU/ml) at age 7 were considered seroatopic. RESULTS: Of 149 participating children, 106 had complete questionnaire data, achieved a valid FENO test and had not taken medication on the day of the test that might have lowered their FENO. The 30 children with a report of wheeze in the previous 12 months had higher FENO concentrations than the 76 without (means 18.3 vs. 13.3 ppb, p 5 0.030). In a multivariable logistic regression model adjusting for seroatopy and FEV1% predicted, FENO was significantly associated with current wheeze (p 5 0.044). FENO at age 7 years was positively associated with domestic ETS exposure at age 4 years (b 5 0.28, p 5 0.005) but inversely associated with ETS exposure at the time of the test (age 7) (b 5 -0.23, p 5 0.020). CONCLUSIONS: Given its association with current wheeze, independent of seroatopy and lung function, FENO may be a valid and convenient outcome measure for inner-city cohort studies of asthma. The positive association of ETS exposure at age 4 with eNO at age 7 suggests a long-term detrimental effect of ETS exposure on the airway of young children.
MONDAY
652