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Sensitization to indoor allergens in patients with cockroach asthma and rhinitis in Belarus
$160
Abstracts
J ALLERGY CLIN IMMUNOL FEBRUARY 2003
63 AtopicDiseasein Childrenwith ElevatedSerumLeadLevels K. Shaw ], J. N. Moy 2, K. Amin3, B. yu4; IAllergy/Immunology, Rush-Presbyterian-St. Luke's/Cook County Hospital, Chicago, IL, 2Allergy/Immunology, Rush-Presbyterian-St. Luke's/Cook County Hospital, Chicago, IL, 3Mt. Sinai Medical Center, Chicago "L, 4Allergy/Immunology, Rush-Presbyterian-St. Luke's/Cook County Hospital, Chicago, IL. RATIONALE: Elevated serum lead (Pb) is associated with increased total IgE in children (Lutz, 1999). Since elevated IgE is characteristic of atopy, we hypothesized that atopic disease prevalence among children with abnormal serum Pb would also be increased. METHODS: Charts of all currently active Cook County Hospital Pediatric outpatients (pts) 6-8 years if age who had serum Pb checked at one year of age were reviewed. Pts were classified as Pb-positive (serum Pb > 10 mcg/dl) or Pb-negative. Pts in both groups were classified as atopic if a diagnosis of allergic rhinoconjunctivitis (ARC), asthma, or atopic dermatitis (AD) was documented. Total lgE was not measured. Data for atopic disease in Pb-positive and Pb-negative patients were compared by chi square analysis. RESULTS: 118 children were Pb-positive. 24% of this group had atopic disease. The Pb-negative group included 116 children, including 22% with atopic disease (p=NS). In Pb-positive pts the prevalences of ARC, asthma, and AD were, respectively, 3%, 15%, and 14%. In the Pb-negative group, the prevalences of the diseases were, respectively, 7%, 17%, and 7%. For AD there was a trend (p=0.09) towards increased prevalence in Pb-positive pts, but no statistically significant difference in prevalences for ARC and asthma. C O N C L U S I O N : Although elevated serum Pb has been linked to increased total lgE in pediatric pts, our data suggest the risk of developing atopic disease is not increased.
Funding: Self-funded
364
Children
M. AI-Mousawi ], H. Lovel 2, A. Kheder 3, N. Behbehani 3, N. Arifhodzic 4, A. R. A1-Dowaisan4, A. Woodcock j, A. Custovic]; INorth West Lung Centre, Manchester, UNITED KINGDOM, 2University of Manchester, Manchester, UNITED KINGDOM, 3University of Kuwait, Kuwait, KUWAIT, 4A1-Rashid Allergy Centre, Kuwait, KUWAIT. RATIONALE: Asthma is increasing in prevalence in the Middle East. We investigated risk factors for asthma in Kuwait] school children. METHODS: 160 children (9-16 years) with physician-diagnosed asthma (symptomatic within previous 12 months) were randomly selected and matched (age, sex) with 303 healthy controls. All participants completed questionnaires and underwent skin testing. Allergen levels (mite, cat, dog, cockroach) were measured in mattress and floor dust samples (ELISA). RESULTS: All indoor allergen levels were low (eg, mite below detection limit in 98.4% samples). In the univariate analysis, significant associations with the patient group (OR, 95% CI) were found for: sensitization to Aspergillus (7.4, 3.7-14.7), Cladosporium (9.1, 3.8-21.4), Alternaria (11.1, 4.5-27.5); mite (5.5, 2.8-10.8); cat (4.8, 3.1-7.5), trees (4.5. 2.38.7), grasses (2.6, 1.7-4.0) and cockroach (2.1, 1.3-3.5). Other significant asso~ iates of asthma group were: family history of asthma (3.8, 2.6-5.7), maternal atopy (3.1, 1.7-5.7), paternal atopy (2.4, 1.3-4.4), >20 cigarettes/day smoked in home (l.9, I.t-16.5), history of whooping cough (6.6, 1.8-24.3), cat at home (5.8, 2.1-16.4) and contact with cats outside home (2.3, 1.2-4.5). In the multivariate analysis, the following factors remained significantly and independently associated with asthma: Sensitization to Alternaria (11.7, 5.2-26.3), cat (13.9, 4.2-46.0) and mite (2.6, 1.0-6.6); family history of asthma (3.7, 2.1-6.5), whooping cough (6.0, 1.4-26.5) and keeping cats at home (4.5, 1.1-18.8). CONCLUSIONS: Sensitization to Alternaria, cat, mite, family history of asthma, history of whooping cough and keeping cats at home were independent risk factors for asthma in Kuwait] children.
65 Symptomsin Atopicand Non-atopicChildrenwith Asthma E. Simons i, J. Brosnan ], R. Wood j, C. Rand 2, S. Kanchanaraksa3, L. Schwarz j, N. Durkin I, P. A. Egglestonl; ]Department of Pediatrics, The Johns Hopkins University, Baltimore, MD, 2Department of Medicine, The Johns Hopkins University, Baltimore, MD, 3Department of Epidemiology, The Johns Hopkins University, Baltimore, MD. RATIONALE: The impact of atopy on childhood asthma has been studied, but few investigations have compared morbidity in atopic and nonatopic asthmatic children. METHODS: We skin tested 312 six-to-18-year-old asthmatic children for common allergens and defined atopy as one or more wheals ->half the histamine control size (275 children). Parental questionnaires were administered and allergen levels were measured in home dust samples. RESULTS: Atopic and non-atopic asthmatics were of similar mean age (10.6 vs. 9.2 years), age at asthma onset (2.4 vs. 1.9 years), gender and ethnicity. Similar numbers of atopics and non-atopics had daily cough or wheeze (47% vs. 43%), used inhaled steroids (49% vs. 40%) and leukotriene modifiers (17% vs. 5%) and required steroid bursts (38% vs. 24%) or emergency room visits (3.5 vs. 3.2 visits/year). Similar frequencies (p>0.5) of daily symptoms were reported in winter (51% vs. 67%), spring (45% vs. 54%) and fall (5i% vs. 33%); non-atopics trended towards a lower frequency of daily symptoms in summer (41% vs. 11%, p>0.1). Atopics had a significantly higher frequency of rhinitis (85% vs. 63%, p<0.01) but no greater antihistamine and intranasal steroid use. As expected, exposure to dust mite, cockroach, cat, dog and cigarette smoke was similar. Surprisingly, atopics were not more likely to have a history of eczema or a parental history of asthma, allergy or eczema. CONCLUSIONS: Although the degree of atopy has been shown to predict asthma symptom severity, our data suggest similar symptom patterns in asthmatics without atopy compared to those with any atopy.
Funding: NHLBI
366 ,st,.SensitizatRhinitist~ i~IndoorinBelarusAllergensin Patientswith Cockroach L. Litvyakova I, G. Lugovtsova2, J. A. Bellanti]; ]Georgetown University, Washington, DC, 2Allergy Center, Vitebsk, BELARUS. RATIONALE: Sensitization to cockroach allergens alone occurs rarely. The purpose of the study was to assess the association of cockroach sensitization with indoor allergens in the patients with cockroach asthma and cockroach rhinitis. METHODS: The study consisted of 226 patients with asthma and 47 with perennial rhinitis (ages 18 to 50). All patients had positive skin and nasal provocation tests with Blatella german]ca and lived in urban inner city community with significant cockroach infestation. Skin testing was performed with allergen extracts: House dust, Library dust, Dust Mite (DP and DF), Cat and Pollen allergens. RESULTS: 184 (81.4%) patients with asthma and 35 (74.5%) patients with rhinitis had sensitization to House dust and 120 (53.1%) and 24 (51.1%) cases to DP respectively. 80 (35.4%) individuals with asthma and 14 (29.8%) patients with rhinitis had positive skin tests to DE Reaction to Library dust was positive in 42 (18.6%) patients with asthma and 8 (17.0%) with rhinitis. Sensitization to Cat allergen was found only in 18 (7.9%) patients with asthma and 4 (8.5%) patients with rhinitis and to Pollen extracts in 28 (12.4%) and 2 (4.2%) patients respectively. Asthma and rhinitis morbidity was found to be greater among patients with a combination of cockroach sensitization with House Dust and Dust Mite, but not with sensitization to Cat and Pollen allergens. CONCLUSIONS: These results suggest that the occurrence of such a combination depends on the prevalence of mite species in the environment or may be due to cross-reactivity between cockroach and mite allergens.
Funding: Self-fi~nded
Abstracts
J ALLERGY CLIN IMMUNOL FEBRUARY 2003
63 AtopicDiseasein Childrenwith ElevatedSerumLeadLevels K. Shaw ], J. N. Moy 2, K. Amin3, B. yu4; IAllergy/Immunology, Rush-Presbyterian-St. Luke's/Cook County Hospital, Chicago, IL, 2Allergy/Immunology, Rush-Presbyterian-St. Luke's/Cook County Hospital, Chicago, IL, 3Mt. Sinai Medical Center, Chicago "L, 4Allergy/Immunology, Rush-Presbyterian-St. Luke's/Cook County Hospital, Chicago, IL. RATIONALE: Elevated serum lead (Pb) is associated with increased total IgE in children (Lutz, 1999). Since elevated IgE is characteristic of atopy, we hypothesized that atopic disease prevalence among children with abnormal serum Pb would also be increased. METHODS: Charts of all currently active Cook County Hospital Pediatric outpatients (pts) 6-8 years if age who had serum Pb checked at one year of age were reviewed. Pts were classified as Pb-positive (serum Pb > 10 mcg/dl) or Pb-negative. Pts in both groups were classified as atopic if a diagnosis of allergic rhinoconjunctivitis (ARC), asthma, or atopic dermatitis (AD) was documented. Total lgE was not measured. Data for atopic disease in Pb-positive and Pb-negative patients were compared by chi square analysis. RESULTS: 118 children were Pb-positive. 24% of this group had atopic disease. The Pb-negative group included 116 children, including 22% with atopic disease (p=NS). In Pb-positive pts the prevalences of ARC, asthma, and AD were, respectively, 3%, 15%, and 14%. In the Pb-negative group, the prevalences of the diseases were, respectively, 7%, 17%, and 7%. For AD there was a trend (p=0.09) towards increased prevalence in Pb-positive pts, but no statistically significant difference in prevalences for ARC and asthma. C O N C L U S I O N : Although elevated serum Pb has been linked to increased total lgE in pediatric pts, our data suggest the risk of developing atopic disease is not increased.
Funding: Self-funded
364
Children
M. AI-Mousawi ], H. Lovel 2, A. Kheder 3, N. Behbehani 3, N. Arifhodzic 4, A. R. A1-Dowaisan4, A. Woodcock j, A. Custovic]; INorth West Lung Centre, Manchester, UNITED KINGDOM, 2University of Manchester, Manchester, UNITED KINGDOM, 3University of Kuwait, Kuwait, KUWAIT, 4A1-Rashid Allergy Centre, Kuwait, KUWAIT. RATIONALE: Asthma is increasing in prevalence in the Middle East. We investigated risk factors for asthma in Kuwait] school children. METHODS: 160 children (9-16 years) with physician-diagnosed asthma (symptomatic within previous 12 months) were randomly selected and matched (age, sex) with 303 healthy controls. All participants completed questionnaires and underwent skin testing. Allergen levels (mite, cat, dog, cockroach) were measured in mattress and floor dust samples (ELISA). RESULTS: All indoor allergen levels were low (eg, mite below detection limit in 98.4% samples). In the univariate analysis, significant associations with the patient group (OR, 95% CI) were found for: sensitization to Aspergillus (7.4, 3.7-14.7), Cladosporium (9.1, 3.8-21.4), Alternaria (11.1, 4.5-27.5); mite (5.5, 2.8-10.8); cat (4.8, 3.1-7.5), trees (4.5. 2.38.7), grasses (2.6, 1.7-4.0) and cockroach (2.1, 1.3-3.5). Other significant asso~ iates of asthma group were: family history of asthma (3.8, 2.6-5.7), maternal atopy (3.1, 1.7-5.7), paternal atopy (2.4, 1.3-4.4), >20 cigarettes/day smoked in home (l.9, I.t-16.5), history of whooping cough (6.6, 1.8-24.3), cat at home (5.8, 2.1-16.4) and contact with cats outside home (2.3, 1.2-4.5). In the multivariate analysis, the following factors remained significantly and independently associated with asthma: Sensitization to Alternaria (11.7, 5.2-26.3), cat (13.9, 4.2-46.0) and mite (2.6, 1.0-6.6); family history of asthma (3.7, 2.1-6.5), whooping cough (6.0, 1.4-26.5) and keeping cats at home (4.5, 1.1-18.8). CONCLUSIONS: Sensitization to Alternaria, cat, mite, family history of asthma, history of whooping cough and keeping cats at home were independent risk factors for asthma in Kuwait] children.
65 Symptomsin Atopicand Non-atopicChildrenwith Asthma E. Simons i, J. Brosnan ], R. Wood j, C. Rand 2, S. Kanchanaraksa3, L. Schwarz j, N. Durkin I, P. A. Egglestonl; ]Department of Pediatrics, The Johns Hopkins University, Baltimore, MD, 2Department of Medicine, The Johns Hopkins University, Baltimore, MD, 3Department of Epidemiology, The Johns Hopkins University, Baltimore, MD. RATIONALE: The impact of atopy on childhood asthma has been studied, but few investigations have compared morbidity in atopic and nonatopic asthmatic children. METHODS: We skin tested 312 six-to-18-year-old asthmatic children for common allergens and defined atopy as one or more wheals ->half the histamine control size (275 children). Parental questionnaires were administered and allergen levels were measured in home dust samples. RESULTS: Atopic and non-atopic asthmatics were of similar mean age (10.6 vs. 9.2 years), age at asthma onset (2.4 vs. 1.9 years), gender and ethnicity. Similar numbers of atopics and non-atopics had daily cough or wheeze (47% vs. 43%), used inhaled steroids (49% vs. 40%) and leukotriene modifiers (17% vs. 5%) and required steroid bursts (38% vs. 24%) or emergency room visits (3.5 vs. 3.2 visits/year). Similar frequencies (p>0.5) of daily symptoms were reported in winter (51% vs. 67%), spring (45% vs. 54%) and fall (5i% vs. 33%); non-atopics trended towards a lower frequency of daily symptoms in summer (41% vs. 11%, p>0.1). Atopics had a significantly higher frequency of rhinitis (85% vs. 63%, p<0.01) but no greater antihistamine and intranasal steroid use. As expected, exposure to dust mite, cockroach, cat, dog and cigarette smoke was similar. Surprisingly, atopics were not more likely to have a history of eczema or a parental history of asthma, allergy or eczema. CONCLUSIONS: Although the degree of atopy has been shown to predict asthma symptom severity, our data suggest similar symptom patterns in asthmatics without atopy compared to those with any atopy.
Funding: NHLBI
366 ,st,.SensitizatRhinitist~ i~IndoorinBelarusAllergensin Patientswith Cockroach L. Litvyakova I, G. Lugovtsova2, J. A. Bellanti]; ]Georgetown University, Washington, DC, 2Allergy Center, Vitebsk, BELARUS. RATIONALE: Sensitization to cockroach allergens alone occurs rarely. The purpose of the study was to assess the association of cockroach sensitization with indoor allergens in the patients with cockroach asthma and cockroach rhinitis. METHODS: The study consisted of 226 patients with asthma and 47 with perennial rhinitis (ages 18 to 50). All patients had positive skin and nasal provocation tests with Blatella german]ca and lived in urban inner city community with significant cockroach infestation. Skin testing was performed with allergen extracts: House dust, Library dust, Dust Mite (DP and DF), Cat and Pollen allergens. RESULTS: 184 (81.4%) patients with asthma and 35 (74.5%) patients with rhinitis had sensitization to House dust and 120 (53.1%) and 24 (51.1%) cases to DP respectively. 80 (35.4%) individuals with asthma and 14 (29.8%) patients with rhinitis had positive skin tests to DE Reaction to Library dust was positive in 42 (18.6%) patients with asthma and 8 (17.0%) with rhinitis. Sensitization to Cat allergen was found only in 18 (7.9%) patients with asthma and 4 (8.5%) patients with rhinitis and to Pollen extracts in 28 (12.4%) and 2 (4.2%) patients respectively. Asthma and rhinitis morbidity was found to be greater among patients with a combination of cockroach sensitization with House Dust and Dust Mite, but not with sensitization to Cat and Pollen allergens. CONCLUSIONS: These results suggest that the occurrence of such a combination depends on the prevalence of mite species in the environment or may be due to cross-reactivity between cockroach and mite allergens.
Funding: Self-fi~nded