A Prospective Study of Fel d1 and Der p1 Exposure in Infancy and Childhood Wheezing

Abstract

The impact of domestic exposure to cat allergen (Fel d1) and house dust mite (Der p1) on wheezing from birth to the age of 4 years was investigated in a multicenter prospective birth cohort; 1,611 mothers were recruited before delivery in Ashford, England, and Barcelona and Menorca, Spain. Exposures were gathered via dust sample collection at children's home in their first year of life. Families provided complete outcome data (wheezing status in all 4 years) for 1,289 children. Domestic allergen levels varied substantially between centers. Six hundred three (47%) children never wheezed during their first 4 years of life. Der p1 did not correlate with any type of wheezing outcome. Fel d1 significantly increased the risk of wheezing in 3- and 4-year-olds in comparison to 1-year-olds. Distinct risk profiles were found for wheezing at different ages. Multivariate analysis revealed an interaction between Fel d1 and maternal asthma among children who wheeze in Year 4 (relative risk = 2.77; 95% confidence interval = 1.19-6.46). Our data support the idea that several patterns of wheezing with different risk profiles exist among young children. The effect of Fel d1 exposure varied according to age and maternal asthma.

Allergen exposure in infancy and the development of sensitization, wheeze, and asthma at 4 years

“…For children with an atopic mother, these results are in accordance with those of other studies that do show an increased risk of wheeze in children with an asthmatic mother. 11,13 With respect to our results in children with a nonatopic mother, Polk et al 11 observed no effects of cat allergen exposure on the risk of wheeze for children with a nonasthmatic mother, whereas Celedon et al 13 observed protective effects of cat allergen exposure. However, the latter study included only children with at least one parent with a history of asthma, which makes it difficult to compare their results with ours.…”

“…This is in accordance with the results of others. 5,8,11 We did observe an association between cat allergen exposure and persistent wheeze, which was borderline significant for the total study population and showed similar trends for children with and without an atopic mother. For children with an atopic mother, these results are in accordance with those of other studies that do show an increased risk of wheeze in children with an asthmatic mother.…”

“…However, these results were not confirmed by later studies in children up to 7 years of age. 5,6,8,[10][11][12] Also, although some studies show no effect of cat and dog allergen exposure on the development of asthma, 5,8,10 others show different effects for children with and without a family history of atopy. 11,13 Studies with indirect measures of allergen exposure, such as the presence of cats or dogs in the home, showed protective effects on the development of sensitization and asthma.…”

“…5,6,8,[10][11][12] Also, although some studies show no effect of cat and dog allergen exposure on the development of asthma, 5,8,10 others show different effects for children with and without a family history of atopy. 11,13 Studies with indirect measures of allergen exposure, such as the presence of cats or dogs in the home, showed protective effects on the development of sensitization and asthma. [14][15][16][17][18] However, because the presence of pets in the home is a relatively poor measure of pet allergen exposure, these studies will not be discussed further.…”

Validity of the interview on pets kept at home for predicting the actual domestic expsoure to their specific allergens. Krakow inner city area study

“…krakow inner city area study allergens. Allergic sensitisation to dog or cat allergens is believed to be an important risk factor for asthma and asthma symptoms, [1][2][3][4][5][6][7][8][9][10][11][12] and many studies reported positive correlations between the ownerships of pets and the excess in the occurrence of asthma symptoms, asthma diagnosis or asthma medication treatment. It was also shown that asthmatics are more likely than nonasthmatics sensitised to pet allergens and exposures to Can f 1 and Fel d 1 as low as 2 mg/g of house dust and 1 mg/g of dust, respectively, have been assumed as clinically relevant risk thresholds [13][14][15].…”