Allergic sensitization and clinical outcomes in urban children with asthma, 2013‐2016

Abstract

Increasing age predicted allergic sensitization and multiple allergen sensitization. Worse obstruction on PFT also predicted multiple allergen sensitization. Continued surveillance of aeroallergen sensitization and PFT results may be beneficial in asthma management, particularly in older urban children.

Allergen sensitization associates with worse lung function parameters

“…Lung function allows an objective assessment of the effect of allergic disease in airways function. With a more pronounced allergic drive, leading to sensitization to more allergens, we could expect a higher impact on lung function and lower spirometric values, as suggested by Nagarajan et al 14 . Nevertheless, although theoretically sound, the available evidence, including this study, does not consistently support such an association.…”

“…In this study, in patients with M a n u s c r i p t a c c e p t e d f o r p u b l i c a t i o n highly allergic asthma (≥4allergens), FEV1/FVC was significantly lower than in the group sensitized to < 4 allergens. Nevertheless, these results are not completely clear as the reported 95% confidence interval is not in agreement with a significant association 14 .…”

“…Some studies reported that polysensitization is significantly associated with a poor quality of life in patients with allergic rhinitis 25 and intermittent asthma 26 , with higher symptom scores for dyspnoea, wheezing, and cough 27 , and with the presence of multimorbidity 7,28,29 Moreover, Ciprandi et al have shown that impaired lung function occurs in polysensitized patients with allergic rhinitis 30 ; however, this study only reported on polysensitized individuals and did not clearly assess the relationship between the number of sensitizations and lung function. We could only find one study, by Nagarajan et al 14 , specifically examining the associations between the number of aeroallergens sensitizations and lung function parameters. In this study, in patients with M a n u s c r i p t a c c e p t e d f o r p u b l i c a t i o n highly allergic asthma (≥4allergens), FEV1/FVC was significantly lower than in the group sensitized to < 4 allergens.…”

“…Only a few studies have previously reported an association between atopy and decreased lung function, mainly in individuals with asthma 12,13 . To our knowledge, only one study, including children with asthma, described a significant relation between polysensitization (≥4 allergens) and lower FEV1/FVC, but the reported 95% confidence interval suggested a nonsignificant association, raising doubts about the meaning of this result 14 . Thus, the association between the number of allergen sensitizations and lung function, irrespective of disease diagnosis, is not well studied yet.…”

Children are not small adults

“…In addition, their results indicated that an asthma diagnosis after 4 years of age may be related to environmental toxins and early exposure to sodas. In a separate cohort study of 386 children with asthma, Nagarajan et al 3 retrospectively sought to determine whether food and/or aeroallergen sensitization was associated with worse asthma outcomes, pulmonary function test results, and laboratory biomarkers. The authors found that multiple allergen sensitizations were associated with increased airway obstruction.…”