Sensitivity and exposure to indoor allergens in adults with differing asthma severity

Abstract

In asthma, it is uncertain whether there is an association between degrees of exposure to domestic allergens and asthma severity. The pattern of sensitivity and exposure to common indoor allergens was examined in subjects with differing asthma severity.Sensitivity to house dust mite, dog and cat allergen and exposure to Der p 1, Can f 1 and Fel d 1 were assessed by skin prick tests and settled dust analysis in 28 subjects with severe asthma and 28 age-and sex-matched subjects with mild asthma (two declined skin prick test).All severe asthmatic subjects had at least one positive skin test and 20 of the 28 subjects were positive to all three allergens. Fourteen of the 26 subjects with mild asthma who took skin prick tests were positive to at least one, and one of these subjects was positive to the three allergens tested. Except for bedroom Fel d 1, the proportion of severe asthmatics both sensitized and exposed to each allergen at each site was significantly greater than the proportion sensitized and exposed in the mild asthma group. The geometric mean allergen concentrations, with the exception of bedroom Fel d 1, were greater in sensitized severe asthmatics than the sensitized mild asthmatics, which was significant for Der p 1 in bedroom samples and Can f 1 in bedroom and living room samples.These results support an association between the degrees of domestic allergen exposure in sensitized individuals and asthma severity. Eur Respir J 1999; 13: 654±659.

Respiratory symptoms in relation to indoor exposure to mite and cat allergens and endotoxins

“…There are only a few studies on adults analysing the impact of allergen exposure on asthma and allergies. CHAN-YEUNG et al [27] did not find a relationship between total allergen levels (sum of Der p 1 and Der f 1) and severity of asthma in adults either with or without house dust mite allergy, whereas CUSTOVIC et al [28], as well as TUNNICLIFFE et al [29], demonstrated a relationship between severity of asthma and exposure to Der p 1 in asthmatics sensitized to house dust mite. In the present study, the risk of asthma attacks and respiratory symptoms was not found to be increased continuously with exposure to mite allergens.…”

Systematic assessment of difficult-to-treat asthma

“…Total serum IgE was normal in a number of those with atopy, emphasising that this is not a useful screen. Previous data from TUNNICLIFFE et al [23] suggest that atopy is not more common amongst severe asthmatics compared to those with mild disease, but exposure to the allergen to which they are sensitised is greater in those with severe disease [23]. It is worth noting that patients9 perception of allergen sensitisation was not always related to detection of specific IgE, emphasising the importance of skin-prick tests or RAST to confirm allergen sensitisation, although this should always be assessed in the context of the clinical history.…”

Indoor Environmental Exposures Among Children With Asthma Seen in an Urban Emergency Department

“…[2][3][4] Indoor exposures to common allergens are also risk factors for the exacerbation of asthma. [5][6][7][8] The same Institute of Medicine report found sufficient evidence for a causal relationship between indoor exposure to allergens produced by cockroaches, cats, dogs, house dust mites, and mold and worsening of asthma.…”