Neither Dust Mite nor Cat Allergen Exposure Is Associated with Lung Function or Asthma Morbidity in Sensitized Baltimore City Children

Abstract

RationaleAlthough pest allergen exposures are associated with asthma morbidity in sensitized Baltimore City children, the effects of dust mite (DM) and cat allergen (Ct) exposures on asthma in this population are unclear.Methods144 children (5-17y) with asthma were skin prick tested (SPT) at baseline. Lung function, health care utilization data, and bedroom dust samples were collected at baseline, 3, 6, 9, and 12 months. Der f 1 and Fel d 1 content in dust samples was quantified by ELISA. +SPT was defined as a net wheal >3mm. Exposure was defined as bedroom DM>2 μg/g and bedroom Ct> 8 μg/g. Analyses were adjusted for age, gender, type of insurance, total IgE, and sensitization and exposure to mouse and cockroach.ResultsParticipants were predominantly African American (91%), had public health insurance (85%), and had ≥1 +SPT (90%). FEV1/FVC% did not significantly differ between cat sensitized and exposed (S+E+) and non-cat-sensitized or non-cat-exposed (S-E-) participants (predicted% [95% CI]: (81.3[78.8-83.7]) and 80.7[79.4-82.0], respectively; p=0.6). This was also true for DM (S+E+: 81.8[78.8-84.8]; S-E-: 80.8[79.5-82.1], p=0.5). Acute asthma visits were similar for the Ct S+E+ and Ct S-E- groups (OR[95%CI]: 1.13[0.61-2.12]). The same trend held for DM S+E+ vs DM S-E- participants (0.41[0.16-1.03]). These findings were similar across various exposure cutpoints and with or without adjustment for pest allergen exposure and sensitization.ConclusionsDM and Ct allergen exposures are not major contributors to asthma morbidity in Baltimore City children. Public health initiatives in Baltimore should focus on pest allergens, which are known to contribute to asthma morbidity. RationaleAlthough pest allergen exposures are associated with asthma morbidity in sensitized Baltimore City children, the effects of dust mite (DM) and cat allergen (Ct) exposures on asthma in this population are unclear. Although pest allergen exposures are associated with asthma morbidity in sensitized Baltimore City children, the effects of dust mite (DM) and cat allergen (Ct) exposures on asthma in this population are unclear. Methods144 children (5-17y) with asthma were skin prick tested (SPT) at baseline. Lung function, health care utilization data, and bedroom dust samples were collected at baseline, 3, 6, 9, and 12 months. Der f 1 and Fel d 1 content in dust samples was quantified by ELISA. +SPT was defined as a net wheal >3mm. Exposure was defined as bedroom DM>2 μg/g and bedroom Ct> 8 μg/g. Analyses were adjusted for age, gender, type of insurance, total IgE, and sensitization and exposure to mouse and cockroach. 144 children (5-17y) with asthma were skin prick tested (SPT) at baseline. Lung function, health care utilization data, and bedroom dust samples were collected at baseline, 3, 6, 9, and 12 months. Der f 1 and Fel d 1 content in dust samples was quantified by ELISA. +SPT was defined as a net wheal >3mm. Exposure was defined as bedroom DM>2 μg/g and bedroom Ct> 8 μg/g. Analyses were adjusted for age, gender, type of insurance, total IgE, and sensitization and exposure to mouse and cockroach. ResultsParticipants were predominantly African American (91%), had public health insurance (85%), and had ≥1 +SPT (90%). FEV1/FVC% did not significantly differ between cat sensitized and exposed (S+E+) and non-cat-sensitized or non-cat-exposed (S-E-) participants (predicted% [95% CI]: (81.3[78.8-83.7]) and 80.7[79.4-82.0], respectively; p=0.6). This was also true for DM (S+E+: 81.8[78.8-84.8]; S-E-: 80.8[79.5-82.1], p=0.5). Acute asthma visits were similar for the Ct S+E+ and Ct S-E- groups (OR[95%CI]: 1.13[0.61-2.12]). The same trend held for DM S+E+ vs DM S-E- participants (0.41[0.16-1.03]). These findings were similar across various exposure cutpoints and with or without adjustment for pest allergen exposure and sensitization. Participants were predominantly African American (91%), had public health insurance (85%), and had ≥1 +SPT (90%). FEV1/FVC% did not significantly differ between cat sensitized and exposed (S+E+) and non-cat-sensitized or non-cat-exposed (S-E-) participants (predicted% [95% CI]: (81.3[78.8-83.7]) and 80.7[79.4-82.0], respectively; p=0.6). This was also true for DM (S+E+: 81.8[78.8-84.8]; S-E-: 80.8[79.5-82.1], p=0.5). Acute asthma visits were similar for the Ct S+E+ and Ct S-E- groups (OR[95%CI]: 1.13[0.61-2.12]). The same trend held for DM S+E+ vs DM S-E- participants (0.41[0.16-1.03]). These findings were similar across various exposure cutpoints and with or without adjustment for pest allergen exposure and sensitization. ConclusionsDM and Ct allergen exposures are not major contributors to asthma morbidity in Baltimore City children. Public health initiatives in Baltimore should focus on pest allergens, which are known to contribute to asthma morbidity. DM and Ct allergen exposures are not major contributors to asthma morbidity in Baltimore City children. Public health initiatives in Baltimore should focus on pest allergens, which are known to contribute to asthma morbidity.