Abstract
Endotoxin, a component of the cell walls of gram-negative bacteria, is a contaminant in organic dusts (house dust) and aerosols. In humans, small amounts of endotoxin may cause a local inflammatory response. Exhaled nitric oxide (eNO) levels, an inflammation indicator, are associated with the pH values of exhaled breath condensate (EBC). This study evaluated seasonal changes on indoor endotoxin concentrations in homes and the relationships between endotoxin exposure and eNO/EBC pH levels for healthy children and children with allergy-related respiratory diseases. In total, 34 children with allergy-related respiratory diseases and 24 healthy children were enrolled. Indoor air quality measurements and dust sample analysis for endotoxin were conducted once each season inside 58 surveyed homes. The eNO, EBC pH levels, and pulmonary function of the children were also determined. The highest endotoxin concentrations were on kitchen floors of homes of children with allergy-related respiratory diseases and healthy children, and on bedroom floors of homes of asthmatic children and healthy children. Seasonal changes existed in endotoxin concentrations in dust samples from homes of children with allergic rhinitis, with or without asthma, and in EBC pH values among healthy children and those with allergy-related respiratory diseases. Strong relationships existed between endotoxin exposure and EBC pH values in children with allergic rhinitis.
Highlights
The prevalence of allergy-related respiratory diseases has gradually increased over the last two decades, especially among children who live in highly urbanized areas
Children with allergyrelated respiratory diseases were mainly sensitized by house dust mite (D. farinae and D. pteronyssinus) allergens, dog and cat danders, the cockroach allergen, and Candida albicans
No significant differences in positive rates of blood allergen-specific IgE tests existed among the asthma group, allergic rhinitis group, and asthma+allergic rhinitis group
Summary
The prevalence of allergy-related respiratory diseases has gradually increased over the last two decades, especially among children who live in highly urbanized areas. Major risk factors for such diseases include modernization and considerable time spent indoors [1]. The development of allergy-related respiratory diseases involves the result of interactions between different genetic and environmental factors. A component of cell walls of gram-negative bacteria, is ubiquitous in indoor environments. In its pure form, endotoxin is a lipopolysaccharide (LPS). Endotoxin has strong pro-inflammatory properties that can induce airway inflammation and cytokine upregulation in humans [2]. Acute endotoxin exposure may induce blood and lung inflammatory responses that involve neutrophils and macrophages, which can result in fever, shaking chills, and severe asthma [3]
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