The effect of household and familial clustering on allergic status in an Indonesian community with endemic filarial infection

Abstract

Rationale Lymphatic filariasis is associated with a strong Th-2 type immune response with high level of IL-4, IL5 and IL-13 production. Both genetic and household environmental factors are known to be significant determinants in lymphatic filariasis infection and susceptibility. At the same time, allergy shares a key features with helminth infection in terms of the Th-2 type response. Methods The present study was conducted in Salubarana, South Sulawesi, Indonesia, to investigate the influence of familial and household clustering on allergic sensitization given endemic filarial infestation. Allergic status to Dermatophagoides pteronyssinus was determined by skin test (SPT) reactivity and by mite specific IgE levels. A total of 417 subjects distributed in 30 families and 112 households participated in the study. The data were analyzed using a multivariate model that was adjusted for age, gender and filiarial infection status and that accounted for familial and household clustering. Results Familial clustering did not effect spt sensitivity (p=0.175) but did significantly influence IgE levels (p=0.005). Meanwhile, household clustering was significantly associated with both spt sensitivity (p=0.003) and IgE levels (p=0.035). Conclusion The results of this study suggest that environmental factors such as household clustering have a stronger influence on physiologic response patterns consistent with allergy when compared to genetic factors such as familial clustering