Mouse Sensitization and Exposure Are Associated with Asthma Severity in Urban Children

被引:40
作者
Grant, Torie [1 ]
Aloe, Charles [1 ]
Perzanowski, Matthew [2 ]
Phipatanakul, Wanda [3 ]
Bollinger, Mary E. [4 ]
Miller, Rachel [2 ,5 ]
Matsui, Elizabeth C. [1 ]
机构
[1] Johns Hopkins Sch Med, Div Pediat Allergy Immunol, Baltimore, MD USA
[2] Columbia Univ, Dept Environm Hlth Sci, New York, NY USA
[3] Harvard Med Sch, Boston Childrens Hosp, Div Pediat Allergy Immunol, Boston, MA USA
[4] Univ Maryland, Sch Med, Dept Pediat, Baltimore, MD 21201 USA
[5] Columbia Univ, Dept Med, Div Pulm Allergy & Crit Care Med, New York, NY USA
基金
美国国家卫生研究院;
关键词
Inner-city asthma; Childhood asthma; Mouse sensitization; Mouse allergen; Indoor allergens; INNER-CITY CHILDREN; ALLERGEN EXPOSURE; LUNG-FUNCTION; INDOOR ALLERGENS; MORBIDITY; REACTIVITY; LIFE;
D O I
10.1016/j.jaip.2016.10.020
中图分类号
R392 [医学免疫学];
学科分类号
100102 ;
摘要
BACKGROUND: Mouse sensitization and exposure are associated with uncontrolled asthma, but whether they are associated with asthma severity, an intrinsic disease characteristic and long-term outcome predictor, is unclear. OBJECTIVE: To examine relationships between mouse sensitization and/or exposure and asthma severity in urban children. METHODS: A total of 645 children (5-17 years) with uncontrolled asthma underwent mouse sensitization evaluation. Sensitized children had mouse allergen measured in bedroom dust. Relationships between mouse sensitization, allergen levels, and asthma severity measures (treatment step and Composite Asthma Severity Index [CASI]) were examined using regression models adjusted for age, sex, atopy, study site, race, ethnicity, and insurance. RESULTS: The study population was predominantly minority (69.6% black, 20.8% Hispanic), low income (61.8%), and mouse sensitized (54.4%). Mean +/- SD treatment step was 3.2 +/- 1.6, equivalent to medium-dose inhaled corticosteroid. Mean +/- SD CASI was 6.5 +/- 3.4, reflecting moderate persistent asthma. Mouse sensitization was associated with higher treatment step (3.5 vs 2.9, mouse-sensitized vs nonsensitized, P < .001), independent of potential confounders (beta [95% CI], 0.36 [0.07-0.64]; P = .01). Mouse sensitization was associated independently with CASI (beta [95% CI], 0.82 [0.16-1.47]; P[. 02). Among mouse-sensitized participants, higher bedroom floor and bed Mus m 1 were independently associated with treatment step (beta [95% CI], 0.26 [0.09-0.43]; P = .002 and beta [95% CI], 0.22 [0.01-0.43]; P = .002, respectively. Higher bedroom floor Mus m 1 was independently associated with CASI (beta [95% CI], 0.43 [0.05-0.81]; P = .03). CONCLUSIONS: Mouse sensitization and exposure are associated with asthma severity, among low-income, minority children. Further studies are needed to determine whether reducing allergen exposure among mouse-sensitized patients with asthma can reduce severity, ultimately altering childhood asthma natural history. (C) 2016 American Academy of Allergy, Asthma & Immunology
引用
收藏
页码:1008 / +
页数:8
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