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Gherasim A, Lee AG, Bernstein JA. Impact of Climate Change on Indoor Air Quality. Immunol Allergy Clin North Am 2024; 44:55-73. [PMID: 37973260 DOI: 10.1016/j.iac.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
Climate change may affect the quality of the indoor environment through heat and mass transfer between indoors and outdoors: first by a direct response to global warming itself and related extreme weather phenomena and second by indirect actions taken to reduce greenhouse gas emissions that can lead to increased concentrations of indoor air contaminants. Therefore, both indoor and outdoor air pollution contribute to poor indoor air quality in this context. Exposures to high concentrations of these pollutants contribute to inflammatory respiratory diseases. Climate change adaptation and mitigation measures could minimize these risks and bring associated health benefits.
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Affiliation(s)
- Alina Gherasim
- ALYATEC Environmental Exposure Chamber, 1 Place de l'Hôpital, Strasbourg, France
| | - Alison G Lee
- Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Place, New York, NY 10029, USA
| | - Jonathan A Bernstein
- Division of Rheumatology, Allergy and Immunology, University of Cincinnati College of Medicine, 231 Albert Sabin Way, Cincinnati, OH 45267, USA.
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2
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Valerian Corda J, Shenoy BS, Ahmad KA, Lewis L, K P, Rao A, Zuber M. Comparison of microparticle transport and deposition in nasal cavity of three different age groups. Inhal Toxicol 2024; 36:44-56. [PMID: 38343121 DOI: 10.1080/08958378.2024.2312801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 01/23/2024] [Indexed: 02/22/2024]
Abstract
Objective: The nasal cavity effectively captures the particles present in inhaled air, thereby preventing harmful and toxic pollutants from reaching the lungs. This filtering ability of the nasal cavity can be effectively utilized for targeted nasal drug delivery applications. This study aims to understand the particle deposition patterns in three age groups: neonate, infant, and adult.Materials and methods: The CT scans are built using MIMICS 21.0, followed by CATIA V6 to generate a patient-specific airway model. Fluid flow is simulated using ANSYS FLUENT 2021 R2. Spherical monodisperse microparticles ranging from 2 to 60 µm and a density of 1100 kg/m3 are simulated at steady-state and sedentary inspiration conditions.Results: The highest nasal valve depositions for the neonate are 25% for 20 µm, for infants, 10% for 50 µm, 15% for adults, and 15% for 15 µm. At mid nasal region, deposition of 15% for 20 µm is observed for infant and 8% for neonate and adult nasal cavities at a particle size of 10 and 20 µm, respectively. The highest particle deposition at the olfactory region is about 2.7% for the adult nasal cavity for 20 µm, and it is <1% for neonate and infant nasal cavities.Discussion and conclusions: The study of preferred nasal depositions during natural sedentary breathing conditions is utilized to determine the size that allows medication particles to be targeted to specific nose regions.
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Affiliation(s)
- John Valerian Corda
- Department of Aeronautical & Automobile Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal-576104, Karnataka, India
| | - B Satish Shenoy
- Department of Aeronautical & Automobile Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal-576104, Karnataka, India
| | - Kamarul Arifin Ahmad
- Department of Aerospace Engineering, Universiti Putra Malaysia, Seri Kembangan, Malaysia
| | - Leslie Lewis
- Department of Paediatrics, Kasturba Medical College & Hospital, Manipal Academy of Higher Education, Manipal-576104, Karnataka, India
| | - Prakashini K
- Department of Radio Diagnosis, Kasturba Medical College & Hospital, Manipal Academy of Higher Education, Manipal-576104, Karnataka, India
| | - Anoop Rao
- Department of Pediatrics, Neonatology, Stanford University, Palo Alto, CA, USA
| | - Mohammad Zuber
- Department of Aeronautical & Automobile Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal-576104, Karnataka, India
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Grant T, Lilley T, McCormack MC, Rathouz PJ, Peng R, Keet CA, Rule A, Davis M, Balcer-Whaley S, Newman M, Matsui EC. Indoor environmental exposures and obstructive lung disease phenotypes among children with asthma living in poor urban neighborhoods. J Allergy Clin Immunol 2023; 151:716-722.e8. [PMID: 36395986 PMCID: PMC9992008 DOI: 10.1016/j.jaci.2022.08.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 08/04/2022] [Accepted: 08/31/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Air trapping is an obstructive phenotype that has been associated with more severe and unstable asthma in children. Air trapping has been defined using pre- and postbronchodilator spirometry. The causes of air trapping are not completely understood. It is possible that environmental exposures could be implicated in air trapping in children with asthma. OBJECTIVE We investigated the association between indoor exposures and air trapping in urban children with asthma. METHODS Children with asthma aged 5 to 17 years living in Baltimore and enrolled onto the Environmental Control as Add-on Therapy for Childhood Asthma study were evaluated for air trapping using spirometry. Aeroallergen sensitization was assessed at baseline, and spirometry was performed at 0, 3, and 6 months. Air trapping was defined as an FVC z score of less than -1.64 or a change in FVC with bronchodilation of ≥10% predicted. Logistic normal random effects models were used to evaluate associations of air trapping and indoor exposures. RESULTS Airborne and bedroom floor mouse allergen concentrations were associated with air trapping but not airflow limitation (odds ratio 1.19, 95% confidence interval 1.02-1.37, P = .02 per 2-fold increase in airborne mouse allergen; odds ratio 1.23, 95% confidence interval 1.07-1.41, P = .003 per 2-fold increase in bedroom floor mouse allergen). Other indoor exposures (cockroach, cat, dog, dust mite, particulate matter, and nicotine) were not associated with air trapping or airflow limitation. CONCLUSION Mouse allergen exposure, but not other indoor exposure, was associated with air trapping in urban children with asthma.
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Affiliation(s)
- Torie Grant
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Md; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Md
| | - Travis Lilley
- Department of Population Health, Dell Medical School at UT Austin, Austin, Tex
| | - Meredith C McCormack
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Md
| | - Paul J Rathouz
- Department of Population Health, Dell Medical School at UT Austin, Austin, Tex
| | - Roger Peng
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md
| | - Corinne A Keet
- Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC
| | - Ana Rule
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Pubilc Health, Baltimore, Md
| | - Meghan Davis
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Pubilc Health, Baltimore, Md
| | - Susan Balcer-Whaley
- Department of Population Health, Dell Medical School at UT Austin, Austin, Tex
| | - Michelle Newman
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Md
| | - Elizabeth C Matsui
- Department of Population Health, Dell Medical School at UT Austin, Austin, Tex; Department of Pediatrics, Dell Medical School at UT Austin, Austin, Tex.
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4
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Karenzmaßnahmen bei Milbenallergie - ein Update. ALLERGO JOURNAL 2023. [DOI: 10.1007/s15007-022-5667-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
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5
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REGN1908/1909 prevented cat allergen-induced early asthmatic responses in an environmental exposure unit. J Allergy Clin Immunol 2022; 150:1437-1446. [PMID: 35934082 DOI: 10.1016/j.jaci.2022.06.025] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 06/22/2022] [Accepted: 06/28/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND The dominant allergen in cat dander, Felis domesticus allergen 1 (Fel d 1), is a persistent trigger for allergic rhinitis and asthma symptoms. OBJECTIVE We evaluated the efficacy of Fel d 1 monoclonal antibodies (REGN1908/1909) in preventing cat allergen-induced early asthmatic responses (EARs) in cat-allergic patients with mild asthma. METHODS Patients were randomized to single-dose REGN1908/1909 600 mg (n = 29) or placebo (n = 27). The FEV1 was measured for up to 4 hours in a cat allergen environmental exposure unit up to 85 days after dosing. Assessments included between-group differences in change from baseline in FEV1 area under the curve (AUC; 0-2 hours) and incidence of EAR (FEV1 reduction ≥20%). TRIAL REGISTRATION NCT03838731. RESULTS Single-dose REGN1908/1909 significantly prevented reductions in FEV1 on days 8, 29, 57, and 85. Most REGN1908/1909 patients did not have an EAR by 4 hours (the last time point tested). In contrast, placebo-treated patients experienced a ≥20% mean FEV1 reduction on days 8, 29, 57, and 85 after dosing, with most experiencing an EAR within 1 hour. REGN1908/1909-treated patients tolerated 3-fold higher allergen quantities (P < .05 at all time points) versus placebo. REGN1908/1909 substantially reduced skin test reactivity to cat allergen versus placebo at all time points tested (nominal P < .001). REGN1908/1909 was generally well tolerated; no serious adverse events or deaths were reported. CONCLUSION Single-dose REGN1908/1909 significantly prevented reductions in FEV1 in cat-allergic patients with mild asthma on cat allergen environmental exposure unit exposure at 8 days and up to 85 days after dose.
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Gültuna S. Clinical characteristics of cat sensitized adults, cat ownership and cat owners' attitudes. Allergy Asthma Proc 2022; 43:e65-e71. [PMID: 36335422 DOI: 10.2500/aap.2022.43.220066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Background: Cat allergen sensitization is a significant risk factor for allergic rhinitis and asthma. There are insufficient data on the preferences and attitudes of cat owners who have a cat allergy. Objective: To investigate the clinical characteristics of adults sensitized to cats and their association with cat ownership, and to assess owners' attitudes and behaviors. Methods: The study evaluated adult patients, ages between 19 and 74 years, who were sensitized to cat allergen as confirmed by skin-prick tests. The demographic and clinical data of the patients were obtained retrospectively from the hospital medical records system. A telephone interview with patients was conducted to evaluate whether they owned a cat and their attitudes toward cat allergy. A total of 143 patients who could not be reached by telephone or who refused to participate in the study were excluded. Patients were categorized into never owned a cat, early cat ownership (having a cat or cats in the first 2 years of the patient's life), and past and current cat ownership according to the status of patients at the time of their skin-prick test. Current cat owners were questioned whether they relinquished their cats and the presence and the degree of symptoms of both patients who relinquished their cats and patients who continued to live with their cats. Results: A total of 245 patients (women/men, 151/94) with a mean age of 31.56 ± 11.33 were included in the study. Eighty-three patients (33.9%) were current cat owners. After the skin-prick test, 54 cat owners (66.1%) continued living with their cats. Two-thirds of these owners were symptomatic, with 95% experiencing nasal symptoms. Only five of the patients with symptoms (14.3%) reported worsening symptoms. Any significant impact on symptoms was not determined with regard to number of cats, cat breeds, and precautionary measures. Conclusion: Cat allergen is a potential risk for public health. The clinician must engage in shared decision-making as to what type of environmental changes that the patient is willing to make and what treatment options, if any, they are ready to accept, recognizing that most patients will prefer to keep their cats.
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Maya‐Manzano JM, Pusch G, Ebner von Eschenbach C, Bartusel E, Belzner T, Karg E, Bardolatzy U, Scheja M, Schmidt‐Weber C, Buters J. Effect of air filtration on house dust mite, cat and dog allergens and particulate matter in homes. Clin Transl Allergy 2022; 12:e12137. [PMID: 35474731 PMCID: PMC9022093 DOI: 10.1002/clt2.12137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 03/09/2022] [Accepted: 03/11/2022] [Indexed: 11/09/2022] Open
Abstract
Background Methods Results Conclusions
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Affiliation(s)
- José María Maya‐Manzano
- Center of Allergy & Environment (ZAUM) Member of the German Center for Lung Research (DZL) Technical University and Helmholtz Center Munich Germany
| | - Gudrun Pusch
- Center of Allergy & Environment (ZAUM) Member of the German Center for Lung Research (DZL) Technical University and Helmholtz Center Munich Germany
| | - Cordula Ebner von Eschenbach
- Center of Allergy & Environment (ZAUM) Member of the German Center for Lung Research (DZL) Technical University and Helmholtz Center Munich Germany
| | - Elke Bartusel
- Center of Allergy & Environment (ZAUM) Member of the German Center for Lung Research (DZL) Technical University and Helmholtz Center Munich Germany
| | - Thomas Belzner
- Center of Allergy & Environment (ZAUM) Member of the German Center for Lung Research (DZL) Technical University and Helmholtz Center Munich Germany
| | - Erwin Karg
- Center of Allergy & Environment (ZAUM) Member of the German Center for Lung Research (DZL) Technical University and Helmholtz Center Munich Germany
| | - Ulrich Bardolatzy
- Center of Allergy & Environment (ZAUM) Member of the German Center for Lung Research (DZL) Technical University and Helmholtz Center Munich Germany
| | | | - Carsten Schmidt‐Weber
- Center of Allergy & Environment (ZAUM) Member of the German Center for Lung Research (DZL) Technical University and Helmholtz Center Munich Germany
| | - Jeroen Buters
- Center of Allergy & Environment (ZAUM) Member of the German Center for Lung Research (DZL) Technical University and Helmholtz Center Munich Germany
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Hazeri M, Faramarzi M, Sadrizadeh S, Ahmadi G, Abouali O. Regional deposition of the allergens and micro-aerosols in the healthy human nasal airways. JOURNAL OF AEROSOL SCIENCE 2021; 152:105700. [PMID: 33100375 PMCID: PMC7569476 DOI: 10.1016/j.jaerosci.2020.105700] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 09/04/2020] [Accepted: 10/16/2020] [Indexed: 05/04/2023]
Abstract
The nasal cavity is the inlet to the human respiratory system and is responsible for the olfactory sensation, filtering pollutant particulate matter, and humidifying the air. Many research studies have been performed to numerically predict allergens, contaminants, and/or drug particle deposition in the human nasal cavity; however, the majority of these investigations studied only one or a small number of nasal passages. In the present study, a series of Computed Tomography (CT) scan images of the nasal cavities from ten healthy subjects were collected and used to reconstruct accurate 3D models. All models were divided into twelve anatomical regions in order to study the transport and deposition features of different regions of the nasal cavity with specific functions. The flow field and micro-particle transport equations were solved, and the total and regional particle deposition fractions were evaluated for the rest and low activity breathing conditions. The results show that there are large variations among different subjects. The standard deviation of the total deposition fraction in the nasal cavities was the highest for 5 × 10 4 <impaction parameter (IP)< 1.125 × 10 5 with a maximum of 20%. The achieved results highlighted the nasal cavity sections that are more involved in the particle deposition. Particles with IP = 30,000 deposit more in the middle turbinate and nasopharynx areas, while for particles with IP = 300,000, deposition is mainly in the anterior parts (kiesselbach and vestibule regions). For small IP values, the amounts of deposition fractions in different regions of the nasal cavity are more uniform.
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Affiliation(s)
- Mohammad Hazeri
- School of Mechanical Engineering, Shiraz University, Shiraz, Iran
| | - Mohammad Faramarzi
- Department of Otolaryngology-Head & Neck Surgery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sasan Sadrizadeh
- Department of Civil and Architectural Engineering, KTH University, Stockholm, Sweden
| | - Goodarz Ahmadi
- Department of Mechanical & Aeronautical Engineering, Clarkson University, Potsdam, NY, USA
| | - Omid Abouali
- School of Mechanical Engineering, Shiraz University, Shiraz, Iran
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Abstract
PURPOSE OF REVIEW The goal of this review is to compress all important information and results of the research in reducing cat allergen exposure using air filtration. Fel d 1 is the major allergen responsible for IgE responses in 90 to 95% of patients with cat allergy. RECENT FINDINGS Reduction of cat allergen in indoor air with different air filtration systems and portable devices has been demonstrated in the majority of the studies. Recently, early and late asthmatic responses were significantly reduced using portable HEPA air cleaners in an environmental exposure chamber. This review provides a comprehensive overview of the current state of airborne Fel d 1 air filtration targeting the most efficient devices in cat allergen reduction. Novel emerging HEPA filters are targeting reduction of cat indoor asthma trigger so patient can might benefit from efficient solution.
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Affiliation(s)
- Alina Gherasim
- ALYATEC® Environmental Exposure Chamber, 1 place de l'Hôpital, 67000, Strasbourg, France.
| | - Frédéric de Blay
- ALYATEC® Environmental Exposure Chamber, 1 place de l'Hôpital, 67000, Strasbourg, France.,Chest Diseases Department, Strasbourg University Hospital, 1 place de l'Hôpital, 67000, Strasbourg, France.,Federation of Translational Medicine EA 3070, University of Strasbourg, Strasbourg, France
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van Boven FE, de Jong NW, Braunstahl GJ, Arends LR, Gerth van Wijk R. Effectiveness of the Air Purification Strategies for the Treatment of Allergic Asthma: A Meta-Analysis. Int Arch Allergy Immunol 2020; 181:395-402. [PMID: 32187604 DOI: 10.1159/000506284] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 01/27/2020] [Indexed: 12/26/2022] Open
Abstract
We updated the meta-analysis published by McDonald et al. [Chest 2002;122;1535-1542] by reviewing the effectiveness of air purification for the treatment of home-related allergic asthma (dust mite, dog, cat, and cockroach). We analysed the trials included by McDonald et al. as well as studies published since 2000. Data on asthma symptoms scores (ASS), medication use, forced expiratory volume in 1 s as a percentage of the predicted value (FEV1 %pred), histamine provocative concentration causing a 20% reduction in FEV1 (PC20), Asthma Quality of Life Questionnaire (AQLQ) scores, and fractional exhaled nitric oxide (FeNO) levels were extracted. The effectiveness was examined using metafor (registered in Prospero CRD42019127227). Ten trials including a total of 482 patients (baseline characteristics: mean FEV1 %pred 83.2%, I2 = 96.7%; mean PC20 4.93 mg/mL, I2 = 44.0%; mean AQLQ 4.67 [max. 7], I2 = 93.7%; mean FeNO 36.5 ppb, I2 = 0%) were included. We assessed the mean differences in the AQLQ scores as +0.36 (95% CI 0.10 to 0.62, p = 0.01, n = 302, I2 = 0%) and the FeNO levels as -6.67 ppb (95% CI -10.56 to -2.77, p = 0.0008, n = 304, I2 = 0%). The standardised mean differences in all other health outcomes were not significant (ASS -0.68, p = 0.20; medication use: -0.01, p = 0.94; FEV1 %pred -0.11, p = 0.34; PC20 +0.24, p = 0.53). We found statistically significant mean differences in the AQLQ scores and FeNO levels in patients with predominantly mild to moderate asthma at baseline. A large trial reported great improvement in the subgroup of patients receiving Global Initiative for Asthma step 4 therapy. We recommend that future studies on air purification focus on patients with severe and poorly controlled allergic asthma.
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Affiliation(s)
- Frank E van Boven
- Department of Internal Medicine, Section of Allergology and Clinical Immunology, Erasmus Medical Center, Rotterdam, The Netherlands,
| | - Nicolette W de Jong
- Department of Internal Medicine, Section of Allergology and Clinical Immunology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Gert Jan Braunstahl
- Department of Pulmonology, Franciscus Gasthuis and Vlietland, Rotterdam, The Netherlands.,Department of Pulmonology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Lidia R Arends
- Department of Biostatistics, Erasmus Medical Center, Rotterdam, The Netherlands.,Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Roy Gerth van Wijk
- Department of Internal Medicine, Section of Allergology and Clinical Immunology, Erasmus Medical Center, Rotterdam, The Netherlands
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Aeroallergen Exposure and Spread in the Modern Era. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2019; 6:1835-1842. [PMID: 30390901 DOI: 10.1016/j.jaip.2018.08.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 08/27/2018] [Accepted: 08/27/2018] [Indexed: 01/29/2023]
Abstract
Since the initial discovery of aeroallergens in the 20th century, our understanding of their properties including sources and factors influencing their spread continues to expand. Both habits of daily living and the presence of environmental factors such as exposure to animals or pollution can influence susceptibility to atopic disease. Because relevant allergens may vary in individuals and communities, it is necessary to understand the physical properties of environmental aeroallergens that are associated with clinical disease to explain symptoms and to implement successful integrated interventions. The objective of this review was to present an overview of aeroallergens and the environmental factors influencing their current distribution. Using historical studies along with recent advancements, we will give an up-to-date description of the physical characteristics and aerodynamics of aeroallergens in addition to location, quantities, and timing of exposure.
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12
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Gherasim A, Jacob A, Schoettel F, Domis N, de Blay F. Efficacy of air cleaners in asthmatics allergic to cat in ALYATEC ® environmental exposure chamber. Clin Exp Allergy 2019; 50:160-169. [PMID: 31596983 DOI: 10.1111/cea.13511] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 09/20/2019] [Accepted: 09/25/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND Air cleaners have been promoted for respiratory allergic disease prevention, but there is no clear clinical proof of their efficacy in allergic asthma. OBJECTIVE To examine the efficacy of a new air cleaner on early and late asthmatic responses in cat-allergic patients. METHODS This randomized, cross-over, double-blind placebo-controlled study enrolled 24 cat-asthmatic patients with GINA 1 asthma. At baseline, participants were exposed to 40 ng/m3 of airborne cat allergen for a maximum of 2 hours in ALYATEC® environmental exposure chamber (EEC). All participants were subsequently randomized into two groups that were exposed to cat allergen, either with active then placebo air cleaners or with placebo then active air cleaners with a 3-week interval in the EEC. This study was registered under number (NCT03928561). RESULTS Fewer patients experienced an EAR with active air cleaners (seven patients; 29.17%) than placebo (21 patients; 87.50%). The response incidence was lower with active than with placebo air cleaners. A Cox model demonstrated a significant treatment effect (hazard ratio, 0.10; P = .002). Active air cleaners also prevented late asthmatic response: four patients (16.67%) had a late asthmatic response with active air cleaners compared to 11 patients (45.83%) with placebo (Prescott test P = .002). Active air cleaners also decreased the maximal severity of bronchial response (FEV1 decrease of 17.24% with active vs 25.62% with placebo air cleaners; P = .001). CONCLUSIONS Our present results demonstrated that Intense Pure Air XL® air cleaners significantly prevented early and late asthmatic responses among cat-allergic asthmatics during cat allergen exposure in the ALYATEC® EEC.
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Affiliation(s)
- Alina Gherasim
- ALYATEC® Environmental Exposure Chamber, 1 place de l'Hôpital, Strasbourg, France
| | - Audrey Jacob
- ALYATEC® Environmental Exposure Chamber, 1 place de l'Hôpital, Strasbourg, France
| | - Florian Schoettel
- ALYATEC® Environmental Exposure Chamber, 1 place de l'Hôpital, Strasbourg, France
| | - Nathalie Domis
- ALYATEC® Environmental Exposure Chamber, 1 place de l'Hôpital, Strasbourg, France
| | - Frederic de Blay
- ALYATEC® Environmental Exposure Chamber, 1 place de l'Hôpital, Strasbourg, France.,Chest Diseases Department, Strasbourg University Hospital, Strasbourg, France.,Federation of translational medicine EA 3070, University of Strasbourg, Strasbourg, France
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13
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Home Environmental Interventions for House Dust Mite. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2019; 6:1-7. [PMID: 29310755 DOI: 10.1016/j.jaip.2017.10.003] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 09/26/2017] [Accepted: 10/03/2017] [Indexed: 11/20/2022]
Abstract
It has been 50 years since the dust mite was first appreciated to be a major source of allergen in house dust, and by extension a key trigger of allergic respiratory disease. Since that time a number of protein allergens have been identified and characterized, mainly from mite feces, and standardized mite extracts and IgE assays have been developed. Insights into the lifecycle of dust mites and aspects of mite allergen biology have shed light on the mechanisms that lead to respiratory disease and to the development of interventions that can minimize dust mite allergen exposure. It is now clear that dust mite allergy is a key contributor to asthma in many parts of the world, and that long-term avoidance can be effective for preventing sensitization and minimizing the development and severity of respiratory disease. Here, we discuss the evidence linking dust mites with respiratory disease, outline studies that support the efficacy of home environmental interventions, and highlight practical methods that have been shown to be effective as part of a multifaceted approach to dust mite avoidance.
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Satyaraj E, Li Q, Sun P, Sherrill S. Anti-Fel d1 immunoglobulin Y antibody-containing egg ingredient lowers allergen levels in cat saliva. J Feline Med Surg 2019; 21:875-881. [PMID: 31310154 PMCID: PMC6764009 DOI: 10.1177/1098612x19861218] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVES Fel d1 is the major cat allergen, causing IgE reactions in up to 90% of cat-allergic adults. Fel d1 secreted in saliva is spread to the haircoat during grooming. Current management includes attempts to reduce or eliminate exposure to Fel d1. A novel approach to reducing immunologically active Fel d1 (aFel d1) exposure, which involves binding the Fel d1 with an anti-Fel d1-specific polyclonal egg IgY antibody (sIgY), was evaluated. The hypothesis was that saliva from cats fed diets containing this sIgY would show a significant reduction in aFel d1. METHODS Two trials in cats were completed. In trial 1, saliva was collected 0, 1, 3 and 5 h post-feeding during a 2 week baseline and subsequent 6 week treatment period. Trial 2 included a control and treatment group, and saliva was collected once daily. Trial 2 cats were fed the control diet during a 1 week baseline period, and then fed either control or sIgY diet during the 4 week treatment period. Fel d1-specific ELISA was used to measure salivary aFel d1. Data were analysed using repeated-measures ANOVA and a linear mixed-model analysis. RESULTS Salivary aFel d1 decreased post-treatment in both trials. There were no differences in aFel d1 based on time of collection relative to feeding in trial 1. In trial 2, 82% of treatment group cats showed a decrease in aFel d1 of at least 20% from baseline vs just 38% of control cats. Only one (9%) treatment cat showed an increase in aFel d1 vs 63% of control cats. CONCLUSIONS AND RELEVANCE Feeding sIgY significantly reduced aFel d1 in the saliva of cats within 3 weeks. Although additional research is needed, these findings show promise for an alternative approach to the management of allergies to cats.
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Affiliation(s)
| | - Qinghong Li
- Research & Development, Nestlé Purina Research,
St Louis, MO, USA
| | - Peichuan Sun
- Research & Development, Nestlé Purina Research,
St Louis, MO, USA
| | - Scott Sherrill
- Research & Development, Nestlé Purina Research,
St Louis, MO, USA
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15
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Satyaraj E, Gardner C, Filipi I, Cramer K, Sherrill S. Reduction of active Fel d1 from cats using an antiFel d1 egg IgY antibody. Immun Inflamm Dis 2019; 7:68-73. [PMID: 30851084 PMCID: PMC6485700 DOI: 10.1002/iid3.244] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 02/07/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Fel d1 is the most important allergen from cats. Fel d1 is produced primarily in saliva and spread to the haircoat during grooming and then transferred to the environment via hair and dander. OBJECTIVES A novel approach to reducing allergenic Fel d1 exposure was evaluated, involving binding the Fel d1 with an anti-Fel d1 polyclonal egg IgY antibody. The hypothesis was that hair from cats who had been fed foods containing anti-Fel d1 IgY would show a significant reduction in active Fel d1 (aFel d1). METHODS Hair collected from 105 cats completing a 12-week study was evaluated for aFel d1 via ELISA. Hair was collected four times over a 2-week baseline period, then weekly during the 10 week treatment period during which cats consumed a food containing the anti-Fel d1 IgY. RESULTS Baseline aFel d1 (μg/g hair) varied greatly among the cats in this study. From week 3, there was a significant reduction in mean aFel d1 with an overall average decrease of 47% by week 10, ranging from a 33-71% decrease vs baseline. Cats with the highest baseline aFel d1 showed the greatest decrease in aFel d1. CONCLUSIONS & CLINICAL IMPLICATIONS Feeding anti-Fel d1 IgY to cats successfully reduced aFel d1 on their haircoat with the greatest decreases observed in cats with initially high levels. Feeding a diet with anti Fel d1 IgY significantly reduced the active Fel d1 on the hair of cats.
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16
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Khayath N, Doyen V, Gherasim A, Radu C, Choual I, Beck N, Jacob A, Schoettel F, Vecellio L, Domis N, de Blay F. Validation of Strasbourg environmental exposure chamber (EEC) ALYATEC ® in mite allergic subjects with asthma. J Asthma 2019; 57:140-148. [PMID: 30919704 DOI: 10.1080/02770903.2018.1563902] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objective: Environmental Exposure Chamber (EEC) should have standardized and controlled allergenic and non-allergenic exposures to perform reproducible clinical studies. The aim was to demonstrate that mite exposure in the Alyatec® EEC could induce early (EAR) and/or late asthmatic reactions (LAR) in at least 60% of subjects allergic to mite.Methods: The EEC has a volume of 147-m3 with 20 seats. The nebulized particle number, airborne Der p1, endotoxins, and volatile organic compound (VOC) concentrations were measured. Twenty-four asthmatics allergic to mite were randomly exposed to 15, 25, and 46 ng/m3 Der p1. Specificity was assessed in not mite-sensitized asthmatics.Results: No significant endotoxin or VOC contamination was measured. The mean inter-assay CVs were 12.5% for the airborne particle number and 28.7% for airborne Der p1 concentrations. For the three Der p1 concentrations, at least 88% of the subjects developed EAR and/or LAR, and at least 46% developed a dual response. No reaction occurred with placebo or in the control group. No severe bronchial reaction occurred.Conclusions: The Alyatec® EEC demonstrated a tight control of allergenic and non-allergenic exposures. The EEC was clinically validated, with airborne Der p1 levels close to levels found in natural settings.
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Affiliation(s)
- Naji Khayath
- Chest Diseases Department, Strasbourg University Hospital, Strasbourg, France.,Federation of Translational Medicine EA 3070, University of Strasbourg, Strasbourg, France
| | - Virginie Doyen
- Clinics of Immuno-Allergology, CHU Brugmann, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | | | - Carmen Radu
- Biocluster des Haras, ALYATEC®, Strasbourg, France
| | | | - Nicole Beck
- Biocluster des Haras, ALYATEC®, Strasbourg, France
| | - Audrey Jacob
- Biocluster des Haras, ALYATEC®, Strasbourg, France
| | | | | | | | - Frédéric de Blay
- Chest Diseases Department, Strasbourg University Hospital, Strasbourg, France.,Federation of Translational Medicine EA 3070, University of Strasbourg, Strasbourg, France.,Biocluster des Haras, ALYATEC®, Strasbourg, France
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17
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Platts-Mills TA, Chapman MD, Pollart SM, Heymann PW, Luczynska CM. Establishing Health Standards for Indoor Foreign Proteins Related to Asthma: Dust Mite, Cat and Cockroach. Toxicol Ind Health 2018. [DOI: 10.1177/074823379000600201] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Thomas A.E. Platts-Mills
- Division of Allergy and Clinical Immunology University of Virginia Medical School Box 225 Charlottesville, Virginia 22908
| | - Martin D. Chapman
- Division of Allergy and Clinical Immunology University of Virginia Medical School Box 225 Charlottesville, Virginia 22908
| | - Susan M. Pollart
- Division of Allergy and Clinical Immunology University of Virginia Medical School Box 225 Charlottesville, Virginia 22908
| | - Peter W. Heymann
- Division of Allergy and Clinical Immunology University of Virginia Medical School Box 225 Charlottesville, Virginia 22908
| | - Christina M. Luczynska
- Division of Allergy and Clinical Immunology University of Virginia Medical School Box 225 Charlottesville, Virginia 22908
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18
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Wilson JM, Platts-Mills TAE. Reply. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2018; 6:1436-1437. [PMID: 30033927 PMCID: PMC6474409 DOI: 10.1016/j.jaip.2018.04.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 04/18/2018] [Indexed: 06/08/2023]
Affiliation(s)
- Jeffrey M Wilson
- Division of Allergy and Immunology, University of Virginia, Charlottesville, Va
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19
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Dávila I, Domínguez‐Ortega J, Navarro‐Pulido A, Alonso A, Antolín‐Amerigo D, González‐Mancebo E, Martín‐García C, Núñez‐Acevedo B, Prior N, Reche M, Rosado A, Ruiz‐Hornillos J, Sánchez MC, Torrecillas M. Consensus document on dog and cat allergy. Allergy 2018; 73:1206-1222. [PMID: 29318625 DOI: 10.1111/all.13391] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2017] [Indexed: 12/16/2022]
Abstract
The prevalence of sensitization to dogs and cats varies by country, exposure time and predisposition to atopy. It is estimated that 26% of European adults coming to the clinic for suspected allergy to inhalant allergens are sensitized to cats and 27% to dogs. This document is intended to be a useful tool for clinicians involved in the management of people with dog or cat allergy. It was prepared from a consensus process based on the RAND/UCLA method. Following a literature review, it proposes various recommendations concerning the diagnosis and treatment of these patients, grounded in evidence and clinical experience. The diagnosis of dog and cat allergy is based on a medical history and physical examination that are consistent with each other and is confirmed with positive results on specific IgE skin tests. Sometimes, especially in polysensitized patients, molecular diagnosis is strongly recommended. Although the most advisable measure would be to avoid the animal, this is often impossible and associated with a major emotional impact. Furthermore, indirect exposure to allergens occurs in environments in which animals are not present. Immunotherapy is emerging as a potential solution to this problem, although further supporting studies are needed.
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Affiliation(s)
- I. Dávila
- Allergy Department University Hospital of Salamanca Salamanca Spain
- Institute for Biomedical Research IBSAL Salamanca Spain
- Department of Biomedical and Diagnostic Sciences University of Salamanca Salamanca Spain
| | - J. Domínguez‐Ortega
- Allergy Department Hospital La Paz Institute for Health Research (IdiPAZ) Madrid Spain
- CIBER de Enfermedades Respiratorias (CIBERES) Madrid Spain
| | - A. Navarro‐Pulido
- Allergology Clinical Management Unit (UGC) El Tomillar Hospital Sevilla Spain
| | - A. Alonso
- Allergy Department Valladolid Medical Alliance Valladolid Spain
| | - D. Antolín‐Amerigo
- Immune System Diseases Department‐Allergy Unit Príncipe de Asturias University Hospital Madrid Spain
- Department of Medicine and medical specialties (IRYCIS) University of Alcalá Madrid Spain
| | | | | | | | - N. Prior
- Allergy Department Severo Ochoa University Hospital Madrid Spain
| | - M. Reche
- Allergy Department Infanta Sofía Hospital Madrid Spain
| | - A. Rosado
- Allergy Unit Alcorcón Foundation University Hospital Madrid Spain
| | | | - M. C. Sánchez
- Allergy Unit Juan Ramón Jiménez Hospital Huelva Spain
| | - M. Torrecillas
- Allergy Department Albacete University General Hospital Complex Albacete Spain
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20
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Bonnet B, Messaoudi K, Jacomet F, Michaud E, Fauquert JL, Caillaud D, Evrard B. An update on molecular cat allergens: Fel d 1 and what else? Chapter 1: Fel d 1, the major cat allergen. ALLERGY, ASTHMA, AND CLINICAL IMMUNOLOGY : OFFICIAL JOURNAL OF THE CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY 2018. [PMID: 29643919 DOI: 10.1186/s13223-018-0239-8.] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Background Cats are the major source of indoor inhalant allergens after house dust mites. The global incidence of cat allergies is rising sharply, posing a major public health problem. Ten cat allergens have been identified. The major allergen responsible for symptoms is Fel d 1, a secretoglobin and not a lipocalin, making the cat a special case among mammals. Main body Given its clinical predominance, it is essential to have a good knowledge of this allergenic fraction, including its basic structure, to understand the new exciting diagnostic and therapeutic applications currently in development. The recent arrival of the component-resolved diagnosis, which uses molecular allergens, represents a unique opportunity to improve our understanding of the disease. Recombinant Fel d 1 is now available for in vitro diagnosis by the anti-Fel d 1 specific IgE assay. The first part of the review will seek to describe the recent advances related to Fel d 1 in terms of positive diagnosis and assessment of disease severity. In daily practice, anti-Fel d 1 IgE tend to replace those directed against the overall extract but is this attitude justified? We will look at the most recent arguments to try to answer this question. In parallel, a second revolution is taking place thanks to molecular engineering, which has allowed the development of various forms of recombinant Fel d 1 and which seeks to modify the immunomodulatory properties of the molecule and thus the clinical history of the disease via various modalities of anti-Fel d 1-specific immunotherapy. We will endeavor to give a clear and practical overview of all these trends.
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Affiliation(s)
- B Bonnet
- 1Laboratoire d'Immunologie, ECREIN, UMR1019 Unité de Nutrition Humaine, Université Clermont Auvergne, 63000 Clermont-Ferrand, France.,2Service d'Immunologie, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - K Messaoudi
- 3Laboratoire de Biochimie, CHU Angers, Angers, France
| | - F Jacomet
- 4Laboratoire d'Immunologie, CHU Poitiers, Poitiers, France
| | - E Michaud
- 5Service de Pédiatrie, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - J L Fauquert
- 5Service de Pédiatrie, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - D Caillaud
- 6Service de Pneumologie, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - B Evrard
- 1Laboratoire d'Immunologie, ECREIN, UMR1019 Unité de Nutrition Humaine, Université Clermont Auvergne, 63000 Clermont-Ferrand, France.,2Service d'Immunologie, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
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21
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Bonnet B, Messaoudi K, Jacomet F, Michaud E, Fauquert JL, Caillaud D, Evrard B. An update on molecular cat allergens: Fel d 1 and what else? Chapter 1: Fel d 1, the major cat allergen. Allergy Asthma Clin Immunol 2018; 14:14. [PMID: 29643919 PMCID: PMC5891966 DOI: 10.1186/s13223-018-0239-8] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 02/21/2018] [Indexed: 02/08/2023] Open
Abstract
Background Cats are the major source of indoor inhalant allergens after house dust mites. The global incidence of cat allergies is rising sharply, posing a major public health problem. Ten cat allergens have been identified. The major allergen responsible for symptoms is Fel d 1, a secretoglobin and not a lipocalin, making the cat a special case among mammals. Main body Given its clinical predominance, it is essential to have a good knowledge of this allergenic fraction, including its basic structure, to understand the new exciting diagnostic and therapeutic applications currently in development. The recent arrival of the component-resolved diagnosis, which uses molecular allergens, represents a unique opportunity to improve our understanding of the disease. Recombinant Fel d 1 is now available for in vitro diagnosis by the anti-Fel d 1 specific IgE assay. The first part of the review will seek to describe the recent advances related to Fel d 1 in terms of positive diagnosis and assessment of disease severity. In daily practice, anti-Fel d 1 IgE tend to replace those directed against the overall extract but is this attitude justified? We will look at the most recent arguments to try to answer this question. In parallel, a second revolution is taking place thanks to molecular engineering, which has allowed the development of various forms of recombinant Fel d 1 and which seeks to modify the immunomodulatory properties of the molecule and thus the clinical history of the disease via various modalities of anti-Fel d 1-specific immunotherapy. We will endeavor to give a clear and practical overview of all these trends.
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Affiliation(s)
- B Bonnet
- 1Laboratoire d'Immunologie, ECREIN, UMR1019 Unité de Nutrition Humaine, Université Clermont Auvergne, 63000 Clermont-Ferrand, France.,2Service d'Immunologie, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - K Messaoudi
- 3Laboratoire de Biochimie, CHU Angers, Angers, France
| | - F Jacomet
- 4Laboratoire d'Immunologie, CHU Poitiers, Poitiers, France
| | - E Michaud
- 5Service de Pédiatrie, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - J L Fauquert
- 5Service de Pédiatrie, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - D Caillaud
- 6Service de Pneumologie, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - B Evrard
- 1Laboratoire d'Immunologie, ECREIN, UMR1019 Unité de Nutrition Humaine, Université Clermont Auvergne, 63000 Clermont-Ferrand, France.,2Service d'Immunologie, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
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22
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Lewis RD, Ong KH, Emo B, Kennedy J, Kesavan J, Elliot M. Resuspension of house dust and allergens during walking and vacuum cleaning. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2018; 15:235-245. [PMID: 29283321 DOI: 10.1080/15459624.2017.1415438] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Conventional wisdom has been that hard, resilient surfaces resuspend fewer particles than carpeted surfaces, however, exceptions to this have been demonstrated and uncertainty remains about the factors that lead to this resuspension, notably, the effect of vacuum cleaning on either increasing or reducing resuspension from flooring. The purpose of this study was to determine how resuspension of house dust by aerodynamic size or particle type, including cat allergen and bacterial endotoxin, is affected by flooring, dust loading, embedding dust, and walking/cleaning activities. House dust was blown in and allowed to settle in a walk-in chamber after overnight deposition followed by walking or a vacuum cleaning procedure. Using an aerosol particle sizer and large-volume air samplers at different heights in the chamber, concentrations of airborne particles, resuspension rates, and fractions were computed for four types of flooring conditions during six walking activities. Carpeting resulted in significantly more airborne cat allergen and airborne endotoxin than a laminate floor. Height does have an effect on measured allergen over carpet and this is apparent with concentrations at the infant and adult air samplers. Walking on laminate flooring resuspends less house dust than walking on an equally dusty carpeted floor, where dust is entirely on the surface of the carpet. However, vacuum cleaning a laminate floor resuspended more dust than vacuum cleaning carpets, at large particle sizes of 5 µm and 10 µm. Activities following a deep cleaning of hard resilient or a carpeted surface is likely to leave no differences in resuspended particles between them.
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Affiliation(s)
- Roger D Lewis
- a Saint Louis University College for Public Health and Social Justice , St. Louis , Missouri
| | | | - Brett Emo
- a Saint Louis University College for Public Health and Social Justice , St. Louis , Missouri
| | - Jason Kennedy
- c Critical Care Medicine , University of Pittsburgh , Pittsburgh , Pennsylvania
| | - Jana Kesavan
- d U.S. Army Edgewood Chemical Biological Center , Aberdeen , Maryland
| | - Michael Elliot
- a Saint Louis University College for Public Health and Social Justice , St. Louis , Missouri
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23
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Passali D, Cingi C, Staffa P, Passali F, Muluk NB, Bellussi ML. The International Study of the Allergic Rhinitis Survey: outcomes from 4 geographical regions. Asia Pac Allergy 2018; 8:e7. [PMID: 29423374 PMCID: PMC5796967 DOI: 10.5415/apallergy.2018.8.e7] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 01/08/2017] [Indexed: 11/07/2022] Open
Abstract
Background Allergic rhinitis (AR) is a global health problem and is characterised by one or more symptoms, including sneezing, itching, nasal congestion and rhinorrhea. Objective We investigated the features of AR and the physician's approach to the management of AR patients in four geographical regions. Methods In this cross-sectional study, a questionnaire survey concerning AR was completed by Honorary and Corresponding Members of the Italian Society of Rhinology from different countries among 4 world geographical regions—Asia, Europe, the Americas, and Africa. Results The prevalence of AR was reported to be 15%–25%. Children and adolescents, as well as young adults, were the age groups more affected by AR with comorbidities of asthma, sinusitis, conjunctivitis, and nasal polyposis. Nasal symptoms of AR were more intense in the spring (51.92%) and autumn (28.85%). The most common aero-allergens were pollen and mites (67.31%), animal dander and pollutants (23.08%), and fungal allergens (21.15%). Allergen-specific immunotherapy was prescribed for both perennial and seasonal allergens (32.69%) via sublingual swallow (46.15%) and subcutaneous (32.69%) routes. For the AR patients, the most prescribed drugs were intranasal corticosteroids (86.54%) and oral H1-antihistamines (82.69%). Conclusion A network of experts can improve our knowledge concerning AR epidemiology, and together with guidelines, could assist practitioners and otolaryngologists in standardising the diagnosis and treatment of AR.
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Affiliation(s)
- Desiderio Passali
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Siena, 53100 Siena, Italy
| | - Cemal Cingi
- Department of Otorhinolaryngology - Head and Neck Surgery, Osmangazi University, Faculty of Medicine, 26040 Eskisehir, Turkey
| | - Paola Staffa
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Siena, 53100 Siena, Italy
| | | | - Nuray Bayar Muluk
- Department of Otorhinolaryngology - Head and Neck Surgery, Kırıkkale University, Faculty of Medicine, 71450 Kırıkkale, Turkey
| | - Maria Luisa Bellussi
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Siena, 53100 Siena, Italy
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Abstract
Cats are usually spreaders of allergens that are critical for sensitive people; the Siberian cat is a breed supposed to be low level allergenic, according to some breeders' statements. The sequence of the two genes, namely Ch1 and Ch2, that code for the allergen Fel d 1, the major allergen responsible for outbreaks of allergy symptoms, is not yet known in the Siberian cat, and finding this was the aim of our investigation. Notably, our work is the first survey of the genetic structure of these genes in Siberian cats. The comparison of the sequences of Siberian cats, non-Siberian cats, and sequences present in the National Center for Biotechnology Information database revealed a considerable number of mutations; some of those detected in the Siberian cat, due to their position in exon regions, could affect the Fel d 1 allergenic properties. Therefore, further investigations are recommended to assess if the identified mutations can be responsible for a reduced-allergen synthesis and can be used as markers for selection of low level allergenic cats.
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25
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Sartore S, Landoni E, Maione S, Tarducci A, Borrelli A, Soglia D, Rasero R, Sacchi P. Polymorphism Analysis of Ch1 and Ch2 Genes in the Siberian Cat. Vet Sci 2017; 4:vetsci4040063. [PMID: 29194349 PMCID: PMC5753643 DOI: 10.3390/vetsci4040063] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 11/15/2017] [Accepted: 11/29/2017] [Indexed: 11/16/2022] Open
Abstract
Cats are usually spreaders of allergens that are critical for sensitive people; the Siberian cat is a breed supposed to be low level allergenic, according to some breeders' statements. The sequence of the two genes, namely Ch1 and Ch2, that code for the allergen Fel d 1, the major allergen responsible for outbreaks of allergy symptoms, is not yet known in the Siberian cat, and finding this was the aim of our investigation. Notably, our work is the first survey of the genetic structure of these genes in Siberian cats. The comparison of the sequences of Siberian cats, non-Siberian cats, and sequences present in the National Center for Biotechnology Information database revealed a considerable number of mutations; some of those detected in the Siberian cat, due to their position in exon regions, could affect the Fel d 1 allergenic properties. Therefore, further investigations are recommended to assess if the identified mutations can be responsible for a reduced-allergen synthesis and can be used as markers for selection of low level allergenic cats.
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Affiliation(s)
- Stefano Sartore
- Department of Veterinary Science, University of Turin, 10095 Grugliasco, Italy.
| | - Eleonora Landoni
- Department of Veterinary Science, University of Turin, 10095 Grugliasco, Italy.
| | - Sandra Maione
- Department of Veterinary Science, University of Turin, 10095 Grugliasco, Italy.
| | - Alberto Tarducci
- Department of Veterinary Science, University of Turin, 10095 Grugliasco, Italy.
| | - Antonio Borrelli
- Department of Veterinary Science, University of Turin, 10095 Grugliasco, Italy.
| | - Dominga Soglia
- Department of Veterinary Science, University of Turin, 10095 Grugliasco, Italy.
| | - Roberto Rasero
- Department of Veterinary Science, University of Turin, 10095 Grugliasco, Italy.
| | - Paola Sacchi
- Department of Veterinary Science, University of Turin, 10095 Grugliasco, Italy.
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26
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Seguel JM, Merrill R, Seguel D, Campagna AC. Indoor Air Quality. Am J Lifestyle Med 2017; 11:284-295. [PMID: 30202344 PMCID: PMC6125109 DOI: 10.1177/1559827616653343] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2014] [Revised: 05/09/2016] [Accepted: 05/11/2016] [Indexed: 01/09/2023] Open
Abstract
Many health care providers are concerned with the role environmental exposures play in the development of respiratory disease. While most individuals understand that outdoor air quality is important to their health status, many are unaware of the detrimental effects indoor air pollution can potentially have on them. The Environmental Protection Agency (EPA) regulates both outdoor and indoor air quality. According to the EPA, indoor levels of pollutants may be up to 100 times higher than outdoor pollutant levels and have been ranked among the top 5 environmental risks to the public. There has been a strong correlation between air quality and health, which is why it is crucial to obtain a complete environmental exposure history from a patient. This article focuses on the effects indoor air quality has on the respiratory system. Specifically, this article will address secondhand smoke, radon, carbon monoxide, nitrogen dioxide, formaldehyde, house cleaning agents, indoor mold, animal dander, and dust mites. These are common agents that may lead to hazardous exposures among individuals living in the United States. It is important for health care providers to be educated on the potential risks of indoor air pollution and the effects it may have on patient outcomes. Health problems resulting from poor indoor air quality are not easily recognized and may affect a patient's health years after the onset of exposure.
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Affiliation(s)
- Joseph M. Seguel
- Joseph M. Seguel, MD, St. Peter’s Hospital, 315 South Manning Boulevard, Albany, NY 12208; e-mail:
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28
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Patelis A, Dosanjh A, Gunnbjörnsdottir M, Borres MP, Högman M, Alving K, Janson C, Malinovschi A. New data analysis in a population study raises the hypothesis that particle size contributes to the pro-asthmatic potential of small pet animal allergens. Ups J Med Sci 2016; 121:25-32. [PMID: 26610050 PMCID: PMC4812054 DOI: 10.3109/03009734.2015.1109569] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The size of inhaled particles influences where they deposit and theoretically should be important for the development of airway inflammation and responsiveness. Our aim was to assess if sensitization to smaller-sized aeroallergens relates to higher prevalence of treated asthma, increased airway responsiveness, and airway and systemic inflammation. METHODS Molecular-based IgE antibody determination was done in 467 subjects. Sensitized subjects were grouped based on the particle size of the aeroallergen: (1) Large particles only (mainly pollen); (2) Medium-sized particles (sensitized to mainly mite and mold and possibly to large particles); and 3) Small particles (sensitized to pet allergens and possibly to medium- and/or large-sized particles). Airway responsiveness to methacholine, exhaled nitric oxide (FENO), and serum eosinophil cationic protein (S-ECP) were measured. Asthma and rhinitis were questionnaire-assessed. RESULTS Subjects sensitized to small particles had higher prevalence of treated asthma (35% versus 10%, P < 0.001), higher FENO50 (32 versus 17 ppb, P < 0.001), higher S-ECP (10 versus 7.5 ng/mL, P = 0.04), and increased bronchial responsiveness (dose-response slope, 5.6 versus 7.5, P < 0.001) compared with non-atopics. This was consistent after adjusting for potential confounders. Sensitization to only large or to medium and possibly also large aeroallergen particles was not related to any of these outcomes after adjustments. CONCLUSIONS Sensitization to smaller particles was associated with a higher prevalence of asthma under treatment, higher airway responsiveness, and airway and systemic inflammation. Mapping of IgE sensitization to small particles might help to detect subjects having increased airway and systemic inflammation and bronchial responsiveness, indicating increased risk of developing asthma.
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Affiliation(s)
- Antonios Patelis
- a Department of Medical Sciences , Respiratory, Allergy and Sleep Research, Uppsala University , Uppsala , Sweden
| | - Amrita Dosanjh
- b Department of Pediatrics , Scripps Hospital , San Diego , CA , USA
| | - Maria Gunnbjörnsdottir
- a Department of Medical Sciences , Respiratory, Allergy and Sleep Research, Uppsala University , Uppsala , Sweden
| | - Magnus P Borres
- c Thermo Fisher Scientific , Uppsala , Sweden
- d Department of Women's and Children's Health , Uppsala University , Uppsala , Sweden
| | - Marieann Högman
- a Department of Medical Sciences , Respiratory, Allergy and Sleep Research, Uppsala University , Uppsala , Sweden
- e Centre for Clinical Research, Uppsala University/Region Gävleborg , Sweden
| | - Kjell Alving
- d Department of Women's and Children's Health , Uppsala University , Uppsala , Sweden
| | - Christer Janson
- a Department of Medical Sciences , Respiratory, Allergy and Sleep Research, Uppsala University , Uppsala , Sweden
| | - Andrei Malinovschi
- f Department of Medical Sciences , Clinical Physiology, Uppsala University , Uppsala , Sweden
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Kim HK, Kim TH. Current trends in treatment of allergic rhinitis. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2016. [DOI: 10.5124/jkma.2016.59.4.300] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Ha Kyun Kim
- Department of Otorhinolaryngology-Head & Neck Surgery, Korea University College of Medicine, Seoul, Korea
| | - Tae Hoon Kim
- Department of Otorhinolaryngology-Head & Neck Surgery, Korea University College of Medicine, Seoul, Korea
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Affiliation(s)
- Kyoung Yong Jeong
- Department of Internal Medicine, Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea
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Woodfolk JA, Commins SP, Schuyler AJ, Erwin EA, Platts-Mills TAE. Allergens, sources, particles, and molecules: Why do we make IgE responses? Allergol Int 2015; 64:295-303. [PMID: 26433525 PMCID: PMC5406225 DOI: 10.1016/j.alit.2015.06.001] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 05/18/2015] [Indexed: 12/16/2022] Open
Abstract
Allergens are foreign proteins or glycoproteins that are the target of IgE antibody responses in humans. The relationship between subsequent exposure and the allergic symptoms is often or usually obvious; however, there is increasing evidence that in asthma, atopic dermatitis and some forms of food allergy the induction of symptoms is delayed or chronic. The primary exposure to inhaled allergens is to the particles, which are capable of carrying allergens in the air. Thus, the response reflects not only the properties of the proteins, but also the biological properties of the other constituents of the particle. This is best understood in relation to the mite fecal particles in which the contents include many different immunologically active substances. Allergic disease first became a major problem over 100 years ago, and for many years sensitization to pollens was the dominant form of these diseases. The rise in pediatric asthma correlates best with the move of children indoors, which started in 1960 and was primarily driven by indoor entertainment for children. While the causes of the increase are not simple they include both a major increase in sensitization to indoor allergens and the complex consequences of inactivity. Most recently, there has also been an increase in food allergy. Understanding this has required a reappraisal of the importance of the skin as a route for sensitization. Overall, understanding allergic diseases requires knowing about the sources, the particles and the routes of exposure as well as the properties of the individual allergens.
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Affiliation(s)
- Judith A Woodfolk
- Asthma and Allergic Diseases Center, University of Virginia Health System, Charlottesville, VA, United States
| | - Scott P Commins
- Asthma and Allergic Diseases Center, University of Virginia Health System, Charlottesville, VA, United States
| | - Alexander J Schuyler
- Asthma and Allergic Diseases Center, University of Virginia Health System, Charlottesville, VA, United States
| | - Elizabeth A Erwin
- Asthma and Allergic Diseases Center, University of Virginia Health System, Charlottesville, VA, United States
| | - Thomas A E Platts-Mills
- Asthma and Allergic Diseases Center, University of Virginia Health System, Charlottesville, VA, United States.
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Toma K, Miki D, Kishikawa C, Yoshimura N, Miyajima K, Arakawa T, Yatsuda H, Mitsubayashi K. Repetitive Immunoassay with a Surface Acoustic Wave Device and a Highly Stable Protein Monolayer for On-Site Monitoring of Airborne Dust Mite Allergens. Anal Chem 2015; 87:10470-4. [DOI: 10.1021/acs.analchem.5b02594] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Koji Toma
- Department
of Biomedical Devices and Instrumentation, Institute of Biomaterials
and Bioengineering, Tokyo Medical and Dental University, 2-3-10 Kanda-Surugadai, Chiyoda-ku, Tokyo 101-0062, Japan
| | - Daisuke Miki
- Graduate
School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan
| | - Chisato Kishikawa
- Graduate
School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan
| | | | - Kumiko Miyajima
- Department
of Biomedical Devices and Instrumentation, Institute of Biomaterials
and Bioengineering, Tokyo Medical and Dental University, 2-3-10 Kanda-Surugadai, Chiyoda-ku, Tokyo 101-0062, Japan
- Japan Society for the Promotion of Science, Tokyo 102-0083, Japan
| | - Takahiro Arakawa
- Department
of Biomedical Devices and Instrumentation, Institute of Biomaterials
and Bioengineering, Tokyo Medical and Dental University, 2-3-10 Kanda-Surugadai, Chiyoda-ku, Tokyo 101-0062, Japan
| | - Hiromi Yatsuda
- Japan Radio Co. Ltd., Saitama 356-8510, Japan
- OJ-Bio Ltd., NE1 4EP Newcastle upon Tyne, United Kingdom
| | - Kohji Mitsubayashi
- Department
of Biomedical Devices and Instrumentation, Institute of Biomaterials
and Bioengineering, Tokyo Medical and Dental University, 2-3-10 Kanda-Surugadai, Chiyoda-ku, Tokyo 101-0062, Japan
- Graduate
School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan
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Warm K, Hedman L, Lindberg A, Lötvall J, Lundbäck B, Rönmark E. Allergic sensitization is age-dependently associated with rhinitis, but less so with asthma. J Allergy Clin Immunol 2015. [PMID: 26220530 DOI: 10.1016/j.jaci.2015.06.015] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Epidemiologic data describing the association between allergic sensitization and asthma and allergic rhinitis in adults are scarce. OBJECTIVE To determine the prevalence and impact of specific sensitization to airborne allergens on asthma and allergic rhinitis among adults in relation to age. METHODS A random population sample (age 21-86 years) was examined with structured interview and analysis of specific IgE to 9 common airborne allergens. Of those invited, 692 (68%) subjects participated in blood sampling. IgE level of 0.35 U/mL or more to the specific allergen was defined as a positive test result. RESULTS Allergic sensitization decreased with increasing age, both in the population sample and among subjects with asthma and allergic rhinitis. In a multivariate model, sensitization to animal was significantly positively associated with asthma (odds ratio [OR], 4.80; 95% CI, 2.68-8.60), whereas sensitization to both animal (OR, 3.90; 95% CI, 2.31-6.58) and pollen (OR, 4.25; 95% CI, 2.55-7.06) was significantly associated with allergic rhinitis. The association between allergic sensitization and rhinitis was consistently strongest among the youngest age group, whereas this pattern was not found for asthma. The prevalence of allergic sensitization among patients with asthma decreased by increasing age of asthma onset, 86% with asthma onset at age 6 y or less, 56% at age 7 to 19 years, and 26% with asthma onset at age 20 years or more. CONCLUSIONS Sensitization to animal was associated with asthma across all age groups; allergic rhinitis was associated with sensitization to both pollen and animal and consistently stronger among younger than among older adults. Early onset of asthma was associated with allergic sensitization among adults with asthma.
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Affiliation(s)
- Katja Warm
- Division of Medicine, Department of Public Health and Clinical Medicine, the OLIN Unit, Umeå University, Umeå, Sweden
| | - Linnea Hedman
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine Unit, the OLIN Unit, Umeå University, Umeå, Sweden
| | - Anne Lindberg
- Division of Medicine, Department of Public Health and Clinical Medicine, the OLIN Unit, Umeå University, Umeå, Sweden
| | - Jan Lötvall
- Krefting Research Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Bo Lundbäck
- Krefting Research Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Eva Rönmark
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine Unit, the OLIN Unit, Umeå University, Umeå, Sweden.
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Gore RB, Boyle RJ, Gore C, Custovic A, Hanna H, Svensson P, Warner JO. Effect of a novel temperature-controlled laminar airflow device on personal breathing zone aeroallergen exposure. INDOOR AIR 2015; 25:36-44. [PMID: 24750266 DOI: 10.1111/ina.12122] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2013] [Accepted: 04/12/2014] [Indexed: 05/16/2023]
Abstract
Temperature-controlled laminar airflow improves symptoms in atopic asthmatics, but its effects on personal allergen exposure are unknown. We aimed to evaluate its effects on personal cat allergen and particulate exposures in a simulated bedroom environment. Five healthy volunteers lay under an active and an inactive temperature-controlled laminar airflow device for 175 min, in a simulated bedroom containing bedding from a cat owner. Total airborne particles (≥0.5 - ≥10 μm diameter) were quantified with a laser particle counter. Airborne allergen was sampled with Institute of Occupational Medicine filters. Inhaled exposure was sampled with nasal air samplers. Allergen-containing particles were quantified by immunoassay. Treatment reduced total airborne particles (>0.5 μm diameter) by >99% (P < 0.001) and reduced airborne allergen concentration within the breathing zone (ratio of median counts = 30, P = 0.043). Treatment reduced inhaled allergen (ratio of median counts = 7, P = 0.043). Treatment was not associated with a change in airborne allergen concentration outside of the breathing zone (P = 0.160). Temperature-controlled laminar airflow treatment of individuals in an allergen-rich experimental environment results in significant reductions in breathing zone allergenic and non-allergenic particle exposure, and in inhaled cat allergen exposure. These findings may explain the clinical benefits of temperature-controlled laminar airflow.
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Affiliation(s)
- R B Gore
- Manchester Academic Health Science Centre, University Hospitals of South Manchester, University of Manchester, Manchester, UK; East and North Herts NHS Trust, Stevenage, UK
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Schiphof-Godart L, van der Wiel E, Ten Hacken NHT, van den Berge M, Postma DS, van der Molen T. Development of a tool to recognize small airways dysfunction in asthma (SADT). Health Qual Life Outcomes 2014; 12:155. [PMID: 25416552 PMCID: PMC4253607 DOI: 10.1186/s12955-014-0155-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Accepted: 10/09/2014] [Indexed: 11/15/2022] Open
Abstract
Background Small airways dysfunction (SAD) contributes to the clinical expression of asthma. The identification of patients who suffer from SAD is important from a clinical perspective, as targeted therapy may improve patients’ well-being and treatment efficacy. Aims We aimed to realize the first step in the development of a simple small airways dysfunction tool (SADT) that may help to identify asthma patients having SAD. Methods Asthma patients with and without SAD were interviewed. Patients were selected to participate in this study based on FEF50% and R5-R20 values from spirometry and impulse oscillometry respectively. Results Ten in depth interviews and two focus groups revealed that patients with and without SAD perceived differences in symptoms and signs, habits and health related issues. For example, patients with SAD reported to wheeze easily, were unable to breathe in deeply, mentioned more symptoms related to bronchial hyperresponsiveness, experienced more pronounced exercise-induced symptoms and more frequently had allergic respiratory symptoms after exposure to cats and birds. Based on these differences, 63 items were retained to be further explored for the SADT. Conclusions The first step of the development of the SADT tool shows that there are relevant differences in signs and respiratory symptoms between asthma patients with and without SAD. The next step is to test and validate all items in order to retain the most relevant items to create a short and simple tool, which should be useful to identify asthma patients with SAD in clinical practice. Electronic supplementary material The online version of this article (doi:10.1186/s12955-014-0155-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lieke Schiphof-Godart
- Department of General Practice, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands. .,University of Groningen, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), A. Deusinglaan 1, 9700 AV, PO Box 196, Groningen, HPC FA 21, The Netherlands.
| | - Erica van der Wiel
- University of Groningen, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), A. Deusinglaan 1, 9700 AV, PO Box 196, Groningen, HPC FA 21, The Netherlands. .,Department of Pulmonary Medicine and Tuberculosis, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
| | - Nick H T Ten Hacken
- University of Groningen, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), A. Deusinglaan 1, 9700 AV, PO Box 196, Groningen, HPC FA 21, The Netherlands. .,Department of Pulmonary Medicine and Tuberculosis, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
| | - Maarten van den Berge
- University of Groningen, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), A. Deusinglaan 1, 9700 AV, PO Box 196, Groningen, HPC FA 21, The Netherlands. .,Department of Pulmonary Medicine and Tuberculosis, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
| | - Dirkje S Postma
- University of Groningen, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), A. Deusinglaan 1, 9700 AV, PO Box 196, Groningen, HPC FA 21, The Netherlands. .,Department of Pulmonary Medicine and Tuberculosis, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
| | - Thys van der Molen
- Department of General Practice, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands. .,University of Groningen, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), A. Deusinglaan 1, 9700 AV, PO Box 196, Groningen, HPC FA 21, The Netherlands.
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Alveolar T-helper type-2 immunity in atopic asthma is associated with poor clinical control. Clin Sci (Lond) 2014; 128:47-56. [PMID: 25059741 DOI: 10.1042/cs20140309] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Real-world evaluation studies have shown that many patients with asthma remain symptomatic despite treatment with inhaled corticosteroids (ICSs). As conventional ICSs have poor access to the peripheral airways, the aim of the present paper was to study the relationship between peripheral airway inflammation and clinical control in allergic asthma. Consequently, bronchial and transbronchial biopsies were obtained from patients with poorly controlled asthma [n=12, asthma control test (ACT) score<20], patients with well-controlled asthma (n=12, ACT score≥20) and healthy controls (n=8). Tissue sections were immunostained to assess multiple leucocyte populations. To determine the degree of T-helper type-2 (Th2) immunity, the logarithmic value of the ratio between Th2 cells/mm2 and Th1 cells/mm2 was used as a surrogate score for Th2-skewed immunity. In the bronchi, the leucocyte infiltration pattern and the Th2-score were similar between patients with well-controlled asthma and those with poorly controlled asthma. In contrast, in the alveolar parenchyma, the expression of T-helper cells was significantly higher in patients with poorly controlled asthma than in patients with well-controlled asthma (P<0.01). Furthermore, the alveolar Th2-score was significantly higher in patients with poorly controlled asthma (median 0.4) than in the controlled patients (median -0.10, P<0.05). In addition, in contrast with bronchial Th2-score, the alveolar Th2-score correlated significantly with ACT score (rs=-0.62, P<0.01) in the pooled asthma group. Collectively, our data reveal an alveolar Th2-skewed inflammation, specifically in asthmatic patients who are poorly controlled with ICSs, and suggest that pharmacological targeting of the peripheral airways may be beneficial in this large patient category.
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Konradsen JR, Fujisawa T, van Hage M, Hedlin G, Hilger C, Kleine-Tebbe J, Matsui EC, Roberts G, Rönmark E, Platts-Mills TAE. Allergy to furry animals: New insights, diagnostic approaches, and challenges. J Allergy Clin Immunol 2014; 135:616-25. [PMID: 25282018 DOI: 10.1016/j.jaci.2014.08.026] [Citation(s) in RCA: 122] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Revised: 07/08/2014] [Accepted: 08/05/2014] [Indexed: 12/16/2022]
Abstract
The prevalence of allergy to furry animals has been increasing, and allergy to cats, dogs, or both is considered a major risk factor for the development of asthma and rhinitis. An important step forward in the diagnosis of allergy to furry animals has been made with the introduction of molecular-based allergy diagnostics. A workshop on furry animals was convened to provide an up-to-date assessment of our understanding of (1) the exposure and immune response to the major mammalian allergens, (2) the relationship of these responses (particularly those to specific proteins or components) to symptoms, and (3) the relevance of these specific antibody responses to current or future investigation of patients presenting with allergic diseases. In this review research results discussed at the workshop are presented, including the effect of concomitant exposures from other allergens or microorganisms, the significance of the community prevalence of furry animals, molecular-based allergy diagnostics, and a detailed discussion of cat and dog components.
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Affiliation(s)
- Jon R Konradsen
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden; Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden; Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.
| | - Takao Fujisawa
- Institute for Clinical Research, Mie National Hospital, Mie, Japan
| | - Marianne van Hage
- Clinical Immunology and Allergy Unit, Department of Medicine, Karolinska Institutet and University Hospital, Stockholm, Sweden
| | - Gunilla Hedlin
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden; Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden; Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Christiane Hilger
- Laboratory of Immunogenetics and Allergology, CRP-Santé, Luxembourg, Luxembourg
| | - Jörg Kleine-Tebbe
- Allergy & Asthma Center Westend, Outpatient Clinic and Research Unit, Berlin, Germany
| | - Elizabeth C Matsui
- Division of Pediatric Allergy/Immunology, Johns Hopkins School of Medicine, Baltimore, Md
| | - Graham Roberts
- David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Isle of Wight, United Kingdom; Human Development and Health and Clinical and Experimental Sciences Academic Units, University of Southampton Faculty of Medicine, Southampton, United Kingdom; NIHR Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Eva Rönmark
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden
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Erwin EA, Woodfolk JA, James HR, Satinover SM, Platts-Mills TAE. Changes in cat specific IgE and IgG antibodies with decreased cat exposure. Ann Allergy Asthma Immunol 2014; 112:545-550.e1. [PMID: 24726651 DOI: 10.1016/j.anai.2014.03.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Revised: 03/13/2014] [Accepted: 03/16/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Current understanding of the effects of reducing exposure to cat allergens is limited. It has also become clear that there are different forms of immune response to cat allergens. OBJECTIVE To investigate changes in skin tests and cat specific IgG and IgE antibodies when students from a home with a cat move to a college dormitory. METHODS Ninety-seven college students participated in a prospective study that consisted of allergy skin prick testing and serum measurement of IgE and IgG antibodies to cat at the beginning and end of one academic year in college. A subgroup returned for follow-up at the end of 2 years. RESULTS Among 97 students, 33% had IgG antibodies to Fel d 1 but no evidence of sensitization, 25% had positive skin test results and/or serum IgE antibodies, and 42% had negative skin test results and no detectable serum antibodies. Among the non-cat sensitized students with IgG antibodies, the titers decreased during 8 months (P = .002). Titers of IgG4 to Fel d 1 also decreased (P < .001). Among the sensitized students, no change in IgE antibodies to cat occurred in 8 months (P = .20), whereas Fel d 1 specific IgG antibodies decreased (P < .001). Thus, ratios of IgG to IgE decreased highly significantly (P = .007). Among the students with negative skin test results who returned for follow-up (n = 56), none developed positive skin test results or serum IgE antibodies. CONCLUSION Under conditions of marked decrease in exposure, no participants developed new-onset sensitization. Among the individuals sensitized at study entry, there were major decreases in the ratio of IgG to IgE.
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Affiliation(s)
- Elizabeth A Erwin
- Center for Innovation in Pediatric Practice, Nationwide Children's Hospital, Columbus, Ohio.
| | - Judith A Woodfolk
- Asthma and Allergic Diseases Center, University of Virginia Health System, Charlottesville, Virginia
| | - Hayley R James
- Asthma and Allergic Diseases Center, University of Virginia Health System, Charlottesville, Virginia
| | - Shama M Satinover
- Asthma and Allergic Diseases Center, University of Virginia Health System, Charlottesville, Virginia
| | - Thomas A E Platts-Mills
- Asthma and Allergic Diseases Center, University of Virginia Health System, Charlottesville, Virginia
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Rivera-Mariani FE, Matsui EC, Breysse PN. Performance of the halogen immunoassay to assess airborne mouse allergen-containing particles in a laboratory animal facility. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2014; 24:3-8. [PMID: 22805992 PMCID: PMC4028687 DOI: 10.1038/jes.2012.76] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2011] [Accepted: 05/29/2012] [Indexed: 05/29/2023]
Abstract
Airborne mouse allergen is a risk factor for respiratory diseases. Conventional assessment techniques provide mass-based exposure estimates that may not capture completely the inhalation risk of airborne allergen particles. In contrast to mass-based estimates, the halogen immunoassay (HIA) combines immunoblotting and microscopy to directly assess allergen-containing particles. We evaluated the HIA for the assessment of airborne mouse allergen and compared the results to the enzyme linked immunosorbent assay (ELISA). Particulate matter (PM)(10) and PM(2.5) samples (30 min, 4 l/m) were collected in a mouse facility before, during, and after disturbance of soiled bedding. Concentrations of Mus m 1-positive particles (haloed particles (HPs)) and intensities of the haloes were determined with the HIA. Although HPs/m(3) were positively correlated with mass concentration (statistically significant only with Mus m 1 concentration on PM(10)), replicates of mass concentration showed higher variability than HPs/m(3). After disturbance, most of the HPs were in the PM(2.5) fraction. Mean haloes intensities were similar before, during, and after disturbance. The HIA was able to measure allergen-containing particles with less variability than the ELISA, detected the shift of HPs to smaller particles after disturbance, and may suggests similar halo intensity by particles detected during and after disturbance. Our findings suggest that the HIA can be used to assess indoor concentrations of mouse allergen particles and their morphological characteristics.
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Affiliation(s)
- Félix E. Rivera-Mariani
- Department of Environmental Health Sciences, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Elizabeth C. Matsui
- Department of Environmental Health Sciences, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Pediatrics, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Patrick N. Breysse
- Department of Environmental Health Sciences, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
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40
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The efficacy of allergen immunotherapy with cat dander in reducing symptoms in clinical practice. BIOMED RESEARCH INTERNATIONAL 2013; 2013:324207. [PMID: 23984343 PMCID: PMC3747492 DOI: 10.1155/2013/324207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Revised: 06/28/2013] [Accepted: 07/12/2013] [Indexed: 11/18/2022]
Abstract
Background. Allergy to cat dander is a common form of allergic disease. Allergen immunotherapy has been demonstrated to be effective in decreasing allergic symptoms.
Objectives. To examine outcomes in allergic asthmatic patients on cat immunotherapy (CIT) compared to allergic asthmatics on traditional immunotherapy (IT) without cat sensitivity. Methods. A retrospective review identified allergic asthmatics on CIT for at least three years. An equal number of allergic asthmatics on IT were identified for comparison. Outcomes investigated include measurements of risk of asthma exacerbation. Results. Thirty-five patients were identified in each group. There were no differences in the CIT group versus the comparison group regarding total number of prednisone tapers (18 tapers versus 14 tapers, resp.), number of patients requiring prednisone tapers (10 patients versus 10 patients, resp.), total number of acute visits (29 visits versus 38 visits, resp.), and number of patients requiring acute visits (15 patients versus 21 patients, resp.). When stratified by concomitant ICS use, patients on CIT were less likely to require an acute visit (46% versus 78%, resp.). Conclusions. Allergic asthmatics with cat sensitivity on CIT with close dander exposure have similar risk of asthma exacerbation compared to allergic asthmatics without cat sensitivity on immunotherapy.
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Abstract
Activation of receptors of the innate immune system is a critical step in the initiation of immune responses. It has been shown that dominant allergens have properties that could allow them to interact with toll-like and C-type lectin receptors to favour Th2-biased responses and many bind lipids and glycans that could associate with ligands to mimic pathogen-associated microbial patterns. In accord with the proposed allergen-specific innate interactions it has been shown that the immune responses to different allergens and antigens from the same source are not necessarily coordinately regulated.
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Affiliation(s)
- W R Thomas
- Centre for Child Health Research, University of Western Australia, Telethon Institute for Child Health Research, Subiaco, Western Australia, Australia.
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Exposure to cats: update on risks for sensitization and allergic diseases. Curr Allergy Asthma Rep 2013; 12:413-23. [PMID: 22878928 DOI: 10.1007/s11882-012-0288-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Cats are the pets most commonly implicated in the etiology of asthma and allergic disease. However, systematic reviews have concluded that there is a lack of evidence to support the idea that cat exposure in early life increases the risk of allergic disease. Indeed, it appears most likely that cat exposure is protective against allergic diseases. Recent large prospective studies have shown that living with a cat during childhood, especially during the first year of a child's life, could be protective. However, any advice given to the parents should also incorporate how new acquisition of cats can affect other family members, especially those who are already sensitized. Research is urgently needed to determine whether the suggested impact of acquisition of cats in adult life is modified by the person's childhood pet ownership, to help parents who seek advice on whether or not to get a cat.
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Pei Y, Geng S, Liu L, Yan F, Guan H, Hou J, Chen Y, Wang B, An X. Fel d 1-airway inflammation prevention and treatment by co-immunization vaccine via induction of CD4+CD25-Foxp3+ Treg cells. Hum Vaccin Immunother 2013; 9:1019-31. [PMID: 23324570 DOI: 10.4161/hv.23518] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Pet allergens are major causes for asthma and allergic rhinitis. Fel d 1 protein, a key pet allergen from domestic cat, can sensitize host and trigger asthma attack. In this study, we report that co-immunization with recombinant Fel d 1 protein (rFel d 1) plus plasmid DNA that contains Fe1 d 1 gene was effective in preventing and treating the natural Fel d 1 (nFel d 1) induced allergic airway inflammation in mice. A population of T regulatory cells (iTreg) exhibiting a CD4+CD25-Foxp3+ phenotype and expressing IL-10 and TGF-β was induced by this co-immunization strategy. Furthermore, after adoptive transfers of the iTreg cells, mice that were pre-sensitized and challenged with nFel d 1 exhibited less signs of allergic inflammation, AHR and a reduced allergic immune response. These data indicate that co-immunization with DNA and protein mixture vaccine may be an effective treatment for cat allergy.
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Affiliation(s)
- Yechun Pei
- State Key Laboratory for Agro-Biotechnology; China Agricultural University; Beijing, P.R. China
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Moscato G, Pala G, Barnig C, Blay F, Del Giacco SR, Folletti I, Heffler E, Maestrelli P, Pauli G, Perfetti L, Quirce S, Sastre J, Siracusa A, Walusiak-Skorupa J, Wjik RG. EAACI consensus statement for investigation of work-related asthma in non-specialized centres. Allergy 2012; 67:491-501. [PMID: 22257175 DOI: 10.1111/j.1398-9995.2011.02784.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2011] [Indexed: 11/28/2022]
Abstract
Work-related asthma (WRA) is a relevant problem in several countries, is cause of disability and socioeconomic consequences for both the patient and the society and is probably still underdiagnosed. A correct diagnosis is extremely important to reduce or limit the consequences of the disease. This consensus document was prepared by a EAACI Task Force consisting of an expert panel of allergologists, pneumologists and occupational physicians from different European countries. This document is not intended to address in detail the full diagnostic work-up of WRA, nor to be a formal evidence-based guideline. It is written to provide an operative protocol to allergologists and physicians dealing with asthma useful for identifying the subjects suspected of having WRA to address them to in-depth investigations in a specialized centre. No evidence-based system could be used because of the low grade of evidence of published studies in this area, and instead, 'key messages' or 'suggestions' are provided based on consensus of the expert panel members.
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Affiliation(s)
- G. Moscato
- Allergy and Immunology Unit; Fondazione ‘Salvatore Maugeri’; Institute of Care and Research; Scientific Institute of Pavia; Pavia; Italy
| | - G. Pala
- Allergy and Immunology Unit; Fondazione ‘Salvatore Maugeri’; Institute of Care and Research; Scientific Institute of Pavia; Pavia; Italy
| | - C. Barnig
- Division of Asthma and Allergy; Department of Chest Diseases; University Hospital Strasbourg; Strasbourg; France
| | - F. Blay
- Division of Asthma and Allergy; Department of Chest Diseases; University Hospital Strasbourg; Strasbourg; France
| | - S. R. Del Giacco
- Department of Medical Sciences ‘M. Aresu’; University of Cagliari; Cagliari; Italy
| | - I. Folletti
- Department of Clinical and Experimental Medicine; Occupational Allergy Unit; Terni Hospital; University of Perugia; Perugia; Italy
| | - E. Heffler
- Allergy and Clinical Immunology; University of Torino; ASO Mauriziano ‘Umberto I’; Torino; Italy
| | - P. Maestrelli
- Department of Environmental Medicine and Public Health; University of Padova; Padova; Italy
| | - G. Pauli
- Division of Asthma and Allergy; Department of Chest Diseases; University Hospital Strasbourg; Strasbourg; France
| | - L. Perfetti
- Allergy and Immunology Unit; Fondazione ‘Salvatore Maugeri’; Institute of Care and Research; Scientific Institute of Pavia; Pavia; Italy
| | - S. Quirce
- Department of Allergy; Hospital La Paz-IdiPAZ and CIBER de Enfermedades Respiratorias CIBERES; Madrid; Spain
| | - J. Sastre
- CIBER de Enfermedades Respiratorias; Ciberes and Department of Allergy; Fundación Jiménez Díaz; Madrid; Spain
| | - A. Siracusa
- Department of Clinical an Experimental Medicine; University of Perugia; Perugia; Italy
| | - J. Walusiak-Skorupa
- Department of Occupational Diseases; Nofer Institute of Occupational Medicine; Lodz; Poland
| | - R. Gerth Wjik
- Section of Allergology; Department of Internal Medicine; Erasmus MC; Rotterdam; the Netherlands
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Abstract
PURPOSE OF REVIEW The objective is to discuss recent progress in our understanding of the role of the indoor environment in asthma, focusing on the special role of cat allergens. RECENT FINDINGS Sensitization to Fel d 1 is the dominant event in inhalant responses to cat; however, there are also IgE responses to the lipocalin (Fel d 4), to cat albumin (Fel d 2), and to the oligosaccharide galactose-alpha-1,3-galactose (alpha-gal) on cat IgA (Fel d 5w) and other molecules. The dose response and routes of sensitization for these allergens are now thought to be diverse. It is important to remember that exposure outside a house with a cat is sufficient to cause sensitization. Furthermore, the only solid evidence about a role in asthma relates to Fel d 1. Recently, it has been shown that tolerance associated with early exposure to cats can persist to age 18 and that IgE to alpha-gal (on cat IgA) is not related to asthma. In addition, a recent study of anti-IgE reinforces the evidence that IgE antibodies to indoor allergens make a major contribution to asthma severity. SUMMARY Exposure to Fel d 1 in a home with a cat is far higher than the levels necessary to induce an allergic (IgE antibody) response. In keeping with that, children may develop tolerance, which can be long-lived. In addition, there is increasing evidence that IgE antibodies to an inhalant allergen, such as Fel d 1, dust mite, or cockroach, are causally related to lung inflammation and asthma.
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Affiliation(s)
- Libby A. Kelly
- University of Virginia Asthma and Allergic Diseases Center, Charlottesville, Virginia
| | - Elizabeth A. Erwin
- Department of Pediatrics, Section of Infectious Diseases and Immunology, NationwideChildren's Hospital, Columbus, Ohio
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Platts-Mills TAE, Woodfolk JA. Allergens and their role in the allergic immune response. Immunol Rev 2011; 242:51-68. [PMID: 21682738 DOI: 10.1111/j.1600-065x.2011.01021.x] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Allergens are recognized as the proteins that induce immunoglobulin E (IgE) responses in humans. The proteins come from a range of sources and, not surprisingly, have many different biological functions. However, the delivery of allergens to the nose is exclusively on particles, which carry a range of molecules in addition to the protein allergens. These molecules include pathogen-associated molecular patterns (PAMPs) that can alter the response. Although the response to allergens is characterized by IgE antibodies, it also includes other isotypes (IgG, IgA, and IgG4), as well as T cells. The challenge is to identify the characteristics of these exposures that favor the production of this form of response. The primary features of the exposure appear to be the delivery in particles, such as pollen grains or mite feces, containing both proteins and PAMPs, but with overall low dose. Within this model, there is a simple direct relationship between the dose of exposure to mite or grass pollen and the prevalence of IgE responses. By contrast, the highest levels of exposure to cat allergen are associated with a lower prevalence of IgE responses. Although the detailed mechanisms for this phenomenon are not clear, it appears that enhanced production of interleukin-10 in response to specific Fel d 1 peptides could influence the response. However, it is striking that the animal sources that are most clearly associated with decreased responses at high allergen dose are derived from animals from which humans evolved more recently (∼65 million years ago). Although the nose is still recognized as the primary route for sensitization to inhalant allergens, there is increasing evidence that the skin is also an important site for the generation of IgE antibody responses. By contrast, it is now evident that delivery of foreign proteins by the oral route or sublingually will favor the generation of tolerance.
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Affiliation(s)
- Thomas A E Platts-Mills
- Asthma and Allergic Diseases Center, University of Virginia Health System, Charlottesville, VA 22908-1355, USA.
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Effects of omalizumab on changes in pulmonary function induced by controlled cat room challenge. J Allergy Clin Immunol 2011; 127:398-405. [PMID: 21281870 DOI: 10.1016/j.jaci.2010.09.043] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2010] [Revised: 09/23/2010] [Accepted: 09/30/2010] [Indexed: 11/20/2022]
Abstract
BACKGROUND Environmental exposure to cat allergen is common, and sensitization to cat allergens is strongly associated with asthma. OBJECTIVE We sought to examine the efficacy of omalizumab in preventing acute bronchoconstriction induced by environmental exposure to cat allergen. METHODS Patients with a history of cat allergen-induced asthma were randomized to treatment with omalizumab or placebo and exposed to cat allergen in a controlled chamber for up to 1 hour at baseline and after 16 weeks of treatment. The primary efficacy outcome was area under the curve for percentage decrease from prechallenge FEV(1) at week 16 for omalizumab-treated versus placebo-treated patients. FEV(1) was recorded before and every 10 minutes during the 1-hour challenge. Chest, nasal, and ocular symptoms were also monitored during cat chamber exposure as secondary end points. RESULTS The area under the curve for percentage decrease in FEV(1) was 15.2% per hour for omalizumab-treated patients (n = 32) and 27.3% per hour for placebo-treated patients (n = 33), reflecting 44% less reduction in FEV(1) and a treatment difference of -12.1% per hour (P = .0009; 95% CI, -19.0 to -5.2). Compared with placebo-treated patients, omalizumab-treated patients were also able to tolerate longer allergen exposure (P = .0006) and demonstrated significant reductions from prechallenge values in their chest symptom score (P < .0001) and nasal-ocular symptom score (P = .0002). CONCLUSIONS The severity of acute airway reactions and symptoms caused by controlled cat room exposure to allergens was significantly reduced by treatment with omalizumab.
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Virtanen TI, Mäntyjärvi RA. Airborne Allergens and Their Quantification and Effect on the Development of Allergy in Occupational Environments. ACTA ACUST UNITED AC 2011. [DOI: 10.1080/1047322x.1994.10388268] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Curtin-Brosnan J, Matsui EC, Breysse P, McCormack MC, Hansel NN, Tonorezos ES, Eggleston PA, Williams DL, Diette GB. Parent report of pests and pets and indoor allergen levels in inner-city homes. Ann Allergy Asthma Immunol 2008; 101:517-23. [PMID: 19055206 DOI: 10.1016/s1081-1206(10)60291-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Guidelines recommend allergen avoidance for patients with allergic asthma, but direct measurements of home allergen levels are not available to most physicians. Parent report of indoor allergen exposure is a potentially convenient and inexpensive surrogate measure of exposure, although validity of parent report to estimate indoor allergen levels is not well established. OBJECTIVE To determine if parent-reported pest and pet exposures can identify patients with clinically relevant allergen exposure. METHODS Parents of 300 inner-city children completed a survey about pests (cockroaches and mice) and furred pets (dogs and cats). Settled dust samples were obtained for Bla g 1, Mus m 1, Can f 1, and Fel d 1 from kitchens and bedrooms. RESULTS Parent reports were associated with clinically relevant levels of Bla g 1, Mus m 1, Can f 1, and Fel d 1 (P < .001 for all). For example, when parents reported cockroaches were present, 86% of homes had settled dust Bla g 1 levels of 1 U/g or higher, and when they reported mice were present, 90% had Mus m 1 levels greater than 500 ng/g. Report of pets was also predictive of clinically meaningful allergen levels. Parent-reported absence of pets provided assurance that allergen levels were below relevant thresholds (negative predictive value, 80%-98%). However, parent-reported absence of pests did not provide assurance of low levels of these allergens (negative predictive value, 38%-75%). CONCLUSIONS Since direct measurement of indoor allergens is not always feasible, especially in the inner city, parent report of pests and pets may be sufficient to recommend environmental control practices for sensitized children. Negative parent reports of pests are not sufficient evidence of low pest allergen exposure.
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Affiliation(s)
- Jean Curtin-Brosnan
- Department of Pediatrics, School of Medicine, Johns Hopkins University, Baltimore, Maryland 21205, USA
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Perzanowski MS, Chew GL, Divjan A, Johnson A, Goldstein IF, Garfinkel RS, Hoepner LA, Platts-Mills TAE, Perera FP, Miller RL. Cat ownership is a risk factor for the development of anti-cat IgE but not current wheeze at age 5 years in an inner-city cohort. J Allergy Clin Immunol 2008; 121:1047-52. [PMID: 18395554 DOI: 10.1016/j.jaci.2008.02.005] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2007] [Revised: 01/28/2008] [Accepted: 02/01/2008] [Indexed: 10/22/2022]
Abstract
BACKGROUND Cat ownership is inversely associated with atopy and asthma in some areas of the world, but the relevance of cat ownership to allergic disease in the inner city is less known. OBJECTIVE We sought to evaluate the relationship between cat ownership and the development of early sensitization and wheeze. METHODS By using a prospective birth cohort study, Dominican and African American mothers living in New York City underwent repeated questionnaires about their child from birth to age 5 years. Sera collected from children at ages 2 (n = 323), 3 (n = 336), and 5 (n = 242) years were assayed for anti-cat IgE and anti-Fel d 1 IgG antibodies. RESULTS Cat ownership was a significant risk factor for the development of anti-cat IgE by age 2 years (risk ratio [RR], 6.4; 95% CI, 1.9-22) but not for anti-cat IgE development between the ages of 2 and 5 years (RR, 0.88; 95% CI, 0.24-2.3). Current wheeze was significantly more common among those children with anti-cat IgE at ages 3 (RR, 3.5; 95% CI, 2.1-6.0) and 5 (RR, 3.4; 95% CI, 2.3-4.9) years. Cat ownership was inversely associated with current wheeze at age 5 years among children without anti-cat IgE (RR, 0.26; 95% CI, 0.083-0.81). Among children with anti-cat IgE, a similar trend was observed (RR, 0.57; P = .044, Fisher exact test), although one with borderline statistical significance. CONCLUSIONS Despite a positive association with sensitization, cat ownership in this inner-city cohort was inversely associated with wheeze, potentially suggesting an IgE-independent protective mechanism in this community.
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Affiliation(s)
- Matthew S Perzanowski
- Columbia Center for Children's Environmental Health, Columbia University, New York, NY 10032, USA.
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