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Lam K, Au E, Ip WK, Tam JK, Leung PSC. Inhalant Mediated Allergy: Immunobiology, Clinical Manifestations and Diagnosis. Clin Rev Allergy Immunol 2025; 68:43. [PMID: 40234356 PMCID: PMC12000167 DOI: 10.1007/s12016-025-09053-2] [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] [Accepted: 03/27/2025] [Indexed: 04/17/2025]
Abstract
Inhalant allergen-mediated respiratory diseases, including asthma and allergic rhinitis, have become increasing global health issues. While air pollution is believed to favor allergic sensitization and intensify clinical symptoms of allergy, allergen sensitization can vary highly with geographical location, climate, and lifestyle differences. Pollen sensitization is higher in European countries, while dust mite is more common in regions with high humidity. Domestic pet sensitization is on the rising trend in industrialized nations, but the paradoxical effect of intensive cat exposure in early childhood is also observed. Clinical management of inhalant allergic diseases has greatly benefited from the immunological and mechanistic understanding of pathophysiology. In this review, we discuss the current knowledge on inhalant mediated allergic disorders with emphasis on (1) the major immune cells and relevant chemokines and cytokines in the sensitization and effector phase with aeroallergen exposure, (2) their manifestation in asthma and allergic rhinitis, (3) characterization of inhalant allergens, (4) chemical contributions to the development of allergic diseases, and (5) clinical diagnosis of aeroallergen sensitization and management of inhalant allergy. Knowledge on the role of Th2 skewing, IgE, basophil, mast cells, and eosinophils in respiratory allergic diseases are fundamental in the diagnosis and management of these disorders. Skin test, basophil activation test, and specific IgE component-resolved diagnostics are used for diagnosis and facilitate further management. Advances in the development of biologics and allergen-specific immunotherapy will strategize the future approaches in the clinical care of respiratory allergic diseases.
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Affiliation(s)
- Ki Lam
- Division of Clinical Immunology, Department of Pathology, Special Administrative Region, Queen Mary Hospital, Hong Kong, China
| | - Elaine Au
- Division of Clinical Immunology, Department of Pathology, Special Administrative Region, Queen Mary Hospital, Hong Kong, China
| | - W K Ip
- Division of Clinical Immunology, Department of Pathology, Special Administrative Region, Queen Mary Hospital, Hong Kong, China
| | - Jenna K Tam
- Institute of Society and Genetics, University of California, Los Angeles, CA, 90095, USA
| | - Patrick S C Leung
- Division of Rheumatology/Allergy and Clinical Immunology, University of California, Davis, CA, 95616, USA.
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Tham EH, Hong SJ, Lee E, Gern JE. Early-Life Allergen Exposure and Its Influence on Risk of Atopic Disease. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2025:S2213-2198(25)00264-8. [PMID: 40120809 DOI: 10.1016/j.jaip.2025.02.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2024] [Revised: 02/10/2025] [Accepted: 02/20/2025] [Indexed: 03/25/2025]
Abstract
Childhood allergic diseases and asthma have their origins in early life, and allergen exposures during this period could be a critical determinant of the progression to tolerance versus disease. Mechanisms for sensitization may be different but overlapping for food and aeroallergen sensitization in children. This suggests differences in how exposure to food and aeroallergens influence allergic sensitization. For food allergy, introducing foods such as peanut and egg proteins into the diet at an early age reduces the risk of peanut and egg allergy, respectively, across a broad demographic, whereas evidence is less established for other foods. The relationship between allergen exposure and sensitization to aeroallergens is more complex but critical, given the close relationship between specific immunoglobulin E and respiratory disease. Several factors could mediate the progression from allergen exposure and allergic sensitization versus tolerance, including epithelial barrier function and altered immune development at the skin and mucosal surfaces, exposure to irritants and pollutants, and genetic susceptibility. Collectively, the current evidence base provides a compelling rationale for the primary prevention of food allergy by introducing common allergens such as peanut and egg early. In contrast, primary prevention of aeroallergen sensitization is more complex and perhaps more challenging to achieve by manipulating allergen exposures. Even so, recent advances in understanding how the microbiome and environmental toxins and irritants modulate the mucosal immune response have identified potential new strategies for primary prevention of food and aeroallergen sensitization.
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Affiliation(s)
- Elizabeth Huiwen Tham
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Khoo Teck Puat-National University Children's Medical Institute (KTP-NUCMI), National University Hospital, Singapore, Singapore
| | - Soo-Jong Hong
- Department of Pediatrics, Childhood Respiratory and Allergy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Republic of Korea
| | - Eun Lee
- Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - James E Gern
- Departments of Pediatrics and Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wis.
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Hellu T, Gomez R, Weiss S, Smith D, Steigelman D. Do commercial dog extracts cross-react with Felis domesticus allergen 1. Allergy Asthma Proc 2024; 45:447-452. [PMID: 39517074 PMCID: PMC11572942 DOI: 10.2500/aap.2024.45.240072] [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: 11/16/2024]
Abstract
Background: Half of U.S. households own a dog despite 10% of individuals being sensitized to dog. Assessment and treatment options for dog allergy include the use of commercial dog extracts which have inconsistent performance, making diagnosing and managing dog allergy challenging. Contamination of dog extracts with other allergens has previously been reported. Objective: We sought to determine whether commercial dog extracts contain other aeroallergens. Methods: An extract purity and quantification study on acetone precipitated dog hair and dander extract (AP dog) was performed, 6 aeroallergens; Alternaria (Alt a 1), Ragweed (Amb a 1), German Cockroach (Bla g 2), Dust Mite (Der p t), Cat (Fel d 1), and Rye Grass (Lol p 1). Following, conventional dog hair and dander extract (CV dog) and the new ultrafiltered dog hair and dander extract (UF dog) were also assessed based on the initial results of AP dog. SDS-PAGE was performed on all three dog extracts to compare allergen content. Lastly, serology results and aeroallergen immunotherapy prescriptions were compared. Results: The ELISA trays with Alt a 1, Amb a 1, Bla g 2, Der p 1, and Lol p 1 antibodies did not capture AP dog, while the ELISA tray with Fel d 1 antibody captured AP dog, CV dog, and UF dog. SDS-PAGE results of the 3 dog extracts did not reveal a band at the molecular weight for Fel d 1. Conculsion: Contamination of commercial dog extracts was not found. However, our findings are supportive of commercial dog extracts containing a Fel d 1-like dog allergen that is cross-reactive to Fel d 1. Cross-reactivity between commercial dog extracts and Fel d 1 could be responsible for double positivity to cat and dog in serology. Additional studies are needed to better illustrate this Fel d 1-like dog allergen.
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Affiliation(s)
- Tasha Hellu
- From the Department of Allergy-Immunology, Wilford Hall Ambulatory Surgical Center, Lackland Air Force Base, San Antonio, Texas
| | - Robert Gomez
- From the Department of Allergy-Immunology, Wilford Hall Ambulatory Surgical Center, Lackland Air Force Base, San Antonio, Texas
| | - Samuel Weiss
- Department of Allergy-Immunology, 48th Medical Group, Royal Air Force Lakenheath, Suffolk, England; and
| | - Derek Smith
- Department of Allergy-Immunology, Joint Base Elmendorf-Richardson Hospital, Joint Base Elmendorf-Richardson, Anchorage, Alaska
| | - Daniel Steigelman
- From the Department of Allergy-Immunology, Wilford Hall Ambulatory Surgical Center, Lackland Air Force Base, San Antonio, Texas
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An W, Li T, Tian X, Fu X, Li C, Wang Z, Wang J, Wang X. Allergies to Allergens from Cats and Dogs: A Review and Update on Sources, Pathogenesis, and Strategies. Int J Mol Sci 2024; 25:10520. [PMID: 39408849 PMCID: PMC11476515 DOI: 10.3390/ijms251910520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2024] [Revised: 09/26/2024] [Accepted: 09/27/2024] [Indexed: 10/20/2024] Open
Abstract
Inhalation allergies caused by cats and dogs can lead to a range of discomforting symptoms, such as rhinitis and asthma, in humans. With the increasing popularity of and care provided to these companion animals, the allergens they produce pose a growing threat to susceptible patients' health. Allergens from cats and dogs have emerged as significant risk factors for triggering asthma and allergic rhinitis worldwide; however, there remains a lack of systematic measures aimed at assisting individuals in recognizing and preventing allergies caused by these animals. This review provides comprehensive insights into the classification of cat and dog allergens, along with their pathogenic mechanisms. This study also discusses implementation strategies for prevention and control measures, including physical methods, gene-editing technology, and immunological approaches, as well as potential strategies for enhancing allergen immunotherapy combined with immunoinformatics. Finally, it presents future prospects for the prevention and treatment of human allergies caused by cats and dogs. This review will improve knowledge regarding allergies to cats and dogs while providing insights into potential targets for the development of next-generation treatments.
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Affiliation(s)
- Wei An
- Institute of Feed Research, Chinese Academy of Agricultural Sciences, Beijing 100081, China; (W.A.); (X.T.); (X.F.); (C.L.); (Z.W.)
- Key Laboratory of Feed Biotechnology, Ministry of Agriculture and Rural Affairs, Beijing 100081, China
| | - Ting Li
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Biotechnology, No. 20, Dongda Street, Beijing 100071, China;
| | - Xinya Tian
- Institute of Feed Research, Chinese Academy of Agricultural Sciences, Beijing 100081, China; (W.A.); (X.T.); (X.F.); (C.L.); (Z.W.)
- Key Laboratory of Feed Biotechnology, Ministry of Agriculture and Rural Affairs, Beijing 100081, China
| | - Xiaoxin Fu
- Institute of Feed Research, Chinese Academy of Agricultural Sciences, Beijing 100081, China; (W.A.); (X.T.); (X.F.); (C.L.); (Z.W.)
- Key Laboratory of Feed Biotechnology, Ministry of Agriculture and Rural Affairs, Beijing 100081, China
| | - Chunxiao Li
- Institute of Feed Research, Chinese Academy of Agricultural Sciences, Beijing 100081, China; (W.A.); (X.T.); (X.F.); (C.L.); (Z.W.)
- Key Laboratory of Feed Biotechnology, Ministry of Agriculture and Rural Affairs, Beijing 100081, China
| | - Zhenlong Wang
- Institute of Feed Research, Chinese Academy of Agricultural Sciences, Beijing 100081, China; (W.A.); (X.T.); (X.F.); (C.L.); (Z.W.)
- Key Laboratory of Feed Biotechnology, Ministry of Agriculture and Rural Affairs, Beijing 100081, China
| | - Jinquan Wang
- Institute of Feed Research, Chinese Academy of Agricultural Sciences, Beijing 100081, China; (W.A.); (X.T.); (X.F.); (C.L.); (Z.W.)
- Key Laboratory of Feed Biotechnology, Ministry of Agriculture and Rural Affairs, Beijing 100081, China
| | - Xiumin Wang
- Institute of Feed Research, Chinese Academy of Agricultural Sciences, Beijing 100081, China; (W.A.); (X.T.); (X.F.); (C.L.); (Z.W.)
- Key Laboratory of Feed Biotechnology, Ministry of Agriculture and Rural Affairs, Beijing 100081, China
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Kwon H, Ko S, Ha K, Lee JK, Choi Y. Assessing the predictive ability of computational epitope prediction methods on Fel d 1 and other allergens. PLoS One 2024; 19:e0306254. [PMID: 39178274 PMCID: PMC11343462 DOI: 10.1371/journal.pone.0306254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Accepted: 06/14/2024] [Indexed: 08/25/2024] Open
Abstract
While computational epitope prediction methods have found broad application, their use, specifically in allergy-related contexts, remains relatively less explored. This study benchmarks several publicly available epitope prediction tools, focusing on the allergenic IgE and T-cell epitopes of Fel d 1, an extensively studied allergen. Using a variety of tools accessible via the Immune Epitope Database (IEDB) and other resources, we evaluate their ability to identify the known linear IgE and T-cell epitopes of Fel d 1. Our results show a limited effectiveness for B-cell epitope prediction methods, with most performing only marginally better than random selection. We also explored the general predictive abilities on other allergens, and the results were largely random. When predicting T-cell epitopes, ProPred successfully identified all known Fel d 1 T-cell epitopes, whereas the IEDB approach missed two known epitopes and demonstrated a tendency to over-predict. However, when applied to a larger test set, both methods performed only slightly better than random selection. Our findings show the limitations of current computational epitope prediction methods in accurately identifying allergenic epitopes, emphasizing the need for methodological advancements in allergen research.
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Affiliation(s)
- Hyeji Kwon
- Combinatorial Tumor Immunotherapy MRC, Chonnam National University Medical School, Hwasun-gun, Jeollanam-do, Republic of Korea
- Cancer Genomic Research Institute, Immunology Laboratory, Seoul Song Do Colorectal Hospital, Seoul, Republic of Korea
| | - Soobon Ko
- Combinatorial Tumor Immunotherapy MRC, Chonnam National University Medical School, Hwasun-gun, Jeollanam-do, Republic of Korea
| | - Kyungsoo Ha
- New Drug Development Center, Osong Medical Innovation Foundation, Osong, Republic of Korea
| | - Jungjoon K. Lee
- NUS Synthetic Biology for Clinical and Technological Innovation (SynCTI), National University of Singapore, Singapore, Singapore
- Synthetic Biology Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yoonjoo Choi
- Combinatorial Tumor Immunotherapy MRC, Chonnam National University Medical School, Hwasun-gun, Jeollanam-do, Republic of Korea
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Biagioni B, Scala E, Cecchi L. What molecular allergy teaches us about genetics and epidemiology of allergies. Curr Opin Allergy Clin Immunol 2024; 24:280-290. [PMID: 38640142 DOI: 10.1097/aci.0000000000000990] [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: 04/21/2024]
Abstract
PURPOSE OF REVIEW To delineate pertinent information regarding the application of molecular allergology within the realm of both genetic and epidemiological facets of allergic diseases. RECENT FINDINGS The emergence of molecular allergy has facilitated the comprehension of the biochemical characteristics of allergens originating from diverse sources. It has allowed for the exploration of sensitization trajectories and provided novel insights into the influence of genetics and environmental exposure on the initiation and development of allergic diseases. This review delves into the primary discoveries related to the genetics and epidemiology of allergies, facilitated by the application of molecular allergy. It also scrutinizes the impact of environmental exposure across varied geoclimatic, socioeconomic, and lifestyle contexts. Additionally, the review introduces specific models of molecular allergy within the realms of plants and animals. SUMMARY The utilization of molecular allergy in clinical practice holds crucially acknowledged diagnostic and therapeutic implications. From a research standpoint, there is a growing need for the widespread adoption of molecular diagnostic tools to achieve a more profound understanding of the epidemiology and natural progression of allergic diseases.
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Affiliation(s)
- Benedetta Biagioni
- Allergy and Clinical Immunology Unit, San Giovanni di Dio Hospital, Florence
| | - Enrico Scala
- Clinical and Laboratory Molecular Allergy Unit, IDI-IRCCS, Rome
| | - Lorenzo Cecchi
- SOSD Allergology and Clinical Immunology, USL Toscana Centro, Prato, Italy
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Cohen B. Allergic Rhinitis. Pediatr Rev 2023; 44:537-550. [PMID: 37777655 DOI: 10.1542/pir.2022-005618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/02/2023]
Abstract
Allergic rhinitis (AR) affects more than 400 million people worldwide, making it 1 of the most prevalent chronic diseases. Childhood AR is increasing, and almost half of patients with AR develop symptoms before age 6 years. Although a diagnosis of AR is associated with higher socioeconomic status, underserved and urban populations have more indoor aeroallergen sensitizations and are likely underdiagnosed with AR, further exacerbating health-care disparities. AR negatively impacts quality of life, school performance, and overall health outcomes. Untreated AR in children increases the risk for poor asthma control, increased asthma severity, and exacerbations. Many patients believe that they have seasonal allergies only but in reality have both perennial and seasonal AR, which may change the approach to allergen avoidance measures and treatment recommendations. Pharmacotherapy of AR has expanded, with many intranasal corticosteroids, intranasal antihistamines, and second-generation oral antihistamines approved for pediatric use. Allergen immunotherapy, including both subcutaneous and sublingual forms, are approved for children and are disease modifying, potentially reducing further allergen sensitization and progression to asthma. Many of the currently available biological therapies indicated for pediatric asthma and/or atopic diseases reduce AR symptoms as well. Children with moderate to severe or refractory AR or those with comorbidities should be referred to allergists for diagnostic testing and expanded management options, including immunotherapy and potential biological treatment.
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Affiliation(s)
- Barrie Cohen
- Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ
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8
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Torres-Borrego J, Sánchez-Solís M. Dissecting Airborne Allergens. J Clin Med 2023; 12:5856. [PMID: 37762797 PMCID: PMC10532401 DOI: 10.3390/jcm12185856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 08/15/2023] [Accepted: 08/25/2023] [Indexed: 09/29/2023] Open
Abstract
Asthma is a heterogeneous and very complex group of diseases, and includes different clinical phenotypes depending on symptoms, progression, exacerbation patterns, or responses to treatment, among other characteristics. The allergic phenotype is the most frequent, especially in pediatric asthma. It is characterized by sensitization (the production of specific IgEs) to allergens and frequent comorbidity with rhinitis as well as atopic dermatitis. Given the complexity of allergic asthma, knowledge of it must be approached from different points of view: clinical, histological, physiological, epidemiological, biochemical, and immunological, among others. Since partial approaches do not allow for the understanding of this complexity, it is necessary to have multidimensional knowledge that helps in performing the optimal management of each case, avoiding a "blind men and elephant parable" approach. Allergens are antigens that trigger the production of specific IgE antibodies in susceptible individuals, who present symptoms that will depend on the type and intensity of the allergenic load as well as the tissue where the interaction occurs. Airborne allergens cause their effects in the respiratory tract and eyes, and can be indoor or outdoor, perennial, or seasonal. Although allergens such as mites, pollens, or animal dander are generally considered single particles, it is important to note that they contain different molecules which could trigger distinct specific IgE molecules in different patients. General practitioners, pediatricians, and other physicians typically diagnose and treat asthma based on clinical and pulmonary function data in their daily practice. This nonsystematic and nonexhaustive revision aims to update other topics, especially those focused on airborne allergens, helping the diagnostic and therapeutic processes of allergic asthma and rhinitis.
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Affiliation(s)
- Javier Torres-Borrego
- Pediatric Allergy and Pulmonology Unit, Reina Sofia Children’s University Hospital, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), University of Cordoba, Av. Menendez Pidal sn, 14004 Cordoba, Spain
| | - Manuel Sánchez-Solís
- Pediatric Respiratory and Cystic Fibrosis Unit, Virgen de la Arrixaca University Children’s Hospital, Biomedical Research Institute of Murcia (IMIB), University of Murcia, Avda Teniente Flomesta, 5, 30003 Murcia, Spain;
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Zahradnik E, Sander I, Lotz A, Liebers V, Thullner I, Tacke S, Raulf M. Exposure levels of animal allergens, endotoxin, and β-(1,3)-glucan on a university campus of veterinary medicine. PLoS One 2023; 18:e0288522. [PMID: 37440536 DOI: 10.1371/journal.pone.0288522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 06/28/2023] [Indexed: 07/15/2023] Open
Abstract
OBJECTIVES The study aimed to determine the allergen, endotoxin and β-(1,3)-glucan concentrations at various areas on a university campus of veterinary medicine. METHODS Dust samples were collected four times a year for three years using electrostatic dust collectors (EDC) at 25 different locations on a campus of veterinary medicine and in laboratories of inorganic chemistry as a control area representing animal-free environment. Major animal allergens from dog, cat, horse, cattle and mouse, domestic mite (DM) allergens, and β-(1,3)-glucan were measured using enzyme immunoassays and endotoxin using the limulus amoebocyte lysate (LAL) assay. Seasonal, annual and local influences on exposure levels were analyzed using Bayesian mixed models. RESULTS With the exception of mouse allergens, all other determinants were found in almost all locations on the campus and in the control area, but in up to 10.000-fold variable concentrations. By far the highest levels of feline, canine, equine and bovine allergens were detected in buildings where the respective species were examined. The highest levels of mouse and DM allergens, β-(1,3)-glucan and endotoxin occurred together and were associated with locations where large animals were present. In buildings without animals, allergen levels were considerably lower but still elevated at several locations compared to the control area, especially for dog and horse allergens, and β-(1,3)-glucan. Significant seasonal effects were observed for dog, cat, horse and DM allergens, and β-(1,3)-glucan. Variations between years were less apparent than between seasons (except for β-(1,3)-glucan). CONCLUSIONS The strongest influencing factor on the concentration of mammalian allergens was the presence of the corresponding animal at the collection site. Seasonal influence on allergen concentrations was observed, while the overall exposure remained constant over the years. At locations with horses, elevated levels of mite allergens, endotoxin, and β-(1,3)-glucan can be expected, probably due to passive transfer from stable environment.
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Affiliation(s)
- Eva Zahradnik
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-Universität Bochum (IPA), Bochum, Germany
| | - Ingrid Sander
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-Universität Bochum (IPA), Bochum, Germany
| | - Anne Lotz
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-Universität Bochum (IPA), Bochum, Germany
| | - Verena Liebers
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-Universität Bochum (IPA), Bochum, Germany
| | | | - Sabine Tacke
- Veterinary Medicine Clinic, Justus-Liebig-University Gießen, Gießen, Germany
| | - Monika Raulf
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-Universität Bochum (IPA), Bochum, Germany
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10
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van Hage M, Käck U, Asarnoj A, Konradsen JR. An update on the prevalence and diagnosis of cat and dog allergy - Emphasizing the role of molecular allergy diagnostics. Mol Immunol 2023; 157:1-7. [PMID: 36947935 DOI: 10.1016/j.molimm.2023.03.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/30/2023] [Accepted: 03/01/2023] [Indexed: 03/24/2023]
Abstract
The clinical presentation of cat and dog allergy vary from discomfort caused by rhinoconjuncitivitis to severe asthma. Exposure to allergens from these animals is ubiquitous and allergic sensitization to cat or dog affect up to 25% of all children and adults, but allergic sensitization does not always cause symptoms. The introduction of molecular-based allergy diagnostics has improved the possibility to characterize the allergic patient in greater detail. However, the full clinical potential of using molecular allergology in the diagnosis, characterization and treatment of patients with allergy to cats and dogs has not yet been established, although significant progress has been made during the last decade, which will be reviewed in detail in this paper.
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Affiliation(s)
- Marianne van Hage
- Department of Medicine Solna, Division of Immunology and Allergy, Karolinska Institutet, and Karolinska University Hospital, Stockholm, Sweden
| | - Ulrika Käck
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden; Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
| | - Anna Asarnoj
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden; Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Jon R Konradsen
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden; Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
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11
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Abstract
Background: In recent years, an increase of allergies and asthma has been observed throughout the world, more so in Western countries than in less developed ones. Although genetics may play a role in this increase, there are many other factors that may have contributed to the upsurge. Objective: The purpose of the present report was to review the many factors associated with modernization and lifestyle that may have contributed to the allergy and/or asthma epidemic, with a particular focus on those aspects that have particular relevance for the allergist/immunologist. Results: The marked rise in allergy and asthma has been significantly seen in more-developed countries, greater in urban than in rural areas, more pronounced in affluent than in poorer societies, and in individuals who have migrated from developing countries to industrialized countries. A widely accepted explanation for this rise is the "hygiene hypothesis," which postulates a critical dependence on microbial infection for maintenance of a healthy balanced immune system and that extremely clean external environments, often found in the developed world, can derail equilibrated immune development. With the control of infectious diseases, the immune system shifts from a balanced equilibrated immunologic structure to a more Th2 driven proinflammatory state often associated with IgE and eosinophil-related disorders. Conclusion: Modernization has been associated with increased development of allergies and asthma through a cleaner environment and more exposure to allergens and to multiple other contributory factors. The marked reduction in infectious diseases in recent decades permitted the immune system to switch from fighting infectious disease agents and parasites to reacting adversely (hypersensitivity) to benign environmental agents (allergens) and even to self-antigens (autoimmunity).
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Affiliation(s)
- Sami L Bahna
- From the Allergy and Immunology Section, Department of Pediatrics, and
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12
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Dai X, Dharmage SC, Lodge CJ. The relationship of early-life household air pollution with childhood asthma and lung function. Eur Respir Rev 2022; 31:220020. [PMID: 38743526 DOI: 10.1183/16000617.0020-2022] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 06/29/2022] [Indexed: 11/05/2022] Open
Abstract
The increase in childhood asthma over the past few decades has made it an important public health issue. Poor lung function growth associated with some phenotypes of asthma compounds its long-term impact on the individual. Exposure to early-life household risk factors is believed to be linked with respiratory health while infants' lungs are still developing. This review summarises epidemiological studies and mechanistic evidence focusing on the detrimental effects of early-life household air exposures on the respiratory health of children, in particular effects on asthma and lung function. Many early-life household air exposures, including tobacco smoke, gases from heating and cooking, mould/dampness and cleaning products are associated with childhood asthma development and lung function growth. These exposures may alter structural and mechanical characteristics of infants' lungs and contribute to deficits in later life. In addition, some risk factors, including tobacco smoke and cleaning products, can transmit effects across generations to increase the risk of asthma in subsequent generations. This review supports the hypothesis that risks of asthma and accelerated lung ageing are established in early life. The timing of exposure may be critical in the pathogenesis of respiratory diseases, in terms of future risk of asthma and reduced lung function in adults.
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Affiliation(s)
- Xin Dai
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Shyamali C Dharmage
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Caroline J Lodge
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
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13
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Choi YJ, Seong S, Lee KS, Lee K, Seo H, Oh JW. Effects of mechanical washing and drying on the removal of pet allergens. Allergy Asthma Proc 2022; 43:e25-e30. [PMID: 35879023 DOI: 10.2500/aap.2022.43.220029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background: In Korea, the number of households with indoor pets is rapidly increasing in parallel with changes in cultural lifestyles. The sensitization rate of pet allergens is also increasing in Korea. Objective: We evaluated the effectiveness of washing machines to remove dog and cat hair and their allergens. In addition, this study aimed to investigate whether only a mechanical dryer without mechanical washing could be used for pet allergen removal. Method: We brushed cats and dogs, and thereafter collected their hair and used a residential vacuum cleaner to obtain dust and other particulate matter from a household. The contents of the vacuum bag were sifted through a 300-μm sieve filter. Some of the contents were placed in phosphate-buffered saline solution with 0.5% Tween 20 to make a liquid extract. Hair, dust, and liquid extract-contaminated fabric samples after mechanical washing or after drying without mechanical washing were analyzed for pet allergens (Fel d l [cat], Can f 1 [dog]) by using a two-site enzyme-linked immunosorbent assay. We assessed the remaining allergens in the contaminated fabrics after mechanical drying and washing. Results: The mean Fel d l and mean Can f 1 removal ratios after mechanical washing with detergent were > 99.99% for the dust, hair, and liquid extract. The removal ratios after mechanical washing without a detergent were lower for both Fel d 1 and Can f 1, for hair, dust, and their respective liquid extracts (p < 0.05). Mechanical drying was just as effective as mechanical washing with detergent for removing Can f 1 but was less effective for Fel d 1 (p < 0.05). Conclusion: Mechanical washing with detergent is important to remove pet allergens from contaminated fabrics. If washing is difficult, then using just a dryer without washing can be an alternative method to remove allergens from contaminated bedding or clothing.
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Affiliation(s)
- Young-Jin Choi
- From the Department of Pediatrics, Hanyang University Guri Hospital, Guri, Korea
| | - Sujin Seong
- Advanced R&D Team, Digital Appliances, Samsung Electronics Company, Suwon, Korea; and
| | - Kyung Suk Lee
- From the Department of Pediatrics, Hanyang University Guri Hospital, Guri, Korea
| | - Kisup Lee
- Advanced R&D Team, Digital Appliances, Samsung Electronics Company, Suwon, Korea; and
| | - Hyeongjoon Seo
- Advanced R&D Team, Digital Appliances, Samsung Electronics Company, Suwon, Korea; and
| | - Jae-Won Oh
- From the Department of Pediatrics, Hanyang University Guri Hospital, Guri, Korea
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14
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Abstract
PRACTICAL RELEVANCE Human allergy to cats affects a substantial and growing proportion of the global population, and cat allergy is regarded as the third most common cause of human respiratory allergies, and the second most common indoor cause. Veterinarians will frequently encounter owners who are cat-allergic, and having an understanding of this disease and the methods available to help control the allergy will assist them in giving appropriate advice, alongside human healthcare professionals. AIM The aim of this review is to summarise currently available data on the prevalence, causes, symptoms and control of human allergy to cats. In terms of managing cat allergy, the emphasis is on reviewing current and emerging modalities to reduce environmental exposure to cat allergens rather than on pharmacotherapy or immunotherapy, as it is in these areas in particular that the veterinarian may be able to offer help and advice to complement that of human healthcare professionals. EVIDENCE BASE The information in this review is drawn from the current and historical literature on human allergy to cats, and approaches to reduce exposure to cat allergens and manage symptoms of cat allergy.
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15
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Abstract
PURPOSE OF REVIEW European and US allergists generally do not agree on the approach to subcutaneous allergy immunotherapy in patients with multiple allergies. The North American approach is to treat with a mixture that contains all the allergen extracts to which the patient has evident clinical sensitivity, whereas the European approach is to select for treatment the one or at the most two allergens that are clinically most important for the patient. RECENT FINDINGS Recent society guidelines continue to recommend these differing practices of treating the polyallergic patient and reviews of prescribing practices indicate these divergent recommendations are followed in Europe and the USA. SUMMARY The objections by European allergists to the practice by US allergists are that multiallergen immunotherapy leads to dilution of allergens to less than effective doses, that proteases in some extracts can degrade allergens in other extracts, that there is a problem of safety and inability to determine which component extract caused a systemic reaction, and finally that there is alack of convincing studies demonstrating efficacy of multiallergen mixtures. Each of these contentions is addressed.
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16
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Abstract
Inner-city children with asthma are known to have high disease mortality and morbidity. Frequently, asthma in this high-risk population is difficult to control and more severe in nature. Several factors, including socioeconomic hardship, ability to access to health care, adherence to medication, exposure to certain allergens, pollution, crowd environment, stress, and infections, play an important role in the pathophysiology of inner-city asthma. Comprehensive control of home allergens and exposure to tobacco smoke, the use of immune based therapies, and school-based asthma programs have shown promising results in asthma control in this population.
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Affiliation(s)
- Divya Seth
- Division of Allergy/Immunology, Department of Pediatrics, Children's Hospital of Michigan, Wayne State University School of Medicine, 3950 Beaubien, 4th Floor, Pediatric Specialty Building, Detroit, MI 48201, USA.
| | - Shweta Saini
- Division of Hospital Medicine, Department of Pediatrics, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI, USA
| | - Pavadee Poowuttikul
- Division of Allergy/Immunology, Department of Pediatrics, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI, USA
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17
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Zahradnik E, Sander I, Kleinmüller O, Lotz A, Liebers V, Janssen-Weets B, Kler S, Hilger C, Beine A, Hoffmeyer F, Nienhaus A, Raulf M. Animal Allergens, Endotoxin, and β-(1,3)-Glucan in Small Animal Practices: Exposure Levels at Work and in Homes of Veterinary Staff. Ann Work Expo Health 2021; 66:27-40. [PMID: 34363388 PMCID: PMC8751790 DOI: 10.1093/annweh/wxab053] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 06/10/2021] [Accepted: 07/01/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES In veterinary settings, high exposures to animal allergens and microbial agents can be expected. However, occupational exposure levels are largely unknown. The objective of this study was to estimate the allergen, endotoxin, and β-(1,3)-glucan concentrations in small animal practices and in the homes of practice employees. METHODS Dust samples were collected using electrostatic dust fall collectors in diverse rooms of 36 small animal practices, as well as in employees' homes. Major animal allergens (Fel d 1, Can f 1, Ory c 3, Cav p 1, Equ c 1, Bos d 2), domestic mite (DM) allergens, and β-(1,3)-glucan levels were measured using enzyme immunoassays. Endotoxin was determined using the Limulus amoebocyte lysate assay. Influences on exposure levels were analyzed using multilevel models. RESULTS The levels of Can f 1, Fel d 1, Ory c 3, and Cav p 1 were up to 30 times higher in practices compared with homes without animals, but significantly lower compared with the homes with the respective pet. Although horses were not treated in the practices, Equ c 1 was found in 87.5% of samples, with the highest concentrations measured in changing rooms. DM levels were significantly lower in practices than in all private homes, and endotoxin levels were similar to those in homes with pets. In the practice itself, exposure levels were significantly influenced by animal presence, type of the room, and area per employee; whereas, room volume and diverse cleaning measures had mostly no effect. CONCLUSIONS Exposure to animal allergens is high in veterinary practices, but it does not reach levels of households with pets. Domestic mite allergen and endotoxin exposure seem to be low for workers in veterinary practices. The high Equ c 1 detection rate strongly indicates dispersal of allergens, most likely through clothing and hair.
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Affiliation(s)
- Eva Zahradnik
- Department of Allergology and Immunology, Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-Universität Bochum (IPA), Bochum, Germany
- Author to whom correspondence should be addressed. Tel: +49-3013001-4325; e-mail:
| | - Ingrid Sander
- Department of Allergology and Immunology, Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-Universität Bochum (IPA), Bochum, Germany
| | - Olaf Kleinmüller
- CVcare, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Anne Lotz
- Department of Epidemiology, Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-Universität Bochum (IPA), Bochum, Germany
| | - Verena Liebers
- Department of Allergology and Immunology, Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-Universität Bochum (IPA), Bochum, Germany
| | - Bente Janssen-Weets
- Department of Infection and Immunity, Luxemburg Institute of Health, Esch-sur-Alzette, Luxemburg
- Department of Dermatology and Allergy Center, Odense Research Center for Anaphylaxis, University of Southern Denmark, Odense, Denmark
| | - Stéphanie Kler
- Department of Infection and Immunity, Luxemburg Institute of Health, Esch-sur-Alzette, Luxemburg
| | - Christiane Hilger
- Department of Infection and Immunity, Luxemburg Institute of Health, Esch-sur-Alzette, Luxemburg
| | - Alexandra Beine
- Department of Medicine, Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-Universität Bochum (IPA), Bochum, Germany
| | - Frank Hoffmeyer
- Department of Medicine, Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-Universität Bochum (IPA), Bochum, Germany
| | - Albert Nienhaus
- CVcare, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
- Department of Occupational Medicine, Hazardous Substances and Health Research (AGG), Institution for Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW), Hamburg, Germany
| | - Monika Raulf
- Department of Allergology and Immunology, Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-Universität Bochum (IPA), Bochum, Germany
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18
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Paciência I, Cavaleiro Rufo J, Farraia M, Leal M, Moreira A. Exposure to indoor and airborne food allergens in commercial airplanes. Allergy 2021; 76:2295-2296. [PMID: 33715190 DOI: 10.1111/all.14813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 03/01/2021] [Accepted: 03/09/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Inês Paciência
- Serviço de Imunologia Básica e Clínica Departamento de Patologia Faculdade de Medicina da Universidade do Porto Porto Portugal
- EPIUnit ‐ Instituto de Saúde Pública Universidade do Porto Porto Portugal
| | - João Cavaleiro Rufo
- Serviço de Imunologia Básica e Clínica Departamento de Patologia Faculdade de Medicina da Universidade do Porto Porto Portugal
- EPIUnit ‐ Instituto de Saúde Pública Universidade do Porto Porto Portugal
| | - Mariana Farraia
- Serviço de Imunologia Básica e Clínica Departamento de Patologia Faculdade de Medicina da Universidade do Porto Porto Portugal
- EPIUnit ‐ Instituto de Saúde Pública Universidade do Porto Porto Portugal
| | - Mariana Leal
- Serviço de Imunologia Básica e Clínica Departamento de Patologia Faculdade de Medicina da Universidade do Porto Porto Portugal
| | - André Moreira
- Serviço de Imunologia Básica e Clínica Departamento de Patologia Faculdade de Medicina da Universidade do Porto Porto Portugal
- EPIUnit ‐ Instituto de Saúde Pública Universidade do Porto Porto Portugal
- Serviço de Imunoalergologia Centro Hospitalar São João Porto Portugal
- Faculdade de Ciências da Nutrição Alimentação da Universidade do Porto Porto Portugal
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19
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Ali Z, Jemec GBE, Ulrik CS. Associations between maternal and environmental exposures on atopic disease in the offspring of mothers with asthma. IMMUNITY INFLAMMATION AND DISEASE 2021; 9:862-870. [PMID: 34145785 PMCID: PMC8342200 DOI: 10.1002/iid3.441] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 03/19/2021] [Accepted: 04/07/2021] [Indexed: 11/22/2022]
Abstract
Background and Objective Available data on the impact of perinatal and environmental factors on atopic diseases in the offspring are sparse and conflicting. We, therefore, investigated the impact of these factors on the risk of atopic diseases in the offspring of women with asthma. Methods Pregnant women referred to give birth at Copenhagen University Hospital‐Hvidovre, Denmark, have since 2007 been invited to participate in the Management of Asthma during Pregnancy program. Women with diagnosed asthma, currently prescribed asthma medication, first visit to the respiratory out‐patient clinic within the first 18 weeks of pregnancy that completed an online questionnaire about atopic diseases in their child were included in the current study. Results Five hundred and seventy‐one pregnancies were included. Among the off‐spring, 113 children (21%) had doctor‐diagnosed asthma, 178 (31%) atopic dermatitis (AD), and 55 (32%) both AD and doctor‐diagnosed asthma. AD in the offspring was associated with having a dog at home (odds ratio [OR], 2.56; 95% confidence interval [CI], [1.40–4.67], p = .002), whereas having a cat at home was associated with a higher risk of asthma in the offspring (OR, 2.16; 95% CI, [1.14–4.11], p = .02). The associations remained significant after adjusting for maternal age, smoking status, allergy, treatment with inhaled corticosteroids, forced expiratory volume in 1 s less than 80% predicted, uncontrolled asthma, and history of pre‐pregnancy asthma exacerbations. No association was found between gestational weight gain (GWG) in first trimester and total GWG and atopic disease in the offspring. Conclusion Having pets at home is associated with AD and asthma in the offspring of mothers with asthma.
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Affiliation(s)
- Zarqa Ali
- Department of Dermatology, Bispebjerg Hospital, Copenhagen, Denmark
| | - Gregor B E Jemec
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark.,Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Charlotte Suppli Ulrik
- Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Department of Pulmonary Medicine, Hvidovre Hospital, Hvidovre, Denmark
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20
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Popescu FD, Ganea CS, Panaitescu C, Vieru M. Molecular diagnosis in cat allergy. World J Methodol 2021; 11:46-60. [PMID: 34026578 PMCID: PMC8127422 DOI: 10.5662/wjm.v11.i3.46] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 02/22/2021] [Accepted: 05/10/2021] [Indexed: 02/06/2023] Open
Abstract
Domestic cats represent one of the most common sources of indoor allergens. All over the world, many households own cats, whose allergens are persistent and widespread. Cat allergy itself is frequent, and its symptoms vary from rhinoconjunctivitis to life-threatening asthma. In vitro diagnosis using precision medicine allergy immunoassays is important because natural cat dander extracts may differ in quality and quantity of some of the individual allergen components and other molecules. In the component-resolved diagnosis of cat allergy, singleplex and multiplex specific immunoglobulin (Ig) E assays include use of the cat-specific major allergen, secretoglobin Fel d 1 (as a species-specific molecule), other allergen components (such as lipocalins Fel d 4, cross-reacting with other animal similar molecules, and Fel d 7, present in small quantities in natural extracts), and serum albumin Fel d 2 (related to the cat-pork syndrome). IgA Fel d 5 and IgM Fel d 6 are not available as allergen components in the current commercial IgE immunoassays, but they may impair the in vitro diagnostic evaluation of cat allergy because galactose-α1,3-galactose is an IgE-binding epitope of these native feline allergens. The benefits of molecular-based cat allergy diagnosis are continually evaluated, as the role of recombinant allergen components already known is detailed and new other molecules of interest may be discovered in the future.
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Affiliation(s)
- Florin-Dan Popescu
- Department of Allergology and Clinical Immunology, “Nicolae Malaxa” Clinical Hospital, Bucharest 022441, Romania
- Department of Allergology, “Carol Davila” University of Medicine and Pharmacy, Bucharest 022441, Romania
| | - Carmen Saviana Ganea
- Department of Allergology and Clinical Immunology, “Nicolae Malaxa” Clinical Hospital, Bucharest 022441, Romania
| | - Carmen Panaitescu
- Department III Functional Sciences, Physiology Discipline, “Victor Babes” University of Medicine and Pharmacy, Timișoara 300041, Romania
- Center for Gene and Cell Therapies in Cancer Treatment OncoGen-SCJUPB Timisoara, Timișoara 300041, Romania
| | - Mariana Vieru
- Department of Allergology and Clinical Immunology, “Nicolae Malaxa” Clinical Hospital, Bucharest 022441, Romania
- Department of Allergology, “Carol Davila” University of Medicine and Pharmacy, Bucharest 022441, Romania
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21
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Sherenian MG, Kothari A, Biagini JM, Kroner JW, Baatyrbek Kyzy A, Johannson E, Atluri G, He H, Martin LJ, Khurana Hershey GK. Sensitization to peanut, egg or pets is associated with skin barrier dysfunction in children with atopic dermatitis. Clin Exp Allergy 2021; 51:666-673. [PMID: 33721370 DOI: 10.1111/cea.13866] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 02/21/2021] [Accepted: 02/24/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Children with atopic dermatitis (AD) are often sensitized to food and aeroallergens, but sensitization patterns have not been analysed with biologic measures of disease pathogenicity. OBJECTIVE We sought to define allergen sensitization grouping(s) using unbiased machine learning and determine their associations with skin filaggrin (FLG) and transepidermal water loss (TEWL) (assesses skin barrier integrity), S100A8 and S100A9 expression (assesses skin inflammation) and AD severity. METHODS We studied 400 children with AD in the Mechanisms of Progression from Atopic Dermatitis to Asthma in Children (MPAACH) cohort to identify groupings of food and aeroallergen sensitizations. MPAACH is a paediatric AD cohort, aged 1-2, recruited through hospital/community settings between 2016 and 2018. We analysed these groupings' associations with AD biomarkers: skin FLG, S100A8 and S100A9 expression, total IgE, TEWL and AD severity. RESULTS An unbiased machine learning approach revealed five allergen clusters. The most common cluster (N = 131), SPTPEP, had sensitization to peanut, egg and/or pets. Three low prevalence clusters, which included children with allergen sensitization other than peanut, egg or pets, were combined into SPTOther . SPTNEG included children with no sensitization(s). SPTPEP children had higher median non-lesional TEWL (16.9 g/m2 /h) and IgE (90 kU/L) compared with SPTOTHER (8.8 g/m2 /h and 24 kU/L; p = .01 and p < .001) and SPTNEG (9 g/m2 /h and 26 kU/L; p = .003 and p < .001). SPTPEP children had lower median lesional (0.70) and non-lesional (1.09) FLG expression compared with SPTOTHER (lesional: 0.9; p = .047, non-lesional: 1.78; p = .01) and SPTNEG (lesional: 1.47; p < .001, non-lesional: 2.21; p < .001). There were no differences among groupings in S100A8 or S100A9 expression. CONCLUSIONS AND CLINICAL RELEVANCE In this largely clinic-based cohort of young children with AD, allergic sensitization to peanut, egg, cat or dog was associated with more severe disease and skin barrier function but not markers of cutaneous inflammation. These data need replicating in a population-based cohort but may have important implications for understanding the interaction between AD and allergic sensitization.
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Affiliation(s)
- Michael G Sherenian
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.,Division of Asthma Research, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Division of Allergy and Immunology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Arjun Kothari
- Division of Asthma Research, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Jocelyn M Biagini
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.,Division of Asthma Research, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - John W Kroner
- Division of Asthma Research, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Asel Baatyrbek Kyzy
- Division of Asthma Research, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Elisabet Johannson
- Division of Asthma Research, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Gowtham Atluri
- Department of Electrical Engineering and Computer Science, University of Cincinnati, Cincinnati, OH, USA
| | - Hua He
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Lisa J Martin
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Gurjit K Khurana Hershey
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.,Division of Asthma Research, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Division of Allergy and Immunology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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22
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Cox L. Pharmacoeconomics of allergy immunotherapy versus pharmacotherapy. Expert Rev Clin Immunol 2021; 17:255-268. [PMID: 33645387 DOI: 10.1080/1744666x.2021.1886079] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Introduction: The purpose of this review is to evaluate the cost-effectiveness of allergy immunotherapy (AIT) in the treatment of allergic rhinitis, asthma, and other allergic conditions.Area covered: An extensive search of the PubMed and Medline database (January 1996 up to June of 2020) was conducted using the search terms allergy immunotherapy, pharmacoeconomics, cost-effectiveness, allergic rhinitis, and asthma. Studies were included if they included information on the economics of AIT in comparison to pharmacotherapy in the treatment of allergic rhinitis or asthma either as actual costs or based on theoretical models. Systematic reviews were included if they included information about the cost-effectiveness of AIT.Most clinical trials found significant cost-savings with AIT. The cost-effective time-point ranged from a few months to several years after treatment initiation.. Cost savings were demonstrated as early as 3 months after treatment initiation and were as great as 80% less than SDT in some studies.Expert opinion: There is strong evidence in the collective literature that AIT is cost-effective as compared to SDT alone. The magnitude of AIT's cost-effectiveness is likely underestimated because most of the studies considered during treatment costs and not AIT's long-term benefits or preventive/prophylactic effects or its impact on co-morbid conditions.
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Affiliation(s)
- Linda Cox
- Department of Medicine, Associate Professor of Medicine Nova Southeastern University, Ft. Lauderdale, Florida, USA
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23
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Schoos AMM, Nwaru BI, Borres MP. Component-resolved diagnostics in pet allergy: Current perspectives and future directions. J Allergy Clin Immunol 2021; 147:1164-1173. [PMID: 33444632 DOI: 10.1016/j.jaci.2020.12.640] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 11/30/2020] [Accepted: 12/23/2020] [Indexed: 12/14/2022]
Abstract
Furry mammals kept as pets are important allergen sources. The prevalence of sensitization to dander from various animals appears to be increasing worldwide. Several mammalian allergens from diverse species and distinct protein families have been characterized, and some are available for component-resolved diagnostics (CRD). This review presents an overview of mammalian aeroallergens, with a focus on cat, dog, and horse allergens. The potential of CRD in fine-tuning the diagnostic workup following traditional methods based on whole- allergen extracts and allergen immunotherapy is discussed. The review highlights the clinical utility of CRD, particularly as a marker/predictor of increased asthma risk and disease severity. Finally, several perspectives of the future implications of CRD are offered in the context of furry animal allergens.
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Affiliation(s)
- Ann-Marie M Schoos
- COpenhagen Prospective Studies on Asthma in Childhood (COPSAC), Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark; Department of Pediatrics, Slagelse Sygehus, Slagelse, Denmark.
| | - Bright I Nwaru
- Krefting Research Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden; Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Magnus P Borres
- Thermo Fisher Scientific, Uppsala, Sweden; Department of Maternal and Child Health, Uppsala University, Uppsala, Sweden
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24
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Lee NG, Kim HK, Choi GS. Comparison of inhalant allergen sensitization between children, adolescents, and adults with asthma and allergic rhinitis. ALLERGY ASTHMA & RESPIRATORY DISEASE 2021. [DOI: 10.4168/aard.2021.9.3.148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Na Gyeom Lee
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Hee-Kyoo Kim
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Gil Soon Choi
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
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25
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Cox L. Biologics and Allergy Immunotherapy in the Treatment of Allergic Diseases. Immunol Allergy Clin North Am 2020; 40:687-700. [PMID: 33012328 DOI: 10.1016/j.iac.2020.06.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Allergic diseases represent some of the most chronic and costly chronic conditions. Medical management may require long-term pharmacotherapy, which is often associated with poor adherence. Although medications provide symptomatic control, they do not modify the allergic disease. Patients may prefer disease-modifying treatments that provide lasting benefits after discontinuation. To date, allergy immunotherapy is the only proved disease modification therapy associated with lasting benefits after discontinuation. However, allergy immunotherapy safety and efficacy has only been established in allergic rhinitis, mild to moderate asthma, and some patients with atopic dermatitis.
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Affiliation(s)
- Linda Cox
- 1108 South Wolcott Street, Casper, WY 82601, USA.
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26
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Won JY, Kwon JW, Hong SN, Lee WH. Age Differences in Pet Sensitization by Pet Ownership. Clin Exp Otorhinolaryngol 2020; 14:210-216. [PMID: 32911877 PMCID: PMC8111394 DOI: 10.21053/ceo.2020.00675] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 08/14/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES The association between pet sensitization and pet ownership remains unclear. Therefore, we aimed to elucidate the association between pet sensitization and pet ownership by age. METHODS We retrospectively reviewed 2,883 patients who visited our allergy clinic for nasal symptoms from January 2003 to December 2014, of whom 1,957 patients with data on skin-prick tests and questionnaire responses were included and divided into adults (age >19 years) and children (age ≤19 years). The association between pet sensitization and pet ownership was evaluated in both groups. RESULTS Among children, dog and cat sensitization showed no associations with dog and cat ownership, respectively. However, among adults, dog sensitization was significantly associated with dog ownership (odds ratio [OR], 3.283; P<0.001), and cat sensitization with cat ownership (OR, 13.732; P<0.001). After adjustment for age, sex, familial history of allergy, sinusitis, diabetes mellitus, other pet ownership, and non-pet sensitization, significant associations remained between dog sensitization and dog ownership (adjusted OR [aOR], 3.881; P<0.001), and between cat sensitization and cat ownership (aOR, 10.804; P<0.001) among adults. Dog ownership did not show any association with allergic rhinitis, asthma, or atopic dermatitis, whereas atopic dermatitis had a significant association with cat ownership in adults (aOR, 4.840; P<0.001). CONCLUSION Pet ownership in adulthood increased the risk of pet sensitization. However, pet ownership was not associated with the prevalence of atopic disorders, regardless of age, except for atopic dermatitis and cat ownership in adults.
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Affiliation(s)
- Jun Yeon Won
- Department of Otolaryngology, Kangwon National University Hospital, Chuncheon, Korea.,Department of Otolaryngology, Kangwon National University College of Medicine, Chuncheon, Korea
| | - Jea-Woo Kwon
- Department of Otolaryngology, Kangwon National University Hospital, Chuncheon, Korea.,Department of Allergy and Clinical Immunology, Kangwon National University College of Medicine, Chuncheon, Korea
| | - Seung-No Hong
- Department of Otorhinolaryngology, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Woo Hyun Lee
- Department of Otolaryngology, Kangwon National University Hospital, Chuncheon, Korea
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Joubert AI, Geppert M, Johnson L, Mills-Goodlet R, Michelini S, Korotchenko E, Duschl A, Weiss R, Horejs-Höck J, Himly M. Mechanisms of Particles in Sensitization, Effector Function and Therapy of Allergic Disease. Front Immunol 2020; 11:1334. [PMID: 32714326 PMCID: PMC7344151 DOI: 10.3389/fimmu.2020.01334] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 05/26/2020] [Indexed: 12/15/2022] Open
Abstract
Humans have always been in contact with natural airborne particles from many sources including biologic particulate matter (PM) which can exhibit allergenic properties. With industrialization, anthropogenic and combustion-derived particles have become a major fraction. Currently, an ever-growing number of diverse and innovative materials containing engineered nanoparticles (NPs) are being developed with great expectations in technology and medicine. Nanomaterials have entered everyday products including cosmetics, textiles, electronics, sports equipment, as well as food, and food packaging. As part of natural evolution humans have adapted to the exposure to particulate matter, aiming to protect the individual's integrity and health. At the respiratory barrier, complications can arise, when allergic sensitization and pulmonary diseases occur in response to particle exposure. Particulate matter in the form of plant pollen, dust mites feces, animal dander, but also aerosols arising from industrial processes in occupational settings including diverse mixtures thereof can exert such effects. This review article gives an overview of the allergic immune response and addresses specifically the mechanisms of particulates in the context of allergic sensitization, effector function and therapy. In regard of the first theme (i), an overview on exposure to particulates and the functionalities of the relevant immune cells involved in allergic sensitization as well as their interactions in innate and adaptive responses are described. As relevant for human disease, we aim to outline (ii) the potential effector mechanisms that lead to the aggravation of an ongoing immune deviation (such as asthma, chronic obstructive pulmonary disease, etc.) by inhaled particulates, including NPs. Even though adverse effects can be exerted by (nano)particles, leading to allergic sensitization, and the exacerbation of allergic symptoms, promising potential has been shown for their use in (iii) therapeutic approaches of allergic disease, for example as adjuvants. Hence, allergen-specific immunotherapy (AIT) is introduced and the role of adjuvants such as alum as well as the current understanding of their mechanisms of action is reviewed. Finally, future prospects of nanomedicines in allergy treatment are described, which involve modern platform technologies combining immunomodulatory effects at several (immuno-)functional levels.
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Affiliation(s)
- Anna I Joubert
- Division of Allergy and Immunology, Department of Biosciences, University of Salzburg, Salzburg, Austria
| | - Mark Geppert
- Division of Allergy and Immunology, Department of Biosciences, University of Salzburg, Salzburg, Austria
| | - Litty Johnson
- Division of Allergy and Immunology, Department of Biosciences, University of Salzburg, Salzburg, Austria
| | - Robert Mills-Goodlet
- Division of Allergy and Immunology, Department of Biosciences, University of Salzburg, Salzburg, Austria
| | - Sara Michelini
- Division of Allergy and Immunology, Department of Biosciences, University of Salzburg, Salzburg, Austria
| | - Evgeniia Korotchenko
- Division of Allergy and Immunology, Department of Biosciences, University of Salzburg, Salzburg, Austria
| | - Albert Duschl
- Division of Allergy and Immunology, Department of Biosciences, University of Salzburg, Salzburg, Austria
| | - Richard Weiss
- Division of Allergy and Immunology, Department of Biosciences, University of Salzburg, Salzburg, Austria
| | - Jutta Horejs-Höck
- Division of Allergy and Immunology, Department of Biosciences, University of Salzburg, Salzburg, Austria
| | - Martin Himly
- Division of Allergy and Immunology, Department of Biosciences, University of Salzburg, Salzburg, Austria
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Abstract
This article evaluates the role of allergen immunotherapy (AIT) in the treatment of allergic rhinitis (AR). AIT has been shown to be effective in treating AR symptoms with resultant improvements in overall quality of life, comorbid illnesses, and medication requirements. Persistent clinical benefits have been shown years after AIT treatment discontinuation. AIT may prevent the progression of AR to asthma. AIT may more cost-effective than pharmacotherapy. Multiple individual studies and systematic reviews provide strong evidence for the clinical effectiveness of AIT in the treatment of AR. Cost-effectiveness and disease modification of AIT compared with standard drug treatment are additional advantages.
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Affiliation(s)
- Linda Cox
- Department of Medicine, Nova Southeastern University, Davie, FL, USA; Department of Medicine, University of Miami, Coral Gables, FL, USA.
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29
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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: 11] [Impact Index Per Article: 1.8] [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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Abstract
Inner-city children with asthma are known to have high disease mortality and morbidity. Frequently, asthma in this high-risk population is difficult to control and more severe in nature. Several factors, including socioeconomic hardship, ability to access to health care, adherence to medication, exposure to certain allergens, pollution, crowd environment, stress, and infections, play an important role in the pathophysiology of inner-city asthma. Comprehensive control of home allergens and exposure to tobacco smoke, the use of immune based therapies, and school-based asthma programs have shown promising results in asthma control in this population.
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Affiliation(s)
- Divya Seth
- Division of Allergy/Immunology, Department of Pediatrics, Children's Hospital of Michigan, Wayne State University School of Medicine, 3950 Beaubien, 4th Floor, Pediatric Specialty Building, Detroit, MI 48201, USA.
| | - Shweta Saini
- Division of Hospital Medicine, Department of Pediatrics, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI, USA
| | - Pavadee Poowuttikul
- Division of Allergy/Immunology, Department of Pediatrics, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI, USA
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31
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Abstract
Asthma in inner-city children is often severe and difficult to control. Residence in poor and urban areas confers increased asthma morbidity even after adjusting for ethnicity, age, and gender. Higher exposure to household pests, such as cockroaches and mice, pollutants and tobacco smoke exposure, poverty, material hardship, poor-quality housing, differences in health care quality, medication compliance, and heath care access also contribute to increased asthma morbidity in this population. Since 1991, the National Institutes of Allergy and Infectious Diseases established research networks: the National Cooperative Inner-City Asthma Study (NCICAS), the Inner-City Asthma Study (ICAS), and the Inner-City Asthma Consortium (ICAC), to improve care for this at risk population. The most striking finding of the NCICAS is the link between asthma morbidity and the high incidence of allergen sensitization and exposure, particularly cockroach. The follow-up ICAS confirmed that reductions in household cockroach and dust mite were associated with reduction in the inner-city asthma morbidity. The ICAC studies have identified that omalizumab lowered fall inner-city asthma exacerbation rate; however, the relationship between inner-city asthma vs immune system dysfunction, respiratory tract infections, prenatal environment, and inner-city environment is still being investigated. Although challenging, certain interventions for inner-city asthma children have shown promising results. These interventions include family-based interventions such as partnering families with asthma-trained social workers, providing guidelines driven asthma care as well as assured access to controller medication, home-based interventions aim at elimination of indoor allergens and tobacco smoke exposure, school-based asthma programs, and computer/web-based asthma programs.
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Abstract
This article on exposome and asthma focuses on the interaction of patients and their environments in various parts of their growth, development, and stages of life. Indoor and outdoor environments play a role in pathogenesis via levels and duration of exposure, with genetic susceptibility as a crucial factor that alters the initiation and trajectory of common conditions such as asthma. Knowledge of environmental exposures globally and changes that are occurring is necessary to function effectively as medical professionals and health advocates.
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Affiliation(s)
- Ahila Subramanian
- Department of Allergy and Clinical Immunology, Respiratory Institute, Cleveland Clinic, Cleveland Clinic Lerner College of Medicine, CWRU School of Medicine, 9500 Euclid Avenue/A90, Cleveland, OH 4419, USA
| | - Sumita B Khatri
- Department of Pulmonary and Critical Care Medicine, Respiratory Institute, Cleveland Clinic, Cleveland Clinic Lerner College of Medicine, CWRU School of Medicine, 9500 Euclid Avenue/A90, Cleveland, OH 4419, USA.
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Hu H, Luo W, Wu Z, Cai C, Huang H, Sun B. A pilot study on the allergen-specific IgE to molecular components on polysensitized mite allergic asthmatic patients in Guangzhou, China. Mol Immunol 2018; 105:38-45. [PMID: 30481720 DOI: 10.1016/j.molimm.2018.11.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 09/17/2018] [Accepted: 11/08/2018] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Using multiplex microarray-based component resolved diagnosis (CRD) to investigate the allergen sensitization profile of allergic asthma patients in southern China. METHOD Serum samples from 57 polysensitized mite allergic asthmatic patients in a tertiary referral centre of southern China were tested with multiplex CRD (ISAC) for specific immunoglobulin E (sIgE) against 112 single allergen and components. Result was then compared with those from singleplex ImmunoCAP. RESULTS With ISAC, the highest sensitization was seen for nDer f 1 (71.9%), rDer f 2 (73.7%), nDer p 1 (70.2%) and rDer p 2 (66.7%), whereas rDer p 10 and other storage mites' components only showed 10% positivity. rFel d 1 and rCan f 1 were found positive in 29.8% and 14.0% samples respectively. Other epithelia components had less than 7.0% positive rate. Sensitization to pollen components was dominated by nCyn d 1 (17.5%) and nPhl p 4 (12.3%), Carbohydrate cross-reactive determinants (CCD) was positive in 4 patients who were also positive to nPhl p 4, nCyn d 1 and rPla a 2, and all of them have combined asthma and rhinitis. The sensitivity to mold (rAsp f 3), cockroach (nBla g 7) and Anisakis simplex component (rAni s 3) were all the same at 8.8%. 93.0% patients were sensitive to more than one component, with more than half of them (57.9%) positive to five or more components. Patients with combined asthma and rhinitis (AA + AR) were sensitive to more components than those with asthma only (AA). Positive rate to nPhl p 4 was significantly higher in patients with AA + AR than with AA only (χ2 = 4.31, P = 0.038). Compared with ImmunoCAP, ISAC showed a similar high detection rate for D. pteronyssinus and D. farinae, but only 10.0% of B. tropicalis sensitive patients were positive to rBlo t 5. Optimal scale analysis on correlation of allergens components showed rDer p 10 was associated to food allergy. CONCLUSION Being the first multiplex microarray based CRD study on southern Chinese, ISAC showed house dust mites components were the major allergen components led to sensitization in asthmatic patients. Patients with combined AA + AR were sensitive to more components than those with AA only. Other components with higher positive rate include pollen components nCyn d 1, nPhl P 4 and animal dander components rFel d 1 and rCan f 1. For B. tropicalis, the rBlo t 5 in ISAC may not represent the major Blomia component in southern Chinese patients.
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Affiliation(s)
- Haisheng Hu
- Department of Allergy and Clinical Immunology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, Guangdong, China; State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou Medical University, Guangzhou 510120, Guangdong, China
| | - Wenting Luo
- Department of Allergy and Clinical Immunology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, Guangdong, China; State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou Medical University, Guangzhou 510120, Guangdong, China
| | - Zehong Wu
- Department of Allergy and Clinical Immunology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, Guangdong, China; State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou Medical University, Guangzhou 510120, Guangdong, China
| | - Chuanxu Cai
- Department of Allergy and Clinical Immunology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, Guangdong, China; State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou Medical University, Guangzhou 510120, Guangdong, China
| | - Huimin Huang
- Department of Allergy and Clinical Immunology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, Guangdong, China; State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou Medical University, Guangzhou 510120, Guangdong, China.
| | - Baoqing Sun
- Department of Allergy and Clinical Immunology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, Guangdong, China; State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou Medical University, Guangzhou 510120, Guangdong, China.
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34
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Simoneti CS, Ferraz E, Menezes MB, Icuma TR, Vianna EO. Cat ownership is associated with increased asthma prevalence and dog ownership with decreased spirometry values. ACTA ACUST UNITED AC 2018; 51:e7558. [PMID: 30365724 PMCID: PMC6207287 DOI: 10.1590/1414-431x20187558] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 08/15/2018] [Indexed: 11/22/2022]
Abstract
The association between pet ownership and the development of allergic and respiratory diseases has been the aim of several studies, however, the effects of exposure in adults remain uncertain. The aims of the present study were to investigate the prevalence of asthma and lung function status among dog and cat owners. This cross-sectional study was performed at two universities with students and workers who were allocated into 3 groups according to pet ownership in the previous year: cat owners, dog owners, and no pets (control group). Subjects underwent spirometry, bronchial challenge test with mannitol, skin prick tests, and questionnaires about animal exposures and respiratory symptoms. Control group comprised 125 subjects; cat owner group, 51 subjects; and dog owner group, 140 subjects. Cat owners had increased asthma prevalence (defined by symptoms and positive bronchial challenge test), but no changes in lung function compared to the control group. The dog owner group had lower spirometry values (forced expiratory volume in one second and lower forced vital capacity), but similar asthma prevalence, compared to the control group. In the cat owner group, excess of asthma may have an immunological basis, since we found an association with atopy. Although we did not have endotoxin data from volunteers' households, we postulated that low values of lung function were associated to exposure to endotoxins present in environments exposed to dogs.
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Affiliation(s)
- C S Simoneti
- Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - E Ferraz
- Departamento de Fisioterapia, Centro Regional Universitário de Espírito Santo do Pinhal, Espírito Santo do Pinhal, SP, Brasil
| | - M B Menezes
- Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - T R Icuma
- Departamento de Medicina Social, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - E O Vianna
- Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
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35
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Abstract
PURPOSE OF REVIEW The review provides insight into recent findings on bedroom allergen exposures, primarily focusing on pet, pest, and fungal exposures. RECENT FINDINGS Large-scale studies and improved exposure assessment technologies, including measurement of airborne allergens and of multiple allergens simultaneously, have extended our understanding of indoor allergen exposures and their impact on allergic disease. Practical, streamlined methods for exposure reduction have shown promise in some settings, and potential protective effects of early-life exposures have been further elucidated through the investigation of specific bacterial taxa. Advances in molecular allergology have yielded novel data on sensitization profiles and cross-reactivity. The role of indoor allergen exposures in allergic disease is complex and remains incompletely understood. Advancing our knowledge of various co-exposures, including the environmental and host microbiome, that interact with allergens in early life will be crucial for the development of efficacious interventions to reduce the substantial economic and social burden of allergic diseases including asthma.
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36
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Tsolakis N, Malinovschi A, Nordvall L, Mattsson L, Lidholm J, Pedroletti C, Janson C, Borres MP, Alving K. Sensitization to minor cat allergen components is associated with type-2 biomarkers in young asthmatics. Clin Exp Allergy 2018; 48:1186-1194. [PMID: 29575179 DOI: 10.1111/cea.13135] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Revised: 02/10/2018] [Accepted: 03/03/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Cat allergy is a major trigger of asthma world-wide. Molecular patterns of cat sensitization vary between individuals, but their relationship to inflammation in asthmatics has not been extensively studied. OBJECTIVE To investigate the prevalence and levels of IgE antibodies against different cat allergen components and their relationship to type-2 inflammation and total IgE among young asthmatic subjects sensitized to furry animals. METHODS Patients with asthma (age 10-35 years; n = 266) and IgE sensitization to cat, dog or horse extract (ImmunoCAP), were analysed for IgE to the cat allergen components Fel d 1 (secretoglobin), Fel d 2 (serum albumin), Fel d 4 and Fel d 7 (lipocalins). Independent associations between IgE-antibody concentrations, and fraction of exhaled nitric oxide (FeNO), blood eosinophil (B-Eos) count, and total IgE were analysed by multiple linear regression after adjustment for possible confounders. RESULTS The level of IgE against Fel d 2 was independently related to FeNO (P = .012) and total IgE (P < .001), and IgE against Fel d 4 associated with Β-Eos count (P = .009) and total IgE (P < .001). IgE antibodies against Fel d 1 or cat extract did not independently relate to these inflammatory markers (P = .23-.51). CONCLUSIONS Levels of IgE to lipocalin (Fel d 4) and serum albumin (Fel d 2), but not to secretoglobin (Fel d 1) or cat extract, were independently associated with type-2 biomarkers and total IgE in young asthmatics. CLINICAL RELEVANCE We suggest that measurement of IgE to minor cat allergen components may be useful when investigating asthma morbidity in cat allergic subjects.
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Affiliation(s)
- N Tsolakis
- Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - A Malinovschi
- Medical Sciences, Uppsala University, Uppsala, Sweden
| | - L Nordvall
- Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - L Mattsson
- Thermo Fisher Scientific, Uppsala, Sweden
| | - J Lidholm
- Thermo Fisher Scientific, Uppsala, Sweden
| | - C Pedroletti
- Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - C Janson
- Medical Sciences, Uppsala University, Uppsala, Sweden
| | - M P Borres
- Women's and Children's Health, Uppsala University, Uppsala, Sweden.,Thermo Fisher Scientific, Uppsala, Sweden
| | - K Alving
- Women's and Children's Health, Uppsala University, Uppsala, Sweden
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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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38
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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: 55] [Impact Index Per Article: 7.9] [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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39
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Salo PM, Wilkerson J, Rose KM, Cohn RD, Calatroni A, Mitchell HE, Sever ML, Gergen PJ, Thorne PS, Zeldin DC. Bedroom allergen exposures in US households. J Allergy Clin Immunol 2017; 141:1870-1879.e14. [PMID: 29198587 DOI: 10.1016/j.jaci.2017.08.033] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 08/16/2017] [Accepted: 08/28/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Bedroom allergen exposures contribute to allergic disease morbidity because people spend considerable time in bedrooms, where they come into close contact with allergen reservoirs. OBJECTIVE We investigated participant and housing characteristics, including sociodemographic, regional, and climatic factors, associated with bedroom allergen exposures in a nationally representative sample of the US population. METHODS Data were obtained from National Health and Nutrition Examination Survey 2005-2006. Information on participant and housing characteristics was collected by using questionnaires and environmental assessments. Concentrations of 8 indoor allergens (Alt a 1, Bla g 1, Can f 1, Fel d 1, Der f 1, Der p 1, Mus m 1, and Rat n 1) in dust vacuumed from nearly 7000 bedrooms were measured by using immunoassays. Exposure levels were classified as increased based on percentile (75th/90th) cutoffs. We estimated the burden of exposure to multiple allergens and used multivariable logistic regression to identify independent predictors for each allergen and household allergen burden. RESULTS Almost all participants (>99%) had at least 1 and 74.2% had 3 to 6 allergens detected. More than two thirds of participants (72.9%) had at least 1 allergen and 18.2% had 3 or more allergens exceeding increased levels. Although exposure variability showed significant racial/ethnic and regional differences, high exposure burden to multiple allergens was most consistently associated with the presence of pets and pests, living in mobile homes/trailers and older and rental homes, and living in nonmetropolitan areas. CONCLUSIONS Exposure to multiple allergens is common. Despite highly variable exposures, bedroom allergen burden is strongly associated with the presence of pets and pests.
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Affiliation(s)
- Päivi M Salo
- Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC
| | | | | | | | | | | | | | - Peter J Gergen
- Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - Peter S Thorne
- University of Iowa College of Public Health, Iowa City, Iowa
| | - Darryl C Zeldin
- Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC.
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40
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Burbank AJ, Sood AK, Kesic MJ, Peden DB, Hernandez ML. Environmental determinants of allergy and asthma in early life. J Allergy Clin Immunol 2017; 140:1-12. [PMID: 28673399 DOI: 10.1016/j.jaci.2017.05.010] [Citation(s) in RCA: 191] [Impact Index Per Article: 23.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Revised: 05/15/2017] [Accepted: 05/16/2017] [Indexed: 12/24/2022]
Abstract
Allergic disease prevalence has increased significantly in recent decades. Primary prevention efforts are being guided by study of the exposome (or collective environmental exposures beginning during the prenatal period) to identify modifiable factors that affect allergic disease risk. In this review we explore the evidence supporting a relationship between key components of the external exposome in the prenatal and early-life periods and their effect on atopy development focused on microbial, allergen, and air pollution exposures. The abundance and diversity of microbial exposures during the first months and years of life have been linked with risk of allergic sensitization and disease. Indoor environmental allergen exposure during early life can also affect disease development, depending on the allergen type, dose, and timing of exposure. Recent evidence supports the role of ambient air pollution in allergic disease inception. The lack of clarity in the literature surrounding the relationship between environment and atopy reflects the complex interplay between cumulative environmental factors and genetic susceptibility, such that no one factor dictates disease development in all subjects. Understanding the effect of the summation of environmental exposures throughout a child's development is needed to identify cost-effective interventions that reduce atopy risk in children.
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Affiliation(s)
- Allison J Burbank
- Center for Environmental Medicine, Asthma and Lung Biology, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Amika K Sood
- Center for Environmental Medicine, Asthma and Lung Biology, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Matthew J Kesic
- Center for Environmental Medicine, Asthma and Lung Biology, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - David B Peden
- Center for Environmental Medicine, Asthma and Lung Biology, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Michelle L Hernandez
- Center for Environmental Medicine, Asthma and Lung Biology, University of North Carolina at Chapel Hill, Chapel Hill, NC.
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Zahradnik E, Raulf M. Respiratory Allergens from Furred Mammals: Environmental and Occupational Exposure. Vet Sci 2017; 4:vetsci4030038. [PMID: 29056697 PMCID: PMC5644656 DOI: 10.3390/vetsci4030038] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 07/31/2017] [Accepted: 08/01/2017] [Indexed: 12/21/2022] Open
Abstract
Furry mammals kept as pets, farm and laboratory animals are important allergen sources. The prevalence of sensitization to furred mammals appears to be increasing worldwide. Several mammalian allergens from diverse species are well characterized with regard to their molecular structure and immunogenicity, and some are already available for component-resolved allergy diagnostics. The distribution of various mammalian allergens has been extensively studied during the past few decades. Animal allergens were found to be ubiquitous in the human environment, even in places where no animals reside, with concentrations differing considerably between locations and geographical regions. This review presents an overview of identified mammalian respiratory allergens classified according to protein families, and compiles the results of allergen exposure assessment studies conducted in different public and occupational environments.
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Affiliation(s)
- Eva Zahradnik
- Center of Allergology/Immunology, Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-Universität Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany.
| | - Monika Raulf
- Center of Allergology/Immunology, Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-Universität Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany.
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Abstract
Furry mammals kept as pets, farm and laboratory animals are important allergen sources. The prevalence of sensitization to furred mammals appears to be increasing worldwide. Several mammalian allergens from diverse species are well characterized with regard to their molecular structure and immunogenicity, and some are already available for component-resolved allergy diagnostics. The distribution of various mammalian allergens has been extensively studied during the past few decades. Animal allergens were found to be ubiquitous in the human environment, even in places where no animals reside, with concentrations differing considerably between locations and geographical regions. This review presents an overview of identified mammalian respiratory allergens classified according to protein families, and compiles the results of allergen exposure assessment studies conducted in different public and occupational environments.
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43
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Cox L. The role of allergen immunotherapy in the management of allergic rhinitis. Am J Rhinol Allergy 2016; 30:48-53. [PMID: 26867530 DOI: 10.2500/ajra.2016.30.4253] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate the role of allergen immunotherapy (AIT) in the treatment of allergic rhinitis (AR). METHOD Individual studies, systematic reviews, and practice guidelines that included information on sublingual AIT (SLIT) and subcutaneous AIT (SCIT) in the treatment of AR were considered. RESULTS AIT via the SLIT or SCIT route has been shown to be effective in treating AR symptoms with resultant improvements in overall quality of life, comorbid illnesses, and medication requirements. Persistent clinical benefits have been demonstrated years after AIT treatment discontinuation. AIT may prevent the progression of AR to asthma. In addition, studies that evaluated the pharmacoeconomics of AR treatment indicate that AIT may be more cost effective than pharmacotherapy. The AIT cost savings are likely underestimated in that few cost comparison studies considered AIT's long-term benefits or preventive effects. CONCLUSION Multiple individual studies and systematic reviews provide strong evidence for the clinical effectiveness of AIT in the treatment of AR. Cost-effectiveness and disease modification are additional advantages of AIT compared with standard drug treatment in the management of AR.
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Affiliation(s)
- Linda Cox
- Department of Medicine, Nova Southeastern University, Davie, Florida, USA
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Abstract
PURPOSE OF REVIEW The aim of the present review is to discuss updates on research regarding the relationship between indoor allergen exposure and childhood asthma with a focus on clinical effects, locations of exposure, and novel treatments. RECENT FINDINGS Recent data continue to demonstrate that early life sensitization to indoor allergens is a predictor of asthma development later in life. Furthermore, avoidance of exposure to these allergens continues to be important especially given that the vast majority of children with asthma are sensitized to at least one indoor allergen. New research suggests that mouse allergen, more so than cockroach allergen, may be the most relevant urban allergen. Recent evidence reminds us that children are exposed to clinically important levels of indoor allergens in locations away from their home, such as schools and daycare centers. Exposure to increased levels of indoor mold in childhood has been associated with asthma development and exacerbation of current asthma; however, emerging evidence suggests that early exposure to higher fungal diversity may actually be protective for asthma development. Novel treatments have been developed that target TH2 pathways thus decreasing asthmatic responses to allergens. These therapies show promise for the treatment of severe allergic asthma refractory to avoidance strategies and standard therapies. SUMMARY Understanding the relationship between indoor allergens and asthma outcomes is a constantly evolving study of timing, location, and amount of exposure.
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Scherer E, Valot B, Vacheyrou M, Naegele A, Knapp J, Rocchi S, Roussel S, Millon L, Reboux G. Assessment of pets (cats and dogs) in homes using electrostatic dust collectors and QPCR: new tools to evaluate exposure and risk of allergies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2016; 26:589-599. [PMID: 27557849 DOI: 10.1080/09603123.2016.1217316] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2015] [Accepted: 06/09/2016] [Indexed: 06/06/2023]
Abstract
Contradictory results are found in the literature concerning fungi, bacteria, and pet exposure and the risk of developing asthma. All these allergens have been thoroughly studied separately in cohort studies, and a variety of sampling and analytical methods are used. It is already possible to characterize fungi, mites, and bacteria by QPCR. The aim of our study is to evaluate QPCR systems to quantify the presence of cats and dogs in homes. Twenty-four houses were sampled with an Electrostatic Dust Collector which was analyzed by QPCR. Questionnaires on the presence of pets in homes were completed. The results from QPCR were correlated for real presence of cats and dogs, and highlighted indirect exposure. This study provides a useful screening tool that will be used in future large cohort studies, such as the ELFE cohort study.
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Affiliation(s)
- Emeline Scherer
- a Chrono-Environnement, UMR/CNRS 6249 , University of Bourgogne-Franche-Comté , Besançon , France
- b Department of Parasitology-Mycology , University Hospital of Besançon , Besançon , France
| | - Benoit Valot
- a Chrono-Environnement, UMR/CNRS 6249 , University of Bourgogne-Franche-Comté , Besançon , France
| | - Mallory Vacheyrou
- a Chrono-Environnement, UMR/CNRS 6249 , University of Bourgogne-Franche-Comté , Besançon , France
| | - Alexandre Naegele
- a Chrono-Environnement, UMR/CNRS 6249 , University of Bourgogne-Franche-Comté , Besançon , France
| | - Jenny Knapp
- a Chrono-Environnement, UMR/CNRS 6249 , University of Bourgogne-Franche-Comté , Besançon , France
| | - Steffi Rocchi
- a Chrono-Environnement, UMR/CNRS 6249 , University of Bourgogne-Franche-Comté , Besançon , France
- b Department of Parasitology-Mycology , University Hospital of Besançon , Besançon , France
| | - Sandrine Roussel
- a Chrono-Environnement, UMR/CNRS 6249 , University of Bourgogne-Franche-Comté , Besançon , France
- b Department of Parasitology-Mycology , University Hospital of Besançon , Besançon , France
| | - Laurence Millon
- a Chrono-Environnement, UMR/CNRS 6249 , University of Bourgogne-Franche-Comté , Besançon , France
- b Department of Parasitology-Mycology , University Hospital of Besançon , Besançon , France
| | - Gabriel Reboux
- a Chrono-Environnement, UMR/CNRS 6249 , University of Bourgogne-Franche-Comté , Besançon , France
- b Department of Parasitology-Mycology , University Hospital of Besançon , Besançon , France
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Ownby DR, Johnson CC. Dogs, cats, and asthma: Will we ever really know the true risks and benefits? J Allergy Clin Immunol 2016; 138:1591-1592. [PMID: 27670242 DOI: 10.1016/j.jaci.2016.08.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Accepted: 08/09/2016] [Indexed: 01/08/2023]
Affiliation(s)
- Dennis R Ownby
- Pediatrics, Medical College of Georgia at Augusta University, Augusta, Ga.
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Niesler A, Ścigała G, Łudzeń-Izbińska B. Cat (Fel d 1) and dog (Can f 1) allergen levels in cars, dwellings and schools. AEROBIOLOGIA 2016; 32:571-580. [PMID: 27616812 PMCID: PMC4996870 DOI: 10.1007/s10453-016-9433-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 03/01/2016] [Indexed: 06/06/2023]
Abstract
Pets are an important source of indoor allergens. The aim of the study was to compare cat and dog allergen levels in cars, schools and homes. The study was carried out in 17 cars, 14 classrooms and 19 dwellings located in the highly industrialized and urbanized region of Poland. Dust and air samples were analyzed for Fel d 1 and Can f 1 using a double monoclonal ELISA assay. The highest amounts of cat and dog allergens (Fel d 1: 1169 μg/g; Can f 1: 277 μg/g) were found in dwellings with pets. Allergen concentrations were correlated with the number of animals kept at home. Although concentrations on automobile seats were lower, Fel d 1 levels exceeded 8 μg/g in 23.5 % of cars and high levels of Can f 1 (>10 μg/g) were found in 17.6 % of cars. The study revealed that cars of pet owners may be reservoirs of cat and dog allergens even when animals are not transported in them. In schools, concentrations of pet allergens did not reach high levels, but the moderate levels of Fel d 1 (≥1-8 μg/g) and Can f 1 (≥2-10 μg/g) were detected in 42.9 and 7.1 % of the investigated classrooms. Concentrations of cat and dog allergen in schools were higher than in homes without pets. While airborne Fel d 1 and Can f 1 levels were found low, residential allergen concentrations in settled dust and air were correlated. The study results suggest that classrooms and cars of pet owners may be important sites of exposure to cat and dog allergens, though the highest concentrations of Fel d 1 and Can f 1 are found in homes of pet owners.
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Affiliation(s)
- A. Niesler
- Department of Biohazards and Immunoallergology, Institute of Occupational Medicine and Environmental Health, 13 Kościelna Street, 41-200 Sosnowiec, Poland
| | - G. Ścigała
- Department of Biohazards and Immunoallergology, Institute of Occupational Medicine and Environmental Health, 13 Kościelna Street, 41-200 Sosnowiec, Poland
| | - B. Łudzeń-Izbińska
- Department of Biohazards and Immunoallergology, Institute of Occupational Medicine and Environmental Health, 13 Kościelna Street, 41-200 Sosnowiec, Poland
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Nguyen NT, Raskopf E, Shah-Hosseini K, Zadoyan G, Mösges R. A review of allergoid immunotherapy: is cat allergy a suitable target? Immunotherapy 2016; 8:331-49. [PMID: 26860435 DOI: 10.2217/imt.15.121] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
To modify the course of allergy, different types of specific allergen immunotherapy have been developed such as sublingual immunotherapy and subcutaneous immunotherapy with native allergens or subcutaneous immunotherapy with polymerized allergoids. However, the optimal specific immunotherapy, especially for cat allergy, remains undetermined. Few studies investigating immunotherapy in cat allergy have been published, and the risk of serious adverse reactions and systemic reactions has often been an important issue. Monomeric allergoids have lower allergenic potential while their immunogenicity remains constant, resulting in excellent safety with notable efficacy. Specific immunotherapy with monomeric allergoids could, therefore, be of high value, especially in cat allergy as well as other types of allergy, and bring relief to a great community of patients.
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Affiliation(s)
- Nhung T Nguyen
- Institute of Medical Statistics, Informatics & Epidemiology (IMSIE), Faculty of Medicine, University of Cologne, Lindenburger Allee 42, 50931 Cologne, Germany
| | - Esther Raskopf
- Institute of Medical Statistics, Informatics & Epidemiology (IMSIE), Faculty of Medicine, University of Cologne, Lindenburger Allee 42, 50931 Cologne, Germany
| | - Kija Shah-Hosseini
- Institute of Medical Statistics, Informatics & Epidemiology (IMSIE), Faculty of Medicine, University of Cologne, Lindenburger Allee 42, 50931 Cologne, Germany
| | - Gregor Zadoyan
- Institute of Medical Statistics, Informatics & Epidemiology (IMSIE), Faculty of Medicine, University of Cologne, Lindenburger Allee 42, 50931 Cologne, Germany
| | - Ralph Mösges
- Institute of Medical Statistics, Informatics & Epidemiology (IMSIE), Faculty of Medicine, University of Cologne, Lindenburger Allee 42, 50931 Cologne, Germany
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Abstract
Allergic reactions to pets have been recognized for at least a hundred years. Yet our understanding of the effects of all of the interactions between pet exposures and human immune responses continues to grow. Allergists, epidemiologists, and immunologists have spent years trying to better understand how exposures to pet allergens lead to allergic sensitization (the production of allergen-specific immunoglobulin class E [IgE] antibodies) and subsequent allergic disease. A major new development in this understanding is the recognition that pet exposures consist of not only allergen exposures but also changes in microbial exposures. Exposures to certain pet-associated microbes, especially in the neonatal period, appear to be able to dramatically alter how a child’s immune system develops and this in turn reduces the risk of allergic sensitization and disease. An exciting challenge in the next few years will be to see whether these changes can be developed into a realistic preventative strategy with the expectation of significantly reducing allergic disease, especially asthma.
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