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Cited by 74Asthma and respiratory diseasesAllergic Rhinitis and SensitizationOccupational exposure and asthma

Relationship between exposure to domestic allergens and bronchial hyperresponsiveness in non-sensitised, atopic asthmatic subjects

Open access
Langley, S J·2005·Thorax
DOI 10.1136/thx.2004.027839PMC PMC1747172
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Abstract

BACKGROUND: The effect of exposure to allergens not causing sensitisation in atopic asthmatic subjects has not previously been studied. A study was undertaken to assess the degree of asthma severity (measured by spirometry, airway reactivity and exhaled nitric oxide) in atopic asthmatic patients not sensitised to the domestic allergen to which they were exposed. METHODS: Dust samples were collected from the living room carpet and mattress in the homes of 248 subjects and dust mite, cat and dog allergen concentrations were measured. Spirometry, non-specific bronchial reactivity (BR), and exhaled nitric oxide (eNO) were ascertained. Patients' sensitisation status was assessed by skin prick testing. RESULTS: Adult atopic asthmatics not sensitised to mite but exposed to high levels of mite allergen had significantly more severe BR than subjects not exposed to high levels of mite (PD(20), geometric mean (GM) 0.21 mg (95% CI 0.09 to 0.47) v 0.86 mg (95% CI 0.44 to 1.67), mean ratio difference 4.1 (95% CI 1.5 to 11.4), p=0.008). Subjects not sensitised but exposed to high levels of dog allergen also had significantly more severe BR than subjects not exposed (PD20 GM 0.16 v 0.52 mg, mean ratio difference 3.3 (95% CI 1.2 to 9.2), p=0.01). The differences in BR between these groups were still significant after adjusting for confounding factors. This effect of greater airway reactivity was not seen in subjects exposed but not sensitised to cat allergens. CONCLUSION: Atopic asthmatic subjects who are exposed to high levels of dust mite or dog allergens but not sensitised to these allergens have evidence of increased airway reactivity.

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  • Despite interventions and treatments aimed at addressing modifiable factors and comorbidities, some children with difficult asthma and Asthma plus may not improve because of continued poor adherence with medications or ongoing high exposure to allergens, in which case they should be considered as having refractory difficult asthma or refractory Asthma plus.

    “However, despite interventions and treatments aimed at addressing modifiable factors and comorbidities, some children with DA and Asthma plus may not improve [e.g., because of the continued poor adherence with medications (50, 68), or ongoing high exposure to allergens (69–71)], in which case they should be considered as having refractory DA or refractory Asthma plus (46, 72).”

    From Epidemiology of Asthma in Children and Adults (2019) · cites this paper as [70]

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Research works printed but not linked: 2

  1. Chapman MD, Woodfolk JA, Heyman PW. Cat allergy. Ann Allergy 1992;69:273-5.
  2. King C, Brennan S, Thompson PJ, et al. Dust mite proteolytic allergens induce cytokine release from cultured airway epithelium. J Immunol 1998;161:3645-51.

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Authors
Langley, S. J.
Affiliations
Wythenshawe Hospital (GB)
Corresponding author
Langley, S J
Venue
Thorax
Publisher
BMJ
Published
2005-01-01
Volume
60
Issue
1
Pages
17-21
ISSN
0040-6376 (ISSN-L)
DOI
10.1136/thx.2004.027839
PMC
PMC1747172
OpenAlex
W2097512862
Cited by
74
References
34
Citations by year
2026: 1 · 2023: 2 · 2022: 4 · 2021: 1 · 2020: 1 · 2019: 3 · 2018: 1 · 2017: 1 · 2016: 4 · 2015: 5 · 2014: 5 · 2013: 3 · 2012: 8
FWCI
1.64
Type
journal article
Language
en
Open access
Locations
  • Thorax (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • HighWire Press Open Archive (submittedVersion)
  • Research Explorer (The University of Manchester) (submittedVersion)
Topics
  • Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
  • Health Sciences › Medicine › Immunology and Allergy › Allergic Rhinitis and Sensitization
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Occupational exposure and asthma
Keywords
allergic asthma, airway hyperresponsiveness, house dust mite allergens, dog allergen, cat allergen, house dust, airway reactivity, exhaled nitric oxide, asthma severity, allergen exposure
MeSH terms
Adolescent, Adult, Aged, Allergens, Analysis of Variance, Animals, Asthma, Breath Tests, Child, Dogs, Dust, Environmental Exposure, Female, Forced Expiratory Volume, Humans, Male, Middle Aged, Nitric Oxide, Skin Tests, Vital Capacity, Bronchial Hyperreactivity, Dermatophagoides pteronyssinus

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