Family history, dust mite exposure in early childhood, and risk for pediatric atopy and asthma

• Published in: Journal of allergy and clinical immunology Vol. 114; no. 1; pp. 105 - 110
• Main Authors: Cole Johnson, Christine, Ownby, Dennis R, Havstad, Suzanne L, Peterson, Edward L
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.07.2004; Elsevier; Elsevier Limited
• Subjects: Age; Allergies; Allergy; Antigens, Dermatophagoides - immunology; Arthropod Proteins; Asthma; Asthma - etiology; Asthma - immunology; atopy; Biological and medical sciences; bronchial hyperreactivity; Child; Child, Preschool; children; Cohort Studies; Cysteine Endopeptidases; Dust; Environmental Exposure - adverse effects; Family; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Health maintenance organizations; HMOs; home allergen level; Housing; Humans; Hypersensitivity - etiology; Hypersensitivity - immunology; IgE; Immunopathology; Infant; Infant, Newborn; Male; Medical History Taking; Medical sciences; Outcome Assessment (Health Care); Population; Prospective Studies; Pyroglyphidae - immunology; Risk Factors; Skin; skin testing; Allergy; OR; children; IgE; home allergen level; atopy; asthma; skin testing; bronchial hyperreactivity; BHR; Pediatrics; Hyperreactivity; Mite; Respiratory system; Atopy; Respiratory tract; Family story; Immunology; Bronchus disease; Obstructive pulmonary disease; Child; Skin test; Human; Lung disease; Immunopathology; Respiratory disease; Exploration; Asthma; Dust; Risk factor; Allergen
• DOI: 10.1016/j.jaci.2004.04.007
• ISSN: 0091-6749

Dust mite allergen exposure is considered a major determinant of sensitization to these allergens during childhood and a risk factor for pediatric asthma. By using a birth cohort in a setting with a substantial burden of dust mite allergen, we evaluated exposure and risk for outcomes related to allergy and asthma. We collected dust from the bedrooms of 428 children born from 1987 to 1989 and measured Der f 1 and Der p 1 (μg/g dust, combined). Follow-up at 6 to 7 years of age included clinical examination, skin prick testing, specific serum IgE measurement, and methacholine challenge. No overall association was evident for any outcome except bronchial hyperresponsiveness (adjusted odds ratio [OR], 0.62; 95% CI, 0.38-1.00; P < .050; and OR, 0.53; CI, 0.27-1.04; P < .065 for dust mite allergen levels ≥2 μg/g and >10 μg/g, respectively). With a parental history of allergy and asthma, there was an association between a positive dust mite skin test (OR, 2.09; CI, 0.93-4.73; P < .076) and dust mite allergen level >10 μg/g. The inverse was true for children without a parental history. Dust mite exposure of >10 μg/g was associated with a decreased risk of current atopic asthma among children with a parental history (OR, 0.39; CI, 0.05-3.13; P < .376), but with increased risk if without a parental history (OR, 1.52; CI, 0.22-10.6; P < .673). Parental history is an important independent variable in the relationship between early dust mite exposure and atopic outcomes. Increased exposure during infancy is associated with a higher risk for sensitization in the presence of a positive parental history, but is protective among children of parents without a history of atopic disease.