High allergen exposure as a risk factor for asthma and allergic disease.

The association between pet ownership in childhood and subsequent asthma and sensitization is very controversial. Intriguing, but contradictory, reports have caused considerable uncertainty in parents who wish to avoid asthma and allergic disease in their children. This article argues that high allergen exposure is a risk factor for asthma and allergic disease. It describes dispersal of pet allergens in society and critically assesses epidemiological studies regarding how early exposure to pet allergens affects subsequent immunoglobulin E-sensitization and allergic diseases. Additionally, this article evaluates the effects of allergen exposure in already sensitized subjects with asthma. Cat and dog allergens are ubiquitous in society and may induce sensitization and allergic symptoms in predisposed individuals, regardless of pet ownership. This, in combination with selection mechanisms for pet ownership in families with a history of allergic diseases, makes it difficult to study associations between early exposure to pets and subsequent allergic disease. Nevertheless, exposure to pet allergens worsens asthma in already sensitized children. Thus, it is clear that clinicians should advise sensitized asthmatics that avoidance of exposure to indoor allergens is an important element in the treatment of allergic disease.