Christopher D Codispoti1, David I Bernstein2, Linda Levin3, Tiina Reponen3, Patrick H Ryan4, Jocelyn M Biagini Myers5, Manuel Villareal2, Jeff Burkle3, Zana Lummus2, James E Lockey6, Gurjit K Khurana Hershey7, Grace K LeMasters3. 1. Department of Internal Medicine, Divisions of Immunology/Allergy and Pulmonary Medicine, University of Cincinnati, Cincinnati, Ohio; Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio; Division of Immunology and Microbiology, Rush University Medical Center, Chicago, Illinois. Electronic address: Christopher_D_Codispoti@rush.edu. 2. Department of Internal Medicine, Divisions of Immunology/Allergy and Pulmonary Medicine, University of Cincinnati, Cincinnati, Ohio. 3. Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio. 4. Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio; Division of Asthma Research, Children's Hospital Medical Center, Rush University Medical Center, Chicago, Illinois. 5. Division of Immunology and Microbiology, Rush University Medical Center, Chicago, Illinois. 6. Department of Internal Medicine, Divisions of Immunology/Allergy and Pulmonary Medicine, University of Cincinnati, Cincinnati, Ohio; Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio. 7. Division of Asthma Research, Children's Hospital Medical Center, Rush University Medical Center, Chicago, Illinois.
Abstract
BACKGROUND: Nasal eosinophils are a biomarker for allergic rhinitis (AR) and are associated with increased symptom severity. OBJECTIVE: To identify predictors of allergic eosinophilic rhinitis (AER) in early childhood in children at higher risk for chronic allergic respiratory disorders. METHODS: In the Cincinnati Childhood Allergy and Air Pollution Study, infants born to aeroallergen-sensitized and symptomatic parents were examined and underwent skin prick testing (SPT) annually to 15 aeroallergens from 1 to 4 years of age. Wheal circumferences were traced and scanned and areas were determined by computer planimetry. At 4 years, AER was defined as (1) at least 1 positive aeroallergen SPT result, (2) presence of sneezing and runny nose without a cold or influenza, and (3) nasal eosinophilia of at least 5%. Wheal areas at 1 to 3 years were analyzed for an association with AER compared with children without AR. RESULTS: At 4 years, 487 children completed rhinitis health histories, SPT, and nasal sampling. Ninety-nine children (22.8%) had AR. Thirty-eight children had AER (8.8% of total sample and 38.4% of AR sample, respectively). At 3 years, for every 1-mm(2) increase in Penicillium species (adjusted odds ratio 1.18, 95% confidence interval 1.06-1.32, P = .002) and maple (adjusted odds ratio 1.07, 95% confidence interval 1.01-1.13, P = .02), wheal area significantly increased the risk of AER at 4 years of age. CONCLUSION: Allergic eosinophilic rhinitis was identified in 8.8% of children at 4 years of age. Age 3 years was the earliest that aeroallergen SPT wheal areas were predictive of AER. Skin testing at 3 years identifies children at risk for an AR phenotype with nasal eosinophilia.
BACKGROUND: Nasal eosinophils are a biomarker for allergic rhinitis (AR) and are associated with increased symptom severity. OBJECTIVE: To identify predictors of allergic eosinophilic rhinitis (AER) in early childhood in children at higher risk for chronic allergic respiratory disorders. METHODS: In the Cincinnati Childhood Allergy and Air Pollution Study, infants born to aeroallergen-sensitized and symptomatic parents were examined and underwent skin prick testing (SPT) annually to 15 aeroallergens from 1 to 4 years of age. Wheal circumferences were traced and scanned and areas were determined by computer planimetry. At 4 years, AER was defined as (1) at least 1 positive aeroallergen SPT result, (2) presence of sneezing and runny nose without a cold or influenza, and (3) nasal eosinophilia of at least 5%. Wheal areas at 1 to 3 years were analyzed for an association with AER compared with children without AR. RESULTS: At 4 years, 487 children completed rhinitis health histories, SPT, and nasal sampling. Ninety-nine children (22.8%) had AR. Thirty-eight children had AER (8.8% of total sample and 38.4% of AR sample, respectively). At 3 years, for every 1-mm(2) increase in Penicillium species (adjusted odds ratio 1.18, 95% confidence interval 1.06-1.32, P = .002) and maple (adjusted odds ratio 1.07, 95% confidence interval 1.01-1.13, P = .02), wheal area significantly increased the risk of AER at 4 years of age. CONCLUSION:Allergic eosinophilic rhinitis was identified in 8.8% of children at 4 years of age. Age 3 years was the earliest that aeroallergen SPT wheal areas were predictive of AER. Skin testing at 3 years identifies children at risk for an AR phenotype with nasal eosinophilia.
Authors: I Leonard Bernstein; James T Li; David I Bernstein; Robert Hamilton; Sheldon L Spector; Ricardo Tan; Scott Sicherer; David B K Golden; David A Khan; Richard A Nicklas; Jay M Portnoy; Joann Blessing-Moore; Linda Cox; David M Lang; John Oppenheimer; Christopher C Randolph; Diane E Schuller; Stephen A Tilles; Dana V Wallace; Estelle Levetin; Richard Weber Journal: Ann Allergy Asthma Immunol Date: 2008-03 Impact factor: 6.347
Authors: Patrick H Ryan; David I Bernstein; James Lockey; Tiina Reponen; Linda Levin; Sergey Grinshpun; Manuel Villareal; Gurjit K Khurana Hershey; Jeff Burkle; Grace LeMasters Journal: Am J Respir Crit Care Med Date: 2009-09-10 Impact factor: 21.405
Authors: Christopher D Codispoti; Linda Levin; Grace K LeMasters; Patrick Ryan; Tiina Reponen; Manuel Villareal; Jeff Burkle; Sherry Stanforth; James E Lockey; Gurjit K Khurana Hershey; David I Bernstein Journal: J Allergy Clin Immunol Date: 2010-04-14 Impact factor: 10.793
Authors: Rhoda Kagan; Doug Hayami; Lawrence Joseph; Yvan St Pierre; Ann E Clarke Journal: Ann Allergy Asthma Immunol Date: 2003-06 Impact factor: 6.347
Authors: Jennifer A Kannan; Cole Brokamp; David I Bernstein; Grace K LeMasters; Gurjit K Khurana Hershey; Manuel S Villareal; James E Lockey; Patrick H Ryan Journal: Pediatr Allergy Immunol Pulmonol Date: 2017-03-01 Impact factor: 1.349
Authors: Rebecca Gernes; Cole Brokamp; Glenn E Rice; J Michael Wright; Michelle C Kondo; Yvonne L Michael; Geoffrey H Donovan; Demetrios Gatziolis; David Bernstein; Grace K LeMasters; James E Lockey; Gurjit K Khurana Hershey; Patrick H Ryan Journal: Sci Total Environ Date: 2019-03-02 Impact factor: 7.963