Torie Grant1, Charles Aloe1, Matthew Perzanowski2, Wanda Phipatanakul3, Mary E Bollinger4, Rachel Miller5, Elizabeth C Matsui6. 1. Division of Pediatric Allergy/Immunology, Johns Hopkins School of Medicine, Baltimore, Md. 2. Department of Environmental Health Sciences, Columbia University, New York, NY. 3. Division of Pediatric Allergy/Immunology, Boston Children's Hospital, Harvard Medical School, Boston, Mass. 4. Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Md. 5. Department of Environmental Health Sciences, Columbia University, New York, NY; Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, Columbia University, New York, NY. 6. Division of Pediatric Allergy/Immunology, Johns Hopkins School of Medicine, Baltimore, Md. Electronic address: ematsui@jhmi.edu.
Abstract
BACKGROUND: Mouse sensitization and exposure are associated with uncontrolled asthma, but whether they are associated with asthma severity, an intrinsic disease characteristic and long-term outcome predictor, is unclear. OBJECTIVE: To examine relationships between mouse sensitization and/or exposure and asthma severity in urban children. METHODS: A total of 645 children (5-17 years) with uncontrolled asthma underwent mouse sensitization evaluation. Sensitized children had mouse allergen measured in bedroom dust. Relationships between mouse sensitization, allergen levels, and asthma severity measures (treatment step and Composite Asthma Severity Index [CASI]) were examined using regression models adjusted for age, sex, atopy, study site, race, ethnicity, and insurance. RESULTS: The study population was predominantly minority (69.6% black, 20.8% Hispanic), low income (61.8%), and mouse sensitized (54.4%). Mean ± SD treatment step was 3.2 ± 1.6, equivalent to medium-dose inhaled corticosteroid. Mean ± SD CASI was 6.5 ± 3.4, reflecting moderate persistent asthma. Mouse sensitization was associated with higher treatment step (3.5 vs 2.9, mouse-sensitized vs nonsensitized, P < .001), independent of potential confounders (β [95% CI], 0.36 [0.07-0.64]; P = .01). Mouse sensitization was associated independently with CASI (β [95% CI], 0.82 [0.16-1.47]; P = .02). Among mouse-sensitized participants, higher bedroom floor and bed Mus m 1 were independently associated with treatment step (β [95% CI], 0.26 [0.09-0.43]; P = .002 and β [95% CI], 0.22 [0.01-0.43]; P = .04), respectively. Higher bedroom floor Mus m 1 was independently associated with CASI (β [95% CI], 0.43 [0.05-0.81]; P = .03). CONCLUSIONS: Mouse sensitization and exposure are associated with asthma severity, among low-income, minority children. Further studies are needed to determine whether reducing allergen exposure among mouse-sensitized patients with asthma can reduce severity, ultimately altering childhood asthma natural history.
BACKGROUND:Mouse sensitization and exposure are associated with uncontrolled asthma, but whether they are associated with asthma severity, an intrinsic disease characteristic and long-term outcome predictor, is unclear. OBJECTIVE: To examine relationships between mouse sensitization and/or exposure and asthma severity in urban children. METHODS: A total of 645 children (5-17 years) with uncontrolled asthma underwent mouse sensitization evaluation. Sensitized children had mouse allergen measured in bedroom dust. Relationships between mouse sensitization, allergen levels, and asthma severity measures (treatment step and Composite Asthma Severity Index [CASI]) were examined using regression models adjusted for age, sex, atopy, study site, race, ethnicity, and insurance. RESULTS: The study population was predominantly minority (69.6% black, 20.8% Hispanic), low income (61.8%), and mouse sensitized (54.4%). Mean ± SD treatment step was 3.2 ± 1.6, equivalent to medium-dose inhaled corticosteroid. Mean ± SD CASI was 6.5 ± 3.4, reflecting moderate persistent asthma. Mouse sensitization was associated with higher treatment step (3.5 vs 2.9, mouse-sensitized vs nonsensitized, P < .001), independent of potential confounders (β [95% CI], 0.36 [0.07-0.64]; P = .01). Mouse sensitization was associated independently with CASI (β [95% CI], 0.82 [0.16-1.47]; P = .02). Among mouse-sensitized participants, higher bedroom floor and bed Mus m 1 were independently associated with treatment step (β [95% CI], 0.26 [0.09-0.43]; P = .002 and β [95% CI], 0.22 [0.01-0.43]; P = .04), respectively. Higher bedroom floor Mus m 1 was independently associated with CASI (β [95% CI], 0.43 [0.05-0.81]; P = .03). CONCLUSIONS:Mouse sensitization and exposure are associated with asthma severity, among low-income, minority children. Further studies are needed to determine whether reducing allergen exposure among mouse-sensitized patients with asthma can reduce severity, ultimately altering childhood asthma natural history.
Authors: Elizabeth C Matsui; Peyton A Eggleston; Timothy J Buckley; Jerry A Krishnan; Patrick N Breysse; Cynthia S Rand; Gregory B Diette Journal: Ann Allergy Asthma Immunol Date: 2006-10 Impact factor: 6.347
Authors: R A Wood; P A Eggleston; P Lind; L Ingemann; B Schwartz; S Graveson; D Terry; B Wheeler; N F Adkinson Journal: Am Rev Respir Dis Date: 1988-02
Authors: Susan L Limb; Kathryn C Brown; Robert A Wood; Robert A Wise; Peyton A Eggleston; James Tonascia; N Franklin Adkinson Journal: J Allergy Clin Immunol Date: 2005-11-02 Impact factor: 10.793
Authors: Susan V Lynch; Robert A Wood; Homer Boushey; Leonard B Bacharier; Gordon R Bloomberg; Meyer Kattan; George T O'Connor; Megan T Sandel; Agustin Calatroni; Elizabeth Matsui; Christine C Johnson; Henry Lynn; Cynthia M Visness; Katy F Jaffee; Peter J Gergen; Diane R Gold; Rosalind J Wright; Kei Fujimura; Marcus Rauch; William W Busse; James E Gern Journal: J Allergy Clin Immunol Date: 2014-06-04 Impact factor: 10.793
Authors: Patrick N Breysse; Timothy J Buckley; D'Ann Williams; Christopher M Beck; Seong-Joon Jo; Barry Merriman; Sukon Kanchanaraksa; Lee J Swartz; Karen A Callahan; Arlene M Butz; Cynthia S Rand; Gregory B Diette; Jerry A Krishnan; Adrian M Moseley; Jean Curtin-Brosnan; Nowella B Durkin; Peyton A Eggleston Journal: Environ Res Date: 2005-06 Impact factor: 6.498
Authors: Jacqueline A Pongracic; Cynthia M Visness; Rebecca S Gruchalla; Richard Evans; Herman E Mitchell Journal: Ann Allergy Asthma Immunol Date: 2008-07 Impact factor: 6.347
Authors: Torie Grant; Ana M Rule; Kirsten Koehler; Robert A Wood; Elizabeth C Matsui Journal: Curr Allergy Asthma Rep Date: 2019-02-12 Impact factor: 4.806
Authors: Anna Pomés; Geoffrey A Mueller; Thomas A Randall; Martin D Chapman; L Karla Arruda Journal: Curr Allergy Asthma Rep Date: 2017-04 Impact factor: 4.806