Sensitization to tropomyosin from shrimp and Anysakis simplex was observed in ... bee venom, sesame and grass pollen was found in 10%-20% of the patients;.
AB166 Abstracts
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The Role of Seasonal Grass Pollen on Childhood Asthma Emergency Department Presentations B. Erbas1, M. Akram2, S. Dharmage3, R. Tham4, M. Dennekamp5, E. Newbigin3, P. Taylor6, M. Tang7, M. J. Abramson2; 1La Trobe University, Melbourne, AUSTRALIA, 2Monash University, Melbourne, AUSTRALIA, 3The University of Melbourne, Melbourne, AUSTRALIA, 4 Monash University, Bendigo, AUSTRALIA, 5Monash, Melbourne, AUSTRALIA, 6Deakin University, Melbourne, AUSTRALIA, 7The Royal Children’s Hospital, Melbourne, AUSTRALIA. RATIONALE: Identifying high grass pollen days is important for asthma management programs that issue warnings to patients who are at an increased risk of an asthma attack due to grass pollen exposure. We sought to examine the association between increasing ambient concentrations of grass pollen and asthma Emergency Department (ED) presentations in children during the 2003 grass pollen season in Melbourne, Victoria; and whether there was any added influence from thunderstorms. METHODS: A short time series ecological study was conducted of ED presentations for asthma in children in Melbourne, Victoria and grass pollen, meteorological and air quality measurements recorded during the selected 2003 period. A semi-parametric Poisson regression model was used to examine the dose-response associations between daily grass pollen levels and mean daily ED attendances for asthma among children. RESULTS: A smoothed plot suggested a dose-response association - as ambient grass pollen increased to about 19 grains/m3 the same day risk of childhood ED presentations also increased (p < 0.001). Grass pollen levels were also associated with an increased risk in asthma ED presentations on the following day (lag 1, p < 0.001). CONCLUSIONS: This is the first study to establish a clear relationship between increased risk of childhood asthma ED attendance and increasing levels of ambient grass pollen below 20 grains/m3, independent of thunderstorm-associated asthma. Lower levels of pollen may contribute to asthma symptoms, so the limits of the pollen season may need to be reviewed and this in turn could affect the timing of immunotherapy.
MONDAY
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Bronchial Asthma in urban Malagasy Children: The VAVANYStudy P. T. Wolff1, L. Arison2, A. Rahasamiakatra2, F. Raserisaona2, B. Niggemann3; 1Pediatric Practice, Pfullendorf, GERMANY, 2Clinique MM 24/ 24 Mpitsabo Mikambana, Antananarivo, MADAGASCAR, 3German Red Cross Hospital Westend, Berlin, GERMANY. RATIONALE: As in other African countries, pneumonia is a leading cause of death for Malagasy children. Bronchial asthma may be an underestimated factor related to this disease. We performed a crosssectional study in Antananarivo, Madagascar’s capital, investigating the prevalence of asthma. METHODS: Using spirometry and a survey based on the ISAAC study questionnaire, we consecutively collected data from 1,236 children aged 615 years at 3 public and 5 private schools. Of those, 1,093 children had a valid lung function measurement. RESULTS: Average age of all children was 10 years (SD 1.7), 51% were female. BMIs were low with a mean of 15.9 (SD 3.0) with striking differences ranging from 13.9 (public schools) to 18.2 (private schools). Children with a greater number of older siblings showed less wheezing (OR 0.76, 95%CI (0.60-0.97), p5 0.036). Other factors such as gender, BMI, school type, smoking at home and means of cooking (charcoal in 90% of households) did not significantly contribute to asthma symptoms. While 9.2% of study participants reported wheezing in the last 12 months, the percentage with asthma symptoms ever was 25%. Asthma prevalence _ 12%) was (change in FEV1 in the Bronchodilator Responsiveness (BDR) > 8.5% for the two schools in which BDR measurements were taken. CONCLUSIONS: Bronchial asthma is a substantial health problem in children living in Antananarivo to an extent that was not reported in an African country so far. The hygiene hypothesis was supported showing that the number of older siblings was beneficial even in the city’s critical sanitary conditions.
J ALLERGY CLIN IMMUNOL FEBRUARY 2012
628
Triclosan, a Common Ingredient in Household Products, is Associated With Allergic Sensitization J. H. Savage, E. C. Matsui, R. A. Wood, C. A. Keet; Johns Hopkins Hospital, Baltimore, MD. RATIONALE: Environmental phenols are endocrine-disrupting compounds with reported immune-modulating effects. We were interested in determining their association with allergen sensitization. METHODS: Data were obtained from the 2005-2006 National Health and Nutrition Examination Survey in which urinary triclosan, 4-tert-octophenyl, bisphenol-A, total IgE, and specific IgE were available on 985 children aged 6-18 years. Aeroallergen and food sensitization were defined as having at least one positive (>0.35 kU/L) specific IgE to an aeroallergen or a food. Logistic regression was used to determine the association of environmental phenols and odds of sensitization. Analyses were adjusted for urinary creatinine, age, ethnicity, and poverty index ratio. RESULTS: The odds of aeroallergen sensitization significantly increased with elevated urinary triclosan levels (OR for 3rd tertile compared to 1st tertile 1.7, p50.02). The odds of food sensitization was significantly increased in the highest tertile of urinary triclosan (OR for 3rd tertile compared to 1st tertile 3.2, p50.03) among male subjects. There was a significant interaction between gender and triclosan, with males being more likely to be food sensitized with triclosan exposure (p50.07). Similar associations were not identified for levels of 4-tert-octophenol or bisphenol A (p>0.2). CONCLUSIONS: As a group, environmental phenols are not associated with allergen sensitization. However, urinary levels of triclosan, a common ingredient in products such as hand sanitizers and mouthwash, were significantly associated with sensitization to aeroallergens and foods. While this may be due to its endocrine effects, it may rather be related to its anti-microbial actions, providing support for the hygiene hypothesis from a nationally representative population sample.
629
Microarray Analysis of IgE Reactivity in Patients with Asthma and/or Rhinitis Allergic to Cockroach and Mites: Clinical Application G. A. Bardini1, A. S. Moreno1, A. C. A. F. Santos1, K. S. Santos2, L. Arruda1; 1School of Medicine of Ribeirao Preto, Ribeirao Preto, BRAZIL, 2 School of Medicine - University of Sao Paulo, Sao Paulo, BRAZIL. RATIONALE: Microarray technology may improve diagnosis of allergy by making it possible to identify disease-causing allergens. We sought to investigate the IgE reactivity profiles in a panel of patients allergic to cockroach and mites by microarray. METHODS: Fifty-one patients with asthma and/or rhinitis, aged 12 to 75years-old, were selected based on presence of positive skin tests to cockroach and mites. ISAC was carried out and IgE profiles were analyzed. RESULTS: IgE reactivity to mite allergens Der p 1,Der p 2,Der f 1,Der f 2,Eur m 2 and Der p 10(mite tropomyosin) was 71%,75%,71%,75%,41% and 51%, respectively. IgE to Bla g 1, Bla g 2 and Bla g 4 was observed in 1 patient each (2%), and to Bla g 5 in two patients (4%). On the other hand, IgE to Bla g 7(cockroach tropomyosin) was found in 26/51 (51%) of the patients. Sensitization to tropomyosin from shrimp and Anysakis simplex was observed in 47% and 53% of the patients, respectively. IgE to cat, bee venom, sesame and grass pollen was found in 10%-20% of the patients; IgE to all other allergens was detected in less than 10% of the patients. No IgE reactivity was detected in 8/9 non-allergic control individuals; only one had detectable IgE to Ole e 2. CONCLUSIONS: Microarray analysis was helpful to define IgE reactivity profiles. More that 70% of our patients showed reactivity to the major group 1 and 2 allergens. The results confirmed that tropomyosin is a major pan-allergen among patients with asthma and/or rhinitis in Brazil.
