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Importance of indoor allergens in the induction of allergy and elicitation of allergic disease.

Custovic A, Simpson A, Woodcock A

Allergy. 1998;53( 48 Suppl):115-20.

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Abstract

During the last few decades, many countries have experienced an increase in the prevalence and severity of asthma.Over the same period, the population in the developed world has retreatedindoors, and homes have become better insulated and more energy efficient,resulting in a warm and humid environment with low ventilation rates,ideally suited to house-dust-mite population growth throughout the year.Increasing exposure and increasing sensitivity to indoor allergensrepresent a progressively higher risk factor for the development ofasthma. The development of sensitivity to indoor allergens and thesymptoms and severity of asthma in later childhood are directly related tothe exposure to allergens in infancy. It was relatively straightforward todemonstrate a quantitative linear dose-response relationship betweenexposure to house-dust-mite allergens and subsequent sensitization.However, showing the same for exposure and asthma severity has been moredifficult, as the relationship between exposure and asthma symptoms inalready sensitized individuals is much more complex than in the case ofexposure and sensitization. Nevertheless, sensitized individuals arelikely to have more severe asthma if exposed to high allergen levels thanif their level of exposure is low. Sensitization to house-dust mites is amajor independent risk factor for asthma in all areas where climate isconducive to mite population growth. The relevance of allergens other thatmite is not consistent between different areas, and depends on theclimate, habits, and socio-economic features of the local community. Itwould appear that presence of mite allergens in homes "overshadows" otherallergens (e.g., cat, dog, or cockroach) as a risk factor forsensitization and sub sequent development of allergic disease. It ispossible that this is the consequence of the difference in inherentpotency between allergen sources, and the question of why mite allergensare so potent in inducing sensitization and atopic disease remains to beanswered.

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Place of publication:
DENMARK
Volume:
53( 48 Suppl)
Start page:
115
End page:
20
Pagination:
115-20
Access state:
Active

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Record metadata

Manchester eScholar ID:
uk-ac-man-scw:1d10328
Created:
29th August, 2009, 15:34:26
Last modified:
29th September, 2015, 13:21:19

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