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Relationship between exposure to domestic allergens and bronchial hyperresponsiveness in non-sensitised, atopic asthmatic subjects.
Langley S, Goldthorpe S, Craven M, Woodcock AA, Custovic A
Thorax. 2005;60( 1):17-21.
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Abstract
BACKGROUND: The effect of exposure to allergens not causing sensitisation in atopic asthmatic subjects has not previously been studied.A study was undertaken to assess the degree of asthma severity (measuredby spirometry, airway reactivity and exhaled nitric oxide) in atopicasthmatic patients not sensitised to the domestic allergen to which theywere exposed. METHODS: Dust samples were collected from the living roomcarpet and mattress in the homes of 248 subjects and dust mite, cat anddog allergen concentrations were measured. Spirometry, non-specificbronchial reactivity (BR), and exhaled nitric oxide (eNO) wereascertained. Patients' sensitisation status was assessed by skin pricktesting. RESULTS: Adult atopic asthmatics not sensitised to mite butexposed to high levels of mite allergen had significantly more severe BRthan subjects not exposed to high levels of mite (PD(20), geometric mean(GM) 0.21 mg (95% CI 0.09 to 0.47) v 0.86 mg (95% CI 0.44 to 1.67), meanratio difference 4.1 (95% CI 1.5 to 11.4), p = 0.008). Subjects notsensitised but exposed to high levels of dog allergen also hadsignificantly more severe BR than subjects not exposed (PD(20) GM 0.16 v0.52 mg, mean ratio difference 3.3 (95% CI 1.2 to 9.2), p = 0.01). Thedifferences in BR between these groups were still significant afteradjusting for confounding factors. This effect of greater airwayreactivity was not seen in subjects exposed but not sensitised to catallergens. CONCLUSION: Atopic asthmatic subjects who are exposed to highlevels of dust mite or dog allergens but not sensitised to these allergenshave evidence of increased airway reactivity.