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Severe childhood asthma and allergy to furry animals: Refined assessment using molecular‐based allergy diagnostics
Author(s) -
Konradsen Jon R.,
Nordlund Björn,
Onell Annica,
Borres Magnus P.,
Grönlund Hans,
Hedlin Gunilla
Publication year - 2014
Publication title -
pediatric allergy and immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.269
H-Index - 89
eISSN - 1399-3038
pISSN - 0905-6157
DOI - 10.1111/pai.12198
Subject(s) - medicine , asthma , allergy , sensitization , immunology , spirometry , immunoglobulin e , methacholine , budesonide , antibody , respiratory disease , lung
Background Allergy to cats and dogs and polysensitization towards these animals are associated with severe childhood asthma. Molecular‐based allergy diagnostics offers new opportunities for improved characterization and has been suggested to be particularly useful in patients with polysensitization and/or severe asthma. The aim was to use extract‐ and molecular‐based allergy diagnostics to compare patterns of IgE sensitization towards aeroallergens in children with problematic severe and controlled asthma. Methods Children with a positive ImmunoCAP towards any furry animal (cat, dog or horse) were recruited from a N ationwide S wedish study on severe childhood asthma. Severe (n = 37, age 13 years) and controlled (n = 28, age 14 years) asthmatics underwent assessment of allergic sensitization by ImmunoCap ( kU A /l) and immunosolid‐phase allergen chip (ISAC). In addition, Asthma Control Test, spirometry and a methacholine challenge were performed. Results Children with severe asthma had lower asthma control (p < 0.001) and FEV 1 (p = 0.001) and more bronchial hyper‐responsiveness (p = 0.008) in spite of high doses of inhaled steroids (≥800 μg budesonide). Children with severe asthma displayed higher levels of IgE antibodies towards cat (17 vs. 3.9, p = 0.027), dog (3.8 vs. 1.2, p = 0.012) and horse (7.4 vs. 0.7, p = 0.014). Sensitization towards Can f 2 (22% vs. 0%, p = 0.009) and Equ c 1 (51% vs. 25%, p = 0.03) was more common in severe asthma. IgE levels towards Equ c 1 correlated with asthma control ( r = −0.41, p = 0.04). Conclusion Children with severe allergic asthma had higher sIgE levels to cat, dog and horse. Molecular‐based allergy diagnostics revealed a more complex molecular spreading of allergen components in children with the most severe disease.