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Indoor fungal diversity in primary schools may differently influence allergic sensitization and asthma in children
Author(s) -
Cavaleiro Rufo João,
Madureira Joana,
Paciência Inês,
Aguiar Lívia,
Pereira Cristiana,
Silva Diana,
Padrão Patrícia,
Moreira Pedro,
Delgado Luís,
AnnesiMaesano Isabella,
Oliveira Fernandes Eduardo,
Teixeira João Paulo,
Moreira André
Publication year - 2017
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.12704
Subject(s) - medicine , limulus amebocyte lysate , asthma , sensitization , exhaled nitric oxide , spirometry , allergy , immunology , atopy , environmental health , lipopolysaccharide
Background Childhood exposure to microbiologic agents may influence the development of allergic and respiratory diseases. Apart from home, children spend most of their time at school, which represents an environment of significant exposure to indoor air microbes. Therefore, we aimed to assess how the prevalence of allergic sensitization and asthma in schoolchildren is affected by microbiologic exposure within classrooms. Methods Spirometry with bronchodilation, exhaled nitric oxide measurements and skin‐prick tests data were retrieved from 858 children aged 8–10 years attending 71 classrooms in 20 primary schools. Air samples were collected in all classrooms using a single‐stage microbiologic air impactor through agar plates. Gram‐negative endotoxins were collected using flow control pumps and analysed by limulus amebocyte lysate assay. Diversity scores were established as the number of different fungal species found in each classroom. Results Classrooms with increased diversity scores showed a significantly lower prevalence of children with atopic sensitization, but not asthma. The risk of sensitization increased with increasing endotoxin exposure in classrooms. Similarly, significantly higher concentrations of Penicillium spp were found in classrooms with a higher number of children with atopic sensitization. Conclusions Although no causal relationships could be established, exposure to higher fungal diversity was protective against allergic sensitization but this was not seen for asthma. In contrast, higher exposure to Gram‐negative endotoxins and Penicillium spp in primary school′s classrooms was associated with increasing odds of allergic sensitization in children.