High titers of IgE antibody to dust mite allergen and risk for wheezing among asthmatic children infected with rhinovirus - 31/05/12
Corresponding author: Peter W. Heymann, MD, Pediatric Respiratory Medicine, University of Virginia School of Medicine, PO Box 800386, Charlottesville, VA 22908-0386.Abstract |
Background |
The relevance of allergic sensitization, as judged by titers of serum IgE antibodies, to the risk of an asthma exacerbation caused by rhinovirus is unclear.
Objective |
We sought to examine the prevalence of rhinovirus infections in relation to the atopic status of children treated for wheezing in Costa Rica, a country with an increased asthma burden.
Methods |
The children enrolled (n = 287) were 7 through 12 years old. They included 96 with acute wheezing, 65 with stable asthma, and 126 nonasthmatic control subjects. PCR methods, including gene sequencing to identify rhinovirus strains, were used to identify viral pathogens in nasal washes. Results were examined in relation to wheezing, IgE, allergen-specific IgE antibody, and fraction of exhaled nitric oxide levels.
Results |
Sixty-four percent of wheezing children compared with 13% of children with stable asthma and 13% of nonasthmatic control subjects had positive test results for rhinovirus (P < .001 for both comparisons). Among wheezing subjects, 75% of the rhinoviruses detected were group C strains. High titers of IgE antibodies to dust mite allergen (especially Dermatophagoides species) were common and correlated significantly with total IgE and fraction of exhaled nitric oxide levels. The greatest risk for wheezing was observed among children with titers of IgE antibodies to dust mite of 17.5 IU/mL or greater who tested positive for rhinovirus (odds ratio for wheezing, 31.5; 95% CI, 8.3-108; P < .001).
Conclusions |
High titers of IgE antibody to dust mite allergen were common and significantly increased the risk for acute wheezing provoked by rhinovirus among asthmatic children.
Le texte complet de cet article est disponible en PDF.Key words : Acute asthma, dust mite–specific IgE, emergency department visits, viral respiratory tract infections, rhinovirus strain C, total serum IgE, inhaled allergens, exhaled nitric oxide
Abbreviations used : ED, ETS, Feno, GM, ICAM-1, RSV
Plan
| Supported by the Cove Point Foundation, National Institutes of Health grants R01 AI020565 and U19 AI070364, and the University of Virginia Children’s Hospital Research Fund. |
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| Disclosure of potential conflict of interest: T. A. E. Platts-Mills has consultant arrangements with IBT/Viracor Labs and has received research support and honorarium from Phadia/Thermo Fisher. J. W. Steinke has received payment as a Board Review Course Speaker for the American Academy of Allergy, Asthma & Immunology; has received research support from the National Institutes of Health and Medtronic; and is the AIR Committee Chair for the American Academy of Allergy, Asthma & Immunology. J. Kennedy has received research support from the National Institutes of Health and the University of Virginia. P. W. Heymann has received research support from the National Institutes of Health, the Cove Point Foundation, and the University of Virginia Children’s Hospital. The rest of the authors declare that they have no relevant conflicts of interest. |
Vol 129 - N° 6
P. 1499 - juin 2012 Retour au numéro
Article précédent
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