Current indoor allergen levels of fungi and cats, but not house dust
mites, influence allergy and asthma in adults with high dust mite
S, Bailey M, Raven J, Mitakakis T, Cheng A, Guest D, Rolland J, Forbes
A, Thien F, Abramson M, Walters EH. . American Journal of Respiratory
and Critical Care Medicine. July, 2001; 164(1):65-71.
Purpose: The authors investigated the influence of indoor levels
of fungi, dust, and cat allergen on sensitization and asthma in adults.
Design: Two-phase sampling from European Community Respiratory
Health Survey ("ECRHS") cohort study. Data were collected using
questionnaires, skin prick tests, and lung function tests. Bedroom dust
and air samples were analyzed for dust mite allergen, cat allergen, and
fungal colony forming units ("CFU") per cubic meter of air. Fungi also
were assessed indirectly using ergosterol levels. Controls consisted of
survey participants that did not have current asthma, bronchial
hyper-reactivity, or wheezing.
Outcome: A total of 485 subjects responded to the questionnaire
and had clinical tests conducted. Three quarters of the subjects were
exposed to allergen levels higher than the levels proposed by the
American Academy of Allergy, Asthma and Immunology. They also found high
levels of fungi in the air of half the homes studied. High levels of
total airborne fungi were actually associated with decreased
sensitization to fungi. On the other hand, the risk of bronchial
hyperactivity was significantly greater in subjects with high total
fungal levels compared to the group with the lowest fungal levels.
Higher levels of cat allergen exposure led to increased clinical
activity of asthma and sensitization in young adults; however, high
levels of house dust mite allergen levels seemed to have no direct
correlation with the presence of asthmatic symptoms.
Significant Quotes: "High Fel d [cat allergen] 1 levels in floor
dust were found to increase the risk of current asthma. Although Der p
[house dust mite allergen] 1 levels in homes were high, people exposed
to high Der p 1 levels in floor dust were less likely to be sensitized
to house dust mites or to have wheezed within the past year." (p. 65).
"Our findings on the influence of ergosterol on sensitization to fungi
and clinical activity of asthma are novel." (p. 71).
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