Furry animal allergen component sensitization and clinical outcomes in adult asthma and rhinitis

Publication date: Available online 27 December 2018

Source: The Journal of Allergy and Clinical Immunology: In Practice

Author(s): Bright I. Nwaru, Shintaro Suzuki, Linda Ekerljung, Sigrid Sjölander, Roxana Mincheva, Erik P. Rönmark, Madeleine Rådinger, Eva Rönmark, Magnus P. Borres, Bo Lundbäck, Jan Lötvall

Abstract

Background

Sensitization to allergen components has been linked to asthma in children, but studies in adults are lacking.

Objective

To study the relation of sensitization to furry animal allergen components to risk of asthma, rhinitis, and markers of asthma severity in adults.

Methods

From the West Sweden Asthma Study, a random population-representative sample of adults aged 16-75 years, 2006 participants were clinically examined; 1872 were analyzed for serum IgE to a mix of aeroallergens. Those with IgE>0.35 kU_A/L to cat, dog or horse were analyzed for specific cat (Fel d 1, Fel d 2, and Fel d 4), dog (Can f 1, Can f 2, Can f 3, and Can f 5), and horse (Equ c 1) allergen components. We defined mono-, double-, and poly-sensitization (>2 components) patterns and applied cluster analysis to derive distinct sensitization clusters.

Results

Sensitization to each allergen component, lipocalins, each sensitization pattern, and each sensitization cluster (non-sensitized, Fel d 1-driven sensitized, and multi-sensitized clusters) was associated with substantial increased risk of asthma, rhinitis, concomitant asthma/rhinitis, and ACT-controlled asthma. Fel d 1, Can f 1, 2, 3, poly-sensitization, and multi-sensitized cluster were further associated with increased FeNO and eosinophil levels, but with lower PD₂₀ methacoline values. There was no association with asthma exacerbations, FEV1 predicted values, emergency visits or regular oral steroid use, and neutrophil levels.

Conclusion

Sensitization to furry animal allergen components are important predictors of asthma, rhinitis and markers of asthma severity with increased blood eosinophils, FeNO, and airway hyper-reactivity.

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