A Prospective Study of Fel d1 and Der p1 Exposure in Infancy and Childhood Wheezing
Sarah Polk,
Jordi Sunyer,
Laura Muñoz-Ortiz,
Maria Barnes,
Maties Torrent,
Cecilia Figueroa,
Jessica Harris,
Oriol Vall,
Josep M. Antó and
Paul Cullinan
Unitat Recerca Respiratòria i Ambietal, Institut Municipal Investigació Mèdica; Universitat Pompeu Fabra; Pediatrics Service, Hospital del Mar, Barcelona; Area de Salud de Menorca, IB-SALUT, Menorca, Spain; and Department of Occupational and Environmental Medicine, Imperial College, London, United Kingdom
Correspondence and requests for reprints should be addressed to Jordi Sunyer, M.D., Institut Municipal Investigació Mèdica—Environmental Respiratory Research Unit, Institut Municipal d'Investigació Mèdica, C. Doctor Aiguader 80, 08003 Barcelona, Spain. E-mail: jsunyer{at}imim.es
The impact of domestic exposure to cat allergen (Fel d1) andhouse dust mite (Der p1) on wheezing from birth to the age of4 years was investigated in a multicenter prospective birthcohort; 1,611 mothers were recruited before delivery in Ashford,England, and Barcelona and Menorca, Spain. Exposures were gatheredvia dust sample collection at children's home in their firstyear of life. Families provided complete outcome data (wheezingstatus in all 4 years) for 1,289 children. Domestic allergenlevels varied substantially between centers. Six hundred three(47%) children never wheezed during their first 4 years of life.Der p1 did not correlate with any type of wheezing outcome.Fel d1 significantly increased the risk of wheezing in 3- and4-year-olds in comparison to 1-year-olds. Distinct risk profileswere found for wheezing at different ages. Multivariate analysisrevealed an interaction between Fel d1 and maternal asthma amongchildren who wheeze in Year 4 (relative risk = 2.77; 95% confidenceinterval = 1.19–6.46). Our data support the idea thatseveral patterns of wheezing with different risk profiles existamong young children. The effect of Fel d1 exposure varied accordingto age and maternal asthma.
Key Words: allergens cohort • infants • wheezing
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