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Published ahead of print on April 29, 2004, doi:10.1164/rccm.200310-1348OC

Am. J. Respir. Crit. Care Med., Volume 170, Number 3, August 2004, 273-278

A more recent version of this article appeared on August 1, 2004
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Submitted on October 1, 2003
Accepted on April 28, 2004

A Prospective Study of Fel d1 and Der p1 Exposure in Infancy and Childhood Wheezing

Sarah Polk1, Jordi Sunyer2*, Laura Munoz-Ortiz1, Maria Barnes3, Maties Torrent4, Cecilia Figueroa5, Jessica Harris3, Oriol Vall5, Josep M Anto2, and Paul Cullinan3

1 Unitat Recerca Respiratoria i Ambiental, Institut Municipal Investigacio Medica, Barcelona, Catalonia, Spain, 2 Unitat Recerca Respiratoria i Ambiental, Institut Municipal Investigacio Medica, Barcelona, Catalonia, Spain; Departament de Ciencies Experimentals i de la Salud, Universitat Pompeu Fabra, Barcelona, Catalonia, Spain, 3 Department of Occupational and Environmental Medicine, Imperial College, London, England, United Kingdom, 4 Area de Salud de Menorca, IB-SALUT, Menorca, Spain, 5 Pediatrics Service, Hospital del Mar, Barcelona, Catalonia, Spain

* To whom correspondence should be addressed. E-mail: jsunyer{at}imim.es.

The impact of domestic exposure to cat allergen (Fel d1) and house dust mite (Der p1) on wheezing from birth to age 4 was investigated in a multi-center prospective birth cohort. 1611 mothers were recruited prior to delivery in Ashford, England and Barcelona and Menorca, Spain. Exposures were gathered via dust sample collection at children's home in their first year of life. Families provided complete outcome data (wheezing status in all four years) for 1289 children. Domestic allergen levels varied substantially between centers. 603(47%) children never wheezed during their first four years of life. Der p1 did not correlate with any type of wheezing outcome. Fel d1 significantly increased the risk of wheezing in 3 and 4 year olds in comparison to one year olds. Distinct risk profiles were found for wheezing at different ages. Multivariate analysis revealed an interaction between Fel d1 and maternal asthma among children who wheeze in year 4 (RR= 2.77; 95% CI = 1.19-6.46). Our data support the idea that several patterns of wheezing with different risk profiles exist among young children. The effect of Fel d1 exposure varied according to age and maternal asthma.
Key words: Allergens Cohort, Infants, Wheezing




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