Published ahead of print on April 19, 2007, doi:10.1164/rccm.200612-1840OC Am. J. Respir. Crit. Care Med., Volume 176, Number 1, July 2007, 20-26 A more recent version of this article appeared on July 1, 2007
Submitted on December 19, 2006 Bronchial Responsiveness in Atopic Adults Increases with Exposure to Cat AllergenSusan Chinn1*,1 Respiratory Epidemiology and Public Health Group, National Heart and Lung Institute, Imperial College London, London, United Kingdom; Division of Asthma, Allergy and Lung Biology, Guy's Campus, King's College London, London, United Kingdom, 2 Institute of Epidemiology, GSF - National Center for Environment and Health, Neuherberg, Germany, 3 Centre for research in Environmental Epidemiology (CREAL), Institut Municipal d'Investigacio Medica (IMM), Barcelona, Spain; Department of Experimental Sciences and Health, Universitat Pompeu Fabra (UPF), Barcelona, Spain, 4 Respiratory Medicine and Allergology, University of Uppsala, Uppsala, Sweden, 5 Occupational and Environmental Medicine, University of Uppsala, Uppsala, Sweden, 6 Unit of Occupational Medicine, Department of Medicine and Public Health, University of Verona, Verona, Italy, 7 Department of Thoracic Medicine, Haukeland Hospital, Bergen, Norway, 8 Unit of Epidemiology and Medical Statistics, Department of Medicine and Public Health, University of Verona, Verona, Italy, 9 Centre for research in Environmental Epidemiology (CREAL), Institut Municipal d'Investigacio Medica (IMM), Barcelona, Spain; Environmental Epidemiology Division, Institute for Risk Assessment Sciences, University of Utrecht, Utrecht, The Netherlands, 10 Respiratory Epidemiology and Public Health Group, National Heart and Lung Institute, Imperial College London, London, United Kingdom * To whom correspondence should be addressed. E-mail: s.chinn{at}imperial.ac.uk.
Rationale: The association of asthma with sensitization and allergen exposure is known to be complex. There have been few studies of bronchial responsiveness in relation to both risk factors in adults. Objectives: To determine the relation of bronchial responsiveness to allergen exposure and IgE sensitization in a community study taking into account the major determinants in adulthood. Measurements and Main Results: Cross-sectional data were drawn from 1884 participants in 20 centers in the European Community Respiratory Health Survey follow-up, which included measurement of house dust mite and cat allergen in mattress dust samples, and IgE sensitization to four allergens. Bronchial responsiveness to methacholine was expressed as a continuous variable, and analyzed by multiple regression. The trend towards greater bronchial responsiveness with increasing exposure to cat allergen was greater in those sensitized to any of the four allergens than those not sensitized (P=0.001); there was no significant interaction between cat sensitization and Fel d 1 exposure. No trend was found with house dust mite allergen exposure. The difference in bronchial responsiveness between those exposed to the highest levels compared to the lowest was approximately -2.02 doubling doses of PD20 (95% confidence interval -3.06 to -0.97), and nearly as great in those exposed to more moderate levels. Conclusions: Cat allergen exposure at moderate levels may be harmful to all atopic adults. Clinical implication: It is insufficient to test asthma patients for cat sensitization; all atopic individuals may benefit from reduced cat exposure. Key words: asthma; bronchial responsiveness; sensitization; cat; mite
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