Allergens on desktop surfaces in preschools and elementary schools of urban children with asthma.

Environmental and occupational allergies

Allergen exposure and asthma

<p><strong>PURPOSE:</strong> To study associations between cat, dog and horse allergens in day care centres and fractional exhaled nitric oxide (FeNO), eosinophilic cationic protein (ECP) in serum, lung function (FEV<sub>1</sub>) and dyspnoea in day care centre staff. Totally 62 subjects, all females, from five Swedish day care centres participated (participation rate 90%).</p><p><strong>METHODS:</strong> Dust was collected by vacuum cleaning and Petri dish sampling and analysed for cat (Fel d 1), dog (Can f 1) and horse (Ecu cx) allergens by ELISA. Dyspnoea was measured on an analogue rating scale. FeNO, serum ECP and symptom ratings were log-transformed. Associations were analysed by linear mixed models, adjusting for personal and home environment factors.<em> </em></p><p><strong>RESULTS:</strong><em> </em>Geometric mean (GM) value for allergens in vacuumed dust were 1199 ng/g for Fel d 1, 666 ng/g for Can f 1 and 478 U/g for Equ cx, respectively. GM value for allergens in Petri dish samples (ng/m<sup>2</sup> per day) was 29.8 for Fel d 1 and 9.1 for Can f 1, respectively. Cat allergen (Fel d 1) were positively associated with FeNO both in vacuumed dust (p=0.03) and in Petri dish samples (p=0.03). Dog allergen (Can f 1) in Petri dish samples was negatively associated with FeNO (p=0.02). Horse allergen (Equ cx) in vacuumed dust was negatively associated with FeNO (P=0.03).</p><p><strong>CONCLUSION:</strong> Cat, dog and horse allergens were commonly found and cat allergen in day care centres can be a risk factor for lower airway inflammation, measured as FeNO, while dog and horse allergens were associated with lower FeNO.</p>

Clothing–Potentially a Significant Source of Endotoxin Exposure

A cross‐sectional study was conducted in Bayamón, Puerto Rico, to identify and quantify indoor allergens, serine proteases, and bacterial endotoxin present in homes of asthmatic children. A total of 126 dust samples from houses were obtained from the entire mattress and bedside floor. Most of the patients had detectable levels of mite, cockroach, cat, and dog allergens. Mold allergens were found only in bedside floor dust samples. Mouse allergens were not detected. Forty‐two percent, 36.5%, and 1.8% of the patients demonstrated exposures to sensitizing levels of mite, Bla g 1 and cat allergens, respectively. The percentage of patients exposed to high levels of allergens capable of triggering asthma symptoms was 33.3% and 26.4% for mite and Bla g 1 allergens. Only dog allergen, bacterial endotoxin, elastase, and trypsin were associated with asthma symptoms. Eighty‐nine percent of the asthmatic children were exposed to endotoxin concentrations greater than 100 EU/mg dust, and more than half of the patients were exposed to high levels of serine proteases. Our study indicates that indoor concentrations of allergens traditionally associated with asthma symptoms and severity may not be applicable in tropical environments and highly ventilated households. In fact, in the study population, endotoxins, dog allergen, and serine proteases may play a dominant role in the induction of asthma symptoms.

Understanding allergen exposure and potential relationships with asthma requires allergen sampling methods, but methods have yet to be standardized. We compared allergen measurements from dust collected from 200 households with asthmatics and conducted a side-by-side vacuum sampling of settled dust in each home's kitchen, living room and subject's bedroom by three methods (EMM, HVS4 and AIHA). Each sample was analyzed for dust mite, cockroach, mouse, rat, cat and dog allergens. The number of samples with sufficient dust mass for allergen analysis was significantly higher for Eureka Mighty Mite (EMM) and high volume small surface sampler (HVS4) compared with American Industrial Hygiene Association (AIHA) in all rooms and surfaces tested (all P<0.05). The allergen concentration (weight of allergen divided by total weight of dust sampled) measured by the EMM and HVS4 methods was higher than that measured by the AIHA. Allergen loadings (weight of allergen divided by surface area sampled) were significantly higher for HVS4 than for AIHA and EMM. Cockroach and rat allergens were rarely detected via any method. The EMM method is most likely to collect sufficient dust from surfaces in the home and is relatively practical and easy. The AIHA and HVS4 methods suffer from insufficient dust collection and/or difficulty in use.

Early exposure to allergens is important for sensitization to inhalant allergens and it has been reported that there is a causal relationship between allergen exposure and bronchial asthma. We investigated the levels of major mite (Der p I/Der f I), cat (Fel d I) and dog (Can f I) allergen levels in dust collected from various locations in seven day-care centres (22 sections). The allergen levels were related to the characteristics of the day-care centres. Children and staff were questioned about contacts with animals, and cleaning personnel were asked about methods and frequency of cleaning. Mite allergen was found in nine of the 22 sections. The concentrations varied between < 16 ng/g and 106 ng/g dust (median < 16 ng/g). Mite allergen was not detected in any floor dust sample. Cat and dog allergen was detected in all centres and sections. The concentrations of dog allergen (median 4.3 micrograms/g; range < 60 ng-21 micrograms/g) were significantly higher (P < 0.05) than that of cat allergen (median 1.6 micrograms/g; range < 16 ng-22.8 micrograms/g). Higher amounts of both Fel d I and Can f I were observed on mattresses/sofas/cushion like toys and curtains than on tables/chairs and floors. The levels of cat or dog allergen on floors significantly correlated with the total number of children and staff with either a cat or a dog at home and or frequent contacts with them. Neither cleaning methods nor the frequency of cleaning influenced the allergen concentrations. The concentration of Fel d I was significantly lower (P < 0.05) in washed than in never washed curtains.(ABSTRACT TRUNCATED AT 250 WORDS)

Allergy to indoor allergens can cause frequent and severe health problems in children. Because little is known about the content of allergens in the indoor environments in Norway, we wanted to assess the levels of cat, dog and mite allergens in schools and day-care centers in Oslo. Allergen levels in dust samples from 155 classrooms and 81 day-care units were measured using commercially available enzyme-linked immunosorbent assay (ELISA) kits. Additionally, we measured the levels of endotoxin in 31 day-care units, using the limulus amebocyte lysate test. Most of the dust samples contained detectable amounts of cat and dog allergens. In mattress and floor dust (day-care centers), and curtain and floor dust (schools) the median Fel d 1 levels were 0.17, 0.002, 0.02 and 0.079 microg/m2, while the median Can f 1 levels were 1.7, 0.03, 0.1 and 0.69 microg/m2, respectively. Levels of cat and dog allergens in school floor dust were associated with the number of pupils with animals at home. In contrast, <1% of the samples had measurable levels of the mite allergen Der p 1. Moreover, the levels of endotoxin tended to be higher in dust from floors (1.4 ng/m2) compared with that from mattresses (0.9 ng/m2). To reduce allergen exposure, allergic individuals should be placed in the classes/rooms with the fewest pet owners. Moreover, mattresses in day-care centers are major reservoirs of cat and dog allergens and should be cleaned frequently.

Objective: Children’s soft toys are known to harbour house dust mite (HDM) allergens, but little is known whether they harbour cat or dog allergens. The objective of the study was to measure cat (Fel d 1), dog (Can f 1) and HDM allergens on children’s soft toys. Methods: Dust was collected from 40 children’s soft toys and their mattresses. Data were collected on pet ownership. Dust samples were analysed for Fel d 1, Can f 1, Der p 1 and Der f 1 by enzyme-linked immunosorbent assay (ELISA) and results are expressed as median levels with inter-quartile ranges. Results: Thirty-five (87.5%) soft toys had detectable Fel d 1 levels (median: 0.73 µg/g; inter-quartile range: 0.26–2.56 µg/g) while 34 (85%) had detectable Can f 1 levels (1.20 µg/g; 0.53–2.68). Correspondingly, 32 (80%) mattresses had detectable Fel d 1 levels (0.18 µg/g, 0.07–1.01) while 34 (85%) had detectable Can f 1 levels (0.50 µg/g; 0.33–1.06). All mattresses and soft toys had detectable HDM allergen (Der p 1 + Der f 1) levels with soft toys containing about three times higher levels than mattresses. In homes with cats (n = 10) Fel d 1 levels were higher on soft toys than homes without cats (2.49 versus 0.48 µg/g; p = 0.0009). In homes with dogs (n = 25) Can f 1 levels were generally higher on soft toys (1.38 versus 0.63 µg/g; p = 0.10). Conclusions: This study has shown that soft toys can harbour cat and dog allergen as well as HDM allergens, some with very high levels. Cat and dog ownership resulted in higher Fel d 1 and Can f 1 levels on soft toys and mattresses. The levels of Fel d 1, Can f 1 and HDM allergens on soft toys could be of importance to sensitized asthmatic children.

Concentration and determinants of molds and allergens in indoor air and house dust of French dwellings

The aim of the study was to describe the exposure to dog (Can f 1) and cat (Fel d 1) allergens within homes of very young children living with and without pets, and to assess the validity of the interview on pets for predicting the actual exposure to pet allergens in house dust. House dust samples were collected in 275 dwellings from the mattresses, children’s bedroom and kitchen floors. In the laboratory, dust samples were analyzed for Can f 1 and Fel d 1 using monoclonal antibody enzyme-linked immunosorbent assays (ELISA). The majority of households (79.3%) had neither a dog nor a cat living in the home over the past 6 months preceding the survey. Dog allergen above 2 μg/g dust were found in 22.5% of homes and 14.2% of homes contained dog allergen above 10 μg/g of house dust. In the total study sample, cat allergen above 1 μg/g of dust were found in 12.7% of homes, and 3.3% of homes contained Fel d 1 levels greater than 8 μg/g of dust. The majority of children (75.0%) with reported ownership of dogs were exposed to Can f 1 levels above 2 μg/g of house dust, and 73.1% of children with cats at home were exposed to Fel d 1 concentrations above 1 μg/g house dust. The results of the study showed that post-test probability of the true exposure to Can f 1 above 2 μg/g dust in houses with positive interview on indoor dogs was 75.0% (95%CI: 61.7–84.8%). On the other hand, the prediction of exposure estimated from the interview data on indoor dogs produced 12.6% of false negatives (95% CI: 9.9–15.8%). Similarly, the post-test probability of the true exposure to Fel d 1 above 1 μg/g dust in houses with positive interview on indoor cats was 73.1% (95%CI: 55.1–85.7%). On the other hand, the interview data produced 6.4% false negatives (95% CI: 4.6–9.0%). In conclusion, the study demonstrated that homes in Poland with pet ownership are important reservoir of Can f 1 and Fel d 1 allergens with levels that might induce allergic symptoms. Even in homes of children without a dog or cat indoors, there was a higher prevalence of pet allergens at the levels above allergic sensitisation thresholds. This may have an important implication for epidemiologic studies on pet related allergy and prevention practice.

Exposure and Sensitization to Pets Modify Endotoxin Association with Asthma and Wheeze

Background and Objectives: Effects of allergen exposure may be modified through endogenous and exogenous factors, resulting in heterogeneity of clinical features, time course and intensity of symptoms of allergic disease. This creates challenges in allergy diagnosis and management, yet studies addressing the variability of allergen reactivity in relation to potential modifying factors are not numerous. The aim of the study was to retrospectively analyze the frequency and profile of reactivity to inhalant allergen extracts in patients followed in a single center in the years 2017–2020, in relation to sex, age, clinical symptoms and final clinical diagnosis. Materials and Methods: This is a retrospective analysis of skin prick test (SPT) results in 1711 outpatients, performed with dust mites, pollen (alder, hazel, birch, grasses, rye, mugwort), cat, dog and Alternaria allergens. Reactivity profiles were assessed in the entire population divided into sex and age subgroups. Relationships between SPT results, age, sex and clinical diagnosis were assessed using factor analysis. Results: The highest reactivity frequencies were found for grass (60.5%), rye (57.22%), birch (47.34%), alder (42.5%) and Dermatophagoides pteronyssinus mites (41.8%). Monovalent reactivity was found mainly to mugwort (3.2%, n = 55), followed by cat and mites allergens. Reactivity to ≥1 allergen was more frequent in males. The risk of allergic rhinitis (AR) was significantly higher in subjects allergic to grass, rye, hazel and alder pollen, as compared to subjects non-sensitized to these allergens. Reactivity to perennial allergens (dog, cat and dust mites) was significantly associated with asthma diagnosis. The risk of developing atopic dermatitis was significantly associated with reactivity to birch and alder pollen. Conclusions: SPTs are a valuable tool for assessing the occurrence of atopy and allergy. Reactivity to specific aeroallergens may be associated with increased probability of development of a given atopic condition. This warrants further studies regarding the interplay between possible modifiers of allergen exposure effects.

EE is an emerging disease reported in children and adults of urbanized countries, where indoor insect allergens are major health risk factors. Review of our hospital patient database uncovered that a number of EE patients have hypersensitivity to indoor cat, dog, cockroach, and dust mite allergens. We tested the hypothesis whether inhaled indoor insect allergens are effective inducers of experimental EE. We delivered cat, dog, cockroach, and dust mite allergen extracts intranasally to wild-type and eotaxin-1/2-, CCR3-, and IL-5-deficient mice. Interestingly, wild-type mice exposed to cockroach or dust mite allergens develop a significant increase in the levels of esophageal eosinophils and mast cells compared with saline-challenged mice. The eosinophil numbers in the esophagus of cockroach- and dust mite-exposed mice were 18.3+/-6.8/mm2 and 33.4+/-11.1/mm2 compared with 2.3+/-1.8/mm2 and 2.1+/-1.2/mm2 in saline-challenged mice. Additionally, we observed an additive effect of these two allergens in inducing esophageal eosinophilia and mastocytosis. Histopathological analysis detected intraepithelial esophageal eosinophilia in mice exposed to both allergens. Furthermore, mice exposed to cockroach and/or dust mite had increased levels of total IgE and antigen-specific IgG1 in the blood and increased esophageal expression of eosinophil-active cytokines (IL-13) and chemokines (eotaxin-1). Notably, mice deficient in eotaxin-1/2, CCR3, and IL-5 showed ablated esophageal eosinophilia following cockroach or dust mite allergen exposure. These data indicate that indoor insect allergens are potent inducers of IL-5 and eotaxin-mediated esophageal eosinophilia. These experimental studies are in accordance with clinical data but may have some limitations inherent to animal models of human disease.

Several recent clinical trials reported that intralymphatic immunotherapy (ILIT) for some allergens, such as cat dander and pollen, induce tolerance more rapidly than conventional subcutaneous or sublingual immunotherapy, have a comparable duration of effect after only 3 injections, and do not provoke serious local or systemic reactions. However, the efficacy and safety of ILIT are using Dermatophagoides farinae (Df), Dermatophagoides pteronyssinus (Dp), and dog, which are indoor allergens that are commonly found globally, need to be evaluated. Furthermore, use of multiple allergens in ILIT should be investigated. We assessed the clinical efficacy and adverse effects of ILIT using aqueous Df, Dp, dog, and cat allergens or mixtures thereof in patients with allergic rhinitis. A total of 11 subjects with AR sensitized to Df, Dp, cat, and/or dog allergens received 3 intralymphatic inguinal injections of sensitized allergen extract (HollisterStier, New Orleans, LA, USA). Clinical parameters were assessed before ILIT, and 4 months and 1 year after the first injection. Rhinitis symptoms were alleviated and quality of life was improved 4 months after ILIT (P=0.012 and P=0.007, respectively), and these improvements lasted for 1 year after ILIT (P=0.047 and P=0.009, respectively). However, we observed 2 cases of anaphylaxis, one case of a moderate-to-severe systemic hypersensitivity reaction and the other case of a severe local reaction at the injection site after ILIT. In conclusion, ILIT can rapidly improve allergy symptoms and quality of life, and this effect lasts for 1 year. In hypersensitized patients, however, ILIT can provoke severe systemic and/or local hypersensitivity reactions when performed using aqueous allergen extracts.