House dust mite allergen exposure is associated with sensitisation and asthma in New Zealand infants J. Crane, M. Duignan, D. Fishwick, P. Fitzharris, R. Kelly, J. Lane, C. McDonald, R. Siebers, I. Town, K. Wickens, H. Wilson (Wellington, Christchurch, New Zealand; Sheffield, United Kingdom)
Source: Annual Congress 2002 - The development of allergic sensitization / asthma in children
Disease area: Airway diseases, Paediatric lung diseasesAbstract New Zealand has a high prevalence of asthma, high levels of sensitisation to HDM and high levels of Der p 1 in the domestic environment. To examine these relationships we have assembled a cohort of 1000 children in Wellington and Christchurch. We have undertaken a preliminary analysis of allergen exposure at 3 months and HDM sensitisation and diagnosed asthma at 15 months, in the 429 infants in Wellington in whom we have complete data. At 15 months, 7% were SPT positive (= 3mm wheal) to HDM and 13% had been diagnosed as having asthma. HDM sensitised infants had higher levels of bed Der p 1 than non sensitised (19.3 vs 13.3μg/g, p=0.03). Asthmatic children had higher mean levels than non-asthmatic children (17.9 vs 12.6μg/g, p=0.05). The odds of being sensitised to HDM at 15m showed a non linear relationship with exposure for those with a family history of allergic disease (FH) but a positive dose response for those without. This suggests that very high HDM allergen exposure may protect against the development of atopy in infancy in those genetically predisposed, while contributing to the risk in those with no familial predisposition. For diagnosed asthma there appears to be an increased risk associated with the highest exposure especially in those with a FH suggesting that high HDM allergen exposures are associated with symptoms in infancy.
Bedding GM Der p 1 @3 months OR SPT = 3mm HDM @ 15 months
OR Diagnosed asthma @ 15 months
All infants
Positive FH
Negative FH
All infants
Positive FH
Negative FH
n=429
n=125
n=304
<8.3μg/g 1.0
1.0
1.0
1.0
1.0
1.0
>8.3-24.8 3.0*
5.5*
2.4
1.8
1.8
1.3
>24.8 2.1
0.7
3.5
2.3*
3.8*
1.6
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J. Crane, M. Duignan, D. Fishwick, P. Fitzharris, R. Kelly, J. Lane, C. McDonald, R. Siebers, I. Town, K. Wickens, H. Wilson (Wellington, Christchurch, New Zealand; Sheffield, United Kingdom). House dust mite allergen exposure is associated with sensitisation and asthma in New Zealand infants. Eur Respir J 2002; 20: Suppl. 38, 789
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