Severe childhood asthma and allergy to furry animals: Refined assessment using molecular-based allergy diagnostics

Authors

  • Jon R. Konradsen,

    Corresponding author
    1. Astrid Lindgren Children′s Hospital, Karolinska University Hospital, Stockholm, Sweden
    2. Department of Women′s and Children′s Health, Karolinska Institutet, Stockholm, Sweden
    3. Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden
    • Correspondence

      Jon R. Konradsen, MD, PhD, Astrid Lindgren Children′s Hospital, Q2:04, Karolinska University Hospital, SE-17176 Stockholm, Sweden

      Tel.: +46704242058

      Fax: +4651773095

      E-mail: jon.konradsen@karolinska.se

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  • Björn Nordlund,

    1. Astrid Lindgren Children′s Hospital, Karolinska University Hospital, Stockholm, Sweden
    2. Department of Women′s and Children′s Health, Karolinska Institutet, Stockholm, Sweden
    3. Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden
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  • Annica Onell,

    1. Thermo Fisher Scientific, Uppsala, Sweden
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  • Magnus P. Borres,

    1. Thermo Fisher Scientific, Uppsala, Sweden
    2. Department of Women′s and Children′s Health, Uppsala University, Uppsala, Sweden
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  • Hans Grönlund,

    1. Department of clinical neuroscience, Karolinska Institutet, Stockholm, Sweden
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  • Gunilla Hedlin

    1. Astrid Lindgren Children′s Hospital, Karolinska University Hospital, Stockholm, Sweden
    2. Department of Women′s and Children′s Health, Karolinska Institutet, Stockholm, Sweden
    3. Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden
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Abstract

Background

Allergy to cats and dogs and polysensitization towards these animals are associated with severe childhood asthma. Molecular-based allergy diagnostics offers new opportunities for improved characterization and has been suggested to be particularly useful in patients with polysensitization and/or severe asthma. The aim was to use extract- and molecular-based allergy diagnostics to compare patterns of IgE sensitization towards aeroallergens in children with problematic severe and controlled asthma.

Methods

Children with a positive ImmunoCAP towards any furry animal (cat, dog or horse) were recruited from a Nationwide Swedish study on severe childhood asthma. Severe (n = 37, age 13 years) and controlled (n = 28, age 14 years) asthmatics underwent assessment of allergic sensitization by ImmunoCap (kUA/l) and immunosolid-phase allergen chip (ISAC). In addition, Asthma Control Test, spirometry and a methacholine challenge were performed.

Results

Children with severe asthma had lower asthma control (p < 0.001) and FEV1 (p = 0.001) and more bronchial hyper-responsiveness (p = 0.008) in spite of high doses of inhaled steroids (≥800 μg budesonide). Children with severe asthma displayed higher levels of IgE antibodies towards cat (17 vs. 3.9, p = 0.027), dog (3.8 vs. 1.2, p = 0.012) and horse (7.4 vs. 0.7, p = 0.014). Sensitization towards Can f 2 (22% vs. 0%, p = 0.009) and Equ c 1 (51% vs. 25%, p = 0.03) was more common in severe asthma. IgE levels towards Equ c 1 correlated with asthma control (r = −0.41, p = 0.04).

Conclusion

Children with severe allergic asthma had higher sIgE levels to cat, dog and horse. Molecular-based allergy diagnostics revealed a more complex molecular spreading of allergen components in children with the most severe disease.

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