Do Baseline Asthma and Allergic Sensitization Characteristics Predict Responsiveness to Mouse Allergen Reduction?

Ammara Ahmed, Christy Sadreameli, Jean Curtin-Brosnan, Torie Grant, Wanda Phipatanakul, Matthew Perzanowski, Susan Balcer-Whaley, Roger Peng, Michelle Newman, Amparito Cunningham, Adnan Divjan, Mary E. Bollinger, Robert A Wise, Rachel Miller, Ginger Chew, Elizabeth C. Matsui

Research output: Contribution to journalArticle

Abstract

Background: Mouse allergen reduction is associated with improvements in asthma among sensitized and exposed children, but whether clinical characteristics predict responsiveness to allergen reduction is unclear. Objective: To examine the effects of clinical characteristics on relationships between mouse allergen reduction and asthma outcomes. Methods: We performed a secondary analysis of data from a randomized clinical trial of a mouse allergen intervention, examining the effects of atopy, demographic characteristics, lung function, asthma control, and asthma severity on relationships between mouse allergen reduction and asthma outcomes. Results: Participants were predominantly low-income and minority (78% black, 22% Hispanic), and had persistent asthma. Among less atopic participants (<6 positive skin prick test results), each 50% reduction in mouse allergen was associated with fewer symptoms (incidence rate ratio [95% CI]: maximal symptoms: 0.94 [0.92-0.96]). There was little effect of mouse allergen reduction on symptoms among more atopic participants (P > .05). The interactions between atopic status and mouse allergen reduction were statistically significant for all symptom outcomes; however, there was no evidence that atopic status influenced the effect of mouse allergen reduction on exacerbation-related outcomes. Older children (≥9 years) tended to experience greater improvement in some asthma outcomes with reduction in mouse allergen exposure than younger children. There was no evidence that either mouse-specific IgE or lung function influenced the effect of mouse allergen reduction on any asthma outcomes. Conclusions: Although there may be variability in the clinical response to mouse allergen reduction among low-income, minority children with asthma, there were no clinical characteristics that clearly identified a subgroup at which the intervention should be targeted.

Original languageEnglish (US)
JournalJournal of Allergy and Clinical Immunology: In Practice
DOIs
StateAccepted/In press - Jan 1 2019

Keywords

  • Allergen exposure
  • Allergen exposure reduction
  • Allergen sensitization
  • Allergic asthma
  • Atopy
  • Mouse allergen exposure

ASJC Scopus subject areas

  • Immunology and Allergy

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  • Cite this

    Ahmed, A., Sadreameli, C., Curtin-Brosnan, J., Grant, T., Phipatanakul, W., Perzanowski, M., Balcer-Whaley, S., Peng, R., Newman, M., Cunningham, A., Divjan, A., Bollinger, M. E., Wise, R. A., Miller, R., Chew, G., & Matsui, E. C. (Accepted/In press). Do Baseline Asthma and Allergic Sensitization Characteristics Predict Responsiveness to Mouse Allergen Reduction? Journal of Allergy and Clinical Immunology: In Practice. https://doi.org/10.1016/j.jaip.2019.08.044