Outdoor Aeroallergen Impacts on Asthma Exacerbation Among Sensitized and Nonsensitized Philadelphia Children

Overview

Journal J Allergy Clin Immunol Glob

Specialty Allergy & Immunology

Date 2024 Apr 22

PMID 38645670

Authors

Anneclaire J De Roos

James P Senter

Leah H Schinasi

Wanyu Huang

Kari Moore

Mitchell Maltenfort

Christopher Forrest

Sarah E Henrickson

Chen C Kenyon

Affiliations

Soon will be listed here.

Abstract

Background: Outdoor aeroallergens, such as pollens and molds, are known triggers of asthma exacerbation; however, few studies have examined children's aeroallergen response based on sensitization.

Objective: Our aim was to compare the relative impact of aeroallergen levels on asthma exacerbation between pediatric patients with asthma who tested positive or negative for sensitization to particular allergens.

Methods: A case-crossover design study was conducted to examine associations between outdoor aeroallergen levels and asthma exacerbation events among children living in Philadelphia, Pennsylvania, who were treated within a large pediatric care network. Sensitization to common allergens was characterized in a subset of patients with asthma exacerbation who had undergone skin prick testing (5.5%). Odds ratios (ORs) and 95% CIs were estimated in all patients with asthma exacerbation and in those sensitized or not sensitized to aeroallergens.

Results: Children who were sensitized to a particular allergen had higher odds of asthma exacerbation with exposure to the allergen (ie, early-season tree pollen, oak tree pollen, early-season weed pollen, and late-season molds) than did all patients with asthma or nonsensitized patients. For example, the association between early-season tree pollen and asthma exacerbation among sensitized children (>90th percentile vs ≤25th, OR = 2.28 [95% CI = 1.23-4.22]) was considerably stronger than that estimated among all patients (OR = 1.34 [95% CI = 1.19-1.50]), and it was also substantially different from the lack of association seen among nonsensitized children (OR = 0.89 [95% CI = 0.51-1.55] [ value for heterogeneity = .03]).

Conclusion: More prevalent allergy testing may be useful for prevention of asthma exacerbation by informing interventions targeted to sensitized children and tailored for particular aeroallergens.

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