Allergy Asthma Respir Dis.  2013 Mar;1(1):50-54. 10.4168/aard.2013.1.1.50.

The differences of clinical profiles by house dust mite sensitization in patients with asthmatics in Soonchunhyang University Hospital cohort

• Kim JH
• Jang AS
• Jeong SO
• Ji YS
• Seo HJ
• Nam JH
• Moon JJ
• Baek AR
• Park JS
• Lee JH
• Park SW
• Kim DJ
• Park CS

• KMID: 2263059
• DOI: http://doi.org/10.4168/aard.2013.1.1.50

Abstract

PURPOSE
The majority of patients with allergic disease are highly sensitized to house dust mites (HDM). There is few data to observe sensitization rate to HDM in asthmatics in Korea. The aim of this study was to observe the differences of clinical profiles by HDM sensitization in patients with asthmatics in Soonchunhyang University Hospital (SCH) cohort.
METHODS
We recruited 2,345 asthmatic patients in SCH cohort. Lung function, body mass index and sputum and blood eosinophils, and PC20, and clinical profiles were compared by HDM sensitization.
RESULTS
Dermatophagoides farinae (Derf) and/or Dermatophagoides pteronyssinus (Derp) (+) sensitization rate was higher prevalence in male than in female. Compared with nonatopy asthmatics, Derf and/or Derp (+) asthmatics had early onset of age [Derf and/or Derp (+) vs. Derf and Derp (-) vs. atopy (-); 32.5+/-0.51 vs. 36.1+/-0.88 vs. 43.1+/-0.54, P<0.05]. Derf and/or Derp (+) asthmatics had shorter duration of asthma symptom than that of nonatopy asthmatics. Derf and/or Derp (+) asthmatics had lower forced expiratory volume in one second and forced vital capacity than those of Derf and Derp (-) asthmatics. PC20 in Derf and/or Derp (+) asthmatics had lower than those of Derf and Derp (-) and nonatopy asthmatics [Derf and/or Derp (+) vs. Derf and Derp (-) vs. atopy (-); 5.4+/-0.24 mg/mL vs. 6.59+/-0.52 mg/mL vs. 7.19+/-0.33 mg/mL, P<0.05]. Blood eosinophils number in Derf and/or Derp (+) asthmatics had higher than that of nonatopy asthmatics (414.7+/-131.1 vs. 350.6+/-14.0, P<0.05). Total immunoglobulin E (IgE) in Derf and/or Derp positive asthmatics had higher than that of Derf and Derp negative and nonatopy asthmatics. There was no difference of body mass index among three groups.
CONCLUSIONS
Our data indicate that atopy asthmatics sensitized to Derf and/or Derp had early onset of age, high total IgE and airway responsiveness, and eosinophilic inflammation.

Keyword

House dust mite; Atopy; Asthma; Cohort

MeSH Terms

Asthma
Body Mass Index
Cohort Studies
Dermatophagoides farinae
Dermatophagoides pteronyssinus
Dust
Eosinophils
Female
Forced Expiratory Volume
Humans
Immunoglobulin E
Immunoglobulins
Inflammation
Korea
Lung
Male
Prevalence
Pyroglyphidae
Sputum
Vital Capacity
Dust
Immunoglobulin E
Immunoglobulins

Figure

• 

  Fig. 1 The prevalence of allergen sensitization. Derf, Dermatophagoides farinae; Derp, Dermatophagoides pteronyssinus.

Reference

1. Mokdad AH, Serdula MK, Dietz WH, Bowman BA, Marks JS, Koplan JP. The spread of the obesity epidemic in the United States, 1991-1998. JAMA. 1999. 282:1519–1522.

2. Mannino DM, Homa DM, Akinbami LJ, Moorman JE, Gwynn C, Redd SC. Surveillance for asthma: United States, 1980-1999. MMWR Surveill Summ. 2002. 51:1–13.

3. Fanta CH. Asthma. N Engl J Med. 2009. 360:1002–1014.

4. Seaton A, Godden DJ, Brown K. Increase in asthma: a more toxic environment or a more susceptible population? Thorax. 1994. 49:171–174.

5. Cookson W. The alliance of genes and environment in asthma and allergy. Nature. 1999. 402:6760 Suppl. B5–B11.

6. Prescott SL, Macaubas C, Holt BJ, Smallacombe TB, Loh R, Sly PD, et al. Transplacental priming of the human immune system to environmental allergens: universal skewing of initial T cell responses toward the Th2 cytokine profile. J Immunol. 1998. 160:4730–4737.

7. Stein RT, Sherrill D, Morgan WJ, Holberg CJ, Halonen M, Taussig LM, et al. Respiratory syncytial virus in early life and risk of wheeze and allergy by age 13 years. Lancet. 1999. 354:541–545.

8. Halonen M, Stern DA, Lohman C, Wright AL, Brown MA, Martinez FD. Two subphenotypes of childhood asthma that differ in maternal and paternal influences on asthma risk. Am J Respir Crit Care Med. 1999. 160:564–570.

9. Venables KM, Chan-Yeung M. Occupational asthma. Lancet. 1997. 349:1465–1469.

10. Platts-Mills TA. The role of immunoglobulin E in allergy and asthma. Am J Respir Crit Care Med. 2001. 164(8 Pt 2):S1–S5.

11. Gould HJ, Sutton BJ, Beavil AJ, Beavil RL, McCloskey N, Coker HA, et al. The biology of IGE and the basis of allergic disease. Annu Rev Immunol. 2003. 21:579–628.

12. Burrows B, Martinez FD, Halonen M, Barbee RA, Cline MG. Association of asthma with serum IgE levels and skin-test reactivity to allergens. N Engl J Med. 1989. 320:271–277.

13. Menz G, Ying S, Durham SR, Corrigan CJ, Robinson DS, Hamid Q, et al. Molecular concepts of IgE-initiated inflammation in atopic and nonatopic asthma. Allergy. 1998. 53:45 Suppl. 15–21.

14. Dust mite allergens and asthma: a worldwide problem. J Allergy Clin Immunol. 1989. 83(2 Pt 1):416–427.

15. Arbes SJ Jr, Gergen PJ, Elliott L, Zeldin DC. Prevalences of positive skin test responses to 10 common allergens in the US population: results from the third National Health and Nutrition Examination Survey. J Allergy Clin Immunol. 2005. 116:377–383.

16. Kang SY, Choi BW, Moon HB, Min KU, Kim YY. The prevalence of immediate skin reactions in patients with respiratory allergies. Allergy. 1984. 4:49–56.

17. Lee MK, Lee WY, Yong SJ, Shin KC, Lee SN, Lee SJ, et al. Sensitization rates to inhalant allergens in patients visiting a university hospital in Gangwon region. Korean J Asthma Allergy Clin Immunol. 2011. 31:27–32.

18. Jeon BH, Lee J, Kim JH, Kim JW, Lee HS, Lee KH. Atopy and sensitization rates to aeroallergens in children and teenagers in Jeju, Korea. Korean J Asthma Allergy Clin Immunol. 2010. 30:14–20.

19. Bateman ED, Hurd SS, Barnes PJ, Bousquet J, Drazen JM, FitzGerald M, et al. Global strategy for asthma management and prevention: GINA executive summary. Eur Respir J. 2008. 31:143–178.

20. Juniper EF CD, Hargreave FE. Histamine and methacholine inhalation tests: a laboratory tidal breathing protocol. 1994. 2nd ed. Lund: Sweden Astra Draco AB.

21. Park CS, Kim YY, Kang SY. Collection between RAST and skin test for inhalant offending allergens. Allergy. 1983. 3:1–9.

22. Adams KF, Schatzkin A, Harris TB, Kipnis V, Mouw T, Ballard-Barbash R, et al. Overweight, obesity, and mortality in a large prospective cohort of persons 50 to 71 years old. N Engl J Med. 2006. 355:763–778.

23. Chu JK, Song SB, Kim DK, Kim YK. Epidemiological studies on the acaroid mite. Kisaengchunghak Chapchi. 1967. 5:71–77.

24. Athanassiou CG, Kavallieratos NG, Palyvos NE, Sciarretta A, Trematerra P. Spatiotemporal distribution of insects and mites in horizontally stored wheat. J Econ Entomol. 2005. 98:1058–1069.

25. Yong TS, Jeong KY. Review on ecology of house dust mites in Korea and suggestion of a standard survey method. Pediatr Allergy Respir Dis. 2011. 21:4–16.

26. Ree HI. Medical entomology. 2005. 4th ed. Seoul: Komoonsa.

27. Yong TS, Jeong KY. Household arthropod allergens in Korea. Korean J Parasitol. 2009. 47:Suppl. S143–S153.

28. Hewitt M, Barrow GI, Miller DC, Turk F, Turk S. Mites in the personal environment and their role in skin disorders. Br J Dermatol. 1973. 89:401–409.

29. Jeong KY, Lee IY, Lee J, Ree HI, Hong CS, Yong TS. Effectiveness of education for control of house dust mites and cockroaches in Seoul, Korea. Korean J Parasitol. 2006. 44:73–79.

30. Holt PG, Sly PD. Interaction between adaptive and innate immune pathways in the pathogenesis of atopic asthma: operation of a lung/bone marrow axis. Chest. 2011. 139:1165–1171.

31. Platts-Mills TA, Vervloet D, Thomas WR, Aalberse RC, Chapman MD. Indoor allergens and asthma: report of the Third International Workshop. J Allergy Clin Immunol. 1997. 100(6 Pt 1):S2–S24.

32. Shin JW, Sue JH, Song TW, Kim KW, Kim ES, Sohn MH, et al. Atopy and house dust mite sensitization as risk factors for asthma in children. Yonsei Med J. 2005. 46:629–634.

33. Charpin D, Birnbaum J, Haddi E, Genard G, Lanteaume A, Toumi M, et al. Altitude and allergy to house-dust mites. A paradigm of the influence of environmental exposure on allergic sensitization. Am Rev Respir Dis. 1991. 143(5 Pt 1):983–986.

34. Sporik R, Chapman MD, Platts-Mills TA. House dust mite exposure as a cause of asthma. Clin Exp Allergy. 1992. 22:897–906.

35. Verhoeff AP, Van Strien RT, Van Wijnen JH, Brunekreef B. House dust mite allergen (Der p I) and respiratory symptoms in children: a case-control study. Clin Exp Allergy. 1994. 24:1061–1069.

36. Polk S, Sunyer J, Munoz-Ortiz L, Barnes M, Torrent M, Figueroa C, et al. A prospective study of Fel d1 and Der p1 exposure in infancy and childhood wheezing. Am J Respir Crit Care Med. 2004. 170:273–278.

37. Wickman M. Experience with quantitative IgE antibody analysis in relation to allergic disease within the BAMSE birth cohort: towards an improved diagnostic process. Allergy. 2004. 59:Suppl 78. 30–31.

38. Moerloose KB, Pauwels RA, Joos GF. Short-term cigarette smoke exposure enhances allergic airway inflammation in mice. Am J Respir Crit Care Med. 2005. 172:168–172.

39. Jang AS, Park JS, Lee JH, Park SW, Kim DJ, Uh ST, et al. The impact of smoking on clinical and therapeutic effects in asthmatics. J Korean Med Sci. 2009. 24:209–214.

40. Choi JS, Jang AS, Park JS, Park SW, Paik SH, Park JS, et al. Role of neutrophils in persistent airway obstruction due to refractory asthma. Respirology. 2012. 17:322–329.