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Early-life mold and tree sensitivity is associated with allergic eosinophilic rhinitis at 4 years of age.

Abstract

BACKGROUND

Nasal eosinophils are a biomarker for allergic rhinitis (AR) and are associated with increased symptom severity.

OBJECTIVE

To identify predictors of allergic eosinophilic rhinitis (AER) in early childhood in children at higher risk for chronic allergic respiratory disorders.

METHODS

In the Cincinnati Childhood Allergy and Air Pollution Study, infants born to aeroallergen-sensitized and symptomatic parents were examined and underwent skin prick testing (SPT) annually to 15 aeroallergens from 1 to 4 years of age. Wheal circumferences were traced and scanned and areas were determined by computer planimetry. At 4 years, AER was defined as (1) at least 1 positive aeroallergen SPT result, (2) presence of sneezing and runny nose without a cold or influenza, and (3) nasal eosinophilia of at least 5%. Wheal areas at 1 to 3 years were analyzed for an association with AER compared with children without AR.

RESULTS

At 4 years, 487 children completed rhinitis health histories, SPT, and nasal sampling. Ninety-nine children (22.8%) had AR. Thirty-eight children had AER (8.8% of total sample and 38.4% of AR sample, respectively). At 3 years, for every 1-mm(2) increase in Penicillium species (adjusted odds ratio 1.18, 95% confidence interval 1.06-1.32, P = .002) and maple (adjusted odds ratio 1.07, 95% confidence interval 1.01-1.13, P = .02), wheal area significantly increased the risk of AER at 4 years of age.

CONCLUSION

Allergic eosinophilic rhinitis was identified in 8.8% of children at 4 years of age. Age 3 years was the earliest that aeroallergen SPT wheal areas were predictive of AER. Skin testing at 3 years identifies children at risk for an AR phenotype with nasal eosinophilia.

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  • Authors+Show Affiliations

    ,

    Department of Internal Medicine, Divisions of Immunology/Allergy and Pulmonary Medicine, University of Cincinnati, Cincinnati, Ohio; Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio; Division of Immunology and Microbiology, Rush University Medical Center, Chicago, Illinois. Electronic address: Christopher_D_Codispoti@rush.edu.

    ,

    Department of Internal Medicine, Divisions of Immunology/Allergy and Pulmonary Medicine, University of Cincinnati, Cincinnati, Ohio.

    ,

    Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio.

    ,

    Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio.

    ,

    Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio; Division of Asthma Research, Children's Hospital Medical Center, Rush University Medical Center, Chicago, Illinois.

    ,

    Division of Immunology and Microbiology, Rush University Medical Center, Chicago, Illinois.

    ,

    Department of Internal Medicine, Divisions of Immunology/Allergy and Pulmonary Medicine, University of Cincinnati, Cincinnati, Ohio.

    ,

    Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio.

    ,

    Department of Internal Medicine, Divisions of Immunology/Allergy and Pulmonary Medicine, University of Cincinnati, Cincinnati, Ohio.

    ,

    Department of Internal Medicine, Divisions of Immunology/Allergy and Pulmonary Medicine, University of Cincinnati, Cincinnati, Ohio; Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio.

    ,

    Division of Asthma Research, Children's Hospital Medical Center, Rush University Medical Center, Chicago, Illinois.

    Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio.

    Source

    MeSH

    Acer
    Allergens
    Biomarkers
    Child, Preschool
    Eosinophilia
    Eosinophils
    Female
    Humans
    Male
    Nasal Mucosa
    Penicillium
    Prospective Studies
    Rhinitis, Allergic, Perennial
    Skin Tests

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    25744905

    Citation

    Codispoti, Christopher D., et al. "Early-life Mold and Tree Sensitivity Is Associated With Allergic Eosinophilic Rhinitis at 4 Years of Age." Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology, vol. 114, no. 3, 2015, pp. 193-198.e4.
    Codispoti CD, Bernstein DI, Levin L, et al. Early-life mold and tree sensitivity is associated with allergic eosinophilic rhinitis at 4 years of age. Ann Allergy Asthma Immunol. 2015;114(3):193-198.e4.
    Codispoti, C. D., Bernstein, D. I., Levin, L., Reponen, T., Ryan, P. H., Biagini Myers, J. M., ... LeMasters, G. K. (2015). Early-life mold and tree sensitivity is associated with allergic eosinophilic rhinitis at 4 years of age. Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology, 114(3), pp. 193-198.e4. doi:10.1016/j.anai.2014.12.008.
    Codispoti CD, et al. Early-life Mold and Tree Sensitivity Is Associated With Allergic Eosinophilic Rhinitis at 4 Years of Age. Ann Allergy Asthma Immunol. 2015;114(3):193-198.e4. PubMed PMID: 25744905.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Early-life mold and tree sensitivity is associated with allergic eosinophilic rhinitis at 4 years of age. AU - Codispoti,Christopher D, AU - Bernstein,David I, AU - Levin,Linda, AU - Reponen,Tiina, AU - Ryan,Patrick H, AU - Biagini Myers,Jocelyn M, AU - Villareal,Manuel, AU - Burkle,Jeff, AU - Lummus,Zana, AU - Lockey,James E, AU - Khurana Hershey,Gurjit K, AU - LeMasters,Grace K, PY - 2014/06/26/received PY - 2014/12/10/revised PY - 2014/12/12/accepted PY - 2015/3/7/entrez PY - 2015/3/7/pubmed PY - 2015/6/16/medline SP - 193 EP - 198.e4 JF - Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology JO - Ann. Allergy Asthma Immunol. VL - 114 IS - 3 N2 - BACKGROUND: Nasal eosinophils are a biomarker for allergic rhinitis (AR) and are associated with increased symptom severity. OBJECTIVE: To identify predictors of allergic eosinophilic rhinitis (AER) in early childhood in children at higher risk for chronic allergic respiratory disorders. METHODS: In the Cincinnati Childhood Allergy and Air Pollution Study, infants born to aeroallergen-sensitized and symptomatic parents were examined and underwent skin prick testing (SPT) annually to 15 aeroallergens from 1 to 4 years of age. Wheal circumferences were traced and scanned and areas were determined by computer planimetry. At 4 years, AER was defined as (1) at least 1 positive aeroallergen SPT result, (2) presence of sneezing and runny nose without a cold or influenza, and (3) nasal eosinophilia of at least 5%. Wheal areas at 1 to 3 years were analyzed for an association with AER compared with children without AR. RESULTS: At 4 years, 487 children completed rhinitis health histories, SPT, and nasal sampling. Ninety-nine children (22.8%) had AR. Thirty-eight children had AER (8.8% of total sample and 38.4% of AR sample, respectively). At 3 years, for every 1-mm(2) increase in Penicillium species (adjusted odds ratio 1.18, 95% confidence interval 1.06-1.32, P = .002) and maple (adjusted odds ratio 1.07, 95% confidence interval 1.01-1.13, P = .02), wheal area significantly increased the risk of AER at 4 years of age. CONCLUSION: Allergic eosinophilic rhinitis was identified in 8.8% of children at 4 years of age. Age 3 years was the earliest that aeroallergen SPT wheal areas were predictive of AER. Skin testing at 3 years identifies children at risk for an AR phenotype with nasal eosinophilia. SN - 1534-4436 UR - https://www.unboundmedicine.com/medline/citation/25744905/Early_life_mold_and_tree_sensitivity_is_associated_with_allergic_eosinophilic_rhinitis_at_4_years_of_age_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1081-1206(14)00889-8 DB - PRIME DP - Unbound Medicine ER -