Anti-cockroach and anti-mouse IgE are associated with early wheeze and atopy in an inner-city birth cohort

Received 25 April 2008; received in revised form 23 July 2008; accepted 14 August 2008.

Background

The relationships between cockroach and mouse allergen exposure, anti-cockroach and anti-mouse IgE, and wheeze, rhinitis, and atopic dermatitis in children as young as age 3 years are of public health importance but have not been thoroughly evaluated.

Objective

We hypothesized that inner-city children might have anti-cockroach and anti-mouse IgE by age 3 years, and their presence would be associated with respiratory and atopic symptoms.

Methods

Children were followed prospectively from birth through age 3 years (n = 404). Residential levels of cockroach and mouse allergens, sera levels of anti-cockroach and anti-mouse IgE, and parental report of wheeze, rhinitis, and atopic dermatitis were measured.

Results

The odds of early wheeze were significantly higher among children who had IgE to cockroach (odds ratio [OR], 3.3; 95% CI, 1.8-6.2), mouse (OR, 4.6; 95% CI, 2.3-9.0), or both (OR, 9.7; 95% CI, 3.4-27.3). The odds of rhinitis or atopic dermatitis were also higher among children with IgE to cockroach, mouse, or both. Higher IgE class to cockroach and mouse was associated with wheeze and atopic dermatitis (tests for trend, P < .002).

Conclusions

Children age 2 to 3 years who have anti-cockroach and anti-mouse IgE are at increased risk of wheeze and atopy. Moreover, a dose-response relationship was found between higher IgE class and increased prevalence of wheeze, rhinitis, or atopic dermatitis. These findings indicate the importance of reducing exposure to cockroach and mouse allergens for susceptible children.

Key words: Cockroach, mouse, allergy, wheeze, inner city, rhinitis, IgE, atopic dermatitis, eczema, asthma, sensitization

Abbreviations used: CAMP, Childhood Asthma Management Program, CCCEH, Columbia Center for Children's Environmental Health, LOD, Level of detection, MUP, Mouse urinary protein, OR, Odds ratio

a Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY

b Columbia Center for Children's Environmental Health (CCCEH), Columbia University, New York, NY

c Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY

d Data Coordinating Center at New York State Psychiatric Institute and Columbia University, New York, NY

e Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, Ill

Reprint requests: Rachel L. Miller, MD, Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, Columbia University College of Physicians and Surgeons, 622 West 168th St, PH 8 E 101, New York, NY 10032.

Supported by the National Institute of Environmental Health Sciences (grant nos. 5 P01 ES009600, 5 R01 ES008977, and P30 ES009089), the US Environmental Protection Agency (grant nos. R827027 and RD-832141), the Irving General Clinical Research Center (grant no. RR00645), the Educational Foundation of America, the Horace W. Goldsmith Foundation, the Gladys & Roland Harriman Foundation, The John Merck Fund, The New York Community Trust, and the Trustees of the Blanchette Hooker Rockefeller Fund.

Disclosure of potential conflict of interest: M. S. Perzanowski has received grant from the National Institutes of Health (NIH). G. L. Chew has received grants from the National Institute of Environmental Health Sciences. R. L. Miller has received grants or other research funding from the NIH, the Environmental Protection Agency, and the Sandler Program for Asthma Research. The rest of the authors have declared that they have no conflict of interest.

PII: S0091-6749(08)01667-9

doi:10.1016/j.jaci.2008.08.034

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