Fungal exposure, atopy, and asthma exacerbations in Puerto Rican children

Joshua Blatter; Erick Forno; John Brehm; Edna Acosta-Pérez; María Alvarez; Angel Colón-Semidey; Peter S Thorne; Nervana Metwali; Glorisa Canino; Juan C Celedón

doi:10.1513/AnnalsATS.201402-077OC

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Fungal exposure, atopy, and asthma exacerbations in Puerto Rican children

Journal article

Open access

Peer reviewed

Fungal exposure, atopy, and asthma exacerbations in Puerto Rican children

Joshua Blatter, Erick Forno, John Brehm, Edna Acosta-Pérez, María Alvarez, Angel Colón-Semidey, Peter S Thorne, Nervana Metwali, Glorisa Canino and Juan C Celedón

Annals of the American Thoracic Society, Vol.11(6), pp.925-932

07/2014

DOI: 10.1513/AnnalsATS.201402-077OC

PMCID: PMC4213992

PMID: 24915164

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Abstract

Glucan is a component of the fungal cell wall that is used as a marker of fungal exposure. Little is known about indoor glucan, atopy, and asthma exacerbations among children living in tropical environments such as Puerto Rico. Our objective was to examine whether glucan exposure is associated with degree of atopy or visits to the emergency department (ED)/urgent care for asthma in Puerto Rican children. This was a cross-sectional study of 317 children aged 6 to 14 years with (cases, n = 160) and without (control subjects, n = 157) asthma in San Juan, Puerto Rico. Our primary outcomes were the number of positive skin tests to allergens (range, 0-15) and (in cases only) having had at least one visit to the ED/urgent care for asthma in the prior year. Levels of glucan, endotoxin, peptidoglycan, and five allergens (Der p 1, Bla g 2, Fel d 1, Can f 1, and Mus m 1) were measured in samples of house dust. Linear or logistic regression was used for the multivariate analysis. In a multivariate analysis adjusting for case-control status, mouse allergen, and other covariates, children exposed to glucan levels in the second and third quartiles had approximately two more positive skin tests than those in the lowest quartile (P < 0.01 in both instances). Among children with asthma, exposure to the highest quartile of glucan was associated with nearly ninefold greater odds of one or more visits to the ED/urgent care for asthma (95% confidence interval for adjusted odds ratio, 2.7-28.4; P < 0.001). Our results suggest that indoor fungal exposure leads to an increased degree of atopy and visits to the ED/urgent care for asthma in Puerto Rican children.

Allergens - adverse effects

Prevalence

Cross-Sectional Studies

Follow-Up Studies

Humans

Dust - immunology

Male

Fungi - immunology

Allergens - immunology

Puerto Rico - epidemiology

Adolescent

Asthma - immunology

Hypersensitivity, Immediate - epidemiology

Hypersensitivity, Immediate - immunology

Female

Retrospective Studies

Odds Ratio

Child

Asthma - epidemiology

Details

Title: Subtitle: Fungal exposure, atopy, and asthma exacerbations in Puerto Rican children
Creators: Joshua Blatter - 1 Division of Pulmonary Medicine, Allergy, and Immunology, Department of Pediatrics, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, Pennsylvania
Erick Forno
John Brehm
Edna Acosta-Pérez
María Alvarez
Angel Colón-Semidey
Peter S Thorne
Nervana Metwali
Glorisa Canino
Juan C Celedón
Resource Type: Journal article
Publication Details: Annals of the American Thoracic Society, Vol.11(6), pp.925-932
DOI: 10.1513/AnnalsATS.201402-077OC
PMID: 24915164
PMCID: PMC4213992
NLM abbreviation: Ann Am Thorac Soc
ISSN: 2325-6621
eISSN: 2325-6621
Publisher: American Thoracic Society; United States
Grant note: P30 ES005605 / NIEHS NIH HHS R01 HL079966 / NHLBI NIH HHS HL079966 / NHLBI NIH HHS R01 HL117191 / NHLBI NIH HHS HD052892 / NICHD NIH HHS HL117191 / NHLBI NIH HHS K12 HD052892 / NICHD NIH HHS
Language: English
Date published: 07/2014
Academic Unit: Civil and Environmental Engineering; Occupational and Environmental Health
Record Identifier: 9983997350302771

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