Does Level of Allergen Sensitization Impact Asthma Related Outcomes Differently in Adult and Pediatric Asthma Patients?
Monday, March 5, 2018
South Hall A2 (Convention Center)
Supriya Jain, MD, Merritt L. Fajt, MD FAAAAI, Sally E. Wenzel, MD FAAAAI
RATIONALE: Studies have shown that environmental allergen sensitivity is an asthma risk factor. However, studies in severe asthma suggest the presence of specific IgE responses may be “protective” in relevant asthma outcomes. It is unknown whether there are differences in adults versus children.

METHODS: 101 asthmatics [77 adults, 24 pediatric] were enrolled in the Severe Asthma Research Program at the Pittsburgh site. We analyzed the relationship between number of positive environmental allergens based on serum specific IgE testing in adult and pediatric asthmatics, comparing those with and without a history of an ED visit or hospitalization in the previous year.

RESULTS: Pediatric asthmatics had a greater number of total allergens vs. adult asthmatics (median 7 vs. 3, p=0.007). In adult asthmatics, patients with no ED visits had more positive environmental allergen tests than those who had visited the ED (median 3 vs. 1, p=0.044) versus no difference in the pediatric asthmatics (p=0.79). Similarly, adults who had been hospitalized in the previous year had fewer positive environmental allergen specific IgE tests than those who had not been hospitalized (median 3 vs. 1, p=0.027), while there were no differences in number of allergens in children with or without a history of a hospitalization, (p=0.25).

CONCLUSIONS: In adult asthma, sensitization to a greater number of environmental allergens does not increase the risk of asthma exacerbations, and may be protective. However, in children, the number of positive tests does not seem to influence the risk for exacerbations. This suggests differences in asthma pathobiology in adults and children.