NEW RESEARCH shows that children living in disadvantaged communities are more exposed to environmental allergens, which may increase their susceptibility to upper respiratory infections (URIs). A study from the University of Texas, Austin, Texas, USA, investigated the links between indoor allergens, including mouse and cockroach allergens, and respiratory outcomes in children with asthma.
The data was gathered from the Environmental Control as Add-on Therapy for Childhood Asthma (ECATCh) study, focusing primarily on Black children. The study examined 90 participants, 92% of whom were Black, and found that 27% of the 192 observations tested positive for URI. Cockroach and mouse allergen concentrations were linked to more severe URI outcomes, including cold symptoms, pulmonary eosinophilic inflammation, and reduced lung function. For example, a doubling of cockroach allergen concentration increased the odds of a URI with cold symptoms by 18% and the odds of a URI with reduced lung function by 45%. These effects were stronger among children sensitised to these allergens.
The findings highlight how children from low-income, Black communities are disproportionately affected by allergen exposure, contributing to higher rates of asthma exacerbations. While cockroach and mouse allergens were strongly associated with URI outcomes, dog and cat allergens showed no significant effect, with cat allergens potentially offering some protective effects.
The study suggests that environmental factors, like poor housing quality, contribute to respiratory health disparities. Interventions to reduce indoor allergen exposure, such as pest control, could help reduce asthma complications among vulnerable children. Furthermore, biologic treatments, like omalizumab, may reduce virus-related asthma flare-ups by addressing the immune response to allergens and infections. More extensive studies are needed to confirm these associations and explore targeted solutions.
Katie Wright, EMJ
Reference
Bhavnani D et al. Indoor allergen exposure and its association to upper respiratory infections and pulmonary outcomes among children with asthma. J Allergy Clin Immunol. 2024;DOI:10.1016/j.jaci.2024.08.006.
