THE EPIDEMIOLOGY OF HOME ALLERGENS AND ASTHMA

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. A longitudinal prospective study of a birth cohort genetically predisposed to developing asthma is the most appropriate study design to determine the immunologic relationship between exposure, serologic response, cellular response, and disease outcome. We propose to utilize a prospective longitudinal cohort study of children of allergic or asthmatic parents to examine the role of infant allergen exposure in the development of (1) antibody and cellular immune responses to these allergens by age 5; (2) skin sensitization, bronchial responsiveness, and asthma/wheeze by age 7. The allergen exposures for the 505 children in the cohort include house dust mite (Der p 1, Der f 1), fungi, cockroach (Bla g 1, Bla g 2), cat, (Fel d I), and dog (Can I). Antibody outcomes include total IgE and allergen specific IgE, IgG, IgG1 and IgG4. In a subset of 50 five year old children with asthmatic parents, 25 with high and 25 with low antigen exposure in infancy, we will assay subsequent response to PHA, mite, cat and cockroach stimulation in the form of lymphocyte proliferation and cytokine production (IL-4, IL-5, and interferon-? (IFN-?)). Additional potentially influential host and environmental factors to be examined include: parent asthma history, maternal prenatal antibody status, perinatal history, acute lower respiratory illness history, day care, environmental tobacco smoke, sex, and race. We hypothesize that by 5 years of age, the following factors will each contribute to the prediction of the total IgE and allergen specific antibody response of the child: a. Parental history of asthma and prenatal maternal antibody levels. b. Lower respiratory illness history before age 2, environmental tobacco smoke exposure, sex and race. c. Allergen distribution and exposure levels in the home during the first year of life.