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Dust mite allergen sensitivity associated with wheezing risk among asthmatic children with rhinovirus

High allergic sensitization to dust mite allergen was common among children with asthma and increased the risk for acute wheezing provoked by rhinovirus, according to new data.

Researchers studied 287 Costa Rican children, aged 7 to 12 years, including 96 with acute wheezing, 65 with stable asthma and 126 nonasthmatic controls. The viral pathogens in nasal washes were than genetically identified. The results were analyzed in relation to wheezing, immunoglobulin E (IgE), allergen-specific IgE antibody and fraction of exhaled nitric oxide levels.

Of the wheezing children, 64% tested positive for rhinovirus compared with 13% of children with stable asthma and 13% of nonasthmatic controls (P<.001). Seventy-five percent of the rhinoviruses detected among wheezing children were group C strains. In addition, high titers of IgE antibodies to dust mite allergen (especially Dermatophagoides) were commonly found, correlating with total IgE and fraction of exhaled nitric oxide levels.

Children with titers of IgE antibodies to dust mite of 17.5 IU/mL or more who tested positive for rhinovirus had the greatest risk for wheezing. (OR=31.5; 95% CI, 8.3-108).

“… characterizing the atopic status of asthmatic children in greater detail, including their titers of allergen-specific IgE antibodies, is needed both to enhance investigations focused on mechanisms of rhinovirus-induced attacks of asthma and to identify children who are most likely to benefit from allergen-specific therapies,” the investigators wrote.