Home environmental factors may affect the response to mouse allergen reduction in children with asthma

Published: September 07, 2021

Mouse allergen sensitization and exposure is associated with asthma morbidity in studies of low-income, minority children, and household reduction in mouse allergen has been associated with improvements in asthma outcomes. However, it is not known whether other home environmental factors could modify the clinical response to mouse allergen reduction.

In a recent article from The Journal of Allergy and Clinical Immunology: In Practice, Sadreameli, S.C. et al. tested the hypothesis that three factors (baseline level of mouse allergen, level of particulate matter 10 microns or smaller (PM10), and sensitization and exposure to other indoor allergens) may modify the effect of mouse allergen reduction on asthma outcomes (symptoms, exacerbations). Allergic sensitization was measured via skin prick testing and indoor exposures were measured via home visits (baseline, six month, and twelve month) that included quantitative measures of mouse allergen (vacuum dust samples from child’s bed), PM10 (active monitoring in the child’s bedroom over three days), and bed dust for allergens (cat, cockroach, dog, and dust mite). Asthma outcomes were measured via telephone and in-person visits, with the primary outcome being maximal symptom days over the previous two weeks.

Participants (N=297) were predominantly minority (78% African American, 22% Hispanic) and publicly insured (88%). Higher baseline mouse allergen levels were associated with a greater clinical response to mouse allergen for several symptom and exacerbation outcomes. Additionally, lower indoor PM10 levels were associated with a greater response to mouse allergen reduction for several symptom, but not exacerbation outcomes. Sensitization and exposure to other indoor allergens did not appear to modify the effect of mouse allergen reduction. In conclusion, children with higher starting levels of mouse allergen may experience greater improvement in asthma outcomes and concomitant PM10 reduction could potentially enhance the clinical benefit of mouse allergen reduction.

The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.

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