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2625110 
Journal Article 
Abstract 
Sensitization to dust mite and dog independently predict asthma severity in African Caribbean asthmatics from Barbados 
Mantese, VJ; Foster, C; Rafaels, NM; Watson, H; Barnes, K; Mathias, RA 
2010 
Yes 
American Journal of Respiratory and Critical Care Medicine
ISSN: 1073-449X
EISSN: 1535-4970 
181 
A2739 
English 
WOS:000208771001652 
is part of a larger document 3452678 Proceedings of the American Thoracic Society 2010 International Conference, May 14-19, 2010, New Orleans
Rationale
The 2007 Expert Panel Report 3 stressed maintaining asthma control through regular evaluation of asthma triggers and testing of common allergens. Previously we demonstrated that Blomia tropicalis and Dermatophagoides pteronyssinus sensitivity as measured with a specific IgE assay are strongly related to asthma; as much as a three-fold increase in asthma in sensitized individuals from Barbados. With over 20% of the population reported as asthmatics, asthma represents a truly burdensome problem for this densely populated tropical island community. It is hoped that by early detection of sensitization to allergens, asthma itself will be detected earlier and treated more effectively. Furthermore, a better understanding of the nature of asthma in the Barbados population will further aid the understanding of well-documented health disparities for this complex disease in populations of African descent. Here we sought to determine the correlation between sensitization to additional common allergens and a quantitative Subject Asthma Severity Score (SASS).

Methods
307 SASS were ascertained using a Seasonally Modified Asthma Severity Questionnaire. Of these 307, 171 asthmatics underwent skin prick tests to D. Pteronyssinus, D. farinae, Bermuda grass, cat, dog, American cockroach, and Alterneria alternate using standard protocol. Reaction area diameter was measured 15 minutes after exposure, with a positive cutoff at >3 mm. The SASS data was analyzed for possible covariance with age/sex. Mean differences in SASS between the sensitization groups to each allergen were evaluated using linear regression models fit in the General Estimating Equation framework correcting for familial clustering including covariates where necessary.

Results
Age and sex were not correlated to SASS (r = 0.0207 and 0.0016, respectively) and were excluded from future regression models. Of the 2 allergens tested, sensitization to dog and house dust mite showed associations with SASS (p = 0.005 and 0.003, respectively); sensitization to both were associated with significantly more severe asthma as seen in the box plots below. While there was some correlation between sensitization to mite/dog, both retained their independent effects on SASS in a model including both allergens simultaneously.

Conclusion
We observed independent correlations between allergic sensitization to house dust mite and dog with SASS in these asthmatics from Barbados implicating these allergens as major contributors to disease risk and severity in this population. 
American Thoracic Society 2010 International Conference 
New Orleans, LA 
May 14-19, 2010