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. 2022 May 2;12(5):e12149.
doi: 10.1002/clt2.12149. eCollection 2022 May.

Allergic sensitization to lipocalins reflects asthma morbidity in dog dander sensitized children

Ulrika Käck  1   2 , Marianne van Hage  3 , Hans Grönlund  4 , Gunnar Lilja  1   2 , Anna Asarnoj  5   6 , Jon R Konradsen  5   6
Affiliations

Allergic sensitization to lipocalins reflects asthma morbidity in dog dander sensitized children

Ulrika Käck et al. Clin Transl Allergy. .

Abstract

Background: Sensitization to dog is an important risk factor for asthma in children, but the clinical relevance of IgE to available dog- and furry animal allergen molecules is uncertain.

Methods: Spirometry, methacholine challenge, fraction of exhaled nitric oxide, nasal challenge with dog extract and questionnaires were performed in 59 dog-sensitized children (age 10-18 years). Serum IgE to dog-, cat-, horse extracts and the allergen molecules Can f 1-6, Fel d 1, Fel d 2, Fel d 4 and Equ c 1 were evaluated.

Results: Median numbers of positive IgE results to furry animal allergen molecules among children without asthma was 3, with asthma 5.5 and with troublesome asthma 9 (asthma vs. no asthma; p = 0.039; troublesome asthma vs. no asthma; p = 0.009). The odds ratio for asthma if sensitized to any lipocalin was 7.2 (95% confidence Interval: 1.44-35.9). Children with troublesome asthma had higher IgE levels to the lipocalins Can f 2, Can f 4 and Can f 6 compared to the rest of the study population (44 vs. 4.1 kUA/L, p = 0.015; 5.8 vs. 0.9 kUA/L, p = 0.018 and 1.3 vs. 0.7 kUA/L, p = 0.03 respectively). Furthermore, a positive nasal challenge was more common among children with troublesome asthma (83% vs. 36%, p = 0.036).

Conclusions: Polysensitization to furry animal allergens and lipocalins is associated with asthma in dog-sensitized children. Children with troublesome asthma have higher IgE levels to several dog lipocalins than other dog sensitized children.

Key message: Polysensitization to furry animal allergens and high IgE levels to the dog lipocalins Can f 2, Can f 4 and Can f 6 is associated with asthma severity in dog dander sensitized children. Molecular allergy diagnostics may thus help the clinicians to evaluate the impact of allergic sensitization on asthma morbidity.

Keywords: allergen molecules; asthma; can f; children; dog allergy; lipocalins; nasal provocation testing.

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Conflict of interest statement

Ulrika Käck report personal fees from Thermo Fisher Scientific, outside the submitted work. Marianne van Hage report personal fees from Thermo Fisher Scientific, outside the submitted work. Anna Asarnoj report personal fees from Meda/Mylan, Orion Pharma, ALK and Thermo Fisher Scientific outside the submitted work. Jon R. Konradsen has received material from Thermo Fisher to perform the IgE analysis in this project. Hans Grönlund and Gunnar Lilja declare that they have no relevant conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Median numbers of positive IgE reactivities (y‐axis) in children with no asthma (blue), asthma (orange) and troublesome asthma (red) to: A. Furry animal allergen molecules (n = 1–10). B. Lipocalins (n = 0–6). Boxes indicate interquartile ranges and whiskers maximum/minimum number of positive IgE reactivities
FIGURE 2
FIGURE 2
A Venn diagram showing overlapping markers for asthma severity. A, Red circle corresponding to children with fraction of exhaled nitric oxide (FeNO) > 35 ppb. B, Green circle corresponding to children with methacholine PD20 < 2 μmol. C, Yellow circle corresponding to children with Asthma Control Test (ACT) score < 20 points. B, Numbers (percentages) of positive IgE sensitizations (≥0.1 kUA/L) to dog allergen molecules and numbers (percentages) of children with positive result at nasal challenge with dog dander extract (bottom line) in children with troublesome asthma in comparison with the rest of the dog sensitized study population. Boldface indicate p < 0.05
FIGURE 3
FIGURE 3
IgE levels among sensitized children with troublesome asthma “ABC” (n = 6), with pronounced bronchial hyperreactivity (PD20 < 2 μmol), poor asthma control (Asthma Control Test (ACT) < 20) and high levels of exhaled fraction of exhaled nitric oxide (FeNO) (>35 ppb) compared with IgE levels among sensitized children with controlled asthma or rhinitis only, “others” (n = 51). Horizontal bars indicate median levels. Levels above 100 kUA/L were set at 100 kUA/L
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