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Predictors of asthma exacerbations in children with or without house dust mite allergy

Katarzyna Gmachowska1, Izabela Socha-Wojtylak2, Paweł Majak3

  • 1Medical University of Lodz, Łódź, Poland (Department of Pediatrics and Allergy).

International Journal of Occupational Medicine and Environmental Health
|July 21, 2026
PubMed

Insights

Asthma exacerbations in children show different patterns based on house dust mite (HDM) sensitization. Non-HDM-sensitized children had higher sRAGE and sinonasal symptoms, while HDM-sensitized children experienced poorer lung function and asthma control.

Area of Science:

  • Pediatric Allergy and Immunology
  • Respiratory Medicine
  • Environmental Health

Background:

  • Childhood asthma exacerbations significantly impact disease burden.
  • Risk of exacerbations varies with allergic sensitization type.
  • Identifying clinical and biological factors can improve risk stratification and management.

Purpose of the Study:

  • To assess relationships between exacerbation frequency, lung function, inflammatory biomarkers, and sinonasal symptoms in children with asthma.
  • To explore how sensitization status influences these relationships.

Main Methods:

  • Retrospective observational study of 80 children with allergic rhinitis and asthma.
  • Stratification by exacerbation frequency (≥2/12 months) and house dust mite (HDM) sensitization.
  • Assessments included spirometry (FEV₁, FEV₁/FVC), FeNO, eosinophil count, sRAGE, c-ACT, SN-5, and skin autofluorescence.

Main Results:

  • In non-HDM-sensitized children, frequent exacerbations correlated with higher sRAGE and more severe sinonasal symptoms.
  • In HDM-sensitized children, frequent exacerbations were linked to lower FEV₁, reduced FEV₁/FVC, and poorer asthma control (c-ACT).
  • Increased sinonasal symptom severity correlated with poorer asthma control.

Conclusions:

  • Asthma exacerbation risk presents distinct profiles based on sensitization status.
  • Elevated sRAGE and sinonasal inflammation may characterize non-HDM phenotypes.
  • Impaired lung function and poor asthma control are predominant in HDM-associated asthma.
Abstract

Keywords:
asthma exacerbationasthma markershouse dust mite allergypediatric asthmasRAGEsoluble receptor for advanced glycation end products

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