Hypersensitivity to common indoor aeroallergens in asthmatic patients

To study whether inhalant allergy to specific allergens is associated with inner city asthma, adult emergency room asthmatic patients (n = 41), and controls (n = 34) were examined for immediate hypersensitivity to six common indoor allergens using both skin tests and serologic tests. A highly significant association was observed between cat epidermis-specific IgE and asthma (P < .01) and this constituted the strongest association for a single allergen. The pooled variable of IgE to cat and/or dog epidermis had an even stronger disease association (P < .001). The presence of IgE to other allergens and the presence of two or more positive IgE tests did not enhance this association. After inclusion of three other significant covariates (elevated serum total IgE, longer duration of residence in the New York City area, and family history of atopic disease) in a logistic prediction model for asthma, skin test-detected IgE to cat and/or dog remained significantly associated with asthma (odds ratio 8.4, P = .019). A higher proportion of asthmatic patients had both IgE to cat and/or dog allergen and ongoing historical exposure to pets and/or rodents compared with controls (P < .005). Skin testing in general distinguished asthmatic patients better than serologic tests. These results suggest that inner city asthma in adults during a nonpeak pollen period is associated with hypersensitivity to specific indoor allergens. The potential to use environmental control to ameliorate disease in such patients may have significant health care implications.