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Allergen exposure and the development of asthma
  1. R Sporik,
  2. T A E Platts-Mills
  1. Asthma & Allergy Center, Department of Medicine, University of Virginia, Charlottesville, Virginia 22908-1355, USA
  1. Dr R Sporik sporik{at}hotmail.com nkm8t{at}virginia.edu

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Introductory article

Early exposure to house-dust mite and cat allergens and development of childhood asthma: a cohort study. Multicentre Allergy Study Group

S Lau, S Illi, C Sommerfeld, B Niggemann, R Bergmann, E von Mutius, U Wahn

Background: In a prospective birth cohort study, we assessed the relevance of mite and cat allergen exposure for the development of childhood asthma up to age 7 years. Methods: Of 1314 newborn infants enrolled in five German cities in 1990, follow-up data at age 7 years were available for 939 children. Assessments included repeated measurement of specific IgE to food and inhalant allergens, measurement of indoor allergen exposure at 6 months, 18 months, and 3 years of age, and yearly interviews by a paediatrician. At age 7 years, pulmonary function was tested and bronchial hyperresponsiveness was measured in 645 children. Findings: At age 7, the prevalence of wheezing in the past 12 months was 10.0% (94 of 938), and 6.1% (57 of 939) parents reported a doctor's diagnosis of asthma in their children. Sensitisation to indoor allergens was associated with asthma, wheeze, and increased bronchial responsiveness. However, no relation between early indoor allergen exposure and the prevalence of asthma, wheeze, and bronchial hyperresponsiveness was seen. Interpretation: Our data do not support the hypothesis that exposure to environmental allergens causes asthma in childhood, but rather that the induction of specific IgE responses and the development of childhood asthma are determined by independent factors. (Lancet 2000;356:1392–7)

In the decade since we last reviewed the literature and presented the case that allergen exposure was the principal cause of childhood asthma,1 the issue has continued to raise controversy and considerable interest. The introductory article2 is one of a number of prospective birth cohort studies started at that time to address the role of early life exposure to …

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