J Allergy Clin Immunol February 2018

AB150 Abstracts J ALLERGY CLIN IMMUNOL
FEBRUARY 2018
475 Household Dust Endotoxin Level and Food

Allergen Sensitization in the National Health and
Nutrition Examination Survey (NHANES)
(84.6%). PGA sensitization was independently associated with marine
sports (odds ratio, 278.0, 95 percent confidential interval, 36.9-6315.9,
p<0.001) adjusted for male sex and bathing, but not with male sex nor bath-
ing. In addition, although there is no significant difference of experience in
Angela Tsuang, MD, MSc1, Ginger L. Chew, ScD2, Joanne marine sports between natto and non-natto allergy groups, natto allergy
Sordillo, ScD3, and Supinda Bunyavanich, MD, MPH, FAAAAI4; 1Icahn group significantly had participated more frequently in marine sports
School of Medicine at Mount Sinai, New York, NY, 2Department of Envi- than non-natto allergy group (p<0.001).
ronmental Health Sciences, Mailman School of Public Health, Columbia CONCLUSIONS: Surfing is a risk factor of PGA sensitization, resulting
University, New York, NY, 3Harvard Medical School, Boston, MA, 4Divi- in subsequent natto allergy. PGA sensitization may occur via inflamed skin
sion of Allergy & Immunology, Department of Pediatrics, Icahn School of in patients by cnidarian stings while floating in the sea.
Medicine at Mount Sinai, New York, NY; Department of Genetics and
Genomic Sciences and Institute of Genomics and Multiscale Biology,
Icahn School of Medicine at Mount Sinai, New York, NY. 477 Persistent Cows Milk Allergy is Associated with
Decreased Growth: A Longitudinal Study
RATIONALE: Household endotoxin levels have been variably linked to
asthma and atopy. We sought to determine the association between Karen A. Robbins, MD1, Robert A. Wood, MD, FAAAAI2, and Corinne
household endotoxin levels and food allergen sensitization in a large Keet, MD, MS, PhD3; 1Children’s National Medical Center, Washington,
national cohort. DC, 2Johns Hopkins University School Medicine, Baltimore, MD, 3Johns
METHODS: We studied 6,963 participants from the 2005-2006 National Hopkins School of Medicine, Baltimore, MD.
Health and Nutrition Examination Survey (NHANES). House dust RATIONALE: Data on the effects of food allergy on growth are limited,
endotoxin was collected from the bedroom, and serum-specific IgE for with most studies providing only cross-sectional information in early
milk, egg, and peanut were measured. Log-transformed endotoxin level childhood. Here we describe longitudinal data on growth in children with
and specific food allergen sensitization (sIgE>50.35 kU/L) were fitted persistent food allergy to cow’s milk or peanut/tree nuts.
into logistic regression models using STATA11. METHODS: A retrospective chart review was conducted for 191 children
RESULTS: The geometric mean of household endotoxin in this large US strictly avoiding cow’s milk (n5111) or peanut/tree nuts (n580) due to
cohort was 15.5 EU/mg (standard error 0.5 EU/mg). The prevalence of IgE-mediated allergy, who had at least one clinic visit between the ages of
food allergen sensitization varied by specific food: milk 5.7%, egg 4.0%, 2-4 years, 5-8 years, and 9-12 years. Differences in height, weight, and
and peanut 7.9%. The unadjusted model revealed that a 10-fold increment BMI z-scores were analyzed by generalized estimating equation regression
in endotoxin was associated with sensitization to milk (OR 1.8, 95%CI 1.3- models.
2.3) and egg (OR 1.4, 95%CI 1.04-1.8) but not peanut (OR 1.1, 95%CI 0.9- RESULTS: In measurements from 1098 clinic visits, children with milk
1.4). Multivariable logistic regression models controlled for identified allergy had lower weight-(mean z difference 0.39,95%CI: 0.13– 0.66
confounders including age, country of birth, total people in household, ,p50.004) and height-(mean z difference 0.39,95%CI: 0.11–
race, history of wheezing, and US region demonstrated that household 0.67,p50.006), but not BMI-for-age (p50.11) z-scores compared to
endotoxin levels remained positively associated with sensitization to milk peanut/tree nut allergic children. These differences were larger in the 5-8
(OR 1.7, 95%CI 1.2-2.1) and egg (OR 1.4, 95%CI 1.01-1.9) but not peanut yo (mean z difference 0.43,95%CI: 0.13–0.73,p50.004) and 9-12 yo
(OR 0.98, 95%CI 0.8-1.2). (mean z difference 0.52,95%CI: 0.21–0.84,p50.001) age groups than the
CONCLUSIONS: Increasing household endotoxin levels is associated <5 yo age group for weight but not height (p<0.05 for interaction with
age), and were unaffected by other atopic conditions, early-onset eczema,
SUNDAY
with higher odds of milk and egg sensitization. Participants with allergies
likely have an altered responsiveness to microbial components leading to or inhaled corticosteroid use. Correspondingly, persistent milk allergy was
allergic disease. This effect of endotoxin is beneficial for understanding associated with a greater decline in weight and also BMI z-scores from
how environmental factors play a role in food allergies. baseline visit (2-4 yo) (weight: mean z-difference 0.25, 95%CI: 0.06– 0.43,
p50.008, BMI: mean z-difference 0.34,95%CI: 0.09- 0.59,p50.007).
CONCLUSIONS: Persistent cow’s milk allergy may negatively influence
476 Surfing is a risk factor of sensitization to
poly(gamma-glutamic acid) in
soybean-induced late-onset anaphylaxis
fermented growth through pre-adolescence. Further study is needed to better under-
stand the complex relationship between food allergy and childhood growth
patterns.
Naoko Inomata, Mami Miyakawa, and Michiko Aihara; Yokohama City
University School of Medicine, Yokohama.
RATIONALE: Poly(g-glutamic acid) (PGA) is the allergen of fermented
soybeans, natto, that causes late-onset anaphylaxis. We speculated that
jellyfish stings sensitize adults to PGA because a surfer had allergies to
both natto and jellyfish, which produce PGA while stinging someone. The
aim of the study was to identify demographic and behavior factors, such as
marine sports, associated with PGA sensitization.
METHODS: Outpatients diagnosed with food allergies based on relevant
clinical history, positive skin test and/or food challenge test were asked to
answer a questionnaire during a regular visit in 2016.
RESULTS: Questionnaire data from 140 outpatients were analyzed.
These patients were divided into two groups: natto allergy group (13
patients, M:F510:3, mean age 40.6 yrs) and non-natto allergy group (127
patients, M:F546:81, mean age 44.5 yrs). All 13 patients with natto allergy
had positive results in both skin prick test and basophil activation test with
PGA. 92.3% of them had a hobby in marine sports, especially surfing

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AB150 Abstracts J ALLERGY CLIN IMMUNOL

475 Household Dust Endotoxin Level and Food

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