J ALLERGY CLIN IMMUNOL
VOLUME 133, NUMBER 2
Abstracts AB285
ESDAY
983 Effect Of Prenatal Exposure To Indoor PM2.5 andEnvironmental Tobacco Smoke Affecting Lower RespiratoryTract Infection Was Modified By ROS Genes: Cocoa Study
Dr. Song I. Yang, MD1, Dr. Eun Lee, MD1, Dr. Young Ho Jung, MD1,
Kil-Yong Choi2, Mi-Jin Kang, MS2, Ho-Sung Yu2, Cheol Min Lee3,
Prof. Youn Ho Shin, MD, PhD4, Prof. Kangmo Ahn, MD, PhD5,
Prof. Kyung Won Kim, MD, PhD6, Prof. Soo-Jong Hong, MD, PhD1
Cocoa study Group7; 1Childhood Asthma Atopy Center, Department of
Pediatrics, Asan Medical Center, University of Ulsan College of Medi-
cine, Seoul, South Korea, 2Asan Institute for Life Sciences, University
of Ulsan College of Medicine, Seoul, South Korea, 3Institute of Environ-
mental and Industrial Medicine, Hanyang University, Seoul, South Korea,4Department of Pediatrics, CHAMedical Center, CHAUniversity College
of Medicine, Seoul, South Korea, 5Department of Pediatrics, Samsung
Medical Center, Sungkyunkwan University School of Medicine, Seoul,
South Korea, 6Department of Pediatrics, Yonsei University College of
Medicine, Seoul, South Korea, 7COCOA study group.
RATIONALE: Prenatal air pollution exposure associates with impaired
fetal growth, decreased lung function, respiratory morbidity and mortality.
We aimed to investigate the influence of prenatal indoor fine particulate
matter (PM2.5) and environmental tobacco smoke (ETS) exposure and ge-
netic polymorphisms on the susceptibility to respiratory tract infection
(RTI) in infancy.
METHODS: Demographic, environmental factors and diagnosis of RTI in
the first year of life were evaluated in 231 infants from a birth cohort of
general population in Korea between 2007 and 2011. Indoor PM2.5 was
measured during the third trimester and mothers were asked about ETS
exposure during pregnancy. Nuclear factor (erythroid-derived 2)-like 2
(NRF2, rs6726395), glutathione S-transferase pi 1 (GSTP1, rs1695) and
glutathione S-transferase mu 1 (GSTM1, copy number variation) genotyp-
ing was performed.
RESULTS: Prenatal indoor PM2.5 or ETS exposure increased the risk of
bronchiolitis and lower RTI (LRTI), but not upper RTI (URTI), in infancy.
They also synergistically increased susceptibility to bronchiolitis and LRTI
(aOR 5.20; 95% CI 1.10-24.61, aOR 5.18; 95% CI 1.40-19.24, respec-
tively), but not URTI. This synergistic effect was increased by Nrf2 GG
(aOR10.23; 95%CI 1.02-102.57, aOR 14.01; 95%CI 1.42-138.02, respec-
tively) and GSTM1 null genotypes (aOR 9.45; 95% CI 1.03-86.78, aOR
5.70; 95% CI 1.02-31.95, respectively).
CONCLUSIONS: Indoor PM2.5 and ETS exposure during the prenatal
period synergistically increased susceptibility to bronchiolitis and LRTI,
but not URTI. This effect was modified by polymorphisms in reactive ox-
ygen species-related genes.
984 IgE Anti-Respiratory Syncytial Virus Antibodies In OlderAsthmatic Children
Mira Mandal1, Dr. Rauno O. Joks, MD, FAAAAI2, Dr. Kevin
Norowitz, MD3, Dr. Diana Weaver, MD4, Dr. Helen G. Durkin, PhD5,
Dr. Martin H. Bluth, MD, PhD6, Dr. Stephan Kohlhoff, MD5, Dr. Tamar
A. Smith-Norowitz, PhD7; 1SUNY Downstate Medical Center,2SUNY-HSC, Brooklyn, NY, 3SUNY Downstate Medical Center, Center
for Allergy and Asthma Research, Brooklyn, NY, 4SUNY Downstate
Med. Ctr, Brooklyn, NY, 5Center for Allergy and Asthma Research, State
University of New York Downstate Medical Center, Brooklyn, NY,6Wayne State University Medicine, Detroit, MI, 7Center for Allergy and
Asthma Research at SUNY Downstate, Brooklyn, NY.
RATIONALE: Respiratory syncytial virus (RSV) causes severe lower
respiratory tract disease in infant and young children, and is a serious
public health concern, as is the increase in pediatric asthma in the United
States. However, it remains unknown if IgE and RSVantibodies (Abs) play
a role in development of asthma.
METHODS: Total serum IgE, and IgE and IgG anti-RSVAb responses
were studied in older asthmatic compared with non asthmatic children (M/
F, mean age: 14) (N5 30, N543, respectively) (UniCAP total IgE
Fluoroenzymeimmunoassay (IU/mL), enzyme-linked immunosorbent
assay (U/mL; OD value).
RESULTS: Total serum IgE levels were increased 3-fold in asthmatic
compared with non asthmatic children (323 + 217, 107 + 116, P5 0.0003).
Further, IgE anti-RSV Ab levels were 1.5-fold higher in asthmatic
compared with nonasthmatic children (P5 0.01); IgG anti-RSVAb levels
were slightly increased in the asthmatic children (112 + 32, 81+ 59,
P50.003). Interestingly, values of IgE anti-RSVAbs positively correlated
with IgG anti-RSVAbs.
CONCLUSIONS: The presence of IgE anti-RSV abs in older children
further lends support to an important role of RSV infection in asthma.
985 Asthma Symptoms and Rhinovirus In A LongitudinalChildren's Cohort
Dr. Euan R. Tovey, PhD1,2, Dr. S. Stelzer-Braid, PhD3,4, Dr. B. G.
Toelle, PhD1, Ms. C. M. Willenborg, BSc3, Dr. H. K. Reddel, PhD,
MBBS1,2, Ms. F. L. Garden, MPH1,2, Prof. A. Jaffe, PhD, MD4,5, Ms. R.
Strachan5, Dr. B. G. Oliver, PhD1,2, Dr. Y. C. Belessis, MBBS4,5,
Prof. G. B. Marks, PhD, MD1,2, Prof. W. D. Rawlinson, PhD, MD3,4;1Woolcock Institute of Medical Research, Sydney, Australia, 2University
of Sydney, Australia, 3Virology Division, SEALS Microbiology, Prince
of Wales Hospital, Sydney, Australia, 4University of NSW, Australia,5Sydney Children’s Hospital, Randwick Australia.
RATIONALE: Emergency presentations for asthma are strongly associ-
ated with rhinovirus (HRV) infections in children. However, community
viral infections are common and often mild or asymptomatic, and the role
of viruses in changing daily symptoms is less clear. We hypothesized such
infections would be associated with increased symptoms.
METHODS: 67 children, aged 5-12, with moderately severe asthma, self-
collected nasal-wash and exhaled breath samples and recorded their recent
asthma and cold symptoms and current lung function, twice per week for
10 weeks. The presence of 8 viruses, including rhinovirus (HRV), was
analysed by PCR. A mixed model, to account for repeated measures, was
used to determine the current and delayed impact of viruses on symptoms
and lung function.
RESULTS: 25.5% of nasal samples and 11.5% of breath samples were
positive for HRV; only 1.8% were positive for other viruses. The presence
of HRVin nasal wash, but not in breath, was associatedwith the presence of
symptoms; adjusted odds ratios: cough 2.53, (95%CI 1.62-3.94), wheeze
3.05, (95%CI 1.89 to 4.93), self-reported febrile 2.07, (95%CI 1.17 to 3.64)
and coryzal symptoms 1.95, (95%CI 1.14 to 3.32) over the previous 3-4
days. These associations remained 3-4 days later, but generally not 7 days
later. There was no association between any virus positivity and changes in
electronically recorded PEFR and FEV1.
CONCLUSIONS: In a longitudinal study of children with moderate
asthma, the presence of rhinovirus in nasal wash, but not in exhaled breath,
was associated with worsening of several indices of respiratory symptoms
for up to a week.
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