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Bedroom Allergen Exposure Beyond House Dust Mites

  • Allergens (RK Bush and S Vieths, Section Editors)
  • Published:
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Abstract

Purpose of Review

The review provides insight into recent findings on bedroom allergen exposures, primarily focusing on pet, pest, and fungal exposures.

Recent Findings

Large-scale studies and improved exposure assessment technologies, including measurement of airborne allergens and of multiple allergens simultaneously, have extended our understanding of indoor allergen exposures and their impact on allergic disease. Practical, streamlined methods for exposure reduction have shown promise in some settings, and potential protective effects of early-life exposures have been further elucidated through the investigation of specific bacterial taxa. Advances in molecular allergology have yielded novel data on sensitization profiles and cross-reactivity.

Summary

The role of indoor allergen exposures in allergic disease is complex and remains incompletely understood. Advancing our knowledge of various co-exposures, including the environmental and host microbiome, that interact with allergens in early life will be crucial for the development of efficacious interventions to reduce the substantial economic and social burden of allergic diseases including asthma.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Custovic A. To what extent is allergen exposure a risk factor for the development of allergic disease? Clin Exp Allergy. 2015;45:54–62. https://doi.org/10.1111/cea.12450.

    Article  PubMed  CAS  Google Scholar 

  2. Burbank AJ, Sood AK, Kesic MJ, Peden DB, Hernandez ML. Environmental determinants of allergy and asthma in early life. J Allergy Clin Immunol. 2017;140:1–12. https://doi.org/10.1016/j.jaci.2017.05.010.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Platts-Mills TA. The allergy epidemics: 1870-2010. J Allergy Clin Immunol. 2015;136:3–13. https://doi.org/10.1016/j.jaci.2015.03.048.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Fukutomi Y, Taniguchi M. Sensitization to fungal allergens: resolved and unresolved issues. Allergol Int. 2015;64:321–31. https://doi.org/10.1016/j.alit.2015.05.007.

    Article  PubMed  CAS  Google Scholar 

  5. Kanchongkittiphon W, Mendell MJ, Gaffin JM, Wang G, Phipatanakul W. Indoor environmental exposures and exacerbation of asthma: an update to the 2000 review by the Institute of Medicine. Environ Health Perspect. 2015;123:6–20. https://doi.org/10.1289/ehp.1307922.

    Article  PubMed  CAS  Google Scholar 

  6. Phipatanakul W, Matsui E, Portnoy J, Williams PB, Barnes C, Kennedy K, et al. Environmental assessment and exposure reduction of rodents: a practice parameter. Ann Allergy Asthma Immunol. 2012;109:375–87. https://doi.org/10.1016/j.anai.2012.09.019.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Portnoy J, Chew GL, Phipatanakul W, Williams PB, Grimes C, Kennedy K, et al. Environmental assessment and exposure reduction of cockroaches: a practice parameter. J Allergy Clin Immunol 2013:132:802–8 e1–25. doi:https://doi.org/10.1016/j.jaci.2013.04.061.

  8. Portnoy J, Kennedy K, Sublett J, Phipatanakul W, Matsui E, Barnes C, et al. Environmental assessment and exposure control: a practice parameter--furry animals. Ann Allergy Asthma Immunol 2012:108:223 e1–15. Doi:https://doi.org/10.1016/j.anai.2012.02.015.

  9. Salo PM, Arbes SJ Jr, Crockett PW, Thorne PS, Cohn RD, Zeldin DC. Exposure to multiple indoor allergens in US homes and its relationship to asthma. J Allergy Clin Immunol. 2008;121:678–84 e2. https://doi.org/10.1016/j.jaci.2007.12.1164.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  10. • Salo PM, Wilkerson J, Rose KM, Cohn RD, Calatroni A, Mitchell HE, et al. Bedroom allergen exposures in US households. J Allergy Clin Immunol. 2018;141:1870–9.e14. https://doi.org/10.1016/j.jaci.2017.08.033. This comprehensive report on bedroom allergen exposures identifies factors that influence allergen levels and burden in U.S. homes. Differences and overlaps between exposure and sensitization patterns in the U.S. population highlight the complex nature of the relationships between allergen exposures, allergic sensitization, and disease.

    Article  PubMed  CAS  Google Scholar 

  11. Boor BE, Spilak MP, Corsi RL, Novoselac A. Characterizing particle resuspension from mattresses: chamber study. Indoor Air. 2015;25:441–56. https://doi.org/10.1111/ina.12148.

    Article  PubMed  CAS  Google Scholar 

  12. Spilak MP, Boor BE, Novoselac A, Corsi RL. Impact of bedding arrangements, pillows, and blankets on particle resuspension in the sleep microenvironment. Build Environ. 2014;81:60–8.

    Article  Google Scholar 

  13. Eggleston PA, Rosenstreich D, Lynn H, Gergen P, Baker D, Kattan M, et al. Relationship of indoor allergen exposure to skin test sensitivity in inner-city children with asthma. J Allergy Clin Immunol. 1998;102:563–70.

    Article  PubMed  CAS  Google Scholar 

  14. Grant T, Aloe C, Perzanowski M, Phipatanakul W, Bollinger ME, Miller R, et al. Mouse sensitization and exposure are associated with asthma severity in urban children. J Allergy Clin Immunol Pract. 2017;5:1008–14 e1. https://doi.org/10.1016/j.jaip.2016.10.020.

    Article  PubMed  Google Scholar 

  15. Arbes SJ Jr, Cohn RD, Yin M, Muilenberg ML, Burge HA, Friedman W, et al. House dust mite allergen in US beds: results from the first National Survey of Lead and Allergens in Housing. J Allergy Clin Immunol. 2003;111:408–14.

    Article  PubMed  Google Scholar 

  16. Calderon MA, Kleine-Tebbe J, Linneberg A, De Blay F, Hernandez Fernandez de Rojas D, Virchow JC, et al. House dust mite respiratory allergy: an overview of current therapeutic strategies. J Allergy Clin Immunol Pract. 2015;3:843–55. https://doi.org/10.1016/j.jaip.2015.06.019.

    Article  PubMed  Google Scholar 

  17. Posa D, Hofmaier S, Arasi S, Matricardi PM. Natural evolution of IgE responses to mite allergens and relationship to progression of allergic disease: a review. Curr Allergy Asthma Rep. 2017;17:28. https://doi.org/10.1007/s11882-017-0697-y.

    Article  PubMed  CAS  Google Scholar 

  18. Posa D, Perna S, Resch Y, Lupinek C, Panetta V, Hofmaier S, et al. Evolution and predictive value of IgE responses toward a comprehensive panel of house dust mite allergens during the first 2 decades of life. J Allergy Clin Immunol. 2017;139:541–9 e8. https://doi.org/10.1016/j.jaci.2016.08.014.

    Article  PubMed  CAS  Google Scholar 

  19. Thomas WR. House dust mite allergens: new discoveries and relevance to the allergic patient. Curr Allergy Asthma Rep. 2016;16:69. https://doi.org/10.1007/s11882-016-0649-y.

    Article  PubMed  CAS  Google Scholar 

  20. Wilson JM, Platts-Mills TAE. Home environmental interventions for house dust mite. J Allergy Clin Immunol Pract. 2018;6:1–7. https://doi.org/10.1016/j.jaip.2017.10.003.

    Article  PubMed  Google Scholar 

  21. Zahradnik E, Raulf M. Respiratory allergens from furred mammals: environmental and occupational exposure. Vet Sci. 2017;4 https://doi.org/10.3390/vetsci4030038.

  22. American Pet Products Association (APPA). The 2017-2018 APPA National Pet Owners Survey Debut: APPA; 2017 [cited 25 May 2018] [Available from: http://www.americanpetproducts.org/Uploads/MemServices/GPE2017_NPOS_Seminar.pdf.

  23. • Gergen PJ, Mitchell HE, Calatroni A, Sever ML, Cohn RD, Salo PM, et al. Sensitization and exposure to pets: the effect on asthma mMorbidity in the US population. J Allergy Clin Immunol Pract. 2018;6:101–7 e2. https://doi.org/10.1016/j.jaip.2017.05.019. This study showed that exposure to elevated levels of dog and cat allergens in the bedroom of atopic asthmatics sensitized to pets increased the number of asthma attacks significantly, suggesting that the combination of asthma, pet exposure, and pet sensitivity results in considerable excess asthma morbidity.

    Article  PubMed  Google Scholar 

  24. Konradsen JR, Fujisawa T, van Hage M, Hedlin G, Hilger C, Kleine-Tebbe J, et al. Allergy to furry animals: new insights, diagnostic approaches, and challenges. J Allergy Clin Immunol. 2015;135:616–25. https://doi.org/10.1016/j.jaci.2014.08.026.

    Article  PubMed  Google Scholar 

  25. Sheikh SI, Pitts J, Ryan-Wenger NA, McCoy KS, Hayes D Jr. Environmental exposures and family history of asthma. J Asthma. 2016;53:465–70. https://doi.org/10.3109/02770903.2015.1108440.

    Article  PubMed  Google Scholar 

  26. Bonnet B, Messaoudi K, Jacomet F, Michaud E, Fauquert JL, Caillaud D, et al. An update on molecular cat allergens: Fel d 1 and what else? Chapter 1: Fel d 1, the major cat allergen. Allergy Asthma Clin Immunol. 2018;14:14. https://doi.org/10.1186/s13223-018-0239-8.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  27. Chan SK, Leung DYM. Dog and cat allergies: current state of diagnostic approaches and challenges. Allergy Asthma Immunol Res. 2018;10:97–105. https://doi.org/10.4168/aair.2018.10.2.97.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Matricardi PM, Kleine-Tebbe J, Hoffmann HJ, Valenta R, Hilger C, Hofmaier S, et al. EAACI molecular allergology user’s guide. Pediatr Allergy Immunol. 2016;27(Suppl 23):1–250. https://doi.org/10.1111/pai.12563.

    Article  PubMed  Google Scholar 

  29. Pomes A, Chapman MD, Wunschmann S. Indoor allergens and allergic respiratory disease. Curr Allergy Asthma Rep. 2016;16:43. https://doi.org/10.1007/s11882-016-0622-9.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  30. Morris DO. Human allergy to environmental pet danders: a public health perspective. Vet Dermatol. 2010;21:441–9. https://doi.org/10.1111/j.1365-3164.2010.00882.x.

    Article  PubMed  Google Scholar 

  31. Nicholas CE, Wegienka GR, Havstad SL, Zoratti EM, Ownby DR, Johnson CC. Dog allergen levels in homes with hypoallergenic compared with nonhypoallergenic dogs. Am J Rhinol Allergy. 2011;25:252–6. https://doi.org/10.2500/ajra.2011.25.3606.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Sartore S, Landoni E, Maione S, Tarducci A, Borrelli A, Soglia D, et al. Polymorphism analysis of Ch1 and Ch2 genes in the Siberian cat. Vet Sci. 2017;4 https://doi.org/10.3390/vetsci4040063.

  33. Vredegoor DW, Willemse T, Chapman MD, Heederik DJ, Krop EJ. Can f 1 levels in hair and homes of different dog breeds: lack of evidence to describe any dog breed as hypoallergenic. J Allergy Clin Immunol. 2012;130:904–9 e7. https://doi.org/10.1016/j.jaci.2012.05.013.

    Article  PubMed  CAS  Google Scholar 

  34. Custovic A, Green R, Fletcher A, Smith A, Pickering CA, Chapman MD, et al. Aerodynamic properties of the major dog allergen Can f 1: distribution in homes, concentration, and particle size of allergen in the air. Am J Respir Crit Care Med. 1997;155:94–8. https://doi.org/10.1164/ajrccm.155.1.9001295.

    Article  PubMed  CAS  Google Scholar 

  35. Custovic A, Simpson A, Pahdi H, Green RM, Chapman MD, Woodcock A. Distribution, aerodynamic characteristics, and removal of the major cat allergen Fel d 1 in British homes. Thorax. 1998;53:33–8.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  36. Arbes SJ Jr, Cohn RD, Yin M, Muilenberg ML, Friedman W, Zeldin DC. Dog allergen (Can f 1) and cat allergen (Fel d 1) in US homes: results from the National Survey of Lead and Allergens in Housing. J Allergy Clin Immunol. 2004;114:111–7. https://doi.org/10.1016/j.jaci.2004.04.036.

    Article  PubMed  Google Scholar 

  37. Niesler A, Scigala G, Ludzen-Izbinska B. Cat (Fel d 1) and dog (Can f 1) allergen levels in cars, dwellings and schools. Aerobiologia (Bologna). 2016;32:571–80. https://doi.org/10.1007/s10453-016-9433-7.

    Article  CAS  Google Scholar 

  38. Gordon J, Detjen P, Nimmagadda S, Rogers L, Patel S, Thompson J, et al. Bedroom exposure to airborne allergens in the Chicago area using a patient-operated sampling device. Ann Allergy Asthma Immunol. 2018; https://doi.org/10.1016/j.anai.2018.05.024.

  39. Heinrich J, Bedada GB, Zock JP, Chinn S, Norback D, Olivieri M, et al. Cat allergen level: its determinants and relationship to specific IgE to cat across European centers. J Allergy Clin Immunol. 2006;118:674–81. https://doi.org/10.1016/j.jaci.2006.06.012.

    Article  PubMed  CAS  Google Scholar 

  40. Nicholas C, Wegienka G, Havstad S, Zoratti E, Ownby D, Johnson CC. Dog characteristics and allergen levels in the home. Ann Allergy Asthma Immunol. 2010;105:228–33. https://doi.org/10.1016/j.anai.2010.06.019.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Liccardi G, Calzetta L, Baldi G, Berra A, Billeri L, Caminati M, et al. Allergic sensitization to common pets (cats/dogs) according to different possible modalities of exposure: an Italian multicenter study. Clin Mol Allergy. 2018;16:3. https://doi.org/10.1186/s12948-018-0081-z.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  42. Liccardi G, Triggiani M, Piccolo A, Salzillo A, Parente R, Manzi F, et al. Sensitization to common and uncommon pets or other furry animals: which may be common mechanisms? Transl Med UniSa. 2016;14:9–14.

    PubMed  PubMed Central  CAS  Google Scholar 

  43. De Lucca SD, O’Meara TJ, Tovey ER. Exposure to mite and cat allergens on a range of clothing items at home and the transfer of cat allergen in the workplace. J Allergy Clin Immunol. 2000;106:874–9. https://doi.org/10.1067/mai.2000.110804.

    Article  PubMed  Google Scholar 

  44. Karlsson AS, Renstrom A. Human hair is a potential source of cat allergen contamination of ambient air. Allergy. 2005;60:961–4. https://doi.org/10.1111/j.1398-9995.2005.00796.x.

    Article  PubMed  Google Scholar 

  45. Chen CM, Tischer C, Schnappinger M, Heinrich J. The role of cats and dogs in asthma and allergy--a systematic review. Int J Hyg Environ Health. 2010;213:1–31. https://doi.org/10.1016/j.ijheh.2009.12.003.

    Article  PubMed  Google Scholar 

  46. Krop EJ, Jacobs JH, Sander I, Raulf-Heimsoth M, Heederik DJ. Allergens and beta-glucans in dutch homes and schools: characterizing airborne levels. PLoS One. 2014;9:e88871. https://doi.org/10.1371/journal.pone.0088871.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  47. Permaul P, Hoffman E, Fu C, Sheehan W, Baxi S, Gaffin J, et al. Allergens in urban schools and homes of children with asthma. Pediatr Allergy Immunol. 2012;23:543–9. https://doi.org/10.1111/j.1399-3038.2012.01327.x.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Sander I, Lotz A, Neumann HD, Czibor C, Flagge A, Zahradnik E, et al. Indoor allergen levels in settled airborne dust are higher in day-care centers than at home. Allergy. 2017; https://doi.org/10.1111/all.13371.

  49. Perzanowski MS, Ronmark E, James HR, Hedman L, Schuyler AJ, Bjerg A, et al. Relevance of specific IgE antibody titer to the prevalence, severity, and persistence of asthma among 19-year-olds in northern Sweden. J Allergy Clin Immunol. 2016;138:1582–90. https://doi.org/10.1016/j.jaci.2016.05.017.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  50. Shargorodsky J, Garcia-Esquinas E, Umanskiy R, Navas-Acien A, Lin SY. Household pet exposure, allergic sensitization, and rhinitis in the U.S. population. Int Forum Allergy Rhinol. 2017;7:645–51. https://doi.org/10.1002/alr.21929.

    Article  PubMed  Google Scholar 

  51. Salo PM, Arbes SJ Jr, Jaramillo R, Calatroni A, Weir CH, Sever ML, et al. Prevalence of allergic sensitization in the United States: results from the National Health and Nutrition Examination Survey (NHANES) 2005-2006. J Allergy Clin Immunol. 2014;134:350–9. https://doi.org/10.1016/j.jaci.2013.12.1071.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Salo PM, Calatroni A, Gergen PJ, Hoppin JA, Sever ML, Jaramillo R, et al. Allergy-related outcomes in relation to serum IgE: results from the National Health and Nutrition Examination Survey 2005-2006. J Allergy Clin Immunol. 2011;127:1226–35 e7. https://doi.org/10.1016/j.jaci.2010.12.1106.

    Article  PubMed  PubMed Central  Google Scholar 

  53. • Ahluwalia SK, Matsui EC. Indoor environmental interventions for furry pet allergens, pest allergens, and mold:looking to the future. J Allergy Clin Immunol Pract. 2018;6:9–19. https://doi.org/10.1016/j.jaip.2017.10.009. This article reviews recent findings on home environmental interventions targeting pet, pest, and mold allergens and their effects on specific indoor allergen levels and asthma-related outcomes.

    Article  PubMed  Google Scholar 

  54. Bjerg A, Winberg A, Berthold M, Mattsson L, Borres MP, Ronmark E. A population-based study of animal component sensitization, asthma, and rhinitis in schoolchildren. Pediatr Allergy Immunol. 2015;26:557–63. https://doi.org/10.1111/pai.12422.

    Article  PubMed  Google Scholar 

  55. Ihuoma H, Belgrave DC, Murray CS, Foden P, Simpson A, Custovic A. Cat ownership, cat allergen exposure, and trajectories of sensitization and asthma throughout childhood. J Allergy Clin Immunol. 2018;141:820–2 e7. https://doi.org/10.1016/j.jaci.2017.09.030.

    Article  PubMed  PubMed Central  Google Scholar 

  56. Asarnoj A, Hamsten C, Waden K, Lupinek C, Andersson N, Kull I, et al. Sensitization to cat and dog allergen molecules in childhood and prediction of symptoms of cat and dog allergy in adolescence: a BAMSE/MeDALL study. J Allergy Clin Immunol. 2016;137:813–21 e7. https://doi.org/10.1016/j.jaci.2015.09.052.

    Article  PubMed  CAS  Google Scholar 

  57. Nordlund B, Konradsen JR, Kull I, Borres MP, Onell A, Hedlin G, et al. IgE antibodies to animal-derived lipocalin, kallikrein and secretoglobin are markers of bronchial inflammation in severe childhood asthma. Allergy. 2012;67:661–9. https://doi.org/10.1111/j.1398-9995.2012.02797.x.

    Article  PubMed  CAS  Google Scholar 

  58. Tsolakis N, Malinovschi A, Nordvall L, Mattsson L, Lidholm J, Pedroletti C, et al. Sensitization to minor cat allergen components is associated with type-2 biomarkers in young asthmatics. Clin Exp Allergy. 2018; https://doi.org/10.1111/cea.13135.

  59. Platts-Mills TA, Woodfolk JA. Allergens and their role in the allergic immune response. Immunol Rev. 2011;242:51–68. https://doi.org/10.1111/j.1600-065X.2011.01021.x.

    Article  PubMed  CAS  Google Scholar 

  60. Schoos AM, Chawes BL, Melen E, Bergstrom A, Kull I, Wickman M, et al. Sensitization trajectories in childhood revealed by using a cluster analysis. J Allergy Clin Immunol. 2017;140:1693–9. https://doi.org/10.1016/j.jaci.2017.01.041.

    Article  PubMed  Google Scholar 

  61. Collin SM, Granell R, Westgarth C, Murray J, Paul E, Sterne JA, et al. Pet ownership is associated with increased risk of non-atopic asthma and reduced risk of atopy in childhood: findings from a UK birth cohort. Clin Exp Allergy. 2015;45:200–10. https://doi.org/10.1111/cea.12380.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  62. Collin SM, Granell R, Westgarth C, Murray J, Paul ES, Sterne JA, et al. Associations of pet ownership with wheezing and lung function in childhood: findings from a UK birth cohort. PLoS One. 2015;10:e0127756. https://doi.org/10.1371/journal.pone.0127756.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  63. Dharmage SC, Lodge CL, Matheson MC, Campbell B, Lowe AJ. Exposure to cats: update on risks for sensitization and allergic diseases. Curr Allergy Asthma Rep. 2012;12:413–23. https://doi.org/10.1007/s11882-012-0288-x.

    Article  PubMed  Google Scholar 

  64. Lodge CJ, Allen KJ, Lowe AJ, Hill DJ, Hosking CS, Abramson MJ, et al. Perinatal cat and dog exposure and the risk of asthma and allergy in the urban environment: a systematic review of longitudinal studies. Clin Dev Immunol. 2012;2012:176484. https://doi.org/10.1155/2012/176484.

    Article  PubMed  Google Scholar 

  65. Erwin EA, Woodfolk JA, James HR, Satinover SM, Platts-Mills TA. Changes in cat specific IgE and IgG antibodies with decreased cat exposure. Ann Allergy Asthma Immunol. 2014;112:545–50 e1. https://doi.org/10.1016/j.anai.2014.03.007.

    Article  PubMed  CAS  Google Scholar 

  66. Ownby D, Johnson CC. Recent understandings of pet allergies. F1000Res 2016:5. Doi:https://doi.org/10.12688/f1000research.7044.1.

  67. Burnett M, Wegienka G, Havstad S, Kim H, Johnson CC, Ownby D, et al. Relationship of dog- and cat-specific IgE and IgG4 levels to allergic symptoms on pet exposure. J Allergy Clin Immunol Pract. 2013;1:350–3. https://doi.org/10.1016/j.jaip.2013.03.011.

    Article  PubMed  PubMed Central  Google Scholar 

  68. Dunn RR, Fierer N, Henley JB, Leff JW, Menninger HL. Home life: factors structuring the bacterial diversity found within and between homes. PLoS One. 2013;8:e64133. https://doi.org/10.1371/journal.pone.0064133.

    Article  PubMed  PubMed Central  Google Scholar 

  69. Fujimura KE, Demoor T, Rauch M, Faruqi AA, Jang S, Johnson CC, et al. House dust exposure mediates gut microbiome Lactobacillus enrichment and airway immune defense against allergens and virus infection. Proc Natl Acad Sci U S A. 2014;111:805–10. https://doi.org/10.1073/pnas.1310750111.

    Article  PubMed  CAS  Google Scholar 

  70. Fujimura KE, Johnson CC, Ownby DR, Cox MJ, Brodie EL, Havstad SL, et al. Man’s best friend? The effect of pet ownership on house dust microbial communities. J Allergy Clin Immunol. 2010;126:410–2, 2 e1–3. https://doi.org/10.1016/j.jaci.2010.05.042.

    Article  PubMed  PubMed Central  Google Scholar 

  71. Konya T, Koster B, Maughan H, Escobar M, Azad MB, Guttman DS, et al. Associations between bacterial communities of house dust and infant gut. Environ Res. 2014;131:25–30. https://doi.org/10.1016/j.envres.2014.02.005.

    Article  PubMed  CAS  Google Scholar 

  72. Sitarik AR, Havstad S, Levin AM, Lynch SV, Fujimura KE, Ownby DR, et al. Dog introduction alters the home dust microbiota. Indoor Air. 2018; https://doi.org/10.1111/ina.12456.

  73. •• Tun HM, Konya T, Takaro TK, Brook JR, Chari R, Field CJ, et al. Exposure to household furry pets influences the gut microbiota of infant at 3-4 months following various birth scenarios. Microbiome. 2017;5:40. https://doi.org/10.1186/s40168-017-0254-x. This article found differential impacts of pre- and postnatal pet exposure on infant gut microbiota, highlighting the need of further research in the field of early-life microbiome.

    Article  PubMed  PubMed Central  Google Scholar 

  74. Liu AH. Revisiting the hygiene hypothesis for allergy and asthma. J Allergy Clin Immunol. 2015;136:860–5. https://doi.org/10.1016/j.jaci.2015.08.012.

    Article  PubMed  Google Scholar 

  75. Mendy A, Wilkerson J, Salo PM, Cohn RD, Zeldin DC, Thorne PS. Exposure and sensitization to pets modify endotoxin association with asthma and wheeze. J Allergy Clin Immunol Pract. 2018; https://doi.org/10.1016/j.jaip.2018.04.009.

  76. Pyrhonen K, Kulmala P, Nayha S. Coincidence of pollen season with the first fetal trimester together with early pet exposure is associated with sensitization to cat and dog allergens in early childhood: a Finnish population-based study. Clin Exp Allergy. 2018;48:306–16. https://doi.org/10.1111/cea.13067.

    Article  PubMed  CAS  Google Scholar 

  77. Stokholm J, Chawes BL, Vissing N, Bonnelykke K, Bisgaard H. Cat exposure in early life decreases asthma risk from the 17q21 high-risk variant. J Allergy Clin Immunol. 2018;141:1598–606. https://doi.org/10.1016/j.jaci.2017.07.044.

    Article  PubMed  Google Scholar 

  78. Torjusen EN, Diette GB, Breysse PN, Curtin-Brosnan J, Aloe C, Matsui EC. Dose-response relationships between mouse allergen exposure and asthma morbidity among urban children and adolescents. Indoor Air. 2013;23:268–74. https://doi.org/10.1111/ina.12009.

    Article  PubMed  CAS  Google Scholar 

  79. Coleman AT, Rettiganti M, Bai S, Brown RH, Perry TT. Mouse and cockroach exposure in rural Arkansas Delta region homes. Ann Allergy Asthma Immunol. 2014;112:256–60. https://doi.org/10.1016/j.anai.2014.01.002.

    Article  PubMed  Google Scholar 

  80. Matsui EC, Wood RA, Rand C, Kanchanaraksa S, Swartz L, Eggleston PA. Mouse allergen exposure and mouse skin test sensitivity in suburban, middle-class children with asthma. J Allergy Clin Immunol. 2004;113:910–5. https://doi.org/10.1016/j.jaci.2004.02.034.

    Article  PubMed  Google Scholar 

  81. Price JA, Longbottom JL. ELISA method for measurement of airborne levels of major laboratory animal allergens. Clin Allergy. 1988;18:95–107.

    Article  PubMed  CAS  Google Scholar 

  82. Berg J, McConnell R, Milam J, Galvan J, Kotlerman J, Thorne P, et al. Rodent allergen in Los Angeles inner city homes of children with asthma. J Urban Health. 2008;85:52–61. https://doi.org/10.1007/s11524-007-9232-0.

    Article  PubMed  Google Scholar 

  83. Chew GL, Carlton EJ, Kass D, Hernandez M, Clarke B, Tiven J, et al. Determinants of cockroach and mouse exposure and associations with asthma in families and elderly individuals living in New York City public housing. Ann Allergy Asthma Immunol. 2006;97:502–13. https://doi.org/10.1016/S1081-1206(10)60942-8.

    Article  PubMed  Google Scholar 

  84. Chew GL, Perzanowski MS, Miller RL, Correa JC, Hoepner LA, Jusino CM, et al. Distribution and determinants of mouse allergen exposure in low-income New York City apartments. Environ Health Perspect. 2003;111:1348–51.

    Article  PubMed  PubMed Central  Google Scholar 

  85. Cohn RD, Arbes SJ Jr, Yin M, Jaramillo R, Zeldin DC. National prevalence and exposure risk for mouse allergen in US households. J Allergy Clin Immunol. 2004;113:1167–71. https://doi.org/10.1016/j.jaci.2003.12.592.

    Article  PubMed  Google Scholar 

  86. Gruchalla RS, Pongracic J, Plaut M, Evans R 3rd, Visness CM, Walter M, et al. Inner City Asthma Study: relationships among sensitivity, allergen exposure, and asthma morbidity. J Allergy Clin Immunol. 2005;115:478–85. https://doi.org/10.1016/j.jaci.2004.12.006.

    Article  PubMed  Google Scholar 

  87. Loo CK, Foty RG, Wheeler AJ, Miller JD, Evans G, Stieb DM, et al. Do questions reflecting indoor air pollutant exposure from a questionnaire predict direct measure of exposure in owner-occupied houses? Int J Environ Res Public Health. 2010;7:3270–97. https://doi.org/10.3390/ijerph7083270.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  88. Phipatanakul W, Eggleston PA, Wright EC, Wood RA. Mouse allergen. I. The prevalence of mouse allergen in inner-city homes. The National Cooperative Inner-City Asthma Study. J Allergy Clin Immunol. 2000;106:1070–4.

    Article  PubMed  CAS  Google Scholar 

  89. Matsui EC, Eggleston PA, Buckley TJ, Krishnan JA, Breysse PN, Rand CS, et al. Household mouse allergen exposure and asthma morbidity in inner-city preschool children. Ann Allergy Asthma Immunol. 2006;97:514–20. https://doi.org/10.1016/S1081-1206(10)60943-X.

    Article  PubMed  Google Scholar 

  90. Phipatanakul W, Eggleston PA, Wright EC, Wood RA. National Coooperative Inner-City Asthma S. Mouse allergen. II. The relationship of mouse allergen exposure to mouse sensitization and asthma morbidity in inner-city children with asthma. J Allergy Clin Immunol. 2000;106:1075–80. https://doi.org/10.1067/mai.2000.110795.

    Article  PubMed  CAS  Google Scholar 

  91. Liccardi G, Salzillo A, Sofia M, Piccolo A, Dente B, Russo M, et al. Sensitization to rodents (mouse/rat) in an urban atopic population without occupational exposure living in Naples, Italy. Eur Ann Allergy Clin Immunol. 2012;44:200–4.

    PubMed  CAS  Google Scholar 

  92. Pongracic JA, Visness CM, Gruchalla RS, Evans R 3rd, Mitchell HE. Effect of mouse allergen and rodent environmental intervention on asthma in inner-city children. Ann Allergy Asthma Immunol. 2008;101:35–41. https://doi.org/10.1016/S1081-1206(10)60832-0.

    Article  PubMed  Google Scholar 

  93. Sheehan WJ, Permaul P, Petty CR, Coull BA, Baxi SN, Gaffin JM, et al. Association between allergen exposure in inner-city schools and asthma morbidity among students. JAMA Pediatr. 2017;171:31–8. https://doi.org/10.1001/jamapediatrics.2016.2543.

    Article  PubMed  PubMed Central  Google Scholar 

  94. Donohue KM, Al-alem U, Perzanowski MS, Chew GL, Johnson A, Divjan A, et al. Anti-cockroach and anti-mouse IgE are associated with early wheeze and atopy in an inner-city birth cohort. J Allergy Clin Immunol. 2008;122:914–20. https://doi.org/10.1016/j.jaci.2008.08.034.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  95. Phipatanakul W, Litonjua AA, Platts-Mills TA, Naccara LM, Celedon JC, Abdulkerim H, et al. Sensitization to mouse allergen and asthma and asthma morbidity among women in Boston. J Allergy Clin Immunol. 2007;120:954–6. https://doi.org/10.1016/j.jaci.2007.05.010.

    Article  PubMed  PubMed Central  Google Scholar 

  96. Salo PM, Jaramillo R, Cohn RD, London SJ, Zeldin DC. Exposure to mouse allergen in U.S. homes associated with asthma symptoms. Environ Health Perspect. 2009;117:387–91. https://doi.org/10.1289/ehp.11847.

    Article  PubMed  CAS  Google Scholar 

  97. Sedaghat AR, Matsui EC, Baxi SN, Bollinger ME, Miller R, Perzanowski M, et al. Mouse sensitivity is an independent risk factor for rhinitis in children with asthma. J Allergy Clin Immunol Pract. 2016;4:82–8 e1. https://doi.org/10.1016/j.jaip.2015.09.006.

    Article  PubMed  Google Scholar 

  98. Jacobs TS, Forno E, Brehm JM, Acosta-Perez E, Han YY, Blatter J, et al. Mouse allergen exposure and decreased risk of allergic rhinitis in school-aged children. Ann Allergy Asthma Immunol. 2014;113:614–8 e2. https://doi.org/10.1016/j.anai.2014.09.007.

    Article  PubMed  PubMed Central  Google Scholar 

  99. Perry T, Matsui E, Merriman B, Duong T, Eggleston P. The prevalence of rat allergen in inner-city homes and its relationship to sensitization and asthma morbidity. J Allergy Clin Immunol. 2003;112:346–52.

    Article  PubMed  Google Scholar 

  100. Lodrup Carlsen KC, Roll S, Carlsen KH, Mowinckel P, Wijga AH, Brunekreef B, et al. Does pet ownership in infancy lead to asthma or allergy at school age? Pooled analysis of individual participant data from 11 European birth cohorts. PLoS One. 2012;7:e43214. https://doi.org/10.1371/journal.pone.0043214.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  101. Lynch SV, Wood RA, Boushey H, Bacharier LB, Bloomberg GR, Kattan M, et al. Effects of early-life exposure to allergens and bacteria on recurrent wheeze and atopy in urban children. J Allergy Clin Immunol. 2014;134:593–601 e12. https://doi.org/10.1016/j.jaci.2014.04.018.

    Article  PubMed  PubMed Central  Google Scholar 

  102. •• O’Connor GT, Lynch SV, Bloomberg GR, Kattan M, Wood RA, Gergen PJ, et al. Early-life home environment and risk of asthma among inner-city children. J Allergy Clin Immunol. 2018;141:1468–75. https://doi.org/10.1016/j.jaci.2017.06.040. This study showed that higher levels of pet or pest allergens in early life were associated with reduced risk of asthma. The abundance of a number of bacterial taxa in house dust was associated with increased or decreased risk of asthma later in childhood, highlighting the relevance of indoor microbiome in early life.

    Article  PubMed  Google Scholar 

  103. Bernton HS, Brown H. Insect allergy--preliminary studies of the cockroach. J Allergy. 1964;35:506–13.

    Article  PubMed  CAS  Google Scholar 

  104. Call RS, Smith TF, Morris E, Chapman MD, Platts-Mills TA. Risk factors for asthma in inner city children. J Pediatr. 1992;121:862–6.

    Article  PubMed  CAS  Google Scholar 

  105. Cohn RD, Arbes SJ Jr, Jaramillo R, Reid LH, Zeldin DC. National prevalence and exposure risk for cockroach allergen in U.S. households. Environ Health Perspect. 2006;114:522–6.

    Article  PubMed  Google Scholar 

  106. Chew GL. Assessment of environmental cockroach allergen exposure. Curr Allergy Asthma Rep. 2012;12:456–64. https://doi.org/10.1007/s11882-012-0287-y.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  107. Pomes A, Arruda LK. Investigating cockroach allergens: aiming to improve diagnosis and treatment of cockroach allergic patients. Methods. 2014;66:75–85. https://doi.org/10.1016/j.ymeth.2013.07.036.

    Article  PubMed  CAS  Google Scholar 

  108. Pomes A, Mueller GA, Randall TA, Chapman MD, Arruda LK. New insights into cockroach allergens. Curr Allergy Asthma Rep. 2017;17:25. https://doi.org/10.1007/s11882-017-0694-1.

    Article  PubMed  PubMed Central  Google Scholar 

  109. Sookrung N, Chaicumpa W. A revisit to cockroach allergens. Asian Pac J Allergy Immunol. 2010;28:95–106.

    PubMed  CAS  Google Scholar 

  110. Mueller GA, Pedersen LC, Lih FB, Glesner J, Moon AF, Chapman MD, et al. The novel structure of the cockroach allergen Bla g 1 has implications for allergenicity and exposure assessment. J Allergy Clin Immunol. 2013;132:1420–6. https://doi.org/10.1016/j.jaci.2013.06.014.

    Article  PubMed  CAS  Google Scholar 

  111. Wunschmann S, Gustchina A, Chapman MD, Pomes A. Cockroach allergen Bla g 2: an unusual aspartic proteinase. J Allergy Clin Immunol. 2005;116:140–5. https://doi.org/10.1016/j.jaci.2005.04.024.

    Article  PubMed  CAS  Google Scholar 

  112. Esposito WA, Chew GL, Correa JC, Chillrud SN, Miller RL, Kinney PL. Quantitative measurement of airborne cockroach allergen in New York City apartments. Indoor Air. 2011;21:512–20. https://doi.org/10.1111/j.1600-0668.2011.00728.x.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  113. Rabito FA, Iqbal S, Holt E, Grimsley LF, Islam TM, Scott SK. Prevalence of indoor allergen exposures among New Orleans children with asthma. J Urban Health. 2007;84:782–92. https://doi.org/10.1007/s11524-007-9216-0.

    Article  PubMed  PubMed Central  Google Scholar 

  114. Rosenstreich DL, Eggleston P, Kattan M, Baker D, Slavin RG, Gergen P, et al. The role of cockroach allergy and exposure to cockroach allergen in causing morbidity among inner-city children with asthma. N Engl J Med. 1997;336:1356–63. https://doi.org/10.1056/NEJM199705083361904.

    Article  PubMed  CAS  Google Scholar 

  115. Wang C, Abou El-Nour MM, Bennett GW. Survey of pest infestation, asthma, and allergy in low-income housing. J Community Health. 2008;33:31–9. https://doi.org/10.1007/s10900-007-9064-6.

    Article  PubMed  CAS  Google Scholar 

  116. Pomes A. Cockroach and other inhalant insect allergens. Clin Allergy Immunol. 2008;21:183–200.

    PubMed  CAS  Google Scholar 

  117. Rosenfeld L, Rudd R, Chew GL, Emmons K, Acevedo-Garcia D. Are neighborhood-level characteristics associated with indoor allergens in the household? J Asthma. 2010;47:66–75. https://doi.org/10.3109/02770900903362676.

    Article  PubMed  PubMed Central  Google Scholar 

  118. Gergen PJ, Togias A. Inner city asthma. Immunol Allergy Clin N Am. 2015;35:101–14. https://doi.org/10.1016/j.iac.2014.09.006.

    Article  Google Scholar 

  119. Milligan KL, Matsui E, Sharma H. Asthma in urban children: epidemiology, environmental risk factors, and the public health domain. Curr Allergy Asthma Rep. 2016;16:33. https://doi.org/10.1007/s11882-016-0609-6.

    Article  PubMed  CAS  Google Scholar 

  120. Togias A, Fenton MJ, Gergen PJ, Rotrosen D, Fauci AS. Asthma in the inner city: the perspective of the National Institute of Allergy and Infectious Diseases. J Allergy Clin Immunol. 2010;125:540–4. https://doi.org/10.1016/j.jaci.2010.01.040.

    Article  PubMed  Google Scholar 

  121. Wang J, Visness CM, Calatroni A, Gergen PJ, Mitchell HE, Sampson HA. Effect of environmental allergen sensitization on asthma morbidity in inner-city asthmatic children. Clin Exp Allergy. 2009;39:1381–9. https://doi.org/10.1111/j.1365-2222.2009.03225.x.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  122. Zoratti EM, Krouse RZ, Babineau DC, Pongracic JA, O’Connor GT, Wood RA, et al. Asthma phenotypes in inner-city children. J Allergy Clin Immunol. 2016;138:1016–29. https://doi.org/10.1016/j.jaci.2016.06.061.

    Article  PubMed  PubMed Central  Google Scholar 

  123. DiMango E, Serebrisky D, Narula S, Shim C, Keating C, Sheares B, et al. Individualized household allergen intervention lowers allergen level but not asthma medication use: a randomized controlled trial. J Allergy Clin Immunol Pract. 2016;4:671–9 e4. https://doi.org/10.1016/j.jaip.2016.01.016.

    Article  PubMed  PubMed Central  Google Scholar 

  124. Perzanowski MS, Chew GL, Divjan A, Jung KH, Ridder R, Tang D, et al. Early-life cockroach allergen and polycyclic aromatic hydrocarbon exposures predict cockroach sensitization among inner-city children. J Allergy Clin Immunol. 2013;131:886–93. https://doi.org/10.1016/j.jaci.2012.12.666.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  125. Do DC, Zhao Y, Gao P. Cockroach allergen exposure and risk of asthma. Allergy. 2016;71:463–74. https://doi.org/10.1111/all.12827.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  126. Huss K, Naumann PL, Mason PJ, Nanda JP, Huss RW. Asthma severity, atopic status, allergen exposure, and quality of life in elderly persons. Ann Allergy Asthma Immunol 2001;86:524-30. https://doi.org/10.1016/S1081-1206(10)62900-6.

  127. Matsui EC, Wood RA, Rand C, Kanchanaraksa S, Swartz L, Curtin-Brosnan J, et al. Cockroach allergen exposure and sensitization in suburban middle-class children with asthma. J Allergy Clin Immunol. 2003;112:87–92.

    Article  PubMed  CAS  Google Scholar 

  128. Arroyave WD, Rabito FA, Carlson JC. The relationship between a specific IgE level and asthma outcomes: results from the 2005-2006 National Health and Nutrition Examination Survey. J Allergy Clin Immunol Pract 2013:1:501–508. Doi:https://doi.org/10.1016/j.jaip.2013.06.013.

  129. Arbes SJ Jr, Gergen PJ, Elliott L, Zeldin DC. Prevalences of positive skin test responses to 10 common allergens in the US population: results from the third National Health and Nutrition Examination Survey. J Allergy Clin Immunol. 2005;116:377–83. https://doi.org/10.1016/j.jaci.2005.05.017.

    Article  PubMed  Google Scholar 

  130. Crameri R, Garbani M, Rhyner C, Huitema C. Fungi: the neglected allergenic sources. Allergy. 2014;69:176–85. https://doi.org/10.1111/all.12325.

    Article  PubMed  CAS  Google Scholar 

  131. Levetin E, Horner WE, Scott JA, Environmental AW. Taxonomy of allergenic fungi. J Allergy Clin Immunol Pract. 2016;4:375–85 e1. https://doi.org/10.1016/j.jaip.2015.10.012.

    Article  PubMed  Google Scholar 

  132. Afanou KA, Straumfors A, Skogstad A, Nayak AP, Skaar I, Hjeljord L, et al. Indirect immunodetection of fungal fragments by field emission scanning electron microscopy. Appl Environ Microbiol. 2015;81:5794–803. https://doi.org/10.1128/AEM.00929-15.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  133. Roy RM, Klein BS. Fungal glycan interactions with epithelial cells in allergic airway disease. Curr Opin Microbiol. 2013;16:404–8. https://doi.org/10.1016/j.mib.2013.03.004.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  134. Salo PM, Sever ML, Zeldin DC. Indoor allergens in school and day care environments. J Allergy Clin Immunol. 2009;124:185–92, 92 e1–9; quiz 93-4. https://doi.org/10.1016/j.jaci.2009.05.012.

    Article  PubMed  PubMed Central  Google Scholar 

  135. Behbod B, Sordillo JE, Hoffman EB, Datta S, Webb TE, Kwan DL, et al. Asthma and allergy development: contrasting influences of yeasts and other fungal exposures. Clin Exp Allergy. 2015;45:154–63. https://doi.org/10.1111/cea.12401.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  136. •• Gold DR, Adamkiewicz G, Arshad SH, Celedon JC, Chapman MD, Chew GL, et al. NIAID, NIEHS, NHLBI, and MCAN Workshop Report: the indoor environment and childhood asthma-implications for home environmental intervention in asthma prevention and management. J Allergy Clin Immunol. 2017;140:933–49. https://doi.org/10.1016/j.jaci.2017.04.024. This article provides insights into the latest advances in asthma-related research, critically reviewing trials and research relevant to prevention or control of asthma, and proposing future research priorities. Recent findings on biologic properties of indoor exposures and new exposure assessment and reduction techniques are also discussed.

    Article  PubMed  PubMed Central  Google Scholar 

  137. Pitkaranta M, Meklin T, Hyvarinen A, Nevalainen A, Paulin L, Auvinen P, et al. Molecular profiling of fungal communities in moisture damaged buildings before and after remediation--a comparison of culture-dependent and culture-independent methods. BMC Microbiol. 2011;11:235. https://doi.org/10.1186/1471-2180-11-235.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  138. Adams RI, Bateman AC, Bik HM, Meadow JF. Microbiota of the indoor environment: a meta-analysis. Microbiome. 2015;3:49. https://doi.org/10.1186/s40168-015-0108-3.

    Article  PubMed  PubMed Central  Google Scholar 

  139. Leung MH, Lee PK. The roles of the outdoors and occupants in contributing to a potential pan-microbiome of the built environment: a review. Microbiome. 2016;4:21. https://doi.org/10.1186/s40168-016-0165-2.

    Article  PubMed  PubMed Central  Google Scholar 

  140. Shelton BG, Kirkland KH, Flanders WD, Morris GK. Profiles of airborne fungi in buildings and outdoor environments in the United States. Appl Environ Microbiol. 2002;68:1743–53.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  141. Salo PM, Yin M, Arbes SJ Jr, Cohn RD, Sever M, Muilenberg M, et al. Dustborne Alternaria alternata antigens in US homes: results from the National Survey of Lead and Allergens in Housing. J Allergy Clin Immunol. 2005;116:623–9. https://doi.org/10.1016/j.jaci.2005.05.030.

    Article  PubMed  PubMed Central  Google Scholar 

  142. Sharpe RA, Bearman N, Thornton CR, Husk K, Osborne NJ. Indoor fungal diversity and asthma: a meta-analysis and systematic review of risk factors. J Allergy Clin Immunol. 2015;135:110–22. https://doi.org/10.1016/j.jaci.2014.07.002.

    Article  PubMed  Google Scholar 

  143. Weikl F, Tischer C, Probst AJ, Heinrich J, Markevych I, Jochner S, et al. Fungal and bacterial communities in indoor dust follow different environmental determinants. PLoS One. 2016;11:e0154131. https://doi.org/10.1371/journal.pone.0154131.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  144. Prussin AJ 2nd, Marr LC. Sources of airborne microorganisms in the built environment. Microbiome. 2015;3:78. https://doi.org/10.1186/s40168-015-0144-z.

    Article  PubMed  PubMed Central  Google Scholar 

  145. Reponen T, Levin L, Zheng S, Vesper S, Ryan P, Grinshpun SA, et al. Family and home characteristics correlate with mold in homes. Environ Res. 2013;124:67–70. https://doi.org/10.1016/j.envres.2013.04.003.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  146. Crawford JA, Rosenbaum PF, Anagnost SE, Hunt A, Abraham JL. Indicators of airborne fungal concentrations in urban homes: understanding the conditions that affect indoor fungal exposures. Sci Total Environ. 2015;517:113–24. https://doi.org/10.1016/j.scitotenv.2015.02.060.

    Article  PubMed  CAS  Google Scholar 

  147. Barnes CS, Horner WE, Kennedy K, Grimes C, Miller JD, Environmental AW. Home assessment and remediation. J Allergy Clin Immunol Pract. 2016;4:423–31 e15. https://doi.org/10.1016/j.jaip.2016.01.006.

    Article  PubMed  Google Scholar 

  148. Fisk WJ, Eliseeva EA, Mendell MJ. Association of residential dampness and mold with respiratory tract infections and bronchitis: a meta-analysis. Environ Health. 2010;9:72. https://doi.org/10.1186/1476-069X-9-72.

    Article  PubMed  PubMed Central  Google Scholar 

  149. Rudert A, Portnoy J. Mold allergy: is it real and what do we do about it? Expert Rev Clin Immunol. 2017;13:823–35. https://doi.org/10.1080/1744666X.2017.1324298.

    Article  PubMed  CAS  Google Scholar 

  150. Fisk WJ, Lei-Gomez Q, Mendell MJ. Meta-analyses of the associations of respiratory health effects with dampness and mold in homes. Indoor Air. 2007;17:284–96. https://doi.org/10.1111/j.1600-0668.2007.00475.x.

    Article  PubMed  CAS  Google Scholar 

  151. Borchers AT, Chang C, Eric Gershwin M. Mold and human health: a reality check. Clin Rev Allergy Immunol. 2017;52:305–22. https://doi.org/10.1007/s12016-017-8601-z.

    Article  PubMed  Google Scholar 

  152. Mudarri DH. Valuing the economic costs of allergic rhinitis, acute bronchitis, and asthma from exposure to indoor dampness and mold in the US. J Environ Public Health. 2016;2016:2386596. https://doi.org/10.1155/2016/2386596.

    Article  PubMed  PubMed Central  Google Scholar 

  153. Esch RE, Codina R. Fungal raw materials used to produce allergen extracts. Ann Allergy Asthma Immunol. 2017;118:399–405. https://doi.org/10.1016/j.anai.2016.05.012.

    Article  PubMed  CAS  Google Scholar 

  154. Croston TL, Nayak AP, Lemons AR, Goldsmith WT, Gu JK, Germolec DR, et al. Influence of Aspergillus fumigatus conidia viability on murine pulmonary microRNA and mRNA expression following subchronic inhalation exposure. Clin Exp Allergy. 2016;46:1315–27. https://doi.org/10.1111/cea.12783.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  155. Nayak AP, Green BJ, Lemons AR, Marshall NB, Goldsmith WT, Kashon ML, et al. Subchronic exposures to fungal bioaerosols promotes allergic pulmonary inflammation in naive mice. Clin Exp Allergy. 2016;46:861–70. https://doi.org/10.1111/cea.12724.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  156. Portnoy JM, Williams PB, Barnes CS. Innate immune responses to fungal allergens. Curr Allergy Asthma Rep. 2016;16:62. https://doi.org/10.1007/s11882-016-0643-4.

    Article  PubMed  CAS  Google Scholar 

  157. Williams PB, Barnes CS, Portnoy JM, Environmental AW. Innate and adaptive immune response to fungal products and allergens. J Allergy Clin Immunol Pract. 2016;4:386–95. https://doi.org/10.1016/j.jaip.2015.11.016.

    Article  PubMed  Google Scholar 

  158. Zhang Z, Reponen T, Hershey GK. Fungal exposure and asthma: IgE and non-IgE-mediated mechanisms. Curr Allergy Asthma Rep. 2016;16:86. https://doi.org/10.1007/s11882-016-0667-9.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  159. Knutsen AP, Bush RK, Demain JG, Denning DW, Dixit A, Fairs A, et al. Fungi and allergic lower respiratory tract diseases. J Allergy Clin Immunol. 2012;129:280–91; quiz 92-3. https://doi.org/10.1016/j.jaci.2011.12.970.

    Article  PubMed  Google Scholar 

  160. O’Driscoll BR, Hopkinson LC, Denning DW. Mold sensitization is common amongst patients with severe asthma requiring multiple hospital admissions. BMC Pulm Med. 2005;5:4. https://doi.org/10.1186/1471-2466-5-4.

    Article  PubMed  PubMed Central  Google Scholar 

  161. Twaroch TE, Curin M, Valenta R, Swoboda I. Mold allergens in respiratory allergy: from structure to therapy. Allergy Asthma Immunol Res. 2015;7:205–20. https://doi.org/10.4168/aair.2015.7.3.205.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  162. Medrek SK, Kao CC, Yang DH, Hanania NA, Parulekar AD. Fungal sensitization is associated with increased risk of life-threatening asthma. J Allergy Clin Immunol Pract. 2017;5:1025–31 e2. https://doi.org/10.1016/j.jaip.2016.11.015.

    Article  PubMed  Google Scholar 

  163. Baxi SN, Portnoy JM, Larenas-Linnemann D, Phipatanakul W, Environmental AW. Exposure and health effects of fungi on humans. J Allergy Clin Immunol Pract. 2016;4:396–404. https://doi.org/10.1016/j.jaip.2016.01.008.

    Article  PubMed  PubMed Central  Google Scholar 

  164. • Caillaud D, Leynaert B, Keirsbulck M, Nadif R. Indoor mould exposure, asthma and rhinitis: findings from systematic reviews and recent longitudinal studies. Eur Respir Rev. 2018;27 https://doi.org/10.1183/16000617.0137-2017. This article summarizes the most recent findings from systematic reviews, meta-analyses, and longitudinal studies on the relationships between mold exposure and asthma and allergic rhinitis, providing increasing evidence for an association.

  165. Quansah R, Jaakkola MS, Hugg TT, Heikkinen SA, Jaakkola JJ. Residential dampness and molds and the risk of developing asthma: a systematic review and meta-analysis. PLoS One. 2012;7:–e47526. https://doi.org/10.1371/journal.pone.0047526.

  166. Blatter J, Forno E, Brehm J, Acosta-Perez E, Alvarez M, Colon-Semidey A, et al. Fungal exposure, atopy, and asthma exacerbations in Puerto Rican children. Ann Am Thorac Soc. 2014;11:925–32. https://doi.org/10.1513/AnnalsATS.201402-077OC.

    Article  PubMed  PubMed Central  Google Scholar 

  167. Dannemiller KC, Gent JF, Leaderer BP, Peccia J. Indoor microbial communities: influence on asthma severity in atopic and nonatopic children. J Allergy Clin Immunol. 2016;138:76–83 e1. https://doi.org/10.1016/j.jaci.2015.11.027.

    Article  PubMed  PubMed Central  Google Scholar 

  168. Karvonen AM, Hyvarinen A, Korppi M, Haverinen-Shaughnessy U, Renz H, Pfefferle PI, et al. Moisture damage and asthma: a birth cohort study. Pediatrics. 2015;135:e598–606. https://doi.org/10.1542/peds.2014-1239.

    Article  PubMed  Google Scholar 

  169. Reponen T, Lockey J, Bernstein DI, Vesper SJ, Levin L, Khurana Hershey GK, et al. Infant origins of childhood asthma associated with specific molds. J Allergy Clin Immunol. 2012;130:639–44 e5. https://doi.org/10.1016/j.jaci.2012.05.030.

    Article  PubMed  PubMed Central  Google Scholar 

  170. Thacher JD, Gruzieva O, Pershagen G, Melen E, Lorentzen JC, Kull I, et al. Mold and dampness exposure and allergic outcomes from birth to adolescence: data from the BAMSE cohort. Allergy. 2017;72:967–74. https://doi.org/10.1111/all.13102.

    Article  PubMed  CAS  Google Scholar 

  171. Jaakkola MS, Quansah R, Hugg TT, Heikkinen SA, Jaakkola JJ. Association of indoor dampness and molds with rhinitis risk: a systematic review and meta-analysis. J Allergy Clin Immunol. 2013;132:1099–110 e18. https://doi.org/10.1016/j.jaci.2013.07.028.

    Article  PubMed  Google Scholar 

  172. Wilson J, Dixon SL, Breysse P, Jacobs D, Adamkiewicz G, Chew GL, et al. Housing and allergens: a pooled analysis of nine US studies. Environ Res. 2010;110:189–98. https://doi.org/10.1016/j.envres.2009.10.007.

    Article  PubMed  CAS  Google Scholar 

  173. Kaarakainen P, Rintala H, Vepsalainen A, Hyvarinen A, Nevalainen A, Meklin T. Microbial content of house dust samples determined with qPCR. Sci Total Environ. 2009;407:4673–80. https://doi.org/10.1016/j.scitotenv.2009.04.046.

    Article  PubMed  CAS  Google Scholar 

  174. Overton NL, Simpson A, Bowyer P, Denning DW. Genetic susceptibility to severe asthma with fungal sensitization. Int J Immunogenet. 2017;44:93–106. https://doi.org/10.1111/iji.12312.

    Article  PubMed  CAS  Google Scholar 

  175. Hanson B, Zhou Y, Bautista EJ, Urch B, Speck M, Silverman F, et al. Characterization of the bacterial and fungal microbiome in indoor dust and outdoor air samples: a pilot study. Environ Sci Process Impacts. 2016;18:713–24. https://doi.org/10.1039/c5em00639b.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  176. Tischer CG, Heinrich J. Exposure assessment of residential mould, fungi and microbial components in relation to children’s health: achievements and challenges. Int J Hyg Environ Health. 2013;216:109–14. https://doi.org/10.1016/j.ijheh.2012.05.002.

    Article  PubMed  Google Scholar 

  177. Sharpe RA, Thornton CR, Tyrrell J, Nikolaou V, Osborne NJ. Variable risk of atopic disease due to indoor fungal exposure in NHANES 2005-2006. Clin Exp Allergy. 2015;45:1566–78. https://doi.org/10.1111/cea.12549.

    Article  PubMed  CAS  Google Scholar 

  178. Bertelsen RJ, Faeste CK, Granum B, Egaas E, London SJ, Carlsen KH, et al. Food allergens in mattress dust in Norwegian homes - a potentially important source of allergen exposure. Clin Exp Allergy. 2014;44:142–9. https://doi.org/10.1111/cea.12231.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  179. Tulum L, Deag Z, Brown M, Furniss A, Meech L, Lalljie A, et al. Airborne protein concentration: a key metric for type 1 allergy risk assessment-in home measurement challenges and considerations. Clin Transl Allergy. 2018;8:10. https://doi.org/10.1186/s13601-018-0196-9.

    Article  PubMed  PubMed Central  Google Scholar 

  180. Phillips JF, Lockey RF. Exotic pet allergy. J Allergy Clin Immunol. 2009;123:513–5. https://doi.org/10.1016/j.jaci.2008.09.019.

    Article  PubMed  Google Scholar 

  181. Leas BF, D’Anci KE, Apter AJ, Bryant-Stephens T, Lynch MP, Kaczmarek JL, et al. Effectiveness of indoor allergen reduction in asthma management: a systematic review. J Allergy Clin Immunol. 2018;141:1854–69. https://doi.org/10.1016/j.jaci.2018.02.001.

    Article  PubMed  Google Scholar 

  182. Phipatanakul W, Cronin B, Wood RA, Eggleston PA, Shih MC, Song L, et al. Effect of environmental intervention on mouse allergen levels in homes of inner-city Boston children with asthma. Ann Allergy Asthma Immunol. 2004;92:420–5. https://doi.org/10.1016/S1081-1206(10)61777-2.

    Article  PubMed  PubMed Central  Google Scholar 

  183. Matsui EC, Perzanowski M, Peng RD, Wise RA, Balcer-Whaley S, Newman M, et al. Effect of an integrated pest management intervention on asthma symptoms among mouse-sensitized children and adolescents with asthma: a randomized clinical trial. JAMA. 2017;317:1027–36. https://doi.org/10.1001/jama.2016.21048.

    Article  PubMed  PubMed Central  Google Scholar 

  184. Morgan WJ, Crain EF, Gruchalla RS, O’Connor GT, Kattan M, Evans R 3rd, et al. Results of a home-based environmental intervention among urban children with asthma. N Engl J Med. 2004;351:1068–80. https://doi.org/10.1056/NEJMoa032097.

    Article  PubMed  CAS  Google Scholar 

  185. Arbes SJ Jr, Sever M, Mehta J, Gore JC, Schal C, Vaughn B, et al. Abatement of cockroach allergens (Bla g 1 and Bla g 2) in low-income, urban housing: month 12 continuation results. J Allergy Clin Immunol. 2004;113:109–14. https://doi.org/10.1016/j.jaci.2003.10.042.

    Article  PubMed  Google Scholar 

  186. Crocker DD, Kinyota S, Dumitru GG, Ligon CB, Herman EJ, Ferdinands JM, et al. Effectiveness of home-based, multi-trigger, multicomponent interventions with an environmental focus for reducing asthma morbidity: a community guide systematic review. Am J Prev Med. 2011;41:S5–32. https://doi.org/10.1016/j.amepre.2011.05.012.

    Article  PubMed  Google Scholar 

  187. Eggleston PA, Butz A, Rand C, Curtin-Brosnan J, Kanchanaraksa S, Swartz L, et al. Home environmental intervention in inner-city asthma: a randomized controlled clinical trial. Ann Allergy Asthma Immunol. 2005;95:518–24. https://doi.org/10.1016/S1081-1206(10)61012-5.

    Article  PubMed  Google Scholar 

  188. Krieger J, Jacobs DE, Ashley PJ, Baeder A, Chew GL, Dearborn D, et al. Housing interventions and control of asthma-related indoor biologic agents: a review of the evidence. J Public Health Manag Pract. 2010;16:S11–20. https://doi.org/10.1097/PHH.0b013e3181ddcbd9.

    Article  PubMed  PubMed Central  Google Scholar 

  189. Sheehan WJ, Rangsithienchai PA, Wood RA, Rivard D, Chinratanapisit S, Perzanowski MS, et al. Pest and allergen exposure and abatement in inner-city asthma: a work group report of the American Academy of Allergy, Asthma & Immunology Indoor Allergy/Air Pollution Committee. J Allergy Clin Immunol. 2010;125:575–81. https://doi.org/10.1016/j.jaci.2010.01.023.

    Article  PubMed  PubMed Central  Google Scholar 

  190. Rabito FA, Carlson JC, He H, Werthmann D, Schal C. A single intervention for cockroach control reduces cockroach exposure and asthma morbidity in children. J Allergy Clin Immunol. 2017;140:565–70. https://doi.org/10.1016/j.jaci.2016.10.019.

    Article  PubMed  Google Scholar 

  191. Sever ML, Arbes SJ Jr, Gore JC, Santangelo RG, Vaughn B, Mitchell H, et al. Cockroach allergen reduction by cockroach control alone in low-income urban homes: a randomized control trial. J Allergy Clin Immunol. 2007;120:849–55. https://doi.org/10.1016/j.jaci.2007.07.003.

    Article  PubMed  PubMed Central  Google Scholar 

  192. WHO. WHO guidelines for indoor air quality: dampness and mould Geneva: WHO; 2009 [cited 30 May 2018] [Available from: http://www.ncbi.nlm.nih.gov/pubmed/23785740.

  193. American Industrial Hygiene Association (AIHA). Position statement on mold and dampness in the built environment: AIHA; 2013 [cited 7 June 2018] [Available from: https://www.aiha.org/government-affairs/PositionStatements/P-Mold-03-26-13.pdf.

  194. Brandt M, Brown C, Burkhart J, Burton N, Cox-Ganser J, Damon S, et al. Mold prevention strategies and possible health effects in the aftermath of hurricanes and major floods. MMWR Recomm Rep. 2006;55:1–27.

    PubMed  Google Scholar 

  195. Sauni R, Verbeek JH, Uitti J, Jauhiainen M, Kreiss K, Sigsgaard T. Remediating buildings damaged by dampness and mould for preventing or reducing respiratory tract symptoms, infections and asthma. Cochrane Database Syst Rev 2015:CD007897. Doi:https://doi.org/10.1002/14651858.CD007897.pub3.

  196. Kader R, Kennedy K, Portnoy JM. Indoor environmental interventions and their effect on asthma outcomes. Curr Allergy Asthma Rep. 2018;18:17. https://doi.org/10.1007/s11882-018-0774-x.

    Article  PubMed  Google Scholar 

  197. Le Cann P, Paulus H, Glorennec P, Le Bot B, Frain S, Gangneux JP. Home environmental interventions for the prevention or control of allergic and respiratory diseases: what really works. J Allergy Clin Immunol Pract. 2017;5:66–79. https://doi.org/10.1016/j.jaip.2016.07.011.

    Article  PubMed  Google Scholar 

  198. Murray CS, Foden P, Sumner H, Shepley E, Custovic A, Simpson A. Preventing severe asthma exacerbations in children. A randomized trial of mite-impermeable bedcovers. Am J Respir Crit Care Med. 2017;196:150–8. https://doi.org/10.1164/rccm.201609-1966OC.

    Article  PubMed  Google Scholar 

  199. Nunes C, Pereira AM, Morais-Almeida M. Asthma costs and social impact. Asthma Res Pract. 2017;3:1. https://doi.org/10.1186/s40733-016-0029-3.

    Article  PubMed  PubMed Central  Google Scholar 

  200. Nurmagambetov T, Kuwahara R, Garbe P. The economic burden of asthma in the United States, 2008-2013. Ann Am Thorac Soc. 2018;15:348–56. https://doi.org/10.1513/AnnalsATS.201703-259OC.

    Article  PubMed  Google Scholar 

  201. Raulf M, Buters J, Chapman M, Cecchi L, de Blay F, Doekes G, et al. Monitoring of occupational and environmental aeroallergens-- EAACI position paper. Concerted action of the EAACI IG occupational allergy and aerobiology & air pollution. Allergy. 2014;69:1280–99. https://doi.org/10.1111/all.12456.

    Article  PubMed  CAS  Google Scholar 

  202. • Tovey ER, Liu-Brennan D, Garden FL, Oliver BG, Perzanowski MS, Marks GB. Time-based measurement of personal mite allergen bioaerosol exposure over 24 hour periods. PLoS One. 2016;11:e0153414. https://doi.org/10.1371/journal.pone.0153414. This report describes the development of novel methods to determine patterns of personal exposure to dust mite allergens throughout the day, providing insights into spatial and temporal exposure patterns.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  203. Tovey ER, Willenborg CM, Crisafulli DA, Rimmer J, Marks GB. Most personal exposure to house dust mite aeroallergen occurs during the day. PLoS One. 2013;8:e69900. https://doi.org/10.1371/journal.pone.0069900.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  204. Allenbrand R, Barnes CS, Mohammed M, Gard L, Pacheco F, Kennedy K, et al. Comparison of allergens collected from furnace filters and vacuum floor dust. Ann Allergy Asthma Immunol. 2017;118:108–9. https://doi.org/10.1016/j.anai.2016.10.001.

    Article  PubMed  Google Scholar 

  205. Gordon J, Reboulet R, Gandhi P, Matsui E. Validation of a novel sampling technology for airborne allergens in low-income urban homes. Ann Allergy Asthma Immunol. 2018;120:96–7 e1. https://doi.org/10.1016/j.anai.2017.10.002.

    Article  PubMed  Google Scholar 

  206. Sander I, Lotz A, Zahradnik E, Raulf M. Allergen quantification by use of electrostatic dust collectors (EDCs): influence of deployment time, extraction buffer, and storage conditions on the results. Ann Occup Hyg. 2016;60:845–59. https://doi.org/10.1093/annhyg/mew027.

    Article  PubMed  CAS  Google Scholar 

  207. King EM, Filep S, Smith B, Platts-Mills T, Hamilton RG, Schmechel D, et al. A multi-center ring trial of allergen analysis using fluorescent multiplex array technology. J Immunol Methods. 2013;387:89–95. https://doi.org/10.1016/j.jim.2012.09.015.

    Article  PubMed  CAS  Google Scholar 

  208. Chen CM, Thiering E, Zock JP, Villani S, Olivieri M, Modig L, et al. Is there a threshold concentration of cat allergen exposure on respiratory symptoms in adults? PLoS One. 2015;10:e0127457. https://doi.org/10.1371/journal.pone.0127457.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  209. Winn AK, Salo PM, Klein C, Sever ML, Harris SF, Johndrow D, et al. Efficacy of an in-home test kit in reducing dust mite allergen levels: results of a randomized controlled pilot study. J Asthma. 2016;53:133–8. https://doi.org/10.3109/02770903.2015.1072721.

    Article  PubMed  CAS  Google Scholar 

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Acknowledgments

We thank Erin Knight and Stacey Mantooth for assistance with the literature search.

Funding

This work was supported, in part, by the Intramural Research Program of the NIH, National Institute of Environmental Health Sciences (Z01 ES025041).

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  1. Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, 111 T.W. Alexander Drive, Research Triangle Park, North Carolina, 27709, USA

    Paivi M. Salo & Darryl C. Zeldin

  2. Independent Consult, Chapel Hill, NC, USA

    Richard D. Cohn

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Salo, P.M., Cohn, R.D. & Zeldin, D.C. Bedroom Allergen Exposure Beyond House Dust Mites. Curr Allergy Asthma Rep 18, 52 (2018). https://doi.org/10.1007/s11882-018-0805-7

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