Allergy to the cat—from diagnosis to management (original) (raw)
Related papers
Annals of Allergy, Asthma & Immunology, 2003
Background: Treatment of cat allergy normally entails removal of the cat from the household, but cat owners are often unwilling to part with their pets, despite clinically relevant allergies. Objective: To determine whether levels of Fel d 1 can be reduced without removal of the cat and whether this will affect symptoms of cat allergy. Methods: Cat-allergic patients underwent randomization to either a group instructed in environmental control (EC) and a group with unchanged environment (UE). Dust samples were obtained and settled Fel d 1 measured by enzyme-linked immunosorbent assay. Patients recorded daily nasal inspiratory flow rates. At baseline, 3 months, and 8 months, patients underwent symptom evaluation. Results: Eighteen patients were randomized to the EC group and 22 to the UE group; the final number completing the study was 31, 15 in the EC group, and 16 in the UE group. At 8 months, home Fel d 1 levels had diminished to 6.8% of baseline levels in the EC group, whereas no reduction in levels was noted in the UE group. In the EC group, significant improvements were found in nasal inspiratory flow rate and symptoms compared with the UE group. Patients did not have difficulties adhering to EC measures. Conclusion: A decrease in the allergen load was found in the EC group, which had a significant effect on symptoms of nasal allergy.
Allergy
Allergies to cats are the most common mammalian-origin allergy in humans 1-3 and affect approximately 1 in 5 adults worldwide. 4,5 Fel d 1 is the major cat allergen, accounting for up to 96% of human allergic sensitization to cats and 60%-90% of the overall antigenicity of cats and cat dander. 2,5-9 Traditional care pathways for cat allergies focus on treating patients who are exposed to cat allergens. The following review expands on information presented during a sponsored symposium at the European Academy of Allergy and Clinical Immunology (EAACI) Annual Congress on June 4, 2019, in Lisbon, Portugal. The symposium, titled "Keep the cat, changes the care pathway: a transformational approach to managing cat allergy," presented a research
The Major Cat Allergen, Fel d 1, in Diagnosis and Therapy
International Archives of Allergy and Immunology, 2010
tides containing T-cell epitopes has been tested in clinical trials. After initial problems with adverse reactions, more recent data show that peptide immunotherapy modulates the immune response to Fel d 1 and reduces early-and latephase effector reactions in cat-allergic patients.
Sensitization to cat allergen and its association with respiratory allergies: cross-sectional study
Sao Paulo medical journal = Revista paulista de medicina, 2017
Cats are a significant source of allergens that contribute towards worsening of allergic diseases. The aim of this study was to investigate the association between sensitization to cat allergens and allergic respiratory diseases.This was an observational retrospective study based on the skin pricktests results of patients at a tertiary-level hospital in São Paulo. A total of 1,985 test results were assessed. The prevalence of sensitization to cat allergen was 20% (399 patients). Our data indicated that in this population of atopic patients, a positive skin prick test result for cat allergen was not associated significantly with a diagnosis of respiratory allergy.
Journal of Allergy and Clinical Immunology, 2019
BACKGROUND: Cat allergy in human subjects is usually caused by the major cat allergen Fel d 1 and is found in approximately 10% of the Western population. Currently, there is no efficient and safe therapy for cat allergy available. Allergic patients usually try to avoid cats or treat their allergy symptoms. OBJECTIVE: We developed a new strategy to treat Fel d 1-induced allergy in human subjects by immunizing cats against their own major allergen, Fel d 1. METHODS: A conjugate vaccine consisting of recombinant Fel d 1 and a virus-like particle derived from the cucumber mosaic virus containing the tetanus toxin-derived universal T-cell epitope tt830-843 (CuMV) was used to immunize cats. A first tolerability and immunogenicity study, including a boost injection, was conducted by using the Fel-CuMV vaccine alone or in combination with an adjuvant. RESULTS: The vaccine was well tolerated and had no overt toxic effect. All cats induced a strong and sustained specific IgG antibody response. The induced anti-Fel d 1 antibodies were of high affinity and exhibited a strong neutralization ability tested both in vitro and in vivo. A reduction in the endogenous allergen level and a reduced allergenicity of tear samples, were observed. CONCLUSION: Vaccination of cats with Fel-CuMV induces neutralizing antibodies and might result in reduced symptoms of allergic cat owners. Both human subjects and animals could profit from this treatment because allergic cat owners would reduce their risk of developing chronic diseases, such as asthma, and become more tolerant of their cats, which therefore could stay in the households and not need to be relinquished to animal shelters.
Cat antigen in homes with and without cats may induce allergic symptoms†
Journal of Allergy and Clinical Immunology, 1996
Although Fel d 1, the major cat allergen, has been found in settled dust samples from homes both with and without cats, the clinical relevance of this allergen has never been studied. In this study we measured airborne concentrations of Fel d 1 in homes both with and without cats and then attempted to relate these levels to those obtained in our experimental cat challenge model to assess their clinical significance. In baseline samples we found measurable levels of airborne Fel d 1 in all 37 homes with cats (range, 1.8 to 578 ng/m3; median, 45.9 ng/m3) and in 10 of the 40 homes without cats (for detectable samples: range, 2.8 to 88.5 ng/m3; median, 17 ng/m3). Fel d 1 was present in the settled dust of 38 of 40 homes without cats (range, 39 to 3750 ng/gm; median, 258 ng/gm), although these levels were only weakly predictive of airborne levels. Repeat samples obtained weekly from 12 homes without cats yielded measurable airborne levels. Fel d 1 in at least one of the four samples from all homes. When compared with challenges performed in our cat room facility at low levels of airborne Fel d 1 (<500 ng/m3), these home levels are within the range capable of causing upper and lower respiratory symptoms in subjects allergic to cats. We therefore conclude that the low level cat exposure that occurs in many homes without cats is capable of inducing symptoms in some patients who are sensitive to cats. The assessment of cat exposure should not be based solely on the presence or absence of a cat in the home.
Decreased prevalence of sensitization to cats with high exposure to cat allergen
Journal of Allergy and Clinical Immunology, 2001
We investigated the relationship between current exposure to cat allergen and sensitization to cats. A questionnaire was administered and skin prick testing and home visits for collection of dust samples (Fel d 1; ELISA) were performed in 2502 adults (mean age, 31.8 years; age range, 18-58 years; 1251 women). The results for Fel d 1 in relation to sensitization to cats were analyzed for 10 deciles of cat allergen exposure (cut points [µg/g]: 0.05, 0.34, 0.48, 0.72, 1.13, 1.92, 7.2, 44, 151). The prevalence of sensitization to cat was significantly decreased in the lowest and the highest exposure groups. In the multivariate regression analysis (age, sex, socioeconomic status, and current smoking being adjusted for), the risk of sensitization to cats was significantly increased with medium exposure to Fel d 1 (3rd centile, OR 2.3, 95% CI 1.2-4.4, P = .01; 4th centile, OR 2.1, 95% CI 1.1-4.0, P = .03; 5th centile, OR 2.2, 95% CI 1.2-4.3, P = .04, 6th centile, OR 2.5, 95% CI 1.3-4.9, P = .005). These results indicate that the prevalence of sensitization to cat is decreased in the lowest and highest cat allergen exposure groups.(J Allergy Clin Immunol 2001;108:537-9.)
Domestic cat allergen and allergic sensitisation in young children
International Journal of Hygiene and Environmental Health, 2008
Studies have presented conflicting associations between cat allergen exposure and sensitisation and atopic disease. We therefore investigated the association between the observed domestic cat allergen level and cat sensitisation in young children in four study populations from three European countries. We recruited children from a nested case-control study, which is composed of four ongoing birth cohorts conducted in three European countries. Children at 2-4 years of age in the four cohorts who were sensitised to cat allergens (n ¼ 106) were compared with 554 nonsensitised children (controls). House dust samples were collected when the children were 5 to 7 years old, and cat allergen levels were measured in ng/g dust and ng/m 2 surface area. In the German study population we found a positive association between domestic cat allergen in house dust and cat sensitisation (OR (CI) ¼ 3.01 (1.16, 7.99)) while in the Swedish study population, we found a negative association (OR (CI) ¼ 0.41 (0.16, 0.98)). No association was found in the Dutch study population (OR (CI) ¼ 0.83 (0.22, 2.93)). Looking into the family history of cat keeping, we found the lowest prevalence of cat sensitisation in children who were cat owners at the age of blood sampling (11%) and the highest prevalence was found in those who have had a cat but not anymore, at the age of blood sampling (41%). The mixed results may be explained by differences in age and avoidance patterns.
Unexpected Cat Allergy in Infants with Persistent Atopic Dermatitis
Journal of Dr. Behcet Uz Children s Hospital, 2021
Atopic dermatitis is a chronic, recurrent inflammatory skin disease usually caused by genetic predisposition, immune dysregulation, epidermal barrier dysfunction and interaction of environmental factors. Atopic dermatitis is part of atopic march and is often accompanied by food allergy. Aeroallergenic sensitization at early age is not an expected finding. Here, we present five cases with moderate-severe atopic dermatitis during infancy, in whom food allergy was detected and the symptoms improved only partially despite elimination and treatment. Sensitization was investigated in patients with a history of intense exposure to cats by specific IgE and skin prick test in infants with atopic dermatitis who had food allergy and persistant findings. Egg allergy was detected in four of the cases, wheat allergy in one. Cat allergy was present in all. Elimination diet was started in all cases. When exposure to cats was reduced, a marked improvement in the findings of atopic dermatitis was obs...
Cat allergen level: Its determinants and relationship to specific IgE to cat across European centers
Journal of Allergy and Clinical Immunology, 2006
Background: Cat allergen level in settled house dust and its determinants in Europe are unknown. Objective: The aim of this study is to quantify the level of cat allergens in mattress dust, to study its determinants, and to analyze the relationship with cat specific IgE on community level across European centers. Methods: Trained field workers collected dust from approximately 3000 mattresses during home visits in 22 European Community Respiratory Health Survey II centers. Sieved dust extracts were assayed for cat allergen using a mAb ELISA assay. Results: The overall geometric mean cat allergen was 0.94 mg/g, ranging from 0.12 mg/g in Huelva, Spain, to 3.76 mg/g in Antwerp, Belgium. Current cat owners' homes showed substantially higher levels than past cat owners' and never cat owners' homes (geometric mean and 95% CI, 61.4 mg/g [48.4-77.9] vs 1.37 mg/g [0.97-1.9] vs 0.29 mg/g [0.27-0.31]). Community prevalence of cat ownership was moderately correlated with cat allergen levels in noncat owners (r s 5 0.50), but not for past or current cat owners. The multilevel model identified community prevalence of cat keeping as the only statistically significant determinant of mattress cat allergen levels for noncat owners. However, averaged cat allergen levels per center were not related to community prevalence of detectable specific IgE to cat. Conclusion: Not having a cat in the home is associated with substantially lower Fel d 1 concentration, but does not protect against high Fel d 1 exposure in communities where cat ownership is common. Clinical implications: People (including patients with cat allergy) who do not own cats may be exposed to high levels of cat allergen in their home, particularly if they live in communities with high levels of cat ownership. (J Allergy Clin Immunol 2006;118:674-81.)