TY - JOUR T1 - Component-resolved allergy diagnostics identify phenotypes in problematic severe childhood asthma JF - European Respiratory Journal JO - Eur Respir J VL - 38 IS - Suppl 55 SP - p1141 AU - Björn Nordlund AU - Jon Konradsen AU - Inger Kull AU - Magnus Borres AU - Annica Önell AU - Hans Grönlund AU - Gunilla Hedlin Y1 - 2011/09/01 UR - http://erj.ersjournals.com/content/38/Suppl_55/p1141.abstract N2 - Aim To analyse clinical phenotypes of problematic severe childhood asthma in relation to component-resolved allergy diagnostics.Methods This cross-sectional study included 56 children with problematic severe asthma, insufficiently controlled despite 800μg daily inhaled corticosteroids (budesonide or equivalents). IgE antibodies against 131 individual allergen components from inhalant and food sources were analysed using immunosolid-phase allergen chips. Airway inflammation (FeNO), lung function (FEV1) and bronchial hyperresponsiveness (methacholine challenge) were assessed in all subjects, and Health-Related-Quality-of-Life (HR-QoL) questionnaires and asthma control tests were completed.Results IgE antibodies were detected in 80% (n=45) of children tested. Airway inflammation was greater in these children (FeNO, mean 31 ppb vs 16 ppb, p=0.039) and lung function was reduced (FEV1%, mean 79 vs 92, p=0.05) compared to children without detectable IgE (n=11, 20%). However, HR-QoL and asthma control test scores, and bronchial hyperresponsiveness, did not differ between these groups. Children (36%, n=20) with specific IgE to >3 (median value) mould/indoor components were more sensitized to specific food components (mean 5.9 vs 2.2, p=0.026) compared to 45% (n=25) of children with specific IgE to fewer mould/indoor components. Also, children with IgE to >3 mould/indoor components showed increased bronchial hyperresponsiveness (methacholine, dose-response slope, 101% vs 31%, p=0.027) and lower HR-QoL scores (5.1 versus 5.7, p=0.011).Conclusions Polysensitization to indoor and mould allergens based on component-resolved diagnostics identifies a more severe subgroup of childhood asthma. ER -