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Communications to the Editor |

Racial Differences in Allergen Sensitivity FREE TO VIEW

Christine L.M. Joseph, PhD, FCCP; Edward L. Peterson, PhD; Christine C. Johnson, PhD; Dennis R. Ownby, MD
Author and Funding Information

Affiliations: Henry Ford Health System, Detroit, MI,  Medical College of Georgia, Augusta, GA,  *Harvard Medical School, Boston, MA,  *Connecticut Children’s Medical Center, Storrs, CT

Correspondence to: Christine L.M. Joseph, PhD, FCCP, Henry Ford Health System, Department of Biostatistics & Research Epidemiology, 1 Ford Pl, 3E, Detroit, MI 48202; e-mail: cjosephl@hfhs.org



Chest. 2004;126(3):1004-1005. doi:10.1378/chest.126.3.1004
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Published online

To the Editor:

We read with interest the article in CHEST by Celedón et al (January 2004)1 on ethnicity and skin test reactivity to aeroallergens. The authors found that African Americans were more likely to have skin test reactions to outdoor allergens. We note that upward of 65% of the nonwhite children in the study of Celedón et al resided in urban areas, compared to 9% of the white children.

Readers may be interested in a similar analysis that we conducted2 among 569 middle-class African-American and white children residing in a geographically defined suburban area of Detroit, MI. These children, who were between the ages of 6 and 8 years, were invited to undergo a clinical evaluation, including the measurement of specific IgE levels and the performance of skin-prick tests. The skin-prick tests were performed by using commercial extracts of Dermatophagoides farinae, Dermatophagoides pteronyssinus, cat, dog, Alternaria, short ragweed, and bluegrass, in addition to saline solution and histamine solution (1 mg/mL), which acted as positive and negative controls, respectively. A positive skin test result was defined as one with a sum of perpendicular wheal diameters of > 4 mm with a larger surrounding flare. Allergen-specific serum IgE concentrations were measured using the commercially available assays to the allergens listed above, along with a sample of children who also were tested for cockroach. A specific IgE concentration of > 0.35 IU/mL was considered to be evidence of a detectable antibody.

Our results showed that African-American children were more likely to be allergic to ragweed and bluegrass according to serum IgE concentrations, and to bluegrass according to skin-prick test (Table 1 ). These were the only statistically significant differences observed by race. Thus, our earlier findings in nonurban children corroborate those of Celedón et al.1 For more information, please see the May 2000 issue of CHEST.

Table Graphic Jump Location
Table 1. Allergen Sensitivity by Race*
* 

AA = African American; ND = not done.

Celedón, JC, Sredl, D, Weiss, ST, et al (2004) Ethnicity and skin test reactivity to aeroallergens among asthmatic children in Connecticut.Chest125,85-92. [CrossRef] [PubMed]
 
Joseph, CLM, Ownby, DR, Peterson, EL, et al Racial differences in physiologic parameters related to asthma among middle-class children.Chest2000;117,1336-1344. [CrossRef] [PubMed]
 
To the Editor:

We appreciate the interest of Dr. Joseph and colleagues in our recent article in CHEST (January 2004)1on ethnicity and skin test reactivity to allergens among children with asthma. We thank them for bringing their article on racial differences in physiologic parameters related to asthma2 to the attention of the readers of CHEST.

We would like to point out that the results of our recent study and those of the study conducted by Joseph and colleagues2 are not comparable. Whereas our study included only children with asthma (791 children), their study included children with and without asthma. In the study conducted by Joseph et al, there was no difference in total serum levels of IgE between African-American children with asthma (8 children) and European-American children with asthma (49 children). In their study, African-American children without asthma had a higher total serum IgE level than did European-American children without asthma. For the analysis of the relation between sensitization to specific allergens and ethnicity, Joseph et al did not present the results of an analysis that had been stratified by asthma status. Thus, it is not clear whether the reported association between African-American ethnicity and sensitization to two outdoor allergens was present in children with or without asthma. It should also be noted that our analysis of the relation between ethnicity and allergen sensitization among children with asthma was adjusted for health insurance status, area of residence, asthma severity, and other potential confounders. In the study by Joseph et al, the analysis of the relation between ethnicity and allergen sensitization was not adjusted for potential confounders.

What the findings of both our study and those of the study conducted by Dr. Joseph and colleagues suggest is that allergy skin testing should be considered more often in African-American children with symptoms that are suggestive of allergic diseases such as asthma. Finally, allergen sensitization in minority populations is deserving of further study, as it may provide important clues to asthma health disparities.

References
Celedón, JC, Sredl, D, Weiss, ST, et al Ethnicity and skin test reactivity to aeroallergens among asthmatic children in Connecticut.Chest2004;125,85-92. [CrossRef] [PubMed]
 
Joseph, CLM, Ownby, DR, Peterson, EL, et al Racial differences in physiologic parameters related to asthma among middle-class children.Chest2000;117,1336-1344. [CrossRef] [PubMed]
 

Figures

Tables

Table Graphic Jump Location
Table 1. Allergen Sensitivity by Race*
* 

AA = African American; ND = not done.

References

Celedón, JC, Sredl, D, Weiss, ST, et al (2004) Ethnicity and skin test reactivity to aeroallergens among asthmatic children in Connecticut.Chest125,85-92. [CrossRef] [PubMed]
 
Joseph, CLM, Ownby, DR, Peterson, EL, et al Racial differences in physiologic parameters related to asthma among middle-class children.Chest2000;117,1336-1344. [CrossRef] [PubMed]
 
Celedón, JC, Sredl, D, Weiss, ST, et al Ethnicity and skin test reactivity to aeroallergens among asthmatic children in Connecticut.Chest2004;125,85-92. [CrossRef] [PubMed]
 
Joseph, CLM, Ownby, DR, Peterson, EL, et al Racial differences in physiologic parameters related to asthma among middle-class children.Chest2000;117,1336-1344. [CrossRef] [PubMed]
 
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