Mold-sensitised adults have lower Th2 cytokines and a higher prevalence of asthma than those sensitised to other aeroallergens

Abstract

Background

Evidence suggests that specific allergen sensitisations are associated with different allergic diseases which may reflect different underlying immune profiles. We aimed to examine the cytokine profiles of individuals sensitised to eight common aeroallergens.

Methods

We used data from the Tasmanian Longitudinal Health Study (TAHS) a population-based cohort study of 45 year olds. Serum cytokines (IL-4, IL-5, IL-6, IL-8, IL-10, TNF-α) were measured in 1,157 subjects using the Lincoplex assays. Participants underwent skin prick testing for house dust mite (HDM), cat, grasses and molds. Multivariable linear regression was used to compare serum cytokine levels between sensitised and non-atopic subjects.

Results

The prevalence of allergic sensitisation to any aeroallergen was 51% (95%CI 47%,54%). Being sensitised to any aeroallergen was strongly associated with current asthma (OR=3.7, 95%CI 2.6,5.3) and being sensitised to molds was associated with a very high risk of current asthma (OR=11.4, 95% 5.4,24.2). The geometric mean (GM) levels of Th2 cytokines (IL-4, IL-5 and IL-6) for adults sensitised to Cladosporium were significantly lower than the levels for non-atopic individuals [IL-4 ratio of GMs=0.25, 95%CI 0.10-0.62, p=0.003; IL-5 GM=0.55, 95%CI 0.30-0.99, p=0.05; and IL-6 GM=0.50, 95%CI 0.24-1.07, p=0.07]. Individuals sensitised to other aeroallergens all showed elevated Th2 cytokine levels.

Conclusion

First large population-based study to demonstrate reduced Th2 cytokines levels in people sensitised to mold. Underlying biological mechanisms driving allergic inflammatory responses in adults sensitised to molds may differ from those sensitised to other aeroallergens. These findings suggest that it may be necessary to tailor treatments in individuals sensitised to molds compared with other aeroallergens in order to optimise outcomes.

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