J ALLERGY CLIN IMMUNOL

VOLUME 133, NUMBER 2

Abstracts AB235

MONDAY

811 Allergic Rhinitis, Asthma and Cardiovascular DiseaseDr. Angelina M. Crans Yoon, MD1, Dr. Anne M.

Staveren, MD1, Dr. Michael S. Kaplan, MD, FAAAAI1, Dr. Javed

Sheikh, MD, FAAAAI2, Dr. Bruce J. Goldberg, MD, PhD, FAAAAI1;1Kaiser Permanente, Los Angeles, CA, 2Kaiser Permanente Los Angeles

Medical Center, Los Angeles, CA.

RATIONALE: Several studies have suggested an association between

eosinophilia, positive skin tests, total IgE, daily pollen burden, asthma and

cardiovascular disease. The relationship between cardiovascular disease

and allergic rhinitis is largely unknown.

METHODS: We assembled a cohort of allergic rhinitis patients

(N5109,229) and a cohort of asthma patients (N592,775) matched 1:1

by age, sex, and ethnicity to reference cohorts and compared the incidence

of cardiovascular and cerebrovascular events and all-cause mortality from

1/1/1995 to 12/31/2012 using the Kaiser Permanente Southern California

regional database and ICD-9 codes. Hazard ratios (HR) were calculated

using survival analysis with a fully adjusted COX proportional model.

RESULTS: Patients with allergic rhinitis had significantly lower risk for

acute myocardial infarction (MI) (HR 0.75, 95% CI [0.71, 0.80]) and

cerebrovascular disease (HR 0.81, 95% CI [0.77, 0.84]), and all-cause

mortality (HR 0.51, 95% CI [0.49, 0.53]). However, their risk of all

cardiovascular events was equivalent to the control cohort (HR 0.97, 95%

CI [0.94, 1.00]). Patients with asthma had significantly higher risk of all

cardiovascular disease (HR 1.36, 95% CI [1.32, 1.40]), however had no

significantly increased risk of cerebrovascular disease (HR 1.03, 95% CI

[0.99, 1.08]) or all-cause mortality (HR 1.00, 95% CI [0.97, 1.03]).

CONCLUSIONS: Our study supported other results that patients with

asthma have increased cardiovascular events. However patients with

allergic rhinitis have decreased acute MI, cerebrovascular disease, and

all-cause mortality. This suggests atopy may not be contributing to the

increased cardiovascular events seen in patients with asthma.

812 Pre-Natal and Early Life Predictors Of Atopy In CanadianChildren: Results Of The Family Study

Tahira Batool, MBBS, FRCPC1, Michael M. Cyr, MD, FRCPC1, Judah

Aryeh Denburg, MD, FRCPC, FAAAAI1, Ms. Karleen Schulze, MMath2,

Sonia Anand, MD, FRCPC2, Koon Teo, MD, FRCPC2, Family Investiga-

tors2; 1Division of Clinical Immunology and Allergy, Department of Med-

icine, McMaster University, ON, Canada, 2Population Health Research

Institute, Department of Medicine, McMaster University, ON, Canada.

RATIONALE: Multiple epidemiologic and immunologic studies have

pointed to the roles of pre-natal and early life environmental exposures in

the development of atopy and allergic disease.

METHODS: The Family Atherosclerosis Monitoring In earLY life

(FAMILY) Study prospectively evaluated 21 pre-natal and 31 early life

traits in 901 babies, 857 mothers and 530 fathers in a general population

birth cohort. The influences of preexisting allergic disease in parents,

maternal diet, antibiotics, tobacco, pet ownership and exposure to farm

animals were evaluated through questionnaires during antenatal and one

year follow up visits. The effects of breastfeeding, infant food intake,

medications, smoking exposure, and vaccination on development of atopy

and allergic disease in the infant were evaluated through questionnaires

and allergy skin prick testing at one year of age.

RESULTS: Key allergic outcomes included: any food allergy (15%);

cow‘s milk allergy (2.1%); wheeze (12%); atopy (14%); and, eczema

(9.2%). Paternal history of allergic disease; exposure to rodents and birds;

use of antibiotics in first year of life; and, introduction of cow‘s milk and

soy before 6 months of age, were all significant predictors of atopy in

infants. Factors associated with decrease in atopy included: exposure to pet

dogs during pregnancy and the first year of life; breast feeding in the first 17

weeks of life; and, infant use of acetaminophen.

CONCLUSIONS: The FAMILY study demonstrated high rates of food

allergy, atopy, wheeze and eczema. Several previously reported, as well as

novel prenatal and postnatal exposures were associated with the develop-

ment of atopy and allergic disease.

813 Association Between Antibiotic Treatment In The First SixMonths Of Life and Clinical Allergic Outcomes At Ages 2 To 3Years

Kyra Jones, MEd1, Alexandra Sitarik, MS1, Ms. Suzanne Havstad, MA1,

Ganesa Wegienka, PhD1, Dr. Dennis Ownby, MD, FAAAAI2, Dr. Edward

M. Zoratti, MD, FAAAAI3, Dr. Christine Cole Johnson, PhD, MPH,

FAAAAI1; 1Department of Public Health Sciences, Henry Ford Hospital,

Detroit, MI, 2Division of Allergy-Immunology and Rheumatology, Geor-

gia Health Sciences University, Augusta, GA, 3Henry Ford Health System,

Detroit, MI.

RATIONALE: Several studies suggest that antibiotic use early in life is

related to later childhood asthma and allergic disease. The objective was to

assess whether antibiotic usewithin the first 6months of lifewas associated

with allergic sensitization or clinical allergic outcomes at ages 2-3 years.

METHODS: Data from the Detroit area WHEALS birth cohort were

evaluated. Total IgE levels at age 2 years as well as sensitization to milk,

egg, peanut, dog, cat, dust mite, grass, ragweed, and cockroach as defined

by allergen-specific IgE >_ 0.35 IU/ml (+sIgE) or by a skin prick test (+SPT)

were determined. These outcomes as well as ever having a physician

diagnosis of eczema at age 2 years or having recurrent wheeze (two

episodes in the first three years of life where one year must be year three)

were analyzed for associations with antibiotic use in the first 6 months of

life. Logistic and linear regression models were used to assess the

associations between antibiotic use and outcomes.

RESULTS: Antibiotic use in the first 6 months was not associated with

total IgE, +sIgE, +SPT, or eczema (all p>0.05). Children who used

antibiotics in the first 6 months were more likely to have had recurrent

wheeze (OR5 1.74, 95% CI 1.05, 2.88; p50.03).

CONCLUSIONS: These data do not support the hypothesis that antibiotic

use in early life is associated with allergic sensitization or clinical allergic

outcomes at ages 2-3 years. Further analyses are needed to understand the

observed association between early antibiotic use and recurrent wheeze.