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J Allergy Clin Immunol Pract. 2018 Nov - Dec;6(6):2006-2013.e4. doi: 10.1016/j.jaip.2018.04.009. Epub 2018 Apr 21.

Exposure and Sensitization to Pets Modify Endotoxin Association with Asthma and Wheeze.

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Department of Occupational and Environmental Health, University of Iowa, Iowa City, Iowa.
Social & Scientific Systems, Inc, Durham, NC.
Division of Intramural Research, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC.
Department of Occupational and Environmental Health, University of Iowa, Iowa City, Iowa. Electronic address:



Pets are major contributors of endotoxin in homes, but whether they influence endotoxin association with respiratory outcomes is unclear.


To examine whether exposure and sensitization to dog and cat modify the relationship between endotoxin exposure and asthma and wheeze.


We analyzed data from 6051 participants in the 2005-2006 cycle of the National Health and Nutrition Examination Survey (NHANES). House dust from bedroom floor and bedding was evaluated for endotoxin and for dog (Canis familiaris 1) and cat (Feline domesticus 1) allergens. The NHANES also collected data on respiratory outcomes and measured IgE specific to allergens. Associations of log-endotoxin and pet exposure with respiratory outcomes were examined, adjusting for covariates including pet avoidance.


Dog and cat ownership among participants was 48.3% and 37.5%, respectively. Endotoxin geometric mean (SE) was 15.49 (0.50) EU/mg. Endotoxin and pet allergen levels were significantly higher in households with a dog or cat. Overall, endotoxin was positively associated with wheeze (odds ratio [OR], 1.30; 95% CI, 1.04-1.62), but not with asthma. However, in participants nonsensitized to dog, the odds of endotoxin association with wheeze were higher with exposure to dog allergen (OR, 1.80; 95% CI, 1.27-2.53; Pinteraction = .048). In participants sensitized to cat and exposed to cat allergen, endotoxin became positively associated with asthma (OR, 1.92; 95% CI, 1.21-3.0; Pinteraction = .040). With coexposure to dog and cat allergens, endotoxin association with asthma and wheeze was exacerbated (OR, 2.00; 95% CI, 1.04-3.83; Pinteraction = .012 and OR, 1.88; 95% CI, 1.32-2.66; Pinteraction = .016, respectively).


Exposure to dog and cat allergens enhances the association of endotoxin with asthma and wheeze.


Asthma; Endotoxin; House dust; Pets; Sensitization; Wheeze


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