AB108 Abstracts
FEBRUARY 2019
324 Prevalence of Asthma in Chronic Opioid Users
Receiving Acute Care in an Inner City,
Municipal New York Hospital
Albert Lee, MD, Roshni Naik, MD, and Rauno Joks, MD; Center for Allergy
and Asthma Research at SUNY Downstate Medical Center, Brooklyn, NY.
RATIONALE: The effects of opioid use on respiratory conditions are
mixed – while licit opiates help with cough and the dyspnea of heart disease
and chronic obstructive pulmonary disease, illicit opiates may exacerbate
asthma. We hypothesized that there would be an increased prevalence of
asthma in patients with chronic opioid dependence.
METHODS: A cross sectional data analysis was performed using
secondary data (ICD 9 and ICD 10) of adults (N51966) treated at Kings
County Hospital Center (inpatient, Emergency Department, Ambulatory
Surgery) with opioid dependence between 2013 to 2017. Of the 1,966
patients with opioid dependence, 338 patients also had a diagnosis of
asthma. The prevalence of asthma was calculated and stratified by gender.
Ages ranged from 18 to 79 years old.
RESULTS: The overall prevalence of asthma in opioid dependent patients
receiving acute care from the services noted from 2013 to 2017 was 17.2%
compared to the national prevalence of adults with asthma in 2016 of 8.3%
(CDC, 2016). The gender stratified prevalence of asthma in opioid
dependent patients was 25% for females and 13.9% for males.
CONCLUSIONS: The prevalence of asthma in opioid dependent patients
(17.2%) is higher than the national prevalence of asthma (8.3%)(CDC,
2016). Women have a higher prevalence of asthma nationally, 9.7%
compared to 6.9% of men, however women with opioid dependence had
asthma at 25%. This suggests that women may also be disproportionately
affected with asthma in the setting of opioid dependence.
325 Prevalence of Food Allergy in At-Risk Asthmatic
Adolescents
Jessica Stern, MD, MS1, Todd A. Jusko, PhD2, Maria Fagnano, MPH3,
Kelly Thevenet-Morrison, MS2, and Jill S. Halterman, MD, MPH3;
1
Department of Pediatric Allergy and Immunology, University of Roches-
ter School of Medicine and Dentistry, Rochester, NY, 2Department of Pub-
SUNDAY
lic Health Sciences, University of Rochester School of Medicine and
Dentistry, Rochester, NY, 3Department of Pediatrics, University of Ro-
chester School of Medicine and Dentistry, Rochester, NY.
RATIONALE: Multiple investigations have observed increased asthma
morbidity among those with both food allergy and asthma. While the exact
mechanism is not fully understood, concurrent food allergy may be a risk
factor for worse asthma outcomes.
METHODS: Adolescents aged 12-16 years from the Rochester City
School District who were participants in the School Based Asthma Care for
Teens trial between 2016 and 2017, were included in the study. Concurrent
with the assessment of asthma outcomes via clinical history and
spirometry, self-reported food allergy was assessed. Food allergy ques-
tionnaire items were modified from NHANES. Multivariable regression
models adjusting for gender, race, age, insurance status and tobacco smoke
exposure were used to estimate the association between food allergy and
asthma morbidity. Secondary outcomes included epinephrine possession
and health care utilization.
RESULTS: Approximately one-quarter of adolescents reported having
food allergy, and the majority also had atopic dermatitis and allergic rhinitis.
Daytime asthma symptoms were not higher among those with food allergy
compared with those without food allergy. There was a trend of increased
odds of activity limitation among those with food allergy compared with
those without food allergy (OR51.7; 95% CI: 0.9, 3.3). Only 30% of
adolescents with food allergy had access to an epinephrine auto-injector.
CONCLUSIONS: The prevalence of food allergy is common among this
cohort of asthmatic adolescents . While we did not observe an association
between food allergy and asthma symptom severity, attention to preventive
care measures and interventions such as availability of epinephrine auto-
injectors, in addition to standard asthma treatments, is warranted.
J ALLERGY CLIN IMMUNOL
326 Sensitization to food allergens in allergic
asthmatic patients: association between
cockroach and shrimp sensitization
Raisa Borges Castro, MD1, Gabriella M. F. S. Dias, MD2, Joao Paulo de
Assis3, Rebeca M. Brugnolli4, Jorge Kalil, MD, PhD5, Pedro Giavina-
Bianchi, MD PhD FAAAAI2,6, and Rosana C. Agondi, MD, PhD6; 1Uni-
versity of S~ao Paulo, S~ao Paulo, Brazil, 2University of Sao Paulo, Sao
Paulo, Brazil, 3Sao Paulo University, Sao Paulo, Brazil, 4Clinical Immu-
nology and Allergy Division, University of Sao Paulo, Sao Paulo, Brazil,
5
Faculty of Medicine FMUSP, University of S~ao Paulo, S~ao Paulo, Brazil,
6
Clinical Immunology and Allergy Division, University of S~ao Paulo
School of Medicine, S~ao Paulo, Brazil.
RATIONALE: Asthma is rarely a manifestation of isolated food allergy.
Children with asthma and sensitized to at least one food allergen had a
higher hospitalization rate and a systemic corticosteroid requirement. The
objective of this study was to evaluate the sensitization to food allergens in
patients with allergic asthma without a history of food allergy.
METHODS: Cross-sectional study of asthmatic patients with no history of
food allergy in follow-up at the asthma outpatient clinic of a tertiary hospital.
All patients had allergic asthma characterized by the presence of specific IgE
to at least one aeroallergen. All of them were submitted to skin prick test to
food allergen (milk, egg, fish, peanut, wheat, and shrimp) from ALCÒ.
RESULTS: We included 49 patients with allergic asthma and negative history
for food allergy. Of these, 23 patients (47%) had positive specific IgE for at least
one food allergen: 17.4% for milk; 21.7% for egg; 60.9% for shrimp; 30.4% to
peanuts, 26.1% to fish and 30.4% to wheat. When compared to the non-
sensitized food allergen group, it was observed that those sensitized to at least
one food allergen had a higher sensitization to cockroaches (30.4% versus
11.1%) and a higher frequency of uncontrolled asthma (52.2% versus 25.9%).
CONCLUSIONS: This study showed that half of the allergic asthma
patients with no history of food allergy had sensitization to food allergens.
The group sensitized to at least one food allergen had poorer control of
asthma and a more frequent association of sensitization to cockroach and
shrimp allergens.
327 Role of Cytokines in the Immunomodulation and
Immunotherapy of Patients with Traumatic Chest
Injury
Minu Kumari, Surbhi Khurana, Nidhi Bhardwaj, Purva Mathur, Sushma
Sagar, Amit Gupta, Richa Aggarwal, Kapil Dev Soni, Vasudevan Sreeni-
vas, and Subodh Kumar; ALL INDIA INSTITUTE OF MEDICAL SCI-
ENCES, NEW DELHI, India.
RATIONALE: Severe trauma causes damage to the protective barriers
and activates immunological reaction. We hypothesized that early
detection of altered lymphocytic response may correlate with the final
outcome of patients with chest trauma.
METHODS: We conducted a pilot study on a homogeneous group of 30
chest trauma patients (mean age: 32.8 6 12.3 years) and 20 healthy
controls (mean age: 28.8 6 5.6 years). Blood samples were collected on
days 0, 2, 5 and day of discharge. Simultaneous quantification of 13
cytokines secreted collectively by Th1, Th2, Th9, Th17, Th22 and T
follicular cells was performed using fluorescence encoded bead-based
assay. Out of the total 30 patients, 28 (93%) patients were discharged, while
2 (7%) patients died. Statistical analysis was done using STATA software.
RESULTS: A significantly high level of IL-13, IL-2, IL-6, IL-9, IL-1b,
IFN-g, TNF-ɑ, IL-17A, IL-17F, IL-21 and IL-22 were found in chest
trauma patients on day 0 in comparison to healthy controls. Level of IL-
5, IL-13, IL-2, IL-9, IFN-g, TNF-ɑ, IL-17A, IL-17F, IL-4, IL-21 and IL-
22 were higher in patients who were discharged in comparison to patients
who died but does not showed any statistical significance. IL-6 (P50.01),
IL-1b (P50.01) and IL-22 (P50.01) levels were higher in patients on day
0 who developed complications.
CONCLUSIONS: Elevated levels of IL-6, IL-1b and IL-22 were
significantly associated with the occurrence of severe complications.