PMID- 37876034 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20231027 IS - 2045-7022 (Print) IS - 2045-7022 (Electronic) IS - 2045-7022 (Linking) VI - 13 IP - 10 DP - 2023 Oct TI - Difficult-to-treat asthma patients from ethnic minority groups in central England are at an enhanced risk of house dust mite sensitisation. PG - e12303 LID - 10.1002/clt2.12303 [doi] LID - e12303 AB - BACKGROUND: House dust mite (HDM) is the most common sensitising allergen in asthma. Ethnic minority groups (EMGs) in the UK are more likely to live in deprived conditionings with a greater exposure to HDM and other aero-allergens. AIM: To compare the ethnicity-based patterns of sensitisation to aero-allergens and the impact of ethnicity on clinical outcomes in patients with difficult-to-treat asthma (DTA). METHODS: Data of patients with DTA were extracted from the registry of the Birmingham Regional Severe Asthma Service (BRSAS), which have a catchment population of 7.3million from Central England. Patients from White and EMG backgrounds were compared in terms of the prevalence of atopy, total serum immunoglobulin E (IgE), specific serum IgE (ssIgE) and asthma related clinical outcomes. Logistic regression analysis was conducted to explore ethnicity-based risk factors for HDM sensitisation. RESULTS: A total of 1272 patients [White 1016 (79.9%), EMG 256 (20.1%) EMG] with a median age of 51 years (range 16-97) were included in the analysis. Patients from EMG were more likely (64%) to reside in the worst scale of index of multiple deprivation (IMD) than the White patients (25.5%), p < 0.0001. Positive HDM sensitisation was more prevalent in the EMG than in the White group [142/216 (66%) versus 375/842 (45%), p < 0.0001]. The median HDM ssIgE level was higher in the EMG than in the White group [3.0 KUA/L (IQR 0.06, 11.5) versus 0.1 (0.01, 3.0), p < 0.000001]. The odds ratio for positive sensitisation to HDM conveyed by the EMG status was 2.61 (95%CI, 1.8-3.8), p < 0.0001. Compared to the White group, the EMG had higher median total serum IgE [326 KU/L (115, 971) versus 114 (29.8, 434.8), p < 0.000001], higher blood eosinophil count (0.36 x 10(9) (0.18, 0.62) versus 0.23 (0.1,0.47), p < 0.000001), were marginally more atopic (79.2% vs. 75.6%, p = 0.098) and were less likely to being on maintenance oral corticosteroids (22% vs. 39.7%, p < 0.0001). CONCLUSION: In this DTA cohort, positive HDM sensitisation was greater amongst the EMG than the White patients. The EMG status was a significant risk factor for HDM sensitisation. CI - (c) 2023 The Authors. Clinical and Translational Allergy published by John Wiley & Sons Ltd on behalf of European Academy of Allergy and Clinical Immunology. FAU - Mansur, Adel H AU - Mansur AH AUID- ORCID: 0000-0002-8615-8778 AD - Birmingham Regional Severe Asthma Service, Birmingham Heartland Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK. AD - Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK. FAU - Marsh, Julie AU - Marsh J AD - Birmingham Regional Severe Asthma Service, Birmingham Heartland Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK. FAU - Bahron, Ali AU - Bahron A AD - Birmingham Regional Severe Asthma Service, Birmingham Heartland Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK. FAU - Thomas, Maximillian AU - Thomas M AD - Birmingham Regional Severe Asthma Service, Birmingham Heartland Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK. FAU - Walters, Gareth AU - Walters G AD - Birmingham Regional Severe Asthma Service, Birmingham Heartland Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK. FAU - Busby, John AU - Busby J AD - Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast, Belfast, UK. FAU - Heaney, Liam G AU - Heaney LG AD - Wellcome-Wolfson Centre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK. FAU - Krishna, Mamidipudi Thirumala AU - Krishna MT AD - Institute of Immunology and Immunotherapy, University of Birmingham, and University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK. LA - eng GR - University Hospitals Birmingham NHS Foundation Trust charitable funds/ PT - Journal Article PL - England TA - Clin Transl Allergy JT - Clinical and translational allergy JID - 101576043 PMC - PMC10560749 OTO - NOTNLM OT - biomarkers OT - disparities OT - ethnicity OT - house dust mite OT - severe asthma COIS- This study is an investigator led and did not receive funds from pharmaceutical companies. AHM declares institutional and personal funds for talks, advisory boards and research grants from AZ, GSK, BI, Chiesi, Teva, Novartis, Sanofi outside the submitted work. LGH declares personal fees from Novartis, Hoffman la Roche/Genetech Inc, Sanofi, GSK, AZ, Teva, Theravance, Circassia, and grants from Medimmune, Novartis UK, Roche/Genentech Inc, GSK, Amgen, AZ, Aerocrine, Vitalograph, all outside the submitted work. MTK received research grants from NIHR, MRC CiC, FSA, GCRF and University of Birmingham outside of the work presented in this manuscript. MTK is participating in a Delphi Advisory panel for treatment pathway for sublingual immunotherapy in allergic rhinitis and asthma organised by ALK Abello. MTKs department received educational grants from ALK Abello, Thermo-Fisher Scientific, MEDA and other pharmaceutical companies for annual PracticAllergy course over the years. JB has received research grants from AstraZeneca outside the presented work and has received personal fees for advisory board attendance from NuvoAir. EDAT- 2023/10/25 06:42 MHDA- 2023/10/25 06:43 PMCR- 2023/10/08 CRDT- 2023/10/25 00:02 PHST- 2023/08/15 00:00 [revised] PHST- 2023/08/13 00:00 [received] PHST- 2023/09/13 00:00 [accepted] PHST- 2023/10/25 06:43 [medline] PHST- 2023/10/25 06:42 [pubmed] PHST- 2023/10/25 00:02 [entrez] PHST- 2023/10/08 00:00 [pmc-release] AID - CLT212303 [pii] AID - 10.1002/clt2.12303 [doi] PST - ppublish SO - Clin Transl Allergy. 2023 Oct;13(10):e12303. doi: 10.1002/clt2.12303.