title: Can the presence of cat/dog at home be considered the only criterion of exposure to cat/dog allergens? A likely underestimated bias in clinical practice and in large epidemiological studies.
abstract: An important aspect of allergic sensitization to furry animals is the association of dog and cat exposure in early childhood with the incidence of respective allergies later in life. This topic is very controversial, because some authors have found a "facilitating" effect, while others have noticed a "protective" or even no significant effect in individuals living in urban areas. It is likely that some biases could be responsible of these contradictory findings. Cat/dog ownership or their presence in indoor environments are considered usually the main criteria to assess the exposure to these pets in studies' questionnaires. Even in clinical practice "are there animals at home?" is the common query usually done when collecting anamnestic data. In our opinion, these commonly used questions should not be considered the main index of exposure to pet allergens, because they can lead to erroneous interpretation of the clinical significance of positive skin prick tests for pet allergens as well as of the real risk of exposure to allergens of dog/cat in epidemiological studies. Consequently, we suggest a new, more realistic, classification of modalities of exposure to pet allergens in "real life" based on five possible conditions.
authors.affiliation: Department of Chest Diseases, Division of Pneumology and Allergology. High Speciality "A. Cardarelli" Hospital, Naples, Italy. Phone: +39 081 747 3335-4-3 Fax: + 39 081 747 3331 E-mail: gennaro.liccardi@tin.it. Postgraduate School of Respiratory Medicine, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Liccardi
authors.affiliation: Department of Chest Diseases, Division of Pneumology and Allergology. High Speciality "A. Cardarelli" Hospital, Naples, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Salzillo
authors.affiliation: Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Calzetta
authors.affiliation: Department of Chest Diseases, Division of Pneumology and Allergology. High Speciality "A. Cardarelli" Hospital, Naples, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Piccolo
authors.affiliation: Veterinary.
authors.forename: G
authors.initials: G
authors.lastname: Menna
authors.affiliation: Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Rogliani
mesh_terms: D000367:Age Factors; D000485:Allergens / Q000009:adverse effects* / Q000276:immunology; D000818:Animals; D015982:Bias; D002415:Cats; D004285:Dogs; D004781:Environmental Exposure / Q000009:adverse effects*; D015340:Epidemiologic Research Design; D006798:Housing; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis* / Q000453:epidemiology* / Q000276:immunology; D057805:Pets / Q000276:immunology; D011237:Predictive Value of Tests; D012307:Risk Factors; D012882:Skin Tests; D011795:Surveys and Questionnaires
chemical_list: D000485:Allergens
keywords: Allergen exposure; allergic rhinitis; allergic sensitization; bronchial asthma; cat, dog, cat/dog allergy, hypersensitivity; pet