Early-life cockroach allergen and polycyclic aromatic hydrocarbon exposures predict cockroach sensitization among inner-city children Matthew S. Perzanowski,

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Early-life cockroach allergen and polycyclic aromatic hydrocarbon exposures predict cockroach sensitization among inner-city children Matthew S. Perzanowski, PhD, Ginger L. Chew, ScD, Adnan Divjan, BA, Kyung Hwa Jung, PhD, Robert Ridder, BS, Deliang Tang, PhD, Diurka Diaz, MA, Inge F. Goldstein, DrPH, Patrick L. Kinney, ScD, Andrew G. Rundle, DrPH, David E. Camann, MS, Frederica P. Perera, DrPH, Rachel L. Miller, MD Journal of Allergy and Clinical Immunology Volume 131, Issue 3, Pages 886-893.e6 (March 2013) DOI: 10.1016/j.jaci.2012.12.666 Copyright © 2013 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 1 Overview of study and children included in analyses. Of the 727 children enrolled prenatally, analyses for the current study were restricted to the 349 who had valid measurements of prenatal Bla g 2 and PAH and allergen-specific IgE at age 5 years, age 7 years, or both. Journal of Allergy and Clinical Immunology 2013 131, 886-893.e6DOI: (10.1016/j.jaci.2012.12.666) Copyright © 2013 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 2 Prevalence of sensitization to cockroach with tertiles of prenatal Bla g 2 levels in kitchen dust. Tertiles of Bla g 2 levels were defined as follows: Low, less than 0.73 ng/g; Moderate, 0.73 to 772 ng/g; and High, greater than 772 ng/g. Sensitization was defined as greater than 0.35 IU/mL IgE to cockroach. Journal of Allergy and Clinical Immunology 2013 131, 886-893.e6DOI: (10.1016/j.jaci.2012.12.666) Copyright © 2013 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 3 Probability of sensitization to cockroach at age 5 to 7 years with prenatal Bla g 2 exposure among children with lower (A) and higher (B) prenatal airborne ∑8PAHnonvolatile exposure. ∑8PAHnonvolatile concentrations were dichotomized at the median (2.25 ng/m3). Unadjusted logistic regression lines are depicted with 95% CIs in the gray shaded area. A, P = .34; B, P < .001. Journal of Allergy and Clinical Immunology 2013 131, 886-893.e6DOI: (10.1016/j.jaci.2012.12.666) Copyright © 2013 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 4 Probability of sensitization to cockroach at age 5 to 7 years with prenatal Bla g 2 exposure stratified by prenatal ∑8PAHnonvolatile exposure and GSTM polymorphisms. ∑8PAHnonvolatile concentrations were dichotomized at the median (2.25 ng/m3). Unadjusted logistic regression lines are depicted with 95% CIs in the gray shaded area. A, P = .43; B, P = .60; C, P = .017; D, P = .005. Journal of Allergy and Clinical Immunology 2013 131, 886-893.e6DOI: (10.1016/j.jaci.2012.12.666) Copyright © 2013 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig E1 Schematic of participants enrolled prenatally and the subset with complete data included in the current analyses. Journal of Allergy and Clinical Immunology 2013 131, 886-893.e6DOI: (10.1016/j.jaci.2012.12.666) Copyright © 2013 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig E2 Correlation between Bla g 2 levels in prenatal kitchen dust and PAH levels in air measured prenatally (r = 0.003, P = .96; A) and Bla g 2 levels in kitchen dust at the ages of 1 to 5 years (r = 0.15, P = .007; B). Journal of Allergy and Clinical Immunology 2013 131, 886-893.e6DOI: (10.1016/j.jaci.2012.12.666) Copyright © 2013 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig E3 Probability of sensitization to cockroach at ages of 5 to 7 years with prenatal Bla g 2 exposure among children with lower (A) and higher (B) prenatal airborne pyrene concentrations. Pyrene concentrations were dichotomized at the median (2.6 ng/m3). Unadjusted logistic regression lines are depicted with 95% CIs in the gray shaded area. A, P = .005; B, P = .071. The corresponding adjusted models for Bla g 2 predicting sensitization yielded the following RRs. Fig E1, A: RR, 1.19; 95% CI, 1.07-1.33; P = .001. Fig E1, B: RR, 1.11; 95% CI, 0.99-1.25; P = .085. The Bla g 2 × pyrene interaction term resulted in a Pinteraction value of .40 in the adjusted model predicting sensitization at age 5 to 7 years. Journal of Allergy and Clinical Immunology 2013 131, 886-893.e6DOI: (10.1016/j.jaci.2012.12.666) Copyright © 2013 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig E4 Probability of sensitization to cockroach at age 5 to 7 years with prenatal Bla g 2 exposure stratified by prenatal ∑8PAHnonvolatile exposure and GSTP polymorphisms. ∑8PAHnonvolatile concentrations were dichotomized at the median (2.25 ng/m3). Effect modification by the presence of the minor allele in GSTP1 (Ile/Val or Val/Val) was evaluated based on previously reported altered susceptibility to the adjuvant effect of DEPs on sensitization.19 Unadjusted logistic regression lines are depicted with 95% CIs in the gray shaded area. A, P = .26; B, P = .94; C, P = .003; D, P = .057. The corresponding adjusted models for Bla g 2 predicting sensitization yielded the following RRs. Fig E2, A: n = 104; RR, 1.10; 95% CI, 0.95-1.28; P = .21. Fig E2, B: n = 45; RR, 1.16; 95% CI, 0.92-1.45; P = .21. Fig E2, C: n = 108; RR, 1.22; 95% CI, 1.07-1.40; P = .004. Fig E2, D: n = 42; RR, 1.17; 95% CI, 0.91-1.50; P = .21. Journal of Allergy and Clinical Immunology 2013 131, 886-893.e6DOI: (10.1016/j.jaci.2012.12.666) Copyright © 2013 American Academy of Allergy, Asthma & Immunology Terms and Conditions