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While viral infections trigger most childhood asthma exacerbations, allergens play a central role in airway inflammation and hyper-responsiveness. Allergen avoidance is a cornerstone for managing allergic disease, but evidence supporting its role in reducing asthma exacerbations is lacking.
In a double-blind U.K. study, 284 dust mite–sensitized children (ages 3–17 years) with asthma and a recent exacerbation requiring an urgent visit were randomized to receive mite-impermeable or control bed coverings. Dust mite levels in the children's mattresses were reduced by 84% in the mite-cover group and were unchanged in the control group. At 12 months, 29% of children in the mite-cover group had a severe exacerbation (requiring systemic steroids and…