室内细菌与成人哮喘：ECRHS II中一项多中心病例对照研究
2018/05/03
摘要
目前已有研究报道了室内微生物暴露对哮喘的保护性影响和不利影响，但对象主要为儿童。迄今为止，在成人中还没有进行使用非靶向方法检测室内细菌，然后进行定量确认的研究。在欧洲共同体呼吸道健康调查（ECRHS）II中进行了198例哮喘和199例对照的横断面研究。使用变性梯度凝胶电泳（DGGE）从床垫粉尘中提取DNA进行细菌分析。对选定的条带进行测序，并与四种定量PCR（qPCR）分析证实的哮喘相关联。在用DGGE检测到的37条带中，与哮喘有至少一种暗示性关联（p <0.25）的15条带被测序。在四种靶向qPCR中，Clostridium XI簇被证实了与保护哮喘相关联。该关联是剂量依赖性的（aOR 0.43（95％CI 0.22-0.84），相对于第一个四分位数，p为趋势0.009）并且独立于其他微生物标记。所应用的其他三种qPCR几乎没有显著关联。在这项大型国际研究中，Clostridium XI簇的水平与哮喘流行低风险独立相关。结果表明环境细菌在成人哮喘中同样具有重要性，但需要在未来的研究中证实。
Indoor bacteria and asthma in adults: a multicentre case-control study within
ECRHS II.
Pekkanen J et al.
Abstract
Both protective and adverse effects of indoor microbial exposure on asthma have been reported, but mostly in children. To date, no study in adults has used non-targeted methods for detection of indoor bacteria followed by quantitative confirmation.A cross-sectional study of 198 asthmatic and 199 controls was conducted within the European Community Respiratory Health Survey (ECRHS) II. DNA was extracted from mattress dust for bacterial analysis using denaturing gradient gel electrophoresis (DGGE). Selected bands were sequenced and associations with asthma confirmed with four quantitative PCR (qPCR) assays.15 out of 37 bands detected with DGGE, which had at least a suggestive association (p<0.25) with asthma, were sequenced. Of the four targeted qPCRs, Clostridium cluster XI confirmed the protective association with asthma. The association was dose dependent (aOR 0.43 (95% CI 0.22-0.84) for the fourth versus first quartile, p for trend 0.009) and independent of other microbial markers. Few significant associations were observed for the three other qPCRs used.In this large international study, the level of Clostridium cluster XI was independently associated with a lower risk of prevalent asthma. Results suggest the importance of environmental bacteria also in adult asthma, but need to be confirmed in future studies.
目前已有研究报道了室内微生物暴露对哮喘的保护性影响和不利影响，但对象主要为儿童。迄今为止，在成人中还没有进行使用非靶向方法检测室内细菌，然后进行定量确认的研究。在欧洲共同体呼吸道健康调查（ECRHS）II中进行了198例哮喘和199例对照的横断面研究。使用变性梯度凝胶电泳（DGGE）从床垫粉尘中提取DNA进行细菌分析。对选定的条带进行测序，并与四种定量PCR（qPCR）分析证实的哮喘相关联。在用DGGE检测到的37条带中，与哮喘有至少一种暗示性关联（p <0.25）的15条带被测序。在四种靶向qPCR中，Clostridium XI簇被证实了与保护哮喘相关联。该关联是剂量依赖性的（aOR 0.43（95％CI 0.22-0.84），相对于第一个四分位数，p为趋势0.009）并且独立于其他微生物标记。所应用的其他三种qPCR几乎没有显著关联。在这项大型国际研究中，Clostridium XI簇的水平与哮喘流行低风险独立相关。结果表明环境细菌在成人哮喘中同样具有重要性，但需要在未来的研究中证实。
（复旦大学附属中山医院 呼吸内科 罗锦龙 摘译 杨冬 审校）
（Eur Respir J. 2018 Feb 7;51(2)）
（Eur Respir J. 2018 Feb 7;51(2)）
Indoor bacteria and asthma in adults: a multicentre case-control study within
ECRHS II.
Pekkanen J et al.
Abstract
Both protective and adverse effects of indoor microbial exposure on asthma have been reported, but mostly in children. To date, no study in adults has used non-targeted methods for detection of indoor bacteria followed by quantitative confirmation.A cross-sectional study of 198 asthmatic and 199 controls was conducted within the European Community Respiratory Health Survey (ECRHS) II. DNA was extracted from mattress dust for bacterial analysis using denaturing gradient gel electrophoresis (DGGE). Selected bands were sequenced and associations with asthma confirmed with four quantitative PCR (qPCR) assays.15 out of 37 bands detected with DGGE, which had at least a suggestive association (p<0.25) with asthma, were sequenced. Of the four targeted qPCRs, Clostridium cluster XI confirmed the protective association with asthma. The association was dose dependent (aOR 0.43 (95% CI 0.22-0.84) for the fourth versus first quartile, p for trend 0.009) and independent of other microbial markers. Few significant associations were observed for the three other qPCRs used.In this large international study, the level of Clostridium cluster XI was independently associated with a lower risk of prevalent asthma. Results suggest the importance of environmental bacteria also in adult asthma, but need to be confirmed in future studies.
