对宠物的暴露和致敏能否改变内毒素与哮喘及喘息的关系
2018/05/08
摘要
背景：宠物是家居内毒素的主要来源，但它们是否影响内毒素与呼吸系统预后的关系还不清楚。
目的：探究对狗和猫的暴露及致敏能否改变内毒素暴露与哮喘和喘息症状之间的关系。
方法：我们分析了2005-2006年间全国健康和营养测评调查（NHANES）的中6051名参与者的数据。测定来自卧室地板和床上用品的室内灰尘的内毒素及来自狗（犬1）和猫（猫科动物1）的过敏原。NHANES还收集了呼吸疾病预后和特异性IgE的数据。检测调整了包括回避宠物的协变量后，内毒素对数和宠物暴露与呼吸系统预后之间的关系。
结果：拥有家犬或猫的参与者分别为48.3%和37.5%。内毒素的几何平均值（标准误差）为15.49（0.50）Eu/mg。拥有家犬或猫的参与者体内内毒素和宠物过敏原水平明显升高。总体来说，内毒素与喘息症状呈正相关（OR 1.30（95% CI：1.04-1.62]），但与哮喘无关。然而，在对狗不敏感的参与者中，暴露于家犬相关过敏原时内毒素相关的喘息症状发生率较高（OR 1.80 [1.27～2.53]，pinteraction＝0.048）。当对猫过敏的参与者暴露于猫相关的致敏源时，内毒素与哮喘呈正相关（OR1.92（1.21-3.0]，pinteraction＝0.040）。对狗和猫致敏原同时暴露，内毒素与哮喘和喘息症状之间的关联加剧（OR 2 [1.04-3.83]，pinteraction＝0.012，OR 1.88（1.32-2.66），pinteraction＝0.016）。
结论：暴露于狗和猫致敏原增强内毒素与哮喘和喘息症状之间的关联。
Exposure and Sensitization to Pets Modify Endotoxin Association with Asthma and Wheeze.
Mendy A, Wilkerson J, Salo PM, Cohn RD, Zeldin DC
Abstract
BACKGROUND:Pets are major contributors of endotoxin in homes, but whether they influence endotoxin association with respiratory outcomes is unclear.
OBJECTIVE:To examine whether exposure and sensitization to dog and cat modify the relationship between endotoxin exposure and asthma and wheeze.
METHODS:We analyzed data from 6,051 participants in the 2005-2006 National Health and Nutrition Examination Survey (NHANES). House dust from bedroom floor and bedding was evaluated for endotoxin and for dog (Canis familiaris 1) and cat (Feline domesticus 1) allergens. The NHANES also collected data on respiratory outcomes and measured immunoglobulin E specific to allergens. Associations of log-endotoxin and pet exposure with respiratory outcomes were examined adjusting for covariates including pet avoidance.
RESULTS:Dog and cat ownership among participants was 48.3% and 37.5%, respectively. Endotoxin geometric mean (standard error) was 15.49 (0.50) EU/mg. Endotoxin and pet allergen levels were significantly higher in households with a dog or cat. Overall, endotoxin was positively associated with wheeze (OR 1.30 [95% CI: 1.04-1.62]), but not with asthma. However, in participants non-sensitized to dog, the odds of endotoxin association with wheeze was higher with exposure to dog allergen (OR 1.80 [1.27-2.53], Pinteraction=0.048). In participants sensitized to cat and exposed to cat allergen, endotoxin became positively associated with asthma (OR 1.92 [1.21-3.0], Pinteraction＝0.040). With co-exposure to dog and cat allergens, endotoxin association with asthma and wheeze was exacerbated (OR 2.00 [1.04-3.83], Pinteraction=0.012 and OR 1.88 [1.32-2.66], Pinteraction=0.016 respectively).
CONCLUSIONS:Exposure to dog and cat allergens enhances the association of endotoxin with asthma and wheeze.
背景：宠物是家居内毒素的主要来源，但它们是否影响内毒素与呼吸系统预后的关系还不清楚。
目的：探究对狗和猫的暴露及致敏能否改变内毒素暴露与哮喘和喘息症状之间的关系。
方法：我们分析了2005-2006年间全国健康和营养测评调查（NHANES）的中6051名参与者的数据。测定来自卧室地板和床上用品的室内灰尘的内毒素及来自狗（犬1）和猫（猫科动物1）的过敏原。NHANES还收集了呼吸疾病预后和特异性IgE的数据。检测调整了包括回避宠物的协变量后，内毒素对数和宠物暴露与呼吸系统预后之间的关系。
结果：拥有家犬或猫的参与者分别为48.3%和37.5%。内毒素的几何平均值（标准误差）为15.49（0.50）Eu/mg。拥有家犬或猫的参与者体内内毒素和宠物过敏原水平明显升高。总体来说，内毒素与喘息症状呈正相关（OR 1.30（95% CI：1.04-1.62]），但与哮喘无关。然而，在对狗不敏感的参与者中，暴露于家犬相关过敏原时内毒素相关的喘息症状发生率较高（OR 1.80 [1.27～2.53]，pinteraction＝0.048）。当对猫过敏的参与者暴露于猫相关的致敏源时，内毒素与哮喘呈正相关（OR1.92（1.21-3.0]，pinteraction＝0.040）。对狗和猫致敏原同时暴露，内毒素与哮喘和喘息症状之间的关联加剧（OR 2 [1.04-3.83]，pinteraction＝0.012，OR 1.88（1.32-2.66），pinteraction＝0.016）。
结论：暴露于狗和猫致敏原增强内毒素与哮喘和喘息症状之间的关联。
(中日友好医院呼吸与危重症医学科 张科文 摘译 林江涛 审校)
(J Allergy Clin Immunol Pract. doi: 10.1016/j.jaip.2018.04.009 )
(J Allergy Clin Immunol Pract. doi: 10.1016/j.jaip.2018.04.009 )
Exposure and Sensitization to Pets Modify Endotoxin Association with Asthma and Wheeze.
Mendy A, Wilkerson J, Salo PM, Cohn RD, Zeldin DC
Abstract
BACKGROUND:Pets are major contributors of endotoxin in homes, but whether they influence endotoxin association with respiratory outcomes is unclear.
OBJECTIVE:To examine whether exposure and sensitization to dog and cat modify the relationship between endotoxin exposure and asthma and wheeze.
METHODS:We analyzed data from 6,051 participants in the 2005-2006 National Health and Nutrition Examination Survey (NHANES). House dust from bedroom floor and bedding was evaluated for endotoxin and for dog (Canis familiaris 1) and cat (Feline domesticus 1) allergens. The NHANES also collected data on respiratory outcomes and measured immunoglobulin E specific to allergens. Associations of log-endotoxin and pet exposure with respiratory outcomes were examined adjusting for covariates including pet avoidance.
RESULTS:Dog and cat ownership among participants was 48.3% and 37.5%, respectively. Endotoxin geometric mean (standard error) was 15.49 (0.50) EU/mg. Endotoxin and pet allergen levels were significantly higher in households with a dog or cat. Overall, endotoxin was positively associated with wheeze (OR 1.30 [95% CI: 1.04-1.62]), but not with asthma. However, in participants non-sensitized to dog, the odds of endotoxin association with wheeze was higher with exposure to dog allergen (OR 1.80 [1.27-2.53], Pinteraction=0.048). In participants sensitized to cat and exposed to cat allergen, endotoxin became positively associated with asthma (OR 1.92 [1.21-3.0], Pinteraction＝0.040). With co-exposure to dog and cat allergens, endotoxin association with asthma and wheeze was exacerbated (OR 2.00 [1.04-3.83], Pinteraction=0.012 and OR 1.88 [1.32-2.66], Pinteraction=0.016 respectively).
CONCLUSIONS:Exposure to dog and cat allergens enhances the association of endotoxin with asthma and wheeze.
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哮喘中的气道病理异质性：应用拓扑数据分析可视化疾病微团簇
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比较老年哮喘或老年非哮喘与年轻哮喘患者之间临床、生理和炎症特征
