葡萄球菌肠毒素的敏感性和哮喘严重程度：EGEA队列中的纵向研究
2019/08/27
背景：越来越多的证据表明，金黄色葡萄球菌在上下气道疾病中起着重要的疾病调节作用。 在之前的横断面研究中，金黄色葡萄球菌肠毒素（SEs）的致敏与重症哮喘的风险增加相关，但缺乏纵向研究的证据。本文旨在评估SE敏感性与哮喘严重程度和急性发作之间的关联。
方法：这是一项针对哮喘遗传与环境-EGEA队列的20年流行病学研究的巢式病例对照研究，包括EGEA2（2003-2007）中的225例成人（75例对照，76例轻度哮喘，75例重症哮喘）。对其中173例（11年前收集的样品（EGEA1））检测SE敏感性，并对EGEA1和EGEA2进行了横断面关联。纵向分析评估了EGEA1中SE敏感性与随访中的重症哮喘和哮喘急性发作风险之间的关系。模型根据性别，年龄，吸烟，父母哮喘/过敏和对屋尘螨的皮肤点刺试验进行了调整。
结果：在EGEA1中，对照组、轻度哮喘和重症哮喘中SE致敏率分别为39％，58％和76％。调整后的横断面关联表明，SE敏感性与重症哮喘的风险增加相关，但与轻度哮喘无关。EGEA1中的SE致敏与10-20年后评估的重症哮喘（调整OR 2.69，95％CI [1.18-6.15]）和哮喘急性发作（调整OR 4.59，95％CI [1.40-15.07]）相关。
结论：这项研究首次表明，对SE敏感与随后的重症哮喘和哮喘急性发作风险增加有关。
(Eur Respir J. 2019 Jul 8. pii: 1900198. doi: 10.1183/13993003.00198-2019. [Epub ahead of print].)
Sensitisation to staphylococcal enterotoxins and asthma severity: a longitudinal study in the EGEA cohort.
Sintobin I, Siroux V, Holtappels G, Pison C, Nadif R, Bousquet J, Bachert C.
Abstract
background:Evidence is accumulating that Staphylococcus aureus plays an important role as disease modifier in upper and lower airway diseases. Sensitisation to Staphylococcus aureus enterotoxins (SEs) was associated with an increased risk for severe asthma in previous cross-sectional studies, but evidences from longitudinal studies are lacking. We aimed to assess associations between SE-sensitisation and the subsequent risk for asthma severity and exacerbations.
MEthodS:This is a nested case-control study from the 20-year Epidemiological study on the Genetics and Environment of Asthma-EGEA cohort, including 225 adults (75 without asthma, 76 with mild and 75 with severe asthma) in EGEA2 (2003-2007). For 173 of these individuals, SE-sensitisation was measured on samples collected 11 years earlier (EGEA1). Cross-sectional associations were conducted for EGEA1 and EGEA2. Longitudinal analyses estimated the association between SE-sensitisation in EGEA1 and the risk of severe asthma and asthma exacerbations assessed in the follow-up. Models were adjusted on gender, age, smoking, parental asthma/allergy and skin prick test to house dust mite.
RESULTS:SE-sensitisation varied between 39% in controls to 58% and 76% in mild and severe asthma in EGEA1. An adjusted cross-sectional association showed that SE-sensitisation was associated with an increased risk for severe, but not for mild asthma. SE-sensitisation in EGEA1 was associated with severe asthma (adjusted-OR 2.69, 95% CI [1.18-6.15]) and asthma exacerbations (adjusted-OR 4.59, 95% CI [1.40-15.07]) assessed 10-20 years later.
CONCLUSIONS:For the first time, this study shows that being sensitised to SEs is associated with an increased subsequent risk of severe asthma and asthma exacerbations.
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室内细菌微生物群与10.5岁前哮喘的发展
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1993-2014年加利福尼亚州空气质量变化与儿童哮喘事件的关系
