过敏原免疫疗法有效降低季节性和常年性过敏性哮喘急性加重和下呼吸道感染的风险：一项全国性流行病学研究
2022/06/17
摘要
背景：过敏性哮喘与呼吸道感染和哮喘恶化的风险增加有关。目前尚不清楚这种易感性是否受季节性或常年性过敏的影响。
目的：研究常年性过敏与季节性过敏作为下呼吸道感染和哮喘恶化的危险因素的比较，以及过敏原免疫疗法 (Allergen Immunotherapy，AIT) 是否可以降低这种风险。
方法：这是一项针对1995-2014年间接受AIT治疗的18-44岁人群的前瞻性全国注册研究。根据AIT的类型和抗哮喘药物的使用情况，将患者分为两组：常年性过敏性哮喘 (Perennial Allergic Asthma，PAA) 与季节性过敏性哮喘 (Seasonal Allergic Asthma，SAA)。在开始AIT前(基线)和完成AIT3年后(随访)分析抗生素治疗下呼吸道感染(Lower Respiratory Tract Infections，LRTI)和口服皮质激素治疗哮喘恶化的数据。
结果：我们确定了 2688 例接受AIT治疗的哮喘患者，其中1249例患有 PAA，1439 例患有 SAA。在基线时，SAA患者的恶化程度更高，分别为23.8%、16.5%（p <0.001），但 LRTI 没有差异。在三年的随访中，我们观察到急性加重的显着减少，PAA平均减少57%，SAA平均减少74%。我们还观察到PAA和SAA的LRTI 显着降低，分别降低17%和20%。
结论：AIT有效降低了季节性和常年性过敏性哮喘患者的病情加重和下呼吸道感染风险。与季节性过敏相比，常年性过敏似乎不是呼吸道感染和哮喘恶化的更大的风险因素。
Allergen immunotherapy effectively reduces the risk of exacerbations and lower respiratory tract infections in both seasonal and perennial allergic asthma: a nationwide epidemiological study
Christian Woehlk, Anna Von Bülow, Muzhda Ghanizada,
Abstrast
Background: Allergic asthma is associated with increased risk of respiratory tract infections and exacerbations. It remains unclear whether this susceptibility is conditioned by seasonal or by perennial allergy.
Aim: To investigate perennial allergy compared with seasonal allergy as a risk factor for lower respiratory tract infections and exacerbations in asthma and whether this risk can be reduced by allergen immunotherapy (AIT).
Methodology: This is a prospective register-based nationwide study of 18–44-year-olds treated with AIT during1995–2014. Based on the type of AIT and use of anti-asthmatic drugs, patients were subdivided into two groups: perennial allergic asthma (PAA) vs. seasonal allergic asthma (SAA). Data on antibiotics against lower respiratory tract infections (LRTI) and oral corticosteroids for exacerbations were analyzed before starting AIT (baseline) and three years after completing AIT (follow-up).
Results: We identified 2688 patients with asthma treated with AIT, among whom, 1249 had PAA and 1439 had SAA. At baseline, patients with SAA had more exacerbations, 23.8%, respectively, 16.5% (p=<.001) but there were no differences in LRTI. During the three-year follow-up, we observed a highly significant reduction of exacerbations with an average decrease of 57% in PAA and 74% in SAA. We also observed a significant reduction of LRTI in both PAA and SAA: 17% and 20% decrease, respectively.
Conclusion: AIT effectively reduced the risk of exacerbations and lower respiratory tract infections in both seasonal- and perennial allergic asthma. Perennial allergy is seemingly not a stronger risk factor for respiratory infections and exacerbations than is seasonal allergy.
背景：过敏性哮喘与呼吸道感染和哮喘恶化的风险增加有关。目前尚不清楚这种易感性是否受季节性或常年性过敏的影响。
目的：研究常年性过敏与季节性过敏作为下呼吸道感染和哮喘恶化的危险因素的比较，以及过敏原免疫疗法 (Allergen Immunotherapy，AIT) 是否可以降低这种风险。
方法：这是一项针对1995-2014年间接受AIT治疗的18-44岁人群的前瞻性全国注册研究。根据AIT的类型和抗哮喘药物的使用情况，将患者分为两组：常年性过敏性哮喘 (Perennial Allergic Asthma，PAA) 与季节性过敏性哮喘 (Seasonal Allergic Asthma，SAA)。在开始AIT前(基线)和完成AIT3年后(随访)分析抗生素治疗下呼吸道感染(Lower Respiratory Tract Infections，LRTI)和口服皮质激素治疗哮喘恶化的数据。
结果：我们确定了 2688 例接受AIT治疗的哮喘患者，其中1249例患有 PAA，1439 例患有 SAA。在基线时，SAA患者的恶化程度更高，分别为23.8%、16.5%（p <0.001），但 LRTI 没有差异。在三年的随访中，我们观察到急性加重的显着减少，PAA平均减少57%，SAA平均减少74%。我们还观察到PAA和SAA的LRTI 显着降低，分别降低17%和20%。
结论：AIT有效降低了季节性和常年性过敏性哮喘患者的病情加重和下呼吸道感染风险。与季节性过敏相比，常年性过敏似乎不是呼吸道感染和哮喘恶化的更大的风险因素。
(中日友好医院呼吸与危重症医学科 万静萱 摘译 林江涛 审校)
(The European respiratory journal 2022 May 26; doi:10.1183/13993003.00446-2022)
(The European respiratory journal 2022 May 26; doi:10.1183/13993003.00446-2022)
Allergen immunotherapy effectively reduces the risk of exacerbations and lower respiratory tract infections in both seasonal and perennial allergic asthma: a nationwide epidemiological study
Christian Woehlk, Anna Von Bülow, Muzhda Ghanizada,
Abstrast
Background: Allergic asthma is associated with increased risk of respiratory tract infections and exacerbations. It remains unclear whether this susceptibility is conditioned by seasonal or by perennial allergy.
Aim: To investigate perennial allergy compared with seasonal allergy as a risk factor for lower respiratory tract infections and exacerbations in asthma and whether this risk can be reduced by allergen immunotherapy (AIT).
Methodology: This is a prospective register-based nationwide study of 18–44-year-olds treated with AIT during1995–2014. Based on the type of AIT and use of anti-asthmatic drugs, patients were subdivided into two groups: perennial allergic asthma (PAA) vs. seasonal allergic asthma (SAA). Data on antibiotics against lower respiratory tract infections (LRTI) and oral corticosteroids for exacerbations were analyzed before starting AIT (baseline) and three years after completing AIT (follow-up).
Results: We identified 2688 patients with asthma treated with AIT, among whom, 1249 had PAA and 1439 had SAA. At baseline, patients with SAA had more exacerbations, 23.8%, respectively, 16.5% (p=<.001) but there were no differences in LRTI. During the three-year follow-up, we observed a highly significant reduction of exacerbations with an average decrease of 57% in PAA and 74% in SAA. We also observed a significant reduction of LRTI in both PAA and SAA: 17% and 20% decrease, respectively.
Conclusion: AIT effectively reduced the risk of exacerbations and lower respiratory tract infections in both seasonal- and perennial allergic asthma. Perennial allergy is seemingly not a stronger risk factor for respiratory infections and exacerbations than is seasonal allergy.
上一篇：
无症状健康哮喘儿童的肺部超声表现
下一篇：
短效β2-激动剂处方与哮喘的不良临床结果有关：多国、横断面SABINA Ⅲ 研究
