瑞士阿尔卑斯山儿科队列中的环境暴露和致敏模式
2023/12/20
摘要
背景：人一生中接触环境的程度可能会导致过敏致敏和过敏性疾病的发生。阿尔卑斯山的气候被认为是一个少有过敏原暴露和污染的健康气候。我们进行了一项横断面研究，以调查在高山环境中出生和长大的当地学龄儿童的当地环境暴露和相应的过敏性疾病发病率。
方法：通过问卷调查收集临床和人口统计学数据。通过居住地尘埃样本评估了过敏原含量，使用来自全国花粉和空气污染监测站的数据计算了花粉和空气污染的终身暴露，使用组分解析诊断（ISAC®）确定了过敏性致敏特征。采用单变量和多变量回归模型来估计暴露与过敏之间的关系。
结果：在一群出生并成长于高寒环境的儿童中，对空气过敏原过敏的儿童非常普遍（38%），尤其是对草（33%）和猫（16%）过敏的儿童。在高达 38% 的居住灰尘样本中检测到了屋尘螨过敏原，但对屋尘螨过敏的比例很低（2.5%）。污染物水平较低，但臭氧和 PM10 的含量呈上升趋势。居住地靠近繁忙的道路会导致对任何过敏原过敏的OR（95% CI）增加 2.7（1.0-7.2），对室外过敏原过敏的OR（95% CI）增加 2.8（1.1-7.1），过敏并报告鼻结膜炎症状的OR（95% CI）增加 4.4（1.3-14.8），报告哮喘症状的OR（95% CI）增加 5.5（1.4-21）。室内居住条件，包括可见霉菌的存在，增加了对室内过敏原过敏的OR（1.9 (1.1-3.2)）以及过敏并报告鼻结膜炎症状的OR（1.9 (1.0-3.6)）和哮喘的OR（2.1 (1.0-4.1)）。
结论：在良好的高山环境中，污染可能仍然是导致过敏的一个重要因素。
Environmental exposure and sensitization patterns in a Swiss alpine pediatric cohort
Fieten KB, Maya-Manzano JM, Rückert B, Candeias J, Pusch G; CK-CARE Study Group; Buters J, Akdis CA, Traidl-Hoffmann C.
Abstract
Background:The level of environmental exposure throughout life may contribute to the prevalence of allergic sensitization and allergic disease. The alpine climate has been considered a healthy climate with little allergen exposure and pollution. We conducted a cross-sectional study to investigate local environmental exposure and concomitant prevalence of allergic sensitization among local school children born and raised in an alpine environment.
Methods:Clinical and demographic data were collected with a questionnaire. Allergen content was assessed in residential settled dust samples, lifetime exposure to pollen and air pollution was calculated using data from national pollen and air pollution monitoring stations, and the allergic sensitization profile was determined with component resolved diagnostics (ISAC®). Univariate and multivariate regression models were used to estimate the relation between exposure and sensitization.
Results:In a cohort of children born and raised in an alpine environment, sensitization to aeroallergens is quite common (38%), especially to grass (33%) and cat (16%). House dust mite allergen was detected in up to 38% of residential dust samples, but sensitization to HDM was low (2.5%). Pollutant levels were low, but an increasing trend was observed in the amount of ozone and PM10. Living close to a busy road was associated with increased odds OR (95% CI) for being sensitized to any allergen 2.7 (1.0-7.2), to outdoor allergens 2.8 (1.1-7.1) and being sensitized plus reporting symptoms of rhinoconjunctivitis 4.4 (1.3-14.8) and asthma 5.5 (1.4-21). Indoor living conditions, including the presence of visible mold, increased the odds of being sensitized to indoor allergens (1.9 (1.1-3.2) and being sensitized plus reporting symptoms of rhinoconjunctivitis 1.9 (1.0-3.6) and asthma 2.1 (1.0-4.1).
Conclusion:In a healthy alpine environment, pollution might still be an important factor contributing to allergic sensitization.
背景：人一生中接触环境的程度可能会导致过敏致敏和过敏性疾病的发生。阿尔卑斯山的气候被认为是一个少有过敏原暴露和污染的健康气候。我们进行了一项横断面研究，以调查在高山环境中出生和长大的当地学龄儿童的当地环境暴露和相应的过敏性疾病发病率。
方法：通过问卷调查收集临床和人口统计学数据。通过居住地尘埃样本评估了过敏原含量，使用来自全国花粉和空气污染监测站的数据计算了花粉和空气污染的终身暴露，使用组分解析诊断（ISAC®）确定了过敏性致敏特征。采用单变量和多变量回归模型来估计暴露与过敏之间的关系。
结果：在一群出生并成长于高寒环境的儿童中，对空气过敏原过敏的儿童非常普遍（38%），尤其是对草（33%）和猫（16%）过敏的儿童。在高达 38% 的居住灰尘样本中检测到了屋尘螨过敏原，但对屋尘螨过敏的比例很低（2.5%）。污染物水平较低，但臭氧和 PM10 的含量呈上升趋势。居住地靠近繁忙的道路会导致对任何过敏原过敏的OR（95% CI）增加 2.7（1.0-7.2），对室外过敏原过敏的OR（95% CI）增加 2.8（1.1-7.1），过敏并报告鼻结膜炎症状的OR（95% CI）增加 4.4（1.3-14.8），报告哮喘症状的OR（95% CI）增加 5.5（1.4-21）。室内居住条件，包括可见霉菌的存在，增加了对室内过敏原过敏的OR（1.9 (1.1-3.2)）以及过敏并报告鼻结膜炎症状的OR（1.9 (1.0-3.6)）和哮喘的OR（2.1 (1.0-4.1)）。
结论：在良好的高山环境中，污染可能仍然是导致过敏的一个重要因素。
(中日友好医院呼吸与危重症医学科 沈焜路 摘译 林江涛 审校)
(World Allergy Organ J. 2023 Dec 3; DOI: 10.1016/j.waojou.2023.100847)
(World Allergy Organ J. 2023 Dec 3; DOI: 10.1016/j.waojou.2023.100847)
Environmental exposure and sensitization patterns in a Swiss alpine pediatric cohort
Fieten KB, Maya-Manzano JM, Rückert B, Candeias J, Pusch G; CK-CARE Study Group; Buters J, Akdis CA, Traidl-Hoffmann C.
Abstract
Background:The level of environmental exposure throughout life may contribute to the prevalence of allergic sensitization and allergic disease. The alpine climate has been considered a healthy climate with little allergen exposure and pollution. We conducted a cross-sectional study to investigate local environmental exposure and concomitant prevalence of allergic sensitization among local school children born and raised in an alpine environment.
Methods:Clinical and demographic data were collected with a questionnaire. Allergen content was assessed in residential settled dust samples, lifetime exposure to pollen and air pollution was calculated using data from national pollen and air pollution monitoring stations, and the allergic sensitization profile was determined with component resolved diagnostics (ISAC®). Univariate and multivariate regression models were used to estimate the relation between exposure and sensitization.
Results:In a cohort of children born and raised in an alpine environment, sensitization to aeroallergens is quite common (38%), especially to grass (33%) and cat (16%). House dust mite allergen was detected in up to 38% of residential dust samples, but sensitization to HDM was low (2.5%). Pollutant levels were low, but an increasing trend was observed in the amount of ozone and PM10. Living close to a busy road was associated with increased odds OR (95% CI) for being sensitized to any allergen 2.7 (1.0-7.2), to outdoor allergens 2.8 (1.1-7.1) and being sensitized plus reporting symptoms of rhinoconjunctivitis 4.4 (1.3-14.8) and asthma 5.5 (1.4-21). Indoor living conditions, including the presence of visible mold, increased the odds of being sensitized to indoor allergens (1.9 (1.1-3.2) and being sensitized plus reporting symptoms of rhinoconjunctivitis 1.9 (1.0-3.6) and asthma 2.1 (1.0-4.1).
Conclusion:In a healthy alpine environment, pollution might still be an important factor contributing to allergic sensitization.
上一篇：
急性毛细支气管炎后的空气污染是学龄前哮喘的危险因素:一项巢式病例对照研究
下一篇：
支气管哮喘与冠心病：一项观察性孟德尔随机研究
