5～6岁过敏儿童对气道过敏原激发试验反应的预测因素
2007/10/26
2007年《Allergy》第4期刊登Douglas等人关于“5～6岁过敏儿童对气道过敏原激发试验反应预测因素”的研究报道，在文章中研究人员研究了5～6岁儿童对气道过敏原激发试验的反应与其临床特征、免疫标志物间的关系。在一个198名有特应性疾病高发风险的儿童参加的出生队列研究中筛选出吸入过敏原皮肤点刺试验（SPT）阳性及阴性（作对照）的儿童，并进行过敏原激发试验。试验发现，风团大小、过敏原特应性IgE、总IgE、现存喘息和持续湿疹是过敏原激发试验阳性的独立预测因素，当特应性疾病免疫标志物、尤其是风团大小与临床特征合并时过敏原激发试验阳性的预测值被显著提高。
作者指出，在该年龄段特应性与气道过敏之间存在量化关系，当特应性免疫标志物量化以及同时存在特应性疾病病史时可能发现更多、更有意义的反映年幼儿童气道过敏的标志物。
作者指出，在该年龄段特应性与气道过敏之间存在量化关系，当特应性免疫标志物量化以及同时存在特应性疾病病史时可能发现更多、更有意义的反映年幼儿童气道过敏的标志物。
（刘燕燕 首都儿科研究所哮喘中心 100020 摘译）
（Allergy 62 ：401–407）
Predictors of response to bronchial allergen challenge in 5- to 6-year-old atopic children
T.A.Douglas, M.Kusel, E.M.Pascoe, R.K.S.Loh, P.G.Holt, P.D.Sly
Abstract 摘要
Background: The relationship between atopy and bronchial allergy in young children is not completely understood.
Objective: To examine the association between response to bronchial allergen challenge, immune markers of atopy and other clinical characteristics in 5- to 6-year-old children.
Methods: Children with positive skin test (SPT) to aeroallergen, together with a proportion of SPT negative children (as controls), were recruited from a birth cohort of 198 children at high risk of developing atopic disease and underwent allergen challenge.
Results: Thirty-seven children (26 atopic and 11 SPT negative), median age 74.5 months, were challenged: 31 with house dust mite and six with grass allergen. Only atopic children responded to challenge: n = 12/26 (46%). Wheal size [odds ratio (OR) 2.5 (1.2–5.3), P = 0.01], allergen-specific immunoglobulin E (IgE) [OR 3.4 (1.23–9.61), P = 0.02], total IgE [OR 8.6 (1.1–68.7), P = 0.04], current wheeze [OR 12 (1.7–81.7), P = 0.006] and persistent eczema [OR 11.0 (1.7–68.3), P = 0.006] emerged as the strongest independent predictors of response to allergen challenge. Prediction of response to allergen challenge was significantly improved when immune markers of atopy, and in particular wheal size, were combined with clinical characteristics.
Conclusion: The relationship between atopy and bronchial allergy is quantitative at this age. There may be potential to create more powerful indicators of the presence of respiratory allergy in young children when immunological markers of atopy are considered quantitatively and when combined with clinical history of coexistent allergic disease.
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