呼吸道合胞病毒感染住院治疗和哮喘间相关性的因果关系
2009/03/20
背景：早期研究报道呼吸道合胞病毒（RSV）感染住院治疗后哮喘风险增加。其他研究还发现哮喘倾向和喘息倾向会增加RSV感染住院治疗的风险。
目的：本研究检测了双胞胎人群队列中RSV感染住院治疗和哮喘间相关性的因果关系。
方法：对1994～2003年间出生的18,614名丹麦双胞胎进行前瞻性队列研究，根据RSV住院治疗和哮喘的登记信息检测RSV住院治疗和哮喘间的相关性。通过以下两个方面检测RSV和哮喘间的相关性：一是检测RSV感染住院治疗后的哮喘风险，二是检测在相同的人群队列中哮喘患儿因RSV感染住院治疗的风险。
结果：RSV感染住院治疗后哮喘住院治疗的风险增加，在RSV感染住院治疗后的最初2个月升高6～8倍，但1年后风险不再升高。哮喘使RSV感染住院治疗的风险升高3倍，且风险升高与时间无关。根据使用吸入性皮质类固醇明确的哮喘分析这些相关性，实质上并未改变风险评估结果。
结论：严重的RSV感染和哮喘双向相关。严重的RSV感染与随后发生哮喘的风险短期升高有关，表明RSV会引起支气管高反应性。哮喘与严重的RSV感染易感性长期增加有关，表明宿主因素导致对RSV感染的严重反应。这些结果表明严重的RSV感染和哮喘可能有共同的遗传倾向和/或环境暴露因素。
（林江涛 审校）
J Allergy Clin Immunol. 2009 Jan;123(1):131-137.e1. Links
Stensballe LG, et al. J Allergy Clin Immunol. 2009 Jan;123(1):131-137.e1. Links
The causal direction in the association between respiratory syncytial virus hospitalization and asthma.
BACKGROUND: Earlier studies have reported an increased risk of asthma after respiratory syncytial virus (RSV) hospitalization. Other studies found that asthmatic disposition and propensity to wheeze increase the risk of RSV hospitalization.
OBJECTIVE: The current study examined the causal direction of the associations between RSV hospitalization and asthma in a population-based cohort of twins.
METHODS: We conducted a prospective cohort study examining the associations between RSV hospitalization and asthma by using registry information on RSV hospitalization and asthma among 18,614 Danish twins born 1994 to 2003. The associations between RSV and asthma were examined in both directions: we examined the risk of asthma after RSV hospitalization, and the risk of RSV hospitalization in children with asthma in the same population-based cohort.
RESULTS: Asthma hospitalization after RSV hospitalization was increased as much as 6-fold to 8-fold during the first 2 months after RSV hospitalization but was no longer increased 1 year later. Asthma increased the risk of RSV hospitalization by 3-fold, and the risk was not time-dependent. Analyzing these associations on the basis of asthma defined from use of inhaled corticosteroid did not materially change the risk estimates.
CONCLUSION: There is a bidirectional association between severe RSV infection and asthma. Severe RSV infection is associated with a short-term increase in the risk of subsequent asthma, suggesting that RSV induce bronchial hyperresponsiveness; and asthma is associated with a long-term increased susceptibility for severe RSV disease, suggesting a host factor being responsible for the severe response to RSV infection. This suggests that severe RSV infection and asthma may share a common genetic predisposition and/or environmental exposure.
目的：本研究检测了双胞胎人群队列中RSV感染住院治疗和哮喘间相关性的因果关系。
方法：对1994～2003年间出生的18,614名丹麦双胞胎进行前瞻性队列研究，根据RSV住院治疗和哮喘的登记信息检测RSV住院治疗和哮喘间的相关性。通过以下两个方面检测RSV和哮喘间的相关性：一是检测RSV感染住院治疗后的哮喘风险，二是检测在相同的人群队列中哮喘患儿因RSV感染住院治疗的风险。
结果：RSV感染住院治疗后哮喘住院治疗的风险增加，在RSV感染住院治疗后的最初2个月升高6～8倍，但1年后风险不再升高。哮喘使RSV感染住院治疗的风险升高3倍，且风险升高与时间无关。根据使用吸入性皮质类固醇明确的哮喘分析这些相关性，实质上并未改变风险评估结果。
结论：严重的RSV感染和哮喘双向相关。严重的RSV感染与随后发生哮喘的风险短期升高有关，表明RSV会引起支气管高反应性。哮喘与严重的RSV感染易感性长期增加有关，表明宿主因素导致对RSV感染的严重反应。这些结果表明严重的RSV感染和哮喘可能有共同的遗传倾向和/或环境暴露因素。
（林江涛 审校）
J Allergy Clin Immunol. 2009 Jan;123(1):131-137.e1. Links
Stensballe LG, et al. J Allergy Clin Immunol. 2009 Jan;123(1):131-137.e1. Links
The causal direction in the association between respiratory syncytial virus hospitalization and asthma.
BACKGROUND: Earlier studies have reported an increased risk of asthma after respiratory syncytial virus (RSV) hospitalization. Other studies found that asthmatic disposition and propensity to wheeze increase the risk of RSV hospitalization.
OBJECTIVE: The current study examined the causal direction of the associations between RSV hospitalization and asthma in a population-based cohort of twins.
METHODS: We conducted a prospective cohort study examining the associations between RSV hospitalization and asthma by using registry information on RSV hospitalization and asthma among 18,614 Danish twins born 1994 to 2003. The associations between RSV and asthma were examined in both directions: we examined the risk of asthma after RSV hospitalization, and the risk of RSV hospitalization in children with asthma in the same population-based cohort.
RESULTS: Asthma hospitalization after RSV hospitalization was increased as much as 6-fold to 8-fold during the first 2 months after RSV hospitalization but was no longer increased 1 year later. Asthma increased the risk of RSV hospitalization by 3-fold, and the risk was not time-dependent. Analyzing these associations on the basis of asthma defined from use of inhaled corticosteroid did not materially change the risk estimates.
CONCLUSION: There is a bidirectional association between severe RSV infection and asthma. Severe RSV infection is associated with a short-term increase in the risk of subsequent asthma, suggesting that RSV induce bronchial hyperresponsiveness; and asthma is associated with a long-term increased susceptibility for severe RSV disease, suggesting a host factor being responsible for the severe response to RSV infection. This suggests that severe RSV infection and asthma may share a common genetic predisposition and/or environmental exposure.
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腺样体切除术对呼吸功能的影响：一项随机前瞻性研究
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首次发现怀孕期间胃酸抑制和儿童哮喘可能相关：一项以人群为基础的登记研究
