呼吸道感染、接触小鼠过敏原及母乳喂养在婴儿期喘息复发中的作用
2009/07/10
背景：环境因素可能影响变应性疾病和哮喘的发展。内毒素和过敏原暴露是婴幼儿喘息的危险因素。本研究旨在评价婴儿期对内毒素和过敏原暴露在反复性喘息中的作用。
方法：入选104名来自低收入家庭的有哮喘高风险的刚出生婴儿。出生后6个月内，收集被褥和卧室地板粉尘。反复性喘息的定义是过去1年中出现3次或3次以上的喘息发作。采用鲎试验检测内毒素，采用ELISA检测粉尘提取物中主要的室内过敏原。采用ImmunoCAP 检测婴儿30个月时IgE抗体。
结果：出生后30个月，完成整个研究的99例婴儿中51人（51.5%）出现反复性喘息。呼吸道感染与反复性喘息具有较强的相关性（OR 6.67, 95% CI 1.96-22.72），而纯母乳喂养至少在1个月内为保护性因素（OR 0.09, 95% CI 0.01-0.51）。非反复性喘息患者暴露于高浓度的小鼠过敏原的频率显著增加，近乎有意义（OR 0.12, 95% CI 0.01-1.13; p = 0.064）。没有儿童对小鼠过敏。90名儿童中26名（28.8%）对螨虫过敏，但与反复性喘息无关。
结论：对于来自巴西社区低收入家庭的哮喘高危儿童，婴儿期（前30个月）的呼吸道感染与反复性喘息具有较强的相关性。
（苏楠 审校）
Rullo VE, et al. Int Arch Allergy Immunol. 2009 May 12;150(2):172-178. [Epub ahead of print]
Respiratory Infection, Exposure to Mouse Allergen and Breastfeeding: Role in Recurrent Wheezing in Early Life.
Rullo VE, Arruda LK, Cardoso MR, Valente V, Zampolo AS, Nóbrega F, Naspitz CK, Solé D.
Division of Pediatric Allergy, Immunology and Rheumatology, Paulista School of Medicine, Federal University of São Paulo, São Paulo, Brazil.
Background: Environmental factors may influence the development of allergen sensitization and asthma. The aim of this study was to evaluate the role of endotoxin and allergen exposure in early life as a risk factor for recurrent wheezing.
Methods: One hundred and four infants from low-income families, at high risk of asthma, were enrolled at birth. Dust samples were collected from the bedding and bedroom floor within 6 months after birth. Recurrent wheezing was defined as 3 or more wheezing episodes in the past year. Endotoxin was determined by Limulus amebocyte lysate assay, and major indoor allergens were quantitated by ELISA in dust extracts. IgE antibodies were measured by ImmunoCAP at 30 months of age.
Results: At 30 months, 51 of the 99 infants who completed the study (51.5%) had recurrent wheezing. Respiratory infection was strongly associated with recurrent wheezing (OR 6.67, 95% CI 1.96-22.72), whereas exclusive breastfeeding for at least 1 month was a protective factor (OR 0.09, 95% CI 0.01-0.51). Exposure to high levels of mouse allergen was more frequent among non-recurrent wheezers, approaching significance (OR 0.12, 95% CI 0.01-1.13; p = 0.064). None of the children were sensitized to mouse. Sensitization to mite was found in 26/90 (28.8%) children, with no association with recurrent wheezing.
Conclusion: Respiratory infection was strongly associated with recurrent wheezing in the first 30 months of life, in children at high risk of asthma, living in a socially deprived community in Brazil. Copyright © 2009 S. Karger AG, Basel.
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哮喘患者的情感神经元回路及精神-躯体的影响
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使用Sauchinone抑制过敏原诱导的、Th2驱动的气道炎症
