学龄期患哮喘和过敏性鼻炎儿童的氧化状态变化
2010/09/14
摘要
氧化应激可以定义为氧化物质和还原物质（抗氧化物质）的平衡产生紊乱。儿童氧化状态可能会影响哮喘和过敏性疾病的风险。本文研究血清抗氧化物质水平，包括硒、维生素E、胆红素、白蛋白、尿酸、转铁蛋白、氧化铁蛋白，以及这些物质与哮喘和过敏性鼻炎的关系。对7～12岁的哮喘（n = 50）和非哮喘（n = 52）（对照）儿童进行针刺试验、肺功能检测、呼出气一氧化氮分数（FeNO）检测及抽血检查。23名儿童有过敏性鼻炎（19名有哮喘，4名为无哮喘儿童）。健康儿童为非哮喘非鼻炎儿童。回归分析中经年龄和性别校正后，与健康儿童相比，哮喘与白蛋白下降，其校正后优势比和95% CI 分别为0.81和（0.66, 0.99）(p = 0.048)。与FeNO <20的对照儿童相比，FeNO≥20 ppb 的哮喘与白蛋白降低相关[校正后优势比和95% CI：0.60，(0.40, 0.89)](p = 0.012)。与健康儿童相比，伴过敏性鼻炎的哮喘患儿其白蛋白下降[校正后优势比和95% CI：0.70，（0.50, 0.99）] (p = 0.04)，铁蛋白较高[校正后优势比和95% CI：1.04，（1.00, 1.09）] (p = 0.03)。与哮喘控制较好儿童相比，哮喘控制较差与维生素E水平低[校正后优势比和95% CI：0.79，（0.65, 0.95）] (p = 0.02)、转铁蛋白水平较低[校正后优势比和95% CI：0.72，（0.57, 0.92）] (p < 0.01)、白蛋白水平较高[校正后优势比和95% CI：1.53，（1.03, 2.28）] (p = 0.04)相关。
总之，学龄期哮喘和鼻炎儿童其主要的血清抗氧化白蛋白水平降低，哮喘控制较差与维生素E水平和转铁蛋白水平较低相关。白蛋白降低与FeNO增加相关，后者是哮喘过敏性炎症的标志物，但我们的结论需在群体性研究中进一步验证。
（陈欣 审校）
Pediatr Allergy Immunol. 2010 Jul 13. [Epub ahead of print]
Altered oxidative state in schoolchildren with asthma and allergic rhinitis
Bakkeheim E, Mowinckel P, Carlsen KH, Burney P, Lødrup Carlsen KC.
Department of Paediatrics, Oslo University Hospital, Oslo, Norway.
Abstract
Oxidative stress may be defined as a disruption of the balance between the level of oxidants and reductants (antioxidants), and oxidative state in children may influence the risk of asthma and allergic disease. We investigated serum antioxidant levels: selenium, vitamin E, bilirubin, albumin, uric acid and transferrin as well as the oxidant ferritin and their association with asthma and allergic rhinitis. Children of 7-12 yr with asthma (n = 50) and no asthma (controls) (n = 52) underwent skin prick test, lung function, fractional exhaled nitric oxide (FeNO) measurements and blood sampling. Allergic rhinitis was found in 23 children, 19 with asthma and four controls. Healthy children were controls without rhinitis. Asthma was associated with reduced albumin (g/l), adjusted odds ratio (aOR) (95% CI) 0.81 (0.66, 0.99) (p = 0.048) compared with healthy children in a regression analysis adjusted for age and gender. Asthma with high FeNO >/=20 ppb was associated with reduced albumin, aOR 0.60 (0.40, 0.89) (p = 0.012) compared to controls with FeNO <20. Asthma with allergic rhinitis had reduced albumin, aOR = 0.70 (0.50, 0.99) (p = 0.04), and higher ferritin levels (mg/l) [aOR = 1.04 (1.00, 1.09) p = 0.03] compared to healthy children. Poorly controlled asthma was associated with lower vitamin E levels, aOR 0.79 (0.65, 0.95) (p = 0.02), lower transferrin levels, aOR 0.72 (0.57, 0.92) (p < 0.01), and higher albumin levels, aOR 1.53 (1.03, 2.28) (p = 0.04), compared to well controlled asthma. In conclusion, schoolchildren with asthma and rhinitis had reduced levels of the major serum antioxidant albumin, and poorly controlled asthma was associated with decreased vitamin E and transferrin levels. Reduced albumin was associated with increased FeNO, a marker of allergic inflammation in asthma, although the discriminatory value of this finding should be further assessed in population studies.
Pediatr Allergy Immunol. 2010 Jul 13. [Epub ahead of print]
氧化应激可以定义为氧化物质和还原物质（抗氧化物质）的平衡产生紊乱。儿童氧化状态可能会影响哮喘和过敏性疾病的风险。本文研究血清抗氧化物质水平，包括硒、维生素E、胆红素、白蛋白、尿酸、转铁蛋白、氧化铁蛋白，以及这些物质与哮喘和过敏性鼻炎的关系。对7～12岁的哮喘（n = 50）和非哮喘（n = 52）（对照）儿童进行针刺试验、肺功能检测、呼出气一氧化氮分数（FeNO）检测及抽血检查。23名儿童有过敏性鼻炎（19名有哮喘，4名为无哮喘儿童）。健康儿童为非哮喘非鼻炎儿童。回归分析中经年龄和性别校正后，与健康儿童相比，哮喘与白蛋白下降，其校正后优势比和95% CI 分别为0.81和（0.66, 0.99）(p = 0.048)。与FeNO <20的对照儿童相比，FeNO≥20 ppb 的哮喘与白蛋白降低相关[校正后优势比和95% CI：0.60，(0.40, 0.89)](p = 0.012)。与健康儿童相比，伴过敏性鼻炎的哮喘患儿其白蛋白下降[校正后优势比和95% CI：0.70，（0.50, 0.99）] (p = 0.04)，铁蛋白较高[校正后优势比和95% CI：1.04，（1.00, 1.09）] (p = 0.03)。与哮喘控制较好儿童相比，哮喘控制较差与维生素E水平低[校正后优势比和95% CI：0.79，（0.65, 0.95）] (p = 0.02)、转铁蛋白水平较低[校正后优势比和95% CI：0.72，（0.57, 0.92）] (p < 0.01)、白蛋白水平较高[校正后优势比和95% CI：1.53，（1.03, 2.28）] (p = 0.04)相关。
总之，学龄期哮喘和鼻炎儿童其主要的血清抗氧化白蛋白水平降低，哮喘控制较差与维生素E水平和转铁蛋白水平较低相关。白蛋白降低与FeNO增加相关，后者是哮喘过敏性炎症的标志物，但我们的结论需在群体性研究中进一步验证。
（陈欣 审校）
Pediatr Allergy Immunol. 2010 Jul 13. [Epub ahead of print]
Altered oxidative state in schoolchildren with asthma and allergic rhinitis
Bakkeheim E, Mowinckel P, Carlsen KH, Burney P, Lødrup Carlsen KC.
Department of Paediatrics, Oslo University Hospital, Oslo, Norway.
Abstract
Oxidative stress may be defined as a disruption of the balance between the level of oxidants and reductants (antioxidants), and oxidative state in children may influence the risk of asthma and allergic disease. We investigated serum antioxidant levels: selenium, vitamin E, bilirubin, albumin, uric acid and transferrin as well as the oxidant ferritin and their association with asthma and allergic rhinitis. Children of 7-12 yr with asthma (n = 50) and no asthma (controls) (n = 52) underwent skin prick test, lung function, fractional exhaled nitric oxide (FeNO) measurements and blood sampling. Allergic rhinitis was found in 23 children, 19 with asthma and four controls. Healthy children were controls without rhinitis. Asthma was associated with reduced albumin (g/l), adjusted odds ratio (aOR) (95% CI) 0.81 (0.66, 0.99) (p = 0.048) compared with healthy children in a regression analysis adjusted for age and gender. Asthma with high FeNO >/=20 ppb was associated with reduced albumin, aOR 0.60 (0.40, 0.89) (p = 0.012) compared to controls with FeNO <20. Asthma with allergic rhinitis had reduced albumin, aOR = 0.70 (0.50, 0.99) (p = 0.04), and higher ferritin levels (mg/l) [aOR = 1.04 (1.00, 1.09) p = 0.03] compared to healthy children. Poorly controlled asthma was associated with lower vitamin E levels, aOR 0.79 (0.65, 0.95) (p = 0.02), lower transferrin levels, aOR 0.72 (0.57, 0.92) (p < 0.01), and higher albumin levels, aOR 1.53 (1.03, 2.28) (p = 0.04), compared to well controlled asthma. In conclusion, schoolchildren with asthma and rhinitis had reduced levels of the major serum antioxidant albumin, and poorly controlled asthma was associated with decreased vitamin E and transferrin levels. Reduced albumin was associated with increased FeNO, a marker of allergic inflammation in asthma, although the discriminatory value of this finding should be further assessed in population studies.
Pediatr Allergy Immunol. 2010 Jul 13. [Epub ahead of print]
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生命早期应激对哮喘大鼠免疫功能的影响以及音乐治疗的作用
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台湾儿童中NOS1基因对哮喘和总IgE水平的影响及其与环境因素的相互作用
