严重哮喘生物学预测因素的种族差异：来自严重哮喘研究项目的数据
2011/03/24
摘要
背景：已知一些生物学因素与哮喘的严重程度有关。但是，有关这些生物学因素对白人和黑人哮喘严重程度的影响是否存在差异尚不清楚。
目的：研究白人和黑人严重哮喘患者在生理学、免疫炎症及社会人口因素上的差异。
方法：白人和黑人严重哮喘成人患者入选此项横断面研究。严重哮喘采用美国胸科协会的定义进行诊断。初始单变量分析后，采用非条件logistic回归模型评价黑人和白人发生严重哮喘的可能性。
结果：黑人和白人的严重哮喘存在着差异。在单变量分析中，未见IgE水平与白人和黑人的严重哮喘相关，而多变量分析显示，IgE水平与黑人，而不是白人的严重哮喘显著相关。对于家庭中有2个或2个以上成员患有哮喘的黑人，其患严重哮喘的优势比增加超过2倍(P =0.026)，而有哮喘家庭史的白人，其患严重哮喘的优势比几乎降低一半 (P =0.05)。在白人和黑人中，单变量分析显示，特应性与严重哮喘呈负相关，但仅在黑人中存在统计学显著性，然而共患病仅在白人中与严重哮喘相关。
结论：仅在黑人中存在与严重哮喘相关的生物学因素。对哮喘相关生物学因素综合评价的研究，有助于开发出针对黑人群体生物学因素异常的靶向治疗。
（陈欣 审校）
J Allergy Clin Immunol. 2010 Dec;126(6):1149-56.e1. Epub 2010 Nov 4.
Racial differences in biologic predictors of severe asthma: Data from the Severe Asthma Research Program.
Gamble C, Talbott E, Youk A, Holguin F, Pitt B, Silveira L, Bleecker E, Busse W, Calhoun W, Castro M, Chung KF, Erzurum S, Israel E, Wenzel S.
University of Pittsburgh, USA. gamble.christy@gmail.com
Abstract
BACKGROUND: Biologic factors are known to contribute to asthma severity. It is unknown whether these factors differentially contribute to asthma severity in black compared with white subjects.
OBJECTIVE: We sought to assess the extent to which racial disparities between black and white subjects with severe asthma are attributable to physiologic, immunoinflammatory, and sociodemographic variables.
METHODS: Black and white asthmatic adults enrolled in a cross-sectional study focused on severe asthma were evaluated. Severe asthma was identified by using the American Thoracic Society definition. After initial univariable analyses, unconditional logistic regression models were used to estimate the probability of having severe asthma for black and white subjects.
RESULTS: Differences in severe asthma in black compared with white subjects were observed. In univariable analysis IgE level was not associated with severe asthma in black or white subjects, whereas in multivariable analysis IgE level was significantly associated with severe asthma for black subjects (P = .014) but not for white subjects. The odds of having severe asthma more than doubled for black subjects with 2 or more family members with asthma (P = .026), whereas the odds of severe asthma for white participants with a strong family history of asthma decreased by almost half (P = .05). Atopy was negatively associated with severe asthma in both races in univariable analysis but remained significant only in black subjects, whereas comorbidities were associated with severe asthma in white subjects.
CONCLUSION: Biologic factors were distinctly associated with severe asthma only in black subjects. Studies that incorporate comprehensive evaluation of biologic factors associated with asthma might lead to the development of therapies that target biologic abnormalities in black subjects.
J Allergy Clin Immunol. 2010 Dec;126(6):1149-56.e1. Epub 2010 Nov 4.
背景：已知一些生物学因素与哮喘的严重程度有关。但是，有关这些生物学因素对白人和黑人哮喘严重程度的影响是否存在差异尚不清楚。
目的：研究白人和黑人严重哮喘患者在生理学、免疫炎症及社会人口因素上的差异。
方法：白人和黑人严重哮喘成人患者入选此项横断面研究。严重哮喘采用美国胸科协会的定义进行诊断。初始单变量分析后，采用非条件logistic回归模型评价黑人和白人发生严重哮喘的可能性。
结果：黑人和白人的严重哮喘存在着差异。在单变量分析中，未见IgE水平与白人和黑人的严重哮喘相关，而多变量分析显示，IgE水平与黑人，而不是白人的严重哮喘显著相关。对于家庭中有2个或2个以上成员患有哮喘的黑人，其患严重哮喘的优势比增加超过2倍(P =0.026)，而有哮喘家庭史的白人，其患严重哮喘的优势比几乎降低一半 (P =0.05)。在白人和黑人中，单变量分析显示，特应性与严重哮喘呈负相关，但仅在黑人中存在统计学显著性，然而共患病仅在白人中与严重哮喘相关。
结论：仅在黑人中存在与严重哮喘相关的生物学因素。对哮喘相关生物学因素综合评价的研究，有助于开发出针对黑人群体生物学因素异常的靶向治疗。
（陈欣 审校）
J Allergy Clin Immunol. 2010 Dec;126(6):1149-56.e1. Epub 2010 Nov 4.
Racial differences in biologic predictors of severe asthma: Data from the Severe Asthma Research Program.
Gamble C, Talbott E, Youk A, Holguin F, Pitt B, Silveira L, Bleecker E, Busse W, Calhoun W, Castro M, Chung KF, Erzurum S, Israel E, Wenzel S.
University of Pittsburgh, USA. gamble.christy@gmail.com
Abstract
BACKGROUND: Biologic factors are known to contribute to asthma severity. It is unknown whether these factors differentially contribute to asthma severity in black compared with white subjects.
OBJECTIVE: We sought to assess the extent to which racial disparities between black and white subjects with severe asthma are attributable to physiologic, immunoinflammatory, and sociodemographic variables.
METHODS: Black and white asthmatic adults enrolled in a cross-sectional study focused on severe asthma were evaluated. Severe asthma was identified by using the American Thoracic Society definition. After initial univariable analyses, unconditional logistic regression models were used to estimate the probability of having severe asthma for black and white subjects.
RESULTS: Differences in severe asthma in black compared with white subjects were observed. In univariable analysis IgE level was not associated with severe asthma in black or white subjects, whereas in multivariable analysis IgE level was significantly associated with severe asthma for black subjects (P = .014) but not for white subjects. The odds of having severe asthma more than doubled for black subjects with 2 or more family members with asthma (P = .026), whereas the odds of severe asthma for white participants with a strong family history of asthma decreased by almost half (P = .05). Atopy was negatively associated with severe asthma in both races in univariable analysis but remained significant only in black subjects, whereas comorbidities were associated with severe asthma in white subjects.
CONCLUSION: Biologic factors were distinctly associated with severe asthma only in black subjects. Studies that incorporate comprehensive evaluation of biologic factors associated with asthma might lead to the development of therapies that target biologic abnormalities in black subjects.
J Allergy Clin Immunol. 2010 Dec;126(6):1149-56.e1. Epub 2010 Nov 4.
