哮喘高风险儿童7岁时内毒素和尘螨过敏原暴露与哮喘和特异性致敏的关系
2011/03/28
摘要
内毒素和屋尘螨过敏原(HDM)在过敏原致敏和哮喘中的作用目前尚未完全清楚。暴露时段和哮喘评价至关重要。本试验旨在7岁儿童中，研究当前内毒素和HDM暴露与喘息反复发作风险、小儿过敏性疾病专家诊断的哮喘和过敏原致敏之间的关系。380名因家庭背景而具有哮喘高风险的7岁儿童入选，小儿过敏性疾病专家采用问卷调查进行访谈，进行过敏原皮肤针刺试验和临床检查。收集家庭灰尘样本，分析内毒素和HDM水平(Der p 1和Der f 1)。
结果显示，灰尘样本的内毒素水平，对采用吸入性激素治疗的儿科过敏性疾病专家诊断的哮喘具有保护作用(OR 0.69, 95% CI 0.53-0.91)，对狗过敏原特异性致敏具有保护作用(OR 0.68, 95% CI 0.51-0.90)。内毒素和HDM与对狗过敏原致敏风险下降相关。对于高风险的7岁儿童，内毒素水平增加与对狗过敏原致敏下降和哮喘发生下降相关。
(陈欣 审校)
Pediatr Allergy Immunol. 2011 Jan 23. doi: 10.1111/j.1399-3038.2010.01123.x.
Association between endotoxin and mite allergen exposure with asthma and specific sensitization at age 7 in high-risk children.
Carlsten C, Ferguson A, Dimich-Ward H, Chan H, Dybuncio A, Rousseau R, Becker A, Chan-Yeung M.
Occupational and Environmental Lung Disease Unit, Respiratory Division, Department of Medicine Division of Allergy, Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada Section of Allergy and Clinical Immunology, Department of Pediatrics and Child Health, and the Manitoba Institute of Child Health, University of Manitoba, Winnipeg, MB, Canada.
Abstract
The role of endotoxin and house dust mite allergen (HDM) in allergen sensitization and asthma is unclear. The timeframe of exposure and asthma assessment appears critical. We aimed to determine, in children at 7 yr of age, the association between current exposure to endotoxin and HDM and risks of recurrent wheeze, paediatric allergist diagnosed asthma and allergen sensitization. Three hundred and eighty children who had an increased risk of asthma because of family background were assessed at age 7 yr by a questionnaire-standardized interview, allergen skin testing and clinical examination by a paediatric allergist. Dust samples were collected from their homes and analysed for levels of endotoxin and HDM (Der p 1 and Der f 1). Levels of endotoxin in dust samples were associated with protection from paediatric allergist diagnosed asthma with inhaled steroid use (OR 0.69, 95% CI 0.53-0.91) and specific sensitization to dog allergen (OR 0.68, 95% CI 0.51-0.90) at the age of 7 yr; both endotoxin and HDM were associated with decreased risk of sensitization to dog allergen. In high-risk children at age 7, endotoxin levels were associated with decreased sensitization to dog, as well as with decreased asthma.
Pediatr Allergy Immunol. 2011 Jan 23. doi: 10.1111/j.1399-3038.2010.01123.x.
内毒素和屋尘螨过敏原(HDM)在过敏原致敏和哮喘中的作用目前尚未完全清楚。暴露时段和哮喘评价至关重要。本试验旨在7岁儿童中，研究当前内毒素和HDM暴露与喘息反复发作风险、小儿过敏性疾病专家诊断的哮喘和过敏原致敏之间的关系。380名因家庭背景而具有哮喘高风险的7岁儿童入选，小儿过敏性疾病专家采用问卷调查进行访谈，进行过敏原皮肤针刺试验和临床检查。收集家庭灰尘样本，分析内毒素和HDM水平(Der p 1和Der f 1)。
结果显示，灰尘样本的内毒素水平，对采用吸入性激素治疗的儿科过敏性疾病专家诊断的哮喘具有保护作用(OR 0.69, 95% CI 0.53-0.91)，对狗过敏原特异性致敏具有保护作用(OR 0.68, 95% CI 0.51-0.90)。内毒素和HDM与对狗过敏原致敏风险下降相关。对于高风险的7岁儿童，内毒素水平增加与对狗过敏原致敏下降和哮喘发生下降相关。
(陈欣 审校)
Pediatr Allergy Immunol. 2011 Jan 23. doi: 10.1111/j.1399-3038.2010.01123.x.
Association between endotoxin and mite allergen exposure with asthma and specific sensitization at age 7 in high-risk children.
Carlsten C, Ferguson A, Dimich-Ward H, Chan H, Dybuncio A, Rousseau R, Becker A, Chan-Yeung M.
Occupational and Environmental Lung Disease Unit, Respiratory Division, Department of Medicine Division of Allergy, Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada Section of Allergy and Clinical Immunology, Department of Pediatrics and Child Health, and the Manitoba Institute of Child Health, University of Manitoba, Winnipeg, MB, Canada.
Abstract
The role of endotoxin and house dust mite allergen (HDM) in allergen sensitization and asthma is unclear. The timeframe of exposure and asthma assessment appears critical. We aimed to determine, in children at 7 yr of age, the association between current exposure to endotoxin and HDM and risks of recurrent wheeze, paediatric allergist diagnosed asthma and allergen sensitization. Three hundred and eighty children who had an increased risk of asthma because of family background were assessed at age 7 yr by a questionnaire-standardized interview, allergen skin testing and clinical examination by a paediatric allergist. Dust samples were collected from their homes and analysed for levels of endotoxin and HDM (Der p 1 and Der f 1). Levels of endotoxin in dust samples were associated with protection from paediatric allergist diagnosed asthma with inhaled steroid use (OR 0.69, 95% CI 0.53-0.91) and specific sensitization to dog allergen (OR 0.68, 95% CI 0.51-0.90) at the age of 7 yr; both endotoxin and HDM were associated with decreased risk of sensitization to dog allergen. In high-risk children at age 7, endotoxin levels were associated with decreased sensitization to dog, as well as with decreased asthma.
Pediatr Allergy Immunol. 2011 Jan 23. doi: 10.1111/j.1399-3038.2010.01123.x.
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哮喘患者呼出气冷凝液中三磷酸腺苷浓度
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哮喘控制测试的效度和信度：来自希腊的研究结果
