对于过敏症和哮喘高危儿童，过敏原暴露能调节致敏与呼出气一氧化氮水平间的关系
2011/06/17
摘要
背景：将呼出气一氧化氮分数（FENO）作为气道炎症标志的研究常常关注该指标与哮喘控制的关系，但过敏原暴露与FENO增加的关系尚不清楚。
目的：本研究评价（1）FENO水平增加是否与儿童致敏或哮喘相关；（2）特异性过敏原暴露是否能增加致敏儿童的FENO，而对未致敏儿童则无此作用；（3）久坐导致FENO增加，且与过敏原暴露无关。
方法：在一项父母有过敏症或哮喘史的儿童出生队列研究中，对12岁儿童采用ELISA检测床尘过敏原（尘螨、猫和蟑螂），基于IgE水平检测特异性致敏，通过问卷调查检测呼吸道疾病（当前哮喘、鼻炎和喘息）和看电视/玩游戏时间。在使用支气管扩张剂前后进行肺活量检测，采用电化学检测法检测FENO水平。
结果：与无哮喘、喘息和鼻炎症状/诊断的儿童(16.4-16.6 ppb)相比，当前哮喘(32.2 ppb)、喘息(27.0 ppb)和鼻炎(23.2 ppb)患儿的FENO水平显著增加（均为P< .005）。室内过敏原（猫、狗和尘螨）致敏能预测较高的FENO水平，而且能解释1/3的FENO变异。FENO水平在致敏并有尘螨暴露的儿童中最高。在经过室内过敏原暴露、体重指数和致敏校正后，工作日看电视超过10 h与FENO增加0.64-log相关。
结论：过敏原暴露和久坐（看电视/玩游戏）能增加气道炎症，后者表现为FENO增加。
（陈欣 审校）
J Allergy Clin Immunol. 2011 Apr 2. [Epub ahead of print]
Allergen exposure modifies the relation of sensitization to fraction of exhaled nitric oxide levels in children at risk for allergy and asthma.
Sordillo JE, Webb T, Kwan D, Kamel J, Hoffman E, Milton DK, Gold DR.
Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital, Boston, Mass; Harvard Medical School, Boston, Mass.
Abstract
BACKGROUND: Studies on airway inflammation, measured as fraction of exhaled nitric oxide (Feno), have focused on its relation to control of asthma, but the contribution of allergen exposure to the increase in Feno levels is unknown.
OBJECTIVE: We evaluated (1) whether Feno levels were increased in children with allergic sensitization or asthma; (2) whether specific allergen exposure increased Feno levels in sensitized, but not unsensitized, children; and (3) whether sedentary behavior increased Feno levels independent of allergen exposures.
METHODS: At age 12 years, in a birth cohort of children with a parental history of allergy or asthma, we measured bed dust allergen (dust mite, cat, and cockroach) by means of ELISA, specific allergic sensitization primarily based on specific IgE levels, and respiratory disease (current asthma, rhinitis, and wheeze) and hours of television viewing/video game playing by means of questionnaire. Children performed spirometric maneuvers before and after bronchodilator responses and had Feno levels measured by using electrochemical detection methods (NIOX MINO).
RESULTS: Feno levels were increased in children with current asthma (32.2 ppb), wheeze (27.0 ppb), or rhinitis (23.2 ppb) compared with subjects without these respective symptoms/diagnoses (16.4-16.6 ppb, P < .005 for all comparisons). Allergic sensitization to indoor allergens (cat, dog, and dust mite) predicted higher Feno levels and explained one third of the variability in Feno levels. Feno levels were highest in children both sensitized and exposed to dust mite. Greater than 10 hours of weekday television viewing was associated with a 0.64-log increase in Feno levels after controlling for indoor allergen exposure, body mass index, and allergic sensitization.
CONCLUSION: Allergen exposures and sedentary behavior (television viewing/video game playing) might increase airway inflammation, which was measured as the Feno.
J Allergy Clin Immunol. 2011 Apr 2. [Epub ahead of print]
背景：将呼出气一氧化氮分数（FENO）作为气道炎症标志的研究常常关注该指标与哮喘控制的关系，但过敏原暴露与FENO增加的关系尚不清楚。
目的：本研究评价（1）FENO水平增加是否与儿童致敏或哮喘相关；（2）特异性过敏原暴露是否能增加致敏儿童的FENO，而对未致敏儿童则无此作用；（3）久坐导致FENO增加，且与过敏原暴露无关。
方法：在一项父母有过敏症或哮喘史的儿童出生队列研究中，对12岁儿童采用ELISA检测床尘过敏原（尘螨、猫和蟑螂），基于IgE水平检测特异性致敏，通过问卷调查检测呼吸道疾病（当前哮喘、鼻炎和喘息）和看电视/玩游戏时间。在使用支气管扩张剂前后进行肺活量检测，采用电化学检测法检测FENO水平。
结果：与无哮喘、喘息和鼻炎症状/诊断的儿童(16.4-16.6 ppb)相比，当前哮喘(32.2 ppb)、喘息(27.0 ppb)和鼻炎(23.2 ppb)患儿的FENO水平显著增加（均为P< .005）。室内过敏原（猫、狗和尘螨）致敏能预测较高的FENO水平，而且能解释1/3的FENO变异。FENO水平在致敏并有尘螨暴露的儿童中最高。在经过室内过敏原暴露、体重指数和致敏校正后，工作日看电视超过10 h与FENO增加0.64-log相关。
结论：过敏原暴露和久坐（看电视/玩游戏）能增加气道炎症，后者表现为FENO增加。
（陈欣 审校）
J Allergy Clin Immunol. 2011 Apr 2. [Epub ahead of print]
Allergen exposure modifies the relation of sensitization to fraction of exhaled nitric oxide levels in children at risk for allergy and asthma.
Sordillo JE, Webb T, Kwan D, Kamel J, Hoffman E, Milton DK, Gold DR.
Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital, Boston, Mass; Harvard Medical School, Boston, Mass.
Abstract
BACKGROUND: Studies on airway inflammation, measured as fraction of exhaled nitric oxide (Feno), have focused on its relation to control of asthma, but the contribution of allergen exposure to the increase in Feno levels is unknown.
OBJECTIVE: We evaluated (1) whether Feno levels were increased in children with allergic sensitization or asthma; (2) whether specific allergen exposure increased Feno levels in sensitized, but not unsensitized, children; and (3) whether sedentary behavior increased Feno levels independent of allergen exposures.
METHODS: At age 12 years, in a birth cohort of children with a parental history of allergy or asthma, we measured bed dust allergen (dust mite, cat, and cockroach) by means of ELISA, specific allergic sensitization primarily based on specific IgE levels, and respiratory disease (current asthma, rhinitis, and wheeze) and hours of television viewing/video game playing by means of questionnaire. Children performed spirometric maneuvers before and after bronchodilator responses and had Feno levels measured by using electrochemical detection methods (NIOX MINO).
RESULTS: Feno levels were increased in children with current asthma (32.2 ppb), wheeze (27.0 ppb), or rhinitis (23.2 ppb) compared with subjects without these respective symptoms/diagnoses (16.4-16.6 ppb, P < .005 for all comparisons). Allergic sensitization to indoor allergens (cat, dog, and dust mite) predicted higher Feno levels and explained one third of the variability in Feno levels. Feno levels were highest in children both sensitized and exposed to dust mite. Greater than 10 hours of weekday television viewing was associated with a 0.64-log increase in Feno levels after controlling for indoor allergen exposure, body mass index, and allergic sensitization.
CONCLUSION: Allergen exposures and sedentary behavior (television viewing/video game playing) might increase airway inflammation, which was measured as the Feno.
J Allergy Clin Immunol. 2011 Apr 2. [Epub ahead of print]
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