哮喘联盟

   摘要
   基本原理:识别亚组人群，特别是对二手烟(SHS)暴露副作用易感的人群可能对预防和干预措施有帮助。
   目的:调查哮喘遗传学是否提示了SHS易感性对成人哮喘发病的危险因素存在影响。
   方法:一个基于人群的临床病例-对照研究，从芬兰南部地区选入成人发病的哮喘患者和随机选入的对照者(21～63岁的成人)。排除现在和既往吸烟的人，共纳入226例病例和450例健康对照者。
   测量方法和主要结果:本研究的结果测量指标是新发病的哮喘成人患者。父母亲患哮喘和近期暴露SHS对哮喘风险有协同作用，SHS校正比值比(OR)为1.97 (95% 置信区间(CI)： 1.12-3.45)，父母亲患哮喘的校正OR为2.64 (1.65-4.24)，两者协同效应校正比值比为12.69 (3.44-46.91) (相互作用的超相对危险比 (RERI) 9.08 (-0.22- 43.18))。遗传与近期和累积SHS暴露的协调作用均呈剂量-依赖模式，父母亲患哮喘和超过100 SHS香烟-年的RERI  为6.17 (0.57-19.16)。
   结论:这是证明暴露于SHS的哮喘遗传个体显著增加成年哮喘的发病风险的首个研究。SHS暴露对哮喘家族史有剂量依赖性协同作用，该联合效应随着更高的暴露水平更强烈。哮喘遗传者避免SHS是减少成年哮喘发病风险重要的预防措施。在临床和预防机构中，询问哮喘家族史是识别这些易感人群有用的工具。
 

(林江涛 审校)
Am J Respir Crit Care Med. 2013 Aug 27. [Epub ahead of print]


 

The Synergistic Effect of Heredity and Exposure to Second-hand Smoke on Adult-onset Asthma.
 

Lajunen TK, Jaakkola JJ, Jaakkola MS.
 

ABSTRACT
RATIONALE: Identification of the subpopulation especially susceptible to the adverse effects of second-hand smoke exposure (SHS) would be useful for preventive actions and interventions.
OBJECTIVE: To investigate whether asthmatic heredity indicates susceptibility to the effects of SHS on the risk of adult-onset asthma.
METHODS: A population-based incident case-control study of clinically defined adult-onset asthma and randomly drawn controls (adults 21-63 years old) from geographically defined area in South Finland. After excluding current and ex-smokers there were 226 cases and 450 disease-free controls.
MEASUREMENTS AND MAIN RESULTS: Our outcome measure was new adult-onset asthma. Parental asthma and recent SHS had synergistic effect on the risk of asthma, the adjusted odds ratio (OR) being 1.97 (95% confidence interval 1.12-3.45) for SHS, 2.64 (1.65-4.24) for parental asthma, and 12.69 (3.44-46.91) for their joint effect (Relative Excess Risk due Interaction (RERI) 9.08 (-0.22- 43.18)). Synergistic effect followed a dose-dependent pattern with both recent and cumulative SHS exposures, with RERI for parental asthma and over 100 SHS cigarette-years of 6.17 (0.57-19.16).
CONCLUSIONS: This is the first study showing that individuals with asthmatic heredity have a considerably increased risk of adult-onset asthma when exposed to SHS. SHS exposure has dose-dependent synergism with family history of asthma, the joint effect being stronger with higher exposure levels. Avoiding SHS could be an important preventive measure for reducing the risk of adult-onset asthma among those with asthmatic heredity. Asking about family history of asthma is a useful tool for identifying these susceptible individuals in clinical and preventive settings.
 

Am J Respir Crit Care Med. 2013 Aug 27. [Epub ahead of print]