哮喘联盟

   摘要
   背景：葡聚糖是真菌细胞壁的组分，可用来标记真菌暴露。居住在热带环境，如波多黎各儿童的室内葡聚糖、过敏性疾病和哮喘发作情况是鲜为人知的。研究旨在检查波多黎各儿童葡聚糖暴露是否与过敏性疾病的程度或到急诊科（ED）/紧急医疗部门治疗哮喘有关。
   方法：横断面研究，纳入317例6至14岁波多黎各圣胡安儿童，其中160例哮喘儿童，157例健康儿童。我们的主要结果为对过敏原的阳性皮肤试验次数（范围=0-15）和前一年至少去过一次急诊科/紧急医疗部门治疗哮喘。检测室内灰尘样品中葡聚糖、内毒素、肽聚糖和5种过敏原（屋尘螨、德国小蠊、猫、狗和小鼠）的水平。使用线性或逻辑回归进行多变量分析。
   结果：在一个对病例对照状态、大鼠过敏原和其他变量调整的多变量分析中，暴露于第二和第三个四分位数葡聚糖水平的孩子较那些暴露于最低四分位数的孩子大约多两个以上阳性皮肤测试（P均<0.01）。儿童哮喘患者，暴露葡聚糖最高四分位数是到急诊科/紧急医疗部门治疗哮喘≥1次几率的近九倍（调整比值比的95％可信区间=2.7-28.4，P<0.001）。
   结论：研究结果表明，波多黎各儿童室内霉菌暴露导致过敏性疾病和到急诊/紧急医疗部门治疗哮喘的程度增加。
 

（苏楠 审校）
Ann Am Thorac Soc. 2014 Jun 10. [Epub ahead of print]

 

Fungal Exposure, Atopy, and Asthma Exacerbations in Puerto Rican Children.
 

Blatter J1, Forno E, Brehm J, Acosta-Pérez E, Alvarez M, Colón-Semidey A, Thorne PS, Metwali N, Canino G, Celedón JC.
 

ABSTRACT
BACKGROUND: Glucan is a component of the fungal cell wall that is used as a marker of fungal exposure. Little is known about indoor glucan, atopy and asthma exacerbations among children living in tropical environments such as Puerto Rico. Our objective was to examine whether glucan exposure is associated with degree of atopy or visits to the Emergency Department (ED)/urgent care for asthma in Puerto Rican children.
METHODS: Cross-sectional study of 317 children aged 6 to 14 years with (cases, n=160) and without (controls, n=157) asthma in San Juan, Puerto Rico. Our primary outcomes were the number of positive skin tests to allergens (range=0-15) and (in cases only) having had at least one visit to the ED/urgent care for asthma in the prior year. Levels of glucan, endotoxin, peptidoglycan and five allergens (Der p 1, Bla g 2, Fel d 1, Can f 1 and Mus m 1) were measured in samples of house dust. Linear or logistic regression was used for the multivariate analysis.
RESULTS:In a multivariate analysis adjusting for case-control status, mouse allergen and other covariates, children exposed to glucan levels in the second and third quartiles had approximately two more positive skin tests than those in the lowest quartile (P<0.01 in both instances). Among children with asthma, exposure to the highest quartile of glucan was associated with nearly ninefold greater odds of ≥1visit to the ED/urgent care for asthma (95% confidence interval for adjusted odds ratio=2.7-28.4, P<0.001).
CONCLUSIONS: Our results suggest that indoor fungal exposure leads to an increased degree of atopy and visits to the ED/urgent care for asthma in Puerto Rican children.
 

Ann Am Thorac Soc. 2014 Jun 10. [Epub ahead of print]