Perzanowski M S, Rönmark E, Nold B, Lundbäck B, Platts-Mills T A
University of Virginia Asthma and Allergic Diseases Center, Charlottesville, VA 22908, USA.
J Allergy Clin Immunol. 1999 Jun;103(6):1018-24. doi: 10.1016/s0091-6749(99)70173-9.
The prevalence of asthma in the northernmost region of Sweden has been estimated at 6% to 8% in spite of the very dry climate. The causes of the increase in asthma are not clear, but conditions are unfavorable for dust mite growth, and domestic animals are thought to be the primary source of indoor allergens.
We sought to investigate the relationship between asthma, exposure, and sensitization in Northern Sweden, with a focus on the role of schools.
Serum was collected from 110 asthmatic children, 55 children with symptoms of asthma but no established diagnosis, and 63 control children (age, 7 and 8 years). Total IgE and specific IgE to 7 allergens were measured. Dust samples were collected from the classrooms of 7- and 8-year-old children in 22 schools from Kiruna and Luleâ, Sweden. For comparison, dust was also collected from 24 homes in Kiruna and 2 schools in Virginia in the United States.
Serum IgE antibody assays on 165 children with respiratory symptoms confirmed that there was a high degree of sensitization to cat, dog, and birch in Northern Sweden. Cat and dog allergens were present in almost all of the school samples in Sweden. By contrast, dust mite and cockroach allergens were generally unmeasurable. The highest levels of cat and dog allergens were found in samples from desks and chairs. Cat and dog allergen levels in the schools were comparable with but higher than those in the homes without pets. The schools in Virginia had similar allergen levels, except that samples from this humid region also had significant mite allergen.
In this climate the primary sensitization associated with asthma is to cat dander and dog dander but also to birch pollen. Mite and cockroach allergens were not present in the dust samples, and sensitization to these allergens was not significant. The schools appear to be a major site of exposure to cat and dog allergens. These results are relevant both to an understanding of the reasons for the increase in asthma in this region and to any proposal to reduce exposure to allergens.
尽管瑞典最北部地区气候非常干燥，但据估计哮喘患病率为6%至8%。哮喘增加的原因尚不清楚，但当地条件不利于尘螨生长，且家畜被认为是室内过敏原的主要来源。
我们试图研究瑞典北部哮喘、暴露与致敏之间的关系，重点关注学校的作用。
收集了110名哮喘儿童、55名有哮喘症状但未确诊的儿童以及63名对照儿童（年龄为7岁和8岁）的血清。检测了总IgE以及针对7种过敏原的特异性IgE。从瑞典基律纳和吕勒奥22所学校7岁和8岁儿童的教室中采集了灰尘样本。为作比较，还从基律纳的24个家庭以及美国弗吉尼亚州的2所学校采集了灰尘样本。
对165名有呼吸道症状儿童的血清IgE抗体检测证实，瑞典北部对猫、狗和桦树有高度致敏现象。猫和狗的过敏原几乎存在于瑞典所有学校样本中。相比之下，尘螨和蟑螂过敏原通常无法检测到。在桌椅样本中发现猫和狗过敏原的含量最高。学校中的猫和狗过敏原水平与无宠物家庭中的水平相当，但更高。弗吉尼亚州的学校有类似的过敏原水平，只是来自这个潮湿地区的样本也有大量螨过敏原。
在这种气候条件下，与哮喘相关的主要致敏原是猫毛屑、狗毛屑以及桦树花粉。灰尘样本中不存在螨和蟑螂过敏原，对这些过敏原的致敏现象不明显。学校似乎是接触猫和狗过敏原的主要场所。这些结果对于理解该地区哮喘增加的原因以及任何减少过敏原暴露的提议都具有重要意义。
