de Blay F, Casel S, Colas F, Spirlet F, Pauli G
Service de Pneumologie, Hôpitaux Universitaires de Strasbourg.
Rev Mal Respir. 2000 Feb;17(1):29-39.
Exposure to allergens could be either a risk factor of sensitization and nonspecific hyperresponsiveness in genetically predisposed patients or a risk of onset of asthma attack in certain allergic asthma. During the past 20 years, in western countries the houses have become higher and the number of furred pets have increased and have been more kept inside the house which makes probable that exposure to indoor aeroallergen has increased. The development of new methods of allergen measurements allows a more precise identification of allergen source and reservoirs, an assessment of allergen exposure and a monitoring of allergen eviction methods. Concerning mite allergens, controlled studies which showed a clinical efficacy are those with a global mite eviction and at least a 6 months follow-up for cat and dog allergens, high efficiency-filters air cleaners or vacuum-cleaners are able to reduce airborne cat or dog allergen levels. According to the increasing number of papers about allergen eviction, it seems logical to propose allergen eviction as "first line treatment" of allergic asthma. In the future, it would be interesting to develop biological markers to identify more accurately patients who have a clinical improvement after allergen eviction.
对于具有遗传易感性的患者，接触过敏原可能是致敏和非特异性高反应性的危险因素，而在某些过敏性哮喘中则可能是哮喘发作的风险因素。在过去20年里，西方国家房屋变高，有毛宠物数量增加且更多地饲养在室内，这使得接触室内空气过敏原的可能性增加。新的过敏原测量方法的发展使得能够更精确地识别过敏原来源和储存库，评估过敏原暴露情况，并监测过敏原清除方法。关于螨类过敏原，显示出临床疗效的对照研究是那些进行全面螨类清除且对猫和狗过敏原至少随访6个月的研究，高效空气过滤器或真空吸尘器能够降低空气中猫或狗过敏原水平。根据关于过敏原清除的论文数量不断增加的情况，将过敏原清除作为过敏性哮喘的“一线治疗”似乎是合理的。未来，开发生物标志物以更准确地识别在过敏原清除后临床症状改善的患者将会很有意思。
