Litonjua A A, Carey V J, Burge H A, Weiss S T, Gold D R
Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA.
J Allergy Clin Immunol. 2001 Jan;107(1):41-7. doi: 10.1067/mai.2001.111143.
Indoor inhaled allergens have been repeatedly demonstrated to worsen asthma in sensitized individuals, but their role in incident asthma is more controversial.
We investigated the relationship between exposure to allergens (dust mite, cat, and cockroach) measured in the home and incident doctor-diagnosed asthma and recurrent wheezing in children born to parents with asthma, allergies, or both.
From an ongoing longitudinal family and birth cohort study, we identified 222 siblings (median age, 2.87 years) of the index children. Allergen levels in the home were measured from dust samples obtained at the beginning of the study. Incident doctor-diagnosed asthma and recurrent wheezing were determined from questionnaires administered at 14 months and 22 months after the initial questionnaire.
Thirteen (5.9%) children were reported to have incident asthma, twenty (9.0%) children had recurrent asthmatic wheezing, and 18 (8.1%) had recurrent wheezing without asthma. Compared with children living in homes with Bla g 1 or 2 levels of less than 0.05 U/g, children exposed to Bla g 1 or 2 levels of 0.05 to less than 2 U/g had a relative risk for incident asthma of 8.27 (95% confidence interval, 1.04-66.04), whereas children exposed to Bla g 1 or 2 levels of 2 U/g or greater had a relative risk for incident asthma of 35.87 (95% confidence interval, 4.49-286.62). Cockroach allergen exposure was likewise a significant predictor for recurrent asthmatic wheezing. Neither dust mite nor cat allergen levels were significantly associated with either outcome. These findings remained after control for several covariates.
Exposure to cockroach allergen early in life may contribute to the development of asthma in susceptible children.
室内吸入性过敏原已被反复证明会使致敏个体的哮喘病情恶化，但其在新发哮喘中的作用更具争议性。
我们调查了家中所测过敏原（尘螨、猫和蟑螂）暴露与父母患有哮喘、过敏或两者皆有的儿童新发医生诊断哮喘及反复喘息之间的关系。
从一项正在进行的纵向家庭与出生队列研究中，我们确定了指标儿童的222名兄弟姐妹（中位年龄2.87岁）。研究开始时从采集的灰尘样本中测量家中的过敏原水平。通过在初始问卷后14个月和22个月时发放的问卷来确定新发医生诊断哮喘及反复喘息情况。
据报告，13名（5.9%）儿童患有新发哮喘，20名（9.0%）儿童有反复哮喘性喘息，18名（8.1%）有非哮喘性反复喘息。与生活在Bla g 1或2水平低于0.05 U/g家庭中的儿童相比，暴露于Bla g 1或2水平为0.05至低于2 U/g的儿童新发哮喘的相对风险为8.27（95%置信区间，1.04 - 66.04），而暴露于Bla g 1或2水平为2 U/g或更高的儿童新发哮喘的相对风险为35.87（95%置信区间，4.49 - 286.62）。蟑螂过敏原暴露同样是反复哮喘性喘息的重要预测因素。尘螨和猫过敏原水平均与任何一种结果均无显著关联。在对多个协变量进行控制后，这些发现依然成立。
生命早期暴露于蟑螂过敏原可能促使易感儿童发生哮喘。
