Ardusso L R, Crisci C D, Codina R, Lockey R F, Galimany J, Marcipar A, Massara A, Strass M, Ardusso D D, Bertoya N I, Medina I, Trojavchich M C, Vinuesa M A, Monje S
Asociación de Alergia e Inmunología de Rosario, España 927, 2000 Rosario, Argentina.
Medicina (B Aires). 2001;61(1):1-7.
The purpose of this study was to correlate soybean dust (SD) exposure, skin reactivity to soybean hull (SH) allergens, and symptoms of asthma and/or allergic rhinitis. A group of 365 subjects with asthma and/or allergic rhinitis and a control group of 50 individuals without respiratory symptoms were studied. The level of exposure to SD is defined as follows: 1) direct (DE); 2) indirect (ID), and 3) urban (UE). All subjects completed standard questionnaires. Skin tests with a SH extract and with common allergens were performed by the prick technique (SPT). Fifty-six (15.3%) patients and no subjects from control group had positive SPT (histamine index > or = 0.5) with a SH allergen extract. The percentages of positive SPT to SH extract were 38.7%, 20.3% and 8.4% in subjects with DE, IE and UE, respectively (p < 0.001). Monosensitization to SH was absent in all subjects. The percent of subjects with positive SPTs to mites (p < 0.01), pollen (p < 0.01) and molds (p < 0.05) were higher in subjects with a positive SPT to SH versus those with a negative SPT to SH. Sixty-six percent of subjects with DE and 13.6% of subjects with IE or UE reported respiratory symptoms after SD inhalation (Odds Ratio: 12.67 [2.4-74.9], p < 0.001). Compared to subjects exclusively sensitized to mites, patients sensitized to SH presented significantly different clinical characteristics. Soybean production has been increasing in Argentina during the last 20 years, determining an increase in the population exposed to chronic SD inhalation. This fact determines a high risk of sensitization and triggering of respiratory symptoms in atopic subjects. This study demonstrates that there is: 1) a high prevalence of skin reactivity to SH in subjects with asthma and/or allergic rhinitis from Argentina and that this prevalence is associated with the level of exposure to SD, and 2) an association between sensitivity to SH and severity of asthma. Measures to avoid release and inhalation of SD in rural areas from Argentina are needed.
本研究的目的是关联大豆粉尘（SD）暴露、对大豆皮壳（SH）过敏原的皮肤反应性以及哮喘和/或过敏性鼻炎的症状。对一组365名患有哮喘和/或过敏性鼻炎的受试者以及50名无呼吸道症状的个体组成的对照组进行了研究。SD的暴露水平定义如下：1）直接暴露（DE）；2）间接暴露（ID），以及3）城市暴露（UE）。所有受试者均完成了标准问卷。采用点刺技术（SPT）对SH提取物和常见过敏原进行皮肤试验。56名（15.3%）患者对SH过敏原提取物的SPT呈阳性（组胺指数≥0.5），而对照组无受试者呈阳性。在直接暴露、间接暴露和城市暴露的受试者中，对SH提取物SPT阳性的百分比分别为38.7%、20.3%和8.4%（p<0.001）。所有受试者均不存在对SH的单一致敏情况。对SH的SPT呈阳性的受试者中，对螨虫（p<0.01）、花粉（p<0.01）和霉菌（p<0.05）的SPT阳性百分比高于对SH的SPT呈阴性的受试者。66%的直接暴露受试者以及13.6%的间接暴露或城市暴露受试者在吸入SD后报告有呼吸道症状（优势比：12.67[2.4 - 74.9]，p<0.001）。与仅对螨虫致敏的受试者相比，对SH致敏的患者表现出明显不同的临床特征。在过去20年中，阿根廷的大豆产量一直在增加，这导致暴露于慢性SD吸入的人口增加。这一事实决定了特应性受试者中致敏和引发呼吸道症状的高风险。本研究表明：1）阿根廷患有哮喘和/或过敏性鼻炎的受试者中，对SH的皮肤反应性患病率很高，且该患病率与SD暴露水平相关；2）对SH的敏感性与哮喘严重程度之间存在关联。需要采取措施避免阿根廷农村地区SD的释放和吸入。
