Guilbert Theresa W, Morgan Wayne J, Zeiger Robert S, Bacharier Leonard B, Boehmer Susan J, Krawiec Marzena, Larsen Gary, Lemanske Robert F, Liu Andrew, Mauger David T, Sorkness Chris, Szefler Stanley J, Strunk Robert C, Taussig Lynn M, Martinez Fernando D
Arizona Respiratory Center, University of Arizona, Tucson, AZ 85724, USA.
J Allergy Clin Immunol. 2004 Dec;114(6):1282-7. doi: 10.1016/j.jaci.2004.09.020.
Few studies have characterized the atopic profile of toddler-aged children with recurrent wheezing at high risk of the development of persistent asthma. Objective We sought to determine the atopic profile of toddler-aged children with frequent wheeze at high risk for the development of persistent asthma who either had a parental history of asthma, a personal history of atopic dermatitis, or both.
Participants enrolled in the Prevention of Early Asthma in Kids study (n = 285) on the basis of a modified Asthma Predictive Index were characterized on the basis of allergy and asthma questionnaire responses and allergy skin puncture test results.
The majority of the children (60.7%, n = 148) were sensitized to either food or aeroallergens. Male children were significantly more likely to be sensitized to aeroallergens ( P = .03) and to have a blood eosinophil level of 4% or greater ( P = .03) and a total serum IgE level of greater than 100 IU/mL ( P = .0004). Additionally, eosinophilia and total serum IgE level had the strongest correlation with aeroallergen sensitization.
The high prevalence of aeroallergen sensitization in this high-risk cohort suggests that aeroallergens might have an important role in the early development of asthma. As such, the Prevention of Early Asthma in Kids cohort appears to be an appropriate cohort in which to test whether early intervention with an inhaled corticosteroid can significantly attenuate, or perhaps even prevent, the allergic march from the initial stages of allergic sensitization to the subsequent development of asthma in toddlers with episodic wheezing.
很少有研究描述有持续性哮喘高风险的反复喘息幼儿的特应性特征。目的：我们试图确定有频繁喘息且有持续性哮喘高风险的幼儿的特应性特征，这些幼儿要么有哮喘家族史，要么有特应性皮炎个人史，或者两者皆有。
基于改良哮喘预测指数纳入儿童早期哮喘预防研究的参与者（n = 285），根据过敏和哮喘问卷调查结果以及过敏皮肤点刺试验结果进行特征描述。
大多数儿童（60.7%，n = 148）对食物或空气过敏原致敏。男性儿童对空气过敏原致敏的可能性显著更高（P = 0.03），血液嗜酸性粒细胞水平达到或高于4%的可能性显著更高（P = 0.03），血清总IgE水平大于100 IU/mL的可能性显著更高（P = 0.0004）。此外，嗜酸性粒细胞增多和血清总IgE水平与空气过敏原致敏的相关性最强。
在这个高风险队列中空气过敏原致敏的高患病率表明，空气过敏原可能在哮喘的早期发展中起重要作用。因此，儿童早期哮喘预防队列似乎是一个合适的队列，可用于测试吸入性糖皮质激素的早期干预是否能显著减轻甚至预防喘息发作幼儿从过敏性致敏初始阶段到随后哮喘发展的过敏进程。
