Turner S W, Heaton T, Rowe J, Suriyaarachchi D, Serralha M, Holt B J, Franklin P J, Stick S M, Goldblatt J, Sly P D, le Souëf P N, Holt P G
School of Child Health and Paediatrics, University of Western Australia, Perth, WA, Australia.
Clin Exp Allergy. 2007 Mar;37(3):371-80. doi: 10.1111/j.1365-2222.2007.02668.x.
Early age at onset of atopy is associated with more severe asthma and increased airway responsiveness (AR); the underlying mechanism is unclear but may involve T cell responses.
To test the hypothesis that enhanced T cell responses may be associated with early-onset atopy.
In a longitudinal study, atopy was determined in infancy and at 6 and 11 years of age. Individuals were categorized as persistent infant-onset atopy (PIOA), early childhood-onset atopy (ECOA) and later childhood-onset atopy (LCOA). At 11 years of age, peripheral blood T cell cytokine responses, AR, exhaled nitric oxide (FE(NO)) and forced expiratory volume in 1 s were determined.
The age at onset of atopy was determined for 60 children, of whom 15 had PIOA, 24 had ECOA and 21 had LCOA. An additional 76 children who were never atopic were also included. T cell responses to house dust mite, including interleukin-5, -9, -10 and tumour necrosis factor alpha, were higher among children with PIA and ECOA, and lower in children with LCOA, P<0.05. In contrast, those children with LCOA or who were not atopic had the highest IL-10 response to PHA (P=0.014). Children with PIOA and ECOA, but not LCOA, had higher AR and FE(NO) compared with non-atopic children (P<0.05). The group with PIOA were more likely among the atopic children to be admitted to hospital for asthma (P<0.05) and also had lower %FEV(1) compared with non-atopic children (P=0.023).
Early age at sensitization is associated with enhanced T cell cytokine responses and indices of adverse asthma outcome. T cell cytokine responses might be programmed at the time of initial atopic sensitization.
特应性疾病发病年龄较早与更严重的哮喘及气道反应性（AR）增加相关；其潜在机制尚不清楚，但可能涉及T细胞反应。
检验增强的T细胞反应可能与早发性特应性疾病相关这一假说。
在一项纵向研究中，于婴儿期、6岁和11岁时确定特应性疾病情况。个体被分为持续性婴儿期发病特应性疾病（PIOA）、儿童早期发病特应性疾病（ECOA）和儿童后期发病特应性疾病（LCOA）。在11岁时，测定外周血T细胞细胞因子反应、AR、呼出一氧化氮（FE(NO)）和1秒用力呼气量。
确定了60名儿童的特应性疾病发病年龄，其中15名患有PIOA，24名患有ECOA，21名患有LCOA。另外还纳入了76名从未患过特应性疾病的儿童。对屋尘螨的T细胞反应，包括白细胞介素-5、-9、-10和肿瘤坏死因子α，在PIOA和ECOA儿童中较高，在LCOA儿童中较低，P<0.05。相比之下，LCOA儿童或非特应性儿童对PHA的白细胞介素-10反应最高（P=0.014）。与非特应性儿童相比，PIOA和ECOA儿童（而非LCOA儿童）的AR和FE(NO)更高（P<0.05）。在特应性儿童中，PIOA组因哮喘住院的可能性更大（P<0.05），与非特应性儿童相比，其FEV(1)%也更低（P=0.023）。
致敏年龄较早与增强的T细胞细胞因子反应及不良哮喘结局指标相关。T细胞细胞因子反应可能在初次特应性致敏时就已编程。
