Ogershok Paul R, Warner Daniel J, Hogan Mary Beth, Wilson Nevin W
Department of Pediatrics, West Virginia University School of Medicine, Morgantown, West Virginia, USA.
Allergy Asthma Proc. 2007 Nov-Dec;28(6):654-8. doi: 10.2500/aap.2007.28.3055.
It is commonly believed that young children are incapable of pollen sensitization; therefore, skin testing usually is not performed to these allergens. The purpose of this study was to identify the frequency of positive skin tests to outdoor allergens among younger children who have asthma. Patients who have asthma, aged 6 months to 10 years, were evaluated for pollen sensitization over a 10-year period. Skin-prick testing was performed to relevant individual aeroallergens including trees, grasses, and weeds. Testing for perennial indoor allergens such as dust mites, cats, dogs, cockroaches, and molds was performed also. A total of 687 children with asthma were evaluated. No child <12 months old was sensitized to pollens. Children between 12 and 24 months of age had a 29% incidence of pollen sensitization. Three-year-old children were as likely to be skin test positive to pollen as an indoor allergen. Notably, 49% of 3- and 4-year olds were sensitized to outdoor allergens. Primary sensitizing pollens in this age group were short ragweed, box elder, and June grass. In this population, pollen sensitization was not related to tobacco or wood smoke exposure. Although it is widely believed that young children with asthma are most commonly allergic to indoor allergens, almost 40% of our 1- to 3-year old children with asthma showed IgE-mediated sensitivity to outdoor allergens. Pediatric allergists should consider performing skin-prick testing to their local common aeroallergens in young children with asthma and seasonal symptoms.
人们普遍认为幼儿不会对花粉过敏；因此，通常不对这些过敏原进行皮肤测试。本研究的目的是确定患有哮喘的年幼儿童中对室外过敏原皮肤测试呈阳性的频率。对年龄在6个月至10岁之间患有哮喘的患者进行了为期10年的花粉过敏评估。对包括树木、草类和杂草在内的相关个体气传过敏原进行了皮肤点刺试验。还对尘螨、猫、狗、蟑螂和霉菌等常年性室内过敏原进行了检测。总共评估了687名哮喘儿童。12个月以下的儿童均未对花粉过敏。12至24个月大的儿童花粉过敏发生率为29%。3岁儿童对花粉皮肤测试呈阳性的可能性与对室内过敏原的可能性相同。值得注意的是，3岁和4岁儿童中有49%对室外过敏原过敏。该年龄组主要的致敏花粉是矮豚草、三叶杨和六月禾。在这个群体中，花粉过敏与接触烟草或木烟无关。尽管人们普遍认为患有哮喘的幼儿最常见的是对室内过敏原过敏，但在我们1至3岁的哮喘儿童中，近40%表现出对室外过敏原的IgE介导的敏感性。儿科过敏症专科医生应考虑对患有哮喘且有季节性症状的年幼儿童进行针对当地常见气传过敏原的皮肤点刺试验。
