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在轻度至中度哮喘患者中,吸入性变应原致敏与激发浓度为20%时的乙酰甲胆碱激发试验阳性浓度(PC20)及呼出一氧化氮相关。

Aeroallergen sensitization correlates with PC(20) and exhaled nitric oxide in subjects with mild-to-moderate asthma.

作者信息

Craig Timothy J, King Tonya S, Lemanske Robert F, Wechsler Michael E, Icitovic Nikolina, Zimmerman Ronald R, Wasserman Stephen

机构信息

Division of Pulmonary Care, Pennsylvania State University College of Medicine, Hershey, PA 17033-0853, USA.

出版信息

J Allergy Clin Immunol. 2008 Mar;121(3):671-7. doi: 10.1016/j.jaci.2007.12.1153. Epub 2008 Jan 30.

Abstract

BACKGROUND

Aeroallergen sensitization in adult asthmatic patients from a wide geographic area has not been correlated with patients' characteristics, markers of airways inflammation, and lung function.

OBJECTIVE

We assessed data obtained from the Asthma Clinical Research Network trials to determine the relationship of aeroallergen sensitization to age, sex, ethnicity, and markers of inflammation and airways function.

METHODS

Skin testing (14 epicutaneous) was performed on 1338 subjects with objectively diagnosed mild-to-moderate asthma from 11 Asthma Clinical Research Network studies. Skin testing used identical techniques and a quality assurance program to ensure uniformity across centers.

RESULTS

Ninety-five percent of the subjects had at least 1 positive skin test response. Of these, 14% had positive reactions to 1 or 2 allergens and 81% had positive reactions to 3 or more allergens, and 2% of subjects reacted only to seasonal allergens, 26% only to perennial allergens, and 67% to both. Increasing IgE and exhaled nitric oxide values, decreasing PC(20) values, and minority ethnicity significantly correlated with the number of positive skin test responses. Subjects with late-onset asthma were less likely to be sensitized; nonetheless, 89% of subjects older than 60 years had positive responses.

CONCLUSION

Ninety-five percent of patients with mild-to-moderate asthma might have an allergic component. Age does not significantly affect aeroallergen sensitization, but the pattern of allergic sensitization varies with ethnicity and geography. Measures used to characterize asthma, such as IgE, exhaled nitric oxide, and PC(20) values, are correlated with aeroallergen sensitization.

摘要

背景

来自广泛地理区域的成年哮喘患者的气传变应原致敏情况与患者特征、气道炎症标志物及肺功能之间尚无关联。

目的

我们评估了从哮喘临床研究网络试验中获得的数据,以确定气传变应原致敏与年龄、性别、种族以及炎症和气道功能标志物之间的关系。

方法

对来自11项哮喘临床研究网络研究的1338名客观诊断为轻至中度哮喘的受试者进行了皮肤试验(14种皮试)。皮肤试验采用相同技术和质量保证程序,以确保各中心之间的一致性。

结果

95%的受试者至少有1次阳性皮肤试验反应。其中,14%对1种或2种变应原呈阳性反应,81%对3种或更多变应原呈阳性反应,2%的受试者仅对季节性变应原反应阳性,26%仅对常年性变应原反应阳性,67%对两者均反应阳性。IgE和呼出一氧化氮值升高、PC20值降低以及少数族裔与阳性皮肤试验反应的数量显著相关。迟发性哮喘患者致敏的可能性较小;尽管如此,60岁以上的受试者中有89%呈阳性反应。

结论

95%的轻至中度哮喘患者可能有过敏成分。年龄对气传变应原致敏无显著影响,但过敏致敏模式因种族和地理位置而异。用于表征哮喘的指标,如IgE、呼出一氧化氮和PC20值,与气传变应原致敏相关。

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