Ozdemir Cevdet, Ceyhan Berrin B, Yazi Didem, Eifan Aarif O, Yesil Ozlem, Bahceciler Nerin N, Barlan Isil B
Division of Pediatric Allergy and Immunology, Marmara University, Istanbul, Turkey.
Pediatr Allergy Immunol. 2008 May;19(3):248-54. doi: 10.1111/j.1399-3038.2007.00620.x.
Data on the pathogenic mechanisms underlying the development of non-atopic asthma in children are scarce. Our aim was to evaluate the association and compare the atopic status, pulmonary functions, bronchial hyperresponsiveness and serum total immunoglobulin E (IgE) levels of parents of atopic and non-atopic asthmatic children by using objective methods. Fifty-one asthmatic children aged 4-16 yr and their parents were included into the study. Initially the American Thoracic Society's Respiratory Disease questionnaire inquiring data on symptoms of asthma, rhinitis and past medical history was filled in. Afterwards, skin prick test with aeroallergens, pulmonary function and methacholine bronchial provocation tests and serum sampling for total IgE level determinations were carried out. Bronchial hyperresponsiveness to methacholine was significantly more common in the mothers of non-atopic children compared to those of atopic ones, although no significant difference was observed in the skin prick test reactivity, pulmonary function test parameters and serum IgE levels. Questionnaire data revealed that the presence of asthmatic symptoms such as wheezing and phlegm and doctor-diagnosed asthma were more common in the mothers of non-atopic children. Meanwhile, asthmatic symptoms were also found to be significantly more common in fathers of non-atopic children. Logistic regression analyses revealed that maternal PC(20) was the only predictive factor for the risk of displaying non-allergic asthma in children. The results demonstrate that among the risk factors studied, maternal bronchial hyperreactivity was associated with the development of asthma in non-atopic children.
关于儿童非特应性哮喘发病机制的数据很少。我们的目的是通过客观方法评估特应性和非特应性哮喘儿童父母的特应性状态、肺功能、支气管高反应性和血清总免疫球蛋白E(IgE)水平之间的关联并进行比较。51名4至16岁的哮喘儿童及其父母被纳入研究。首先填写美国胸科学会的呼吸系统疾病问卷,询问哮喘、鼻炎症状和既往病史数据。之后,进行空气变应原皮肤点刺试验、肺功能和乙酰甲胆碱支气管激发试验,并采集血清样本测定总IgE水平。与特应性儿童的母亲相比,非特应性儿童的母亲对乙酰甲胆碱的支气管高反应性明显更常见,尽管在皮肤点刺试验反应性、肺功能测试参数和血清IgE水平方面未观察到显著差异。问卷数据显示,喘息和咳痰等哮喘症状以及医生诊断的哮喘在非特应性儿童的母亲中更常见。同时,非特应性儿童的父亲中哮喘症状也明显更常见。逻辑回归分析显示,母亲的PC(20)是儿童发生非过敏性哮喘风险的唯一预测因素。结果表明,在所研究的风险因素中,母亲的支气管高反应性与非特应性儿童哮喘的发生有关。