Burastero S E, Masciulli A, Villa A M
San Raffaele Scientific Institute, Milan, Italy.
Allergol Immunopathol (Madr). 2011 Jul-Aug;39(4):232-9. doi: 10.1016/j.aller.2010.07.004. Epub 2010 Dec 13.
Allergy is determined by genetic and environmental factors. People immigrating from under-developed to industrialised countries are at higher risk of developing allergic diseases and immigration is as a good epidemiological model to quantify the influence of the environment. We performed the allergological assessment of 32,555 recent immigrants from different areas of the world to a polluted metropolitan area of Northern Italy.
We evaluated time of onset of allergic rhinitis and/or asthma, sensitisations and clinical characteristics of 395 subjects (3.74 ± 2.94 yrs, mean ± SD) from four macro-areas (Asia, Africa, East-Europe, South America) arriving to Milan, Italy from June 2005 to June 2009. Data were compared with immigrants having access to the same medical facility for any medical problem and with resident Italians living in the same area.
Immigrants with allergic rhinitis and/or asthma days since arrival in Italy correlated with number of sensitisations (p=0.0030). Moreover, personal (2.02%) or familial (2.78%) history of allergic diseases was lower in allergic immigrants as compared to allergic residents (37.77 and 29.39%, respectively; p<0.0001 for both comparisons). Finally, the frequency of allergic immigrants from South America (63.3%) was higher than expected from the overall proportion of individuals from this macro-area who sought medical help at the same facility (40.4%; p<0.0001, OR 2.289, CI 2.1670-3.255).
Environmental factors play a relevant role in the induction of allergies in immigrants to Northern Italy. Genetics appears as a further promoting factor in the case of immigrants from South America.
过敏由遗传和环境因素决定。从不发达国家移民到工业化国家的人群患过敏性疾病的风险更高，移民是量化环境影响的良好流行病学模型。我们对来自世界不同地区、近期移民到意大利北部一个污染大都市地区的32555人进行了变应性评估。
我们评估了2005年6月至2009年6月期间从四个大区（亚洲、非洲、东欧、南美洲）抵达意大利米兰的395名受试者（平均年龄3.74±2.94岁，均值±标准差）的变应性鼻炎和/或哮喘发病时间、致敏情况及临床特征。将数据与因任何医疗问题使用同一医疗机构的移民以及居住在同一地区的意大利居民进行比较。
抵达意大利后出现变应性鼻炎和/或哮喘的移民天数与致敏数量相关（p = 0.0030）。此外，与变应性居民相比，变应性移民的个人（2.02%）或家族（2.78%）过敏疾病史较低（分别为37.77%和29.39%；两项比较p均<0.0001）。最后，来自南美洲的变应性移民频率（63.3%）高于在同一医疗机构寻求医疗帮助的该大区个体总体比例所预期的频率（40.4%；p<0.0001，比值比2.289，可信区间2.1670 - 3.255）。
环境因素在意大利北部移民的过敏诱发中起重要作用。对于来自南美洲的移民，遗传因素似乎是进一步的促进因素。
