Respiratory Division, Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
Pediatr Allergy Immunol. 2011 May;22(3):320-6. doi: 10.1111/j.1399-3038.2010.01123.x. Epub 2011 Jan 23.
The role of endotoxin and house dust mite allergen (HDM) in allergen sensitization and asthma is unclear. The timeframe of exposure and asthma assessment appears critical. We aimed to determine, in children at 7 yr of age, the association between current exposure to endotoxin and HDM and risks of recurrent wheeze, paediatric allergist diagnosed asthma and allergen sensitization. Three hundred and eighty children who had an increased risk of asthma because of family background were assessed at age 7 yr by a questionnaire-standardized interview, allergen skin testing and clinical examination by a paediatric allergist. Dust samples were collected from their homes and analysed for levels of endotoxin and HDM (Der p 1 and Der f 1). Levels of endotoxin in dust samples were associated with protection from paediatric allergist diagnosed asthma with inhaled steroid use (OR 0.69, 95% CI 0.53-0.91) and specific sensitization to dog allergen (OR 0.68, 95% CI 0.51-0.90) at the age of 7 yr; both endotoxin and HDM were associated with decreased risk of sensitization to dog allergen. In high-risk children at age 7, endotoxin levels were associated with decreased sensitization to dog, as well as with decreased asthma.
内毒素和屋尘螨过敏原（HDM）在过敏原致敏和哮喘中的作用尚不清楚。暴露和哮喘评估的时间范围似乎至关重要。我们旨在确定 7 岁儿童目前接触内毒素和 HDM 与反复喘息、儿童哮喘专科医生诊断的哮喘和过敏原致敏的风险之间的关联。由于家族背景，380 名儿童患哮喘的风险增加，他们在 7 岁时通过问卷调查标准化访谈、过敏原皮肤测试和儿童哮喘专科医生的临床检查进行评估。从他们的家中采集灰尘样本，并分析内毒素和 HDM（Der p 1 和 Der f 1）的水平。灰尘样本中的内毒素水平与使用吸入性类固醇预防儿童哮喘专科医生诊断的哮喘（OR 0.69，95%CI 0.53-0.91）和 7 岁时对狗过敏原的特异性致敏（OR 0.68，95%CI 0.51-0.90）有关；内毒素和 HDM 均与降低对狗过敏原致敏的风险有关。在 7 岁的高危儿童中，内毒素水平与对狗的致敏降低有关，与哮喘降低有关。
