Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
J Allergy Clin Immunol. 2011 Aug;128(2):390-396.e7. doi: 10.1016/j.jaci.2011.04.050. Epub 2011 Jun 22.
The role of natural aeroallergen exposure in modulating allergen-specific immune responses is not well understood.
We sought to examine relationships between mouse allergen exposure and mouse-specific immune responses.
New employees (n = 179) at a mouse facility underwent repeated assessment of mouse allergen exposure, skin prick tests (SPTs), and measurement of mouse-specific IgG levels. Relationships between the mean level of exposure, variability of exposure (calculated as log deviation), and time to development of immunologic outcomes were examined by using Cox proportional hazards models.
By 24 months, 32 (23%) participants had experienced a positive SPT response, and 10 (8%) had mouse-specific IgG₄. The incidence of a positive SPT response increased as levels of exposure increased from low to moderate, peaking at 1.2 ng/m³, and decreased beyond this point (P = .04). The more variable the exposure was across visits, the lower the incidence of a positive SPT response (hazard ratio [HR], 0.17; 95% CI, 0.07-0.41). Variability of exposure was an independent predictor of a positive SPT response in a model that included both exposure metrics. In contrast, the incidence of mouse-specific IgG₄ increased with increasing levels of mouse allergen exposure (HR, 2.9; 95% CI, 1.4-6.0), and there was evidence of a higher risk of mouse-specific IgG₄ with greater variability of exposure (HR, 6.3; 95% CI, 0.4-95.2).
Both the level and variability of mouse allergen exposure influence the humoral immune response, with specific patterns of exposure associated with specific immunophenotypes. Exposure variability might be a more important predictor of a positive SPT response, whereas the average exposure level might be a more important predictor of mouse-specific IgG₄.
自然吸入性过敏原暴露在调节过敏原特异性免疫反应中的作用尚不清楚。
我们旨在研究小鼠过敏原暴露与小鼠特异性免疫反应之间的关系。
在一个小鼠设施工作的新员工（n=179）接受了反复的小鼠过敏原暴露评估、皮肤点刺试验（SPT）和小鼠特异性 IgG 水平的测量。使用 Cox 比例风险模型来检查暴露的平均水平、暴露的变异性（计算为对数偏差）以及免疫结果发展时间之间的关系。
在 24 个月时，32 名（23%）参与者经历了 SPT 阳性反应，10 名（8%）参与者出现了小鼠特异性 IgG₄。暴露水平从低到中等增加时，SPT 阳性反应的发生率增加，在 1.2ng/m³时达到峰值，超过该点后则降低（P=0.04）。暴露在不同访问之间的变异性越大，SPT 阳性反应的发生率越低（风险比[HR]，0.17；95%置信区间，0.07-0.41）。暴露变异性是包括暴露指标的 SPT 阳性反应模型的独立预测因子。相比之下，随着小鼠过敏原暴露水平的增加，小鼠特异性 IgG₄的发生率增加（HR，2.9；95%置信区间，1.4-6.0），并且暴露变异性越大，出现小鼠特异性 IgG₄的风险更高（HR，6.3；95%置信区间，0.4-95.2）。
小鼠过敏原暴露的水平和变异性均会影响体液免疫反应，特定的暴露模式与特定的免疫表型相关。暴露变异性可能是 SPT 阳性反应的更重要预测因子，而平均暴露水平可能是小鼠特异性 IgG₄的更重要预测因子。
