Grainger D N, Stenton S C, Avery A J, Duddridge M, Walters E H, Hendrick D J
Chest Unit, Newcastle General Hospital, University of Newcastle upon Tyne, U.K.
Clin Exp Allergy. 1990 Mar;20(2):181-7. doi: 10.1111/j.1365-2222.1990.tb02665.x.
Atopy is often regarded as a risk factor for the development of asthma, particularly childhood asthma and occupational asthma. This could reflect an association with non-specific bronchial responsiveness (NSBR), though atopy could influence asthma independently. We have evaluated the possible relationship between atopy and NSBR (PD20FEV1 to methacholine) in the siblings of 59 probands with atopic asthma. Thirty-four (58%) were atopic (greater than or equal to 1 prick test with weal diameter greater than or equal to that of a 0.1% histamine control) and 28 (47%) showed NSBR. Atopy and NSBR occurred together more frequently than would be expected by chance (P less than 0.05); both variables being observed in 20 subjects, neither in 17, and only one in 22. A significant association was also noted when atopy was defined by a serum total IgE greater than 150 IU (or greater than 50 IU), but when atopy was defined by other commonly used criteria (greater than or equal to 2 prick tests with weal diameter greater than or equal to histamine control; or weal diameter 2 mm or more greater than a saline control), no significant association was demonstrated. Furthermore, linear logistic regression and multiple regression analyses showed that both the presence and the degree of NSBR were influenced much more by the baseline level of FEV1 than by atopic status. At best, atopy accounted for 10% of the variance of the PD20 measurements. We conclude that atopy is associated with NSBR but not strongly; that the relationship may be readily obscured according to the defining criteria used for atopy; and that atopy should not be used as a marker for NSBR.
特应性通常被视为哮喘发生的一个危险因素，尤其是儿童哮喘和职业性哮喘。这可能反映了与非特异性支气管反应性（NSBR）的关联，尽管特应性可能独立影响哮喘。我们评估了59例患有特应性哮喘先证者的同胞中特应性与NSBR（对乙酰甲胆碱的PD20FEV1）之间的可能关系。34例（58%）为特应性（至少1次皮内试验风团直径大于或等于0.1%组胺对照），28例（47%）表现出NSBR。特应性和NSBR同时出现的频率高于偶然预期（P<0.05）；20例同时观察到这两个变量，17例两者均未观察到，22例仅1例观察到其中一个变量。当以血清总IgE大于150 IU（或大于50 IU）定义特应性时，也观察到显著关联，但当以其他常用标准定义特应性时（至少2次皮内试验风团直径大于或等于组胺对照；或风团直径比生理盐水对照大2 mm或更多），未显示出显著关联。此外，线性逻辑回归和多元回归分析表明，NSBR的存在和程度受FEV1基线水平的影响远大于特应性状态。特应性充其量仅占PD20测量值方差的10%。我们得出结论，特应性与NSBR相关但不紧密；根据用于定义特应性的标准，这种关系可能很容易被掩盖；并且特应性不应用作NSBR的标志物。
