Shendell Derek G, Mizan Samina S, Yamamoto Naomichi, Peccia Jordan
School of Public Health (SPH), Center for School and Community-Based Research and Education, University of Medicine and Dentistry of New Jersey (UMDNJ), New Brunswick, NJ, USA.
J Asthma. 2012 Jun;49(5):502-9. doi: 10.3109/02770903.2012.682633.
Many fungi may cause allergic reactions and increase asthma symptoms prevalence and severity. One susceptible, vulnerable population subgroup of increasing size in industrialized countries and of public health concern who spends the majority of their time at home is older adults. Older adults diagnosed with chronic obstructive pulmonary disease (COPD) are at risk of exposure to fungi. Currently, species identification is based on observation of microscopic and macroscopic morphologies, which may underestimate concentrations compared to quantitative polymerase chain reaction (qPCR)-based measurements which are toxicologically more relevant to exposure science.
This article analyzes quantitative indoor exposure data on fungi in floor dust (cells/cm(2) floor) by real-time qPCR-based detection with quantitative outcome data via field spirometry in a pilot community-based study in Visalia, Tulare County, California, between July 2009 and January 2010. Subjects (n = 9, five females, four males) were Caucasian, English-speaking, nonsmoking older adults with doctor-diagnosed asthma and/or COPD.
While certain results did not reach statistical significance (p ≤ .10) due to sample size-overall and by gender-we found consistent trends and statistically significant associations for total fungal DNA (summer data) with forced vital capacity and forced expiratory volume in 1 second.
The results of this pilot study are novel and suggest adverse effects of exposure inside homes to certain fungal species. This pilot study supports the need for larger prospective epidemiologic studies of older adults with asthma and/or chronic bronchitis based on quantitative environmental and clinical measures.
许多真菌可能引发过敏反应,并增加哮喘症状的患病率和严重程度。在工业化国家中,规模不断扩大且受到公共卫生关注的一个易感、脆弱人群亚组是老年人,他们大部分时间都待在家里。被诊断患有慢性阻塞性肺疾病(COPD)的老年人有接触真菌的风险。目前,物种鉴定基于微观和宏观形态的观察,与基于定量聚合酶链反应(qPCR)的测量相比,这可能会低估浓度,而基于qPCR的测量在毒理学上与暴露科学更相关。
本文通过基于实时qPCR的检测分析了地板灰尘中真菌的定量室内暴露数据(每平方厘米地板上的细胞数),并在2009年7月至2010年1月于加利福尼亚州图莱里县维塞利亚进行的一项基于社区的试点研究中,通过现场肺活量测定获得定量结果数据。受试者(n = 9,5名女性,4名男性)为白人、说英语、不吸烟的老年人,患有医生诊断的哮喘和/或COPD。
虽然由于样本量总体和按性别分类,某些结果未达到统计学显著性(p≤0.10),但我们发现总真菌DNA(夏季数据)与用力肺活量和1秒用力呼气量之间存在一致的趋势和统计学显著关联。
这项试点研究结果新颖,表明在家中接触某些真菌物种存在不良影响。这项试点研究支持有必要基于定量环境和临床测量,对患有哮喘和/或慢性支气管炎的老年人进行更大规模的前瞻性流行病学研究。