Yale Center for Perinatal, Pediatric and Environmental Epidemiology, Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT 06510, USA.
Environ Res. 2012 Oct;118:86-93. doi: 10.1016/j.envres.2012.07.005. Epub 2012 Aug 3.
Few studies address concurrent exposures to common household allergens, specific allergen sensitization and childhood asthma morbidity.
To identify levels of allergen exposures that trigger asthma exacerbations in sensitized individuals.
We sampled homes for common indoor allergens (fungi, dust mites (Der p 1, Der f 1), cat (Fel d 1), dog (Can f 1) and cockroach (Bla g 1)) for levels associated with respiratory responses among school-aged children with asthma (N=1233) in a month-long study. Blood samples for allergy testing and samples of airborne fungi and settled dust were collected at enrollment. Symptoms and medication use were recorded on calendars. Combined effects of specific allergen sensitization and level of exposure on wheeze, persistent cough, rescue medication use and a 5-level asthma severity score were examined using ordered logistic regression.
Children sensitized and exposed to any Penicillium experienced increased risk of wheeze (odds ratio [OR] 2.12 95% confidence interval [CI] 1.12, 4.04), persistent cough (OR 2.01 95% CI 1.05, 3.85) and higher asthma severity score (OR 1.99 95% CI 1.06, 3.72) compared to those not sensitized or sensitized but unexposed. Children sensitized and exposed to pet allergen were at significantly increased risk of wheeze (by 39% and 53% for Fel d 1>0.12 μg/g and Can f 1>1.2 μg/g, respectively). Increased rescue medication use was significantly associated with sensitization and exposure to Der p 1>0.10 μg/g (by 47%) and Fel d 1>0.12 μg/g (by 32%).
Asthmatic children sensitized and exposed to low levels of common household allergens Penicillium, Der p 1, Fel d 1 and Can f 1 are at significant risk for increased morbidity.
很少有研究涉及常见家庭过敏原、特定过敏原致敏和儿童哮喘发病的同时暴露情况。
确定引发致敏个体哮喘加重的过敏原暴露水平。
我们对 1233 名有哮喘的学龄儿童家庭进行了为期一个月的研究，以确定与呼吸道反应相关的常见室内过敏原（真菌、尘螨（Der p 1、Der f 1）、猫（Fel d 1）、狗（Can f 1）和蟑螂（Bla g 1））的暴露水平。在入组时收集用于过敏测试的血液样本以及空气中真菌和沉降灰尘样本。使用日历记录症状和用药情况。使用有序逻辑回归检验特定过敏原致敏和暴露水平对喘息、持续性咳嗽、急救药物使用和 5 级哮喘严重程度评分的综合影响。
与未致敏或致敏但未暴露的儿童相比，对任何青霉属过敏且暴露于青霉属的儿童发生喘息（比值比 [OR] 2.12，95%置信区间 [CI] 1.12，4.04）、持续性咳嗽（OR 2.01，95% CI 1.05，3.85）和更高的哮喘严重程度评分（OR 1.99，95% CI 1.06，3.72）的风险增加。对宠物过敏原致敏且暴露的儿童发生喘息的风险显著增加（分别为 Fel d 1>0.12 μg/g 和 Can f 1>1.2 μg/g 时增加 39%和 53%）。急救药物使用增加与 Der p 1>0.10 μg/g（增加 47%）和 Fel d 1>0.12 μg/g（增加 32%）的致敏和暴露显著相关。
对常见家庭过敏原青霉属、Der p 1、Fel d 1 和 Can f 1 致敏且暴露于低水平的哮喘儿童患哮喘发病率显著增加。
