Peat J K, Salome C M, Woolcock A J
Department of Medicine, University of Sydney, Australia.
J Allergy Clin Immunol. 1990 Jan;85(1 Pt 1):65-74. doi: 10.1016/0091-6749(90)90223-q.
A total of 380 schoolchildren living in Belmont, New South Wales, a coastal town where the predominant aeroallergens are house dust mites, were studied on three occasions at 2-year intervals. At each study, atopy was measured by skin prick tests to 13 allergens, bronchial responsiveness was measured by histamine inhalation test, and respiratory illness history was assessed by a self-administered questionnaire to parents. The age of the group was 8 to 10 years at enrollment. We found that skin wheals less than 4 mm were not associated with respiratory or allergic illness, and therefore, we defined atopy as the presence of a skin wheal of greater than or equal to 4 mm. In the sample, 24% of the children were atopic at 8 to 10 years (early-onset atopy), and an additional 15% became atopic during the study (late-onset atopy). Both early- and late-onset atopy had a close association with hay fever. Late-onset atopy was strongly associated with inconsistent reporting of symptoms. Early-onset atopy was an important risk factor for bronchial hyperresponsiveness (BHR), diagnosed asthma, and continuing symptoms of wheeze, and was a particularly important risk factor for BHR with current wheeze in late childhood years. We conclude that atopy acquired at an early age is an important predictive factor for respiratory symptoms occurring with BHR and continuing into late childhood.
共有380名居住在新南威尔士州贝尔蒙特的学童参与了研究，贝尔蒙特是一个沿海城镇，主要的空气过敏原是屋尘螨。研究分三次进行，每次间隔两年。每次研究时，通过对13种过敏原进行皮肤点刺试验来测量特应性，通过组胺吸入试验来测量支气管反应性，并通过家长自行填写的问卷来评估呼吸道疾病史。该组儿童入学时年龄为8至10岁。我们发现，小于4毫米的皮肤风团与呼吸道或过敏性疾病无关，因此，我们将特应性定义为存在大于或等于4毫米的皮肤风团。在样本中，24%的儿童在8至10岁时患有特应性（早发性特应性），另有15%的儿童在研究期间患上特应性（迟发性特应性）。早发性和迟发性特应性均与花粉症密切相关。迟发性特应性与症状报告不一致密切相关。早发性特应性是支气管高反应性（BHR）、确诊哮喘和持续喘息症状的重要危险因素，并且是儿童晚期当前喘息伴BHR的特别重要的危险因素。我们得出结论，早年获得的特应性是BHR出现并持续至儿童晚期的呼吸道症状的重要预测因素。
