Department of Allergy and Respirology, National Hospital Organization Sagamihara National Hospital, 18-1 Sakuradai, Minami-ku, Sagamihara, Kanagawa 252-0392, Japan.
Allergy Asthma Clin Immunol. 2013 Nov 11;9(1):44. doi: 10.1186/1710-1492-9-44.
Studies of avoidance of exposure to group 1 allergens of the Dermatophagoides group (Der p 1) have not yielded consistent improvements in adult asthma through avoidance. We explored whether the use of pillow and bed covers and allergen-avoidance counseling resulted in Der 1-level reduction, as measured by enzyme-linked immunosorbent assay, and thus improved asthma symptoms in adult patients.
Twenty-five adult patients with moderate or severe atopic asthma were randomized into intervention and control groups. Intervention patients slept on pillows and mattresses or futons encased in microfine-fiber covers and were counseled in allergen avoidance through bedroom cleaning. Control patients received neither special covers nor counseling. In the period August to October in 2009 (pre-intervention) and 2010 (post-intervention), dust samples were collected in open Petri dishes placed in bedrooms for 2 weeks and by rapid lifting of dust from bedding and skin using adhesive tape on the morning of 1 day of Petri dish placement. We examined the associations between changes in Der 1 level (as measured by enzyme-linked immunosorbent assay) and clinical symptom score, minimum % peak expiratory flow, and fraction of exhaled nitric oxide.
Der 1 allergen levels on the mattress/futon covers and near the floor of the bedrooms of intervention patients, but not controls, were lower in 2010 than in 2009. From 2009 to 2010, asthma symptom scores decreased significantly, and minimum % peak expiratory flow increased significantly, in intervention patients. The fall in Der p 1 concentration was correlated with a reduction in the fraction of exhaled nitric oxide.
Minimization of Der 1 allergen exposure by encasing pillows and mattresses or futons and receiving counseling on avoiding exposure to indoor allergens improved asthma control in adult patients.
避免接触屋尘螨组 1 过敏原（Der p 1）的研究并未通过避免接触来改善成人哮喘。我们探讨了使用枕头和床罩以及过敏原回避咨询是否会导致 Der 1 水平降低，如酶联免疫吸附试验所示，从而改善成年患者的哮喘症状。
25 例中重度特应性哮喘成人患者随机分为干预组和对照组。干预组患者睡在包裹有超细纤维套的枕头和床垫或被褥上，并接受卧室清洁的过敏原回避咨询。对照组患者既不使用特殊罩子，也不接受咨询。在 2009 年 8 月至 10 月（干预前）和 2010 年（干预后）期间，将开放的培养皿放置在卧室中 2 周，并用粘性胶带快速从床上用品和皮肤上提起灰尘，以收集灰尘样本。我们检查了 Der 1 水平（酶联免疫吸附试验测定）与临床症状评分、最小%峰值呼气流速和呼出一氧化氮分数之间的变化的相关性。
干预组患者床垫/被褥和卧室地板附近的 Der 1 过敏原水平在 2010 年低于 2009 年，但对照组患者无此情况。与 2009 年相比，2010 年干预组患者的哮喘症状评分显著下降，最小%峰值呼气流速显著增加。Der p 1 浓度下降与呼出一氧化氮分数减少相关。
通过包裹枕头和床垫或被褥并接受避免接触室内过敏原的咨询，最大限度地减少 Der 1 过敏原暴露，改善了成年患者的哮喘控制。
