Mener David J, Garcia-Esquinas Esther, Navas-Acien Ana, Dietert Rodney R, Shargorodsky Josef, Lin Sandra Y
Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD.
Int Forum Allergy Rhinol. 2015 Mar;5(3):214-20. doi: 10.1002/alr.21460. Epub 2014 Dec 18.
Whether blood lead levels are associated with sensitization to food allergens in adults and children is unclear. Prior studies have shown that exposure to lead is associated with atopic sensitization and modulation of several cytokines (eg, interleukin [IL]-12, IL-10, interferon [IFN]-γ, and IL-4 production) and with T-cell dysregulation and bias toward T helper 2 (Th2) activity. The objective of this work was to assess whether exposure to lead is independently associated with allergic symptoms and sensitizations in a large nationally representative sample of children and adults.
We studied 2712 children and 4333 adults enrolled in the 2005-2006 cycle of the National Health and Nutritional Examination Surveys (NHANES). Participants were tested for serum-specific immunoglobulin E (IgE) levels to food allergens as well as blood lead levels. Food allergens tested included shrimp, egg, peanut, and milk. Logistic regression models adjusted for demographic factors, body mass index, history of asthma, smoking, housing characteristics, and current exposure to animals in the home, to assess the association of blood lead levels with sensitization to food allergens.
Median (interquartile range [IQR]) for serum blood was 0.87 μg/L (0.61 to 1.31) in children and 1.48 μg/L (0.92 to 2.34) in adults. At baseline, 672 (24.7%) of children participants and 719 (16.6%) of adult participants tested positive for increased sensitization to food allergens. A 2-fold increase in blood lead levels in adult participants was associated with increased sensitization to food allergens (odds ratio [OR], 1.11; 95% confidence interval [CI], 1.02 to 1.22). Blood lead was not associated with sensitization to food allergens among pediatric participants (OR, 0.95; 95% CI, 0.82 to 1.10).
Exposure to lead was associated with increased odds of sensitization to food allergens in adult but not children participants.
尚不清楚成人和儿童的血铅水平是否与食物过敏原致敏有关。先前的研究表明，铅暴露与特应性致敏、多种细胞因子的调节（如白细胞介素[IL]-12、IL-10、干扰素[IFN]-γ以及IL-4的产生）以及T细胞失调和向辅助性T细胞2（Th2）活性的偏向有关。这项研究的目的是评估在一个具有全国代表性的大型儿童和成人样本中，铅暴露是否与过敏症状和致敏独立相关。
我们研究了参与2005 - 2006年全国健康与营养检查调查（NHANES）的2712名儿童和4333名成人。对参与者进行了食物过敏原血清特异性免疫球蛋白E（IgE）水平以及血铅水平的检测。检测的食物过敏原包括虾、鸡蛋、花生和牛奶。采用逻辑回归模型，对人口统计学因素、体重指数、哮喘病史、吸烟、住房特征以及当前家中接触动物的情况进行了调整，以评估血铅水平与食物过敏原致敏之间的关联。
儿童血清血铅的中位数（四分位间距[IQR]）为0.87μg/L（0.61至1.31），成人为1.48μg/L（0.92至2.34）。在基线时，672名（24.7%）儿童参与者和719名（16.6%）成人参与者食物过敏原致敏检测呈阳性。成人参与者血铅水平增加2倍与食物过敏原致敏增加相关（比值比[OR]，1.11；95%置信区间[CI]，1.02至1.22）。儿童参与者中血铅与食物过敏原致敏无关（OR，0.95；95%CI，0.82至1.10）。
铅暴露与成人而非儿童参与者食物过敏原致敏几率增加有关。
