Sunyer J, Antó J M, Rodrigo M J, Morell F
Servei d'Estudis Epidemiològics i Ambientals, Ajuntament de Barcelona, Spain.
Lancet. 1989 Jan 28;1(8631):179-82. doi: 10.1016/s0140-6736(89)91201-4.
Since 1981, twenty-six asthma outbreaks have been identified in Barcelona, all coinciding with the unloading of soybean in the harbour. Serum from patients with epidemic asthma and individually matched controls with non-epidemic asthma was assayed for immunoglobulin-E (IgE) antibodies against soybean antigens by means of a radioallergosorbent test. In 64 of 86 cases (74.4%) there was a reaction with commercial soybean antigen extracts, compared with only 4 of the 86 controls (4.6%) (odds ratio = 61; lower 95% confidence limit = 8.1). The statistical significance was greater for reactions with extracts of soybean dust taken from Barcelona harbour (odds ratio, unquantifiably high; lower 95% confidence limit = 11.7). No other serological covariate (total serum IgE levels or specific IgE levels against the commonest airborne allergens or legumes) confounded the association between serum anti-soybean IgE antibodies and epidemic asthma. These results support a causal relation between the release of dust during unloading of soybean at the harbour and the occurrence of asthma outbreaks, suggesting an underlying allergic mechanism.
自1981年以来，巴塞罗那已确认发生了26起哮喘疫情，均与港口大豆卸载过程相吻合。通过放射变应原吸附试验，对流行性哮喘患者以及与非流行性哮喘患者个体匹配的对照者的血清进行了针对大豆抗原的免疫球蛋白E（IgE）抗体检测。86例病例中有64例（74.4%）对商用大豆抗原提取物有反应，而86例对照者中只有4例（4.6%）有反应（优势比=61；95%置信下限=8.1）。对于来自巴塞罗那港口的大豆粉尘提取物的反应，统计学显著性更高（优势比，高到无法量化；95%置信下限=11.7）。没有其他血清学协变量（总血清IgE水平或针对最常见空气传播过敏原或豆类的特异性IgE水平）混淆血清抗大豆IgE抗体与流行性哮喘之间的关联。这些结果支持港口大豆卸载过程中粉尘释放与哮喘疫情发生之间存在因果关系，提示存在潜在的过敏机制。
