The David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Newport Isle of Wight, UK.
MSc Allergy Student, Faculty of Medicine, University of Southampton, UK.
Clin Exp Allergy. 2015 Sep;45(9):1430-8. doi: 10.1111/cea.12534.
While the prevalence of asthma in children is decreasing or remaining the same, time trends in the prevalence of rhinitis in children are not known. Understanding sensitisation trends may help inform about trends in asthma and rhinitis prevalence.
To assess time trends of wheeze, rhinitis and aero-allergen sensitisation prevalence at 10 years of age, we compared two birth cohorts established 12 years apart. To gain insight into differences in disease prevalence, we assessed association of family history, early life exposures and sensitisation with wheeze and rhinitis in each cohort.
The IoW (Isle of Wight) and FAIR (Food Allergy and Intolerance Research) unselected birth cohorts were established in 1989 and 2001 respectively in IoW. Identical ISAAC questionnaire and skin prick test data were collected and compared at 10 years of age.
Over the 12-year period from 2001 to 2012, prevalence of lifetime wheeze, current wheeze and those ever treated for asthma decreased by 15.9% (45.5 vs. 29.6, P < 0.001), 3.9% (18.9 vs. 15, P = 0.020) and 8.2% (31.7 vs. 23.5, P = 0.001), respectively. Conversely, current rhinitis and lifetime rhinitis prevalence increased by 5.5% (22.6 vs. 28.1, P = 0.004) and 13% (18.6 vs. 31.7, P < 0.001), respectively. Atopic status remained stable; however, house dust mite (HDM) sensitisation decreased by 5.6% (19.2 vs. 13.6, P = 0.004) and grass sensitisation increased by 3.5% (12.9 vs. 16.4, P = 0.054). Male sex, parental history of asthma and HDM sensitisation were significantly associated with lifetime wheeze in both cohorts, while maternal smoking during pregnancy was a significant risk factor only in the earlier IoW cohort. Parental history of rhinitis and grass sensitisation was significantly associated with lifetime rhinitis in both cohorts, while HDM sensitisation was significant only for the IoW cohort.
Contrasting changes were noted with falling wheeze and HDM sensitisation but rising rhinitis and grass sensitisation prevalence. Changing prevalence of aero-allergen sensitisations may explain the different time trends observed in these cohorts.
尽管儿童哮喘的患病率在下降或保持不变，但儿童鼻炎的时间趋势尚不清楚。了解致敏趋势可能有助于了解哮喘和鼻炎患病率的趋势。
为了评估 10 岁时喘息、鼻炎和变应原致敏的时间趋势，我们比较了相隔 12 年建立的两个出生队列。为了深入了解疾病患病率的差异，我们评估了家族史、生命早期暴露和致敏与每个队列中喘息和鼻炎的关系。
1989 年在怀特岛（Isle of Wight）建立了 IoW（怀特岛）和 FAIR（食物过敏和不耐受研究）未选择的出生队列，2001 年在怀特岛建立了 FAIR 队列。在 10 岁时收集了相同的 ISAAC 问卷和皮肤点刺试验数据，并进行了比较。
在 2001 年至 2012 年的 12 年期间，终生喘息、当前喘息和曾因哮喘治疗的比例分别下降了 15.9%（45.5 对 29.6，P <0.001）、3.9%（18.9 对 15，P =0.020）和 8.2%（31.7 对 23.5，P =0.001）。相反，当前鼻炎和终生鼻炎的患病率分别增加了 5.5%（22.6 对 28.1，P =0.004）和 13%（18.6 对 31.7，P <0.001）。特应性状态保持稳定；然而，屋尘螨（HDM）致敏下降了 5.6%（19.2 对 13.6，P =0.004），草致敏增加了 3.5%（12.9 对 16.4，P =0.054）。在两个队列中，男性、父母哮喘史和 HDM 致敏均与终生喘息显著相关，而母亲在怀孕期间吸烟仅在较早的 IoW 队列中是一个显著的危险因素。在两个队列中，父母鼻炎史和草致敏与终生鼻炎显著相关，而 HDM 致敏仅在 IoW 队列中显著。
喘息和 HDM 致敏率下降，但鼻炎和草致敏率上升，出现了截然相反的变化。变应原致敏的流行率变化可能解释了这些队列中观察到的不同时间趋势。
