Toskala Elina, Kennedy David W
Department of Otorhinolaryngology-Head and Neck Surgery, Temple University, Philadelphia, PA.
Department of Otorhinolaryngology-Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
Int Forum Allergy Rhinol. 2015 Sep;5 Suppl 1(Suppl 1):S11-6. doi: 10.1002/alr.21557.
Bronchial asthma is one of the most common chronic diseases in childhood, with a current prevalence of 6% to 9%, but a prevalence that is increasing at an alarming rate. Asthma is a complex genetic disorder with strong environmental influence. It imposes a growing burden on our society in terms of morbidity, quality of life, and healthcare costs. Despite large-scale efforts, only a few asthma genes have been confirmed, suggesting that the genetic underpinning of asthma is highly complex.
A review of the literature was performed regarding atopic and nonatopic asthma risk factors, including environmental risk factors and genetic studies in adults and children.
Several environmental risk factors have been identified to increase the risk of developing asthma such as exposure to air pollution and tobaccos smoke as well as occupational risk factors. In addition atopy, stress, and obesity all can increases the risk for asthma in genetically susceptible persons.
Asthma represents a dysfunctional interaction with our genes and the environment to which they are exposed, especially in fetal and early infant life. The increasing prevalence of asthma in all age groups indicate that our living environment and immunity are in imbalance with each other reacting with airway inflammation to the environmental exposures and often non-harmful proteins, such as allergens causing the current "asthma and allergy epidemic." Because of the close relationship between asthma and chronic rhinosinusitis, it is important that otolaryngologists have a good understanding of asthma, the etiologic factors associated with disease, and its evaluation and management.
支气管哮喘是儿童期最常见的慢性疾病之一,目前患病率为6%至9%,且患病率正以惊人的速度上升。哮喘是一种受环境影响很大的复杂遗传疾病。它在发病率、生活质量和医疗费用方面给社会带来了日益沉重的负担。尽管进行了大规模的研究,但仅证实了少数哮喘基因,这表明哮喘的遗传基础高度复杂。
对有关特应性和非特应性哮喘危险因素的文献进行了综述,包括环境危险因素以及成人和儿童的遗传研究。
已确定多种环境危险因素会增加患哮喘的风险,如接触空气污染、烟草烟雾以及职业危险因素。此外,特应性、压力和肥胖都会增加遗传易感性个体患哮喘的风险。
哮喘表现为我们的基因与它们所接触的环境之间的功能失调相互作用,尤其是在胎儿期和婴儿早期。各年龄组哮喘患病率的上升表明,我们的生活环境和免疫力相互失衡,对环境暴露以及通常无害的蛋白质(如变应原)产生气道炎症反应,从而导致当前的“哮喘和过敏流行”。由于哮喘与慢性鼻 - 鼻窦炎关系密切,耳鼻喉科医生了解哮喘、与疾病相关的病因因素及其评估和管理非常重要。