Demoly Pascal, Matucci Andrea, Rossi Oliviero, Vidal Carmen
Allergy Division, Pulmonology Department, Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, Montpellier, France.
Sorbonne Universités, UPMC Paris 06, UMR-S 1136 INSERM, IPLESP, Equipe EPAR, Paris, France.
BMC Pulm Med. 2016 May 23;16(1):85. doi: 10.1186/s12890-016-0246-9.
House dust mite (HDM) allergens constitute the leading trigger for the symptoms of persistent respiratory allergies (such as allergic rhinitis and asthma). However, the fluctuating, pernicious nature of the symptoms has given rise to a perception that HDM-induced respiratory allergy is not a "real" disease.
In order to assess the self-reported disease profile and behaviour of adult patients with a self-reported history of severe, poorly controlled, physician-diagnosed HDM respiratory allergy, we performed an observational, international, multicentre survey in three European countries (France, Italy and Spain). Participants were included in the survey if they passed a short Internet-based screening questionnaire. Following completion of a detailed post-inclusion questionnaire, 28 fortnightly telephone interviews were used to gather extensive data on the participants' symptom prevalence and intensity, medical consultations, disease burden, quality of life, and medication use from late May 2012 to early July 2013.
Twenty-two thousand nine hundred ninety five individuals completed the Internet screening questionnaire and 339 respondents (67 % female) met all the inclusion criteria. 313 of the 339 (92 %) completed the post-inclusion questionnaire (n = 114 in Italy, 92 in France and 107 in Spain). The median time since the first symptoms of HDM allergy was over 13 years in all three countries. The response rate for the fortnightly interviews averaged 75 % (range: 29 to 97 %). The reported fortnightly prevalence of nasal and ocular symptoms peaked in the autumn (September to November) and spring (March to May). These peaks in prevalence coincided with increased reports of symptom worsening and higher physician consultation rates. In participants not allergic to pollen, the autumn and spring peaks were accompanied by a third peak in late December 2012. Very few participants reported that their symptoms had never improved (4 %) or never worsened (11 %) during the survey period.
In a survey in France, Italy and Spain, patients with severe HDM-induced respiratory allergies experienced a complex set of changing, troublesome symptoms throughout the year, with peaks in spring, autumn and (to a lesser extent) mid-winter.
屋尘螨(HDM)过敏原是持续性呼吸道过敏症状(如过敏性鼻炎和哮喘)的主要诱发因素。然而,这些症状的波动性和危害性导致人们认为HDM诱发的呼吸道过敏并非一种“真正的”疾病。
为了评估自我报告有严重、控制不佳、经医生诊断为HDM呼吸道过敏病史的成年患者的自我报告疾病概况和行为,我们在三个欧洲国家(法国、意大利和西班牙)开展了一项观察性、国际性、多中心调查。如果参与者通过了一份简短的基于互联网的筛查问卷,就会被纳入调查。在完成一份详细的纳入后问卷后,从2012年5月下旬至2013年7月初,通过28次每两周一次的电话访谈收集了关于参与者症状发生率和严重程度、医疗咨询、疾病负担、生活质量以及用药情况的广泛数据。
22995人完成了互联网筛查问卷,339名受访者(67%为女性)符合所有纳入标准。339人中的313人(92%)完成了纳入后问卷(意大利114人,法国92人,西班牙107人)。在所有三个国家,自首次出现HDM过敏症状以来的中位时间超过13年。每两周一次访谈的回复率平均为75%(范围:29%至97%)。报告的每两周一次的鼻和眼症状发生率在秋季(9月至11月)和春季(3月至5月)达到峰值。这些发生率峰值与症状恶化报告增加以及更高的医生咨询率相吻合。在对花粉不过敏的参与者中,秋季和春季峰值之后在2012年12月下旬出现了第三个峰值。在调查期间,很少有参与者报告其症状从未改善(4%)或从未恶化(11%)。
在法国、意大利和西班牙进行的一项调查中,患有严重HDM诱发的呼吸道过敏的患者全年经历了一系列复杂多变且令人烦恼的症状,在春季、秋季以及(程度较轻的)仲冬出现峰值。