Kołodziejczyk Krzysztof, Bożek Andrzej, Jarząb Jerzy, Gawlik Radosław
Clinical Department of Internal Medicine, Dermatology and Allergology, Medical University of Silesia, Katowice, Poland.
Pneumonol Alergol Pol. 2016;84(2):81-6. doi: 10.5603/PiAP.2016.0005.
Bronchial asthma is an increasing problem worldwide. The course of bronchial asthma is dependent on the type of inducing allergens. The differences between the clinical features of asthma in patients with monovalent allergies to molds and with other allergies were explored.
Randomly selected 1910 patients (924 women and 986 men) between 18-86 years in age were analyzed according to type of allergy and asthma. The diagnosis of asthma was confirmed on the basis of GINA criteria, physical examination and spirometry. Allergy diagnosis was confirmed on the basis of medical history, a positive skin prick test and the measurement of serum-specific IgE to inhalant allergens, using an extended profile of mold allergens.
Patients with monovalent allergies to molds (4% of analyzed group) had significantly more frequent diagnoses of asthma than patients in the other group (53% vs. 27.1-32.4%, p < 0.05). Patients with allergies to Alternaria alternata had an odds ratio of 2.11 (95%CI: 1.86-2.32) for receiving a diagnosis of bronchial asthma. They had less control over their asthma, which was more severe compared to patients with other allergies. Patients with asthma and allergies to mold had significantly more frequent exacerbation of asthma requiring systemic corticosteroids and/or hospitalization. They used a significantly greater mean daily dose of inhaled steroids compared to other patients.
Patients with monovalent IgE allergies to molds are at a higher risk for asthma than patients with other allergies. Their asthma is often more intense and less controlled compared to that of patients with other types of allergies.
支气管哮喘在全球范围内是一个日益严重的问题。支气管哮喘的病程取决于诱发过敏原的类型。本研究探讨了对霉菌单一致敏与其他过敏患者哮喘临床特征的差异。
根据过敏和哮喘类型,对随机选取的1910例年龄在18 - 86岁之间的患者(924名女性和986名男性)进行分析。哮喘诊断依据全球哮喘防治创议(GINA)标准、体格检查和肺功能测定来确定。过敏诊断依据病史、皮肤点刺试验阳性以及使用扩展霉菌过敏原谱测定血清特异性IgE来确定。
对霉菌单一致敏的患者(占分析组的4%)哮喘诊断率显著高于其他组患者(53%对27.1 - 32.4%,p < 0.05)。对链格孢过敏的患者被诊断为支气管哮喘的比值比为2.11(95%置信区间:1.86 - 2.32)。他们对哮喘的控制较差,与其他过敏患者相比病情更严重。患有哮喘且对霉菌过敏的患者哮喘发作更频繁,需要全身使用皮质类固醇和/或住院治疗。与其他患者相比,他们吸入类固醇的平均每日剂量显著更高。
对霉菌单一致敏的IgE患者比其他过敏患者患哮喘的风险更高。与其他类型过敏患者相比,他们的哮喘往往更严重且控制不佳。