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对实验室动物的过敏致敏与哮喘、鼻炎和皮肤症状的相关性高于对常见过敏原的致敏。

Allergic sensitization to laboratory animals is more associated with asthma, rhinitis, and skin symptoms than sensitization to common allergens.

机构信息

Department of Medicine, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.

Regional University Center of Espírito Santo do Pinhal, Espírito Santo do Pinhal, Brazil.

出版信息

Clin Exp Allergy. 2017 Nov;47(11):1436-1444. doi: 10.1111/cea.12994. Epub 2017 Sep 5.

Abstract

BACKGROUND

Workers exposed to laboratory animals have a high risk of developing laboratory animal allergy (LAA). Atopy seems to be the main risk factor for LAA. We hypothesized that occupational sensitization is a better predictor for the development of asthma, rhinitis, and bronchial hyperresponsiveness (BHR) than common sensitization.

OBJECTIVE

To investigate the association between occupational sensitization to laboratory animals and clinical outcomes.

METHODS

This was a cross-sectional study performed at two universities on students and employees dealing with small rodents. The subjects were allocated in groups: non-sensitized, common sensitization, or occupational sensitization, according to the results of the skin prick test (SPT). All subjects answered a questionnaire about animal exposures, symptoms, allergic diseases, and underwent spirometry and bronchial challenge test with mannitol. Multivariate analysis was performed using Poisson regression to estimate the prevalence ratio (PR).

RESULTS

Data from 453 volunteers were analysed. Non-sensitized group comprised 237 subjects; common sensitization group, 142 subjects; and occupational sensitization group, 74 subjects. Occupational sensitization was associated with greater risk for all outcomes studied. When the common sensitization group was reference, skin symptoms had PR of 1.36, 95% confidence interval (CI): 1.01-1.85; wheezing had PR of 1.75, CI 95%: 1.21-2.53; rhinitis had PR of 1.25, 95%: 1.11-1.40; nocturnal dyspnoea had PR of 2.40, 95% CI: 1.31-4.40; bronchial hyperresponsiveness (BHR) had PR of 2.47, 95% CI: 1.50-4.09; and confirmed asthma had PR of 2.65, 95% CI: 1.45-4.85. In addition, the overlap of asthma, rhinitis, and skin symptoms in a same subject was significantly more prevalent in the occupational sensitization group, 16.2% versus 4.9% in the common sensitization group.

CONCLUSION AND CLINICAL RELEVANCE

Occupational sensitization is associated with allergic symptoms and respiratory diseases. SPT with occupational allergens along with other parameters may contribute to detection of risk for allergic and respiratory diseases associated with exposure to laboratory animals.

摘要

背景

接触实验动物的工人患实验动物过敏(LAA)的风险很高。特应性似乎是 LAA 的主要危险因素。我们假设职业致敏是哮喘、鼻炎和支气管高反应性(BHR)发展的更好预测因素,而不是常见致敏。

目的

研究职业性接触实验动物与临床结果的关系。

方法

这是一项在两所大学进行的横断面研究,对象为接触小型啮齿动物的学生和员工。根据皮肤点刺试验(SPT)的结果,将受试者分为非致敏组、常见致敏组和职业致敏组。所有受试者均回答了一份关于动物接触、症状、过敏性疾病的问卷,并进行了肺量测定和甘露醇支气管激发试验。采用泊松回归进行多变量分析,以估计患病率比(PR)。

结果

对 453 名志愿者的数据进行了分析。非致敏组包括 237 名受试者;常见致敏组包括 142 名受试者;职业致敏组包括 74 名受试者。职业致敏与所有研究结果的风险增加相关。当以常见致敏组为参考时,皮肤症状的患病率比(PR)为 1.36,95%置信区间(CI):1.01-1.85;喘息的 PR 为 1.75,CI 95%:1.21-2.53;鼻炎的 PR 为 1.25,95%:1.11-1.40;夜间呼吸困难的 PR 为 2.40,CI 95%:1.31-4.40;支气管高反应性(BHR)的 PR 为 2.47,CI 95%:1.50-4.09;确诊哮喘的 PR 为 2.65,CI 95%:1.45-4.85。此外,在同一受试者中,哮喘、鼻炎和皮肤症状的重叠在职业致敏组中更为常见,为 16.2%,而在常见致敏组中为 4.9%。

结论和临床相关性

职业致敏与过敏症状和呼吸道疾病有关。职业过敏原的 SPT 与其他参数一起,可能有助于检测与接触实验动物相关的过敏和呼吸道疾病的风险。

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