Pediatric Pulmonology Section, Fundación Neumológica Colombiana, Bogotá, Colombia.
Research Department, Fundación Neumológica Colombiana, Bogotá, Colombia.
Pediatr Pulmonol. 2018 Oct;53(10):1356-1361. doi: 10.1002/ppul.24079. Epub 2018 Jun 25.
Some studies, mainly in Europe, have shown a low level of sensitization to house dust mite (HDM) allergens at high altitude (HA). Differently, some others in tropical countries have shown a higher level. The aim of this study was to evaluate allergens sensitization, including HDM, in children with severe asthma (SA), residents at HA in a tropical middle-income developing country.
Observational, analytical, cross-sectional study in children aged 6-15 years old with SA at HA (2640 m). Skin prick tests (SPT), serum IgE, exhaled fraction of nitric oxide (FE ), spirometry, and asthma questionnaire (ACT) were performed. Associations were explored by Pearson or Spearman coefficients.
We included 61 children. Most patients were male (61.3%), median age: 10 years (Interquartile range [IQR]: 8-12), median BMI: 17 kg/m (IQR: 16-20); Median of positive SPT: 2 (IQR: 2-3). At least one SPT was positive in 88.7% of patients and 87.9% were positive for at least one HDM. Serum IgE: 348 UI/mL (IQR: 154-760) and FE : 22 ppb (IQR: 9-41). Prebronchodilator values were (% predicted): FVC: 109.7% (±15.5%), FEV : 98.4% (±16.3); FEV /FVC: 82% (±8%). SPT were inversely correlated with the FEV /FVC (Rho: -0.34; 95% CI: -0.55 a -0.09; P = 0.008).
These children with SA living at HA in a tropical middle-income developing country have a high prevalence of HDM sensitization. One explanation for this might be that tropical conditions, such as temperature and humidity, could modify the effect of the altitude on asthma.
一些主要在欧洲进行的研究表明，在高海拔地区（HA），人们对屋尘螨（HDM）过敏原的敏感性较低。然而，一些在热带国家进行的研究则表明，敏感性水平较高。本研究旨在评估生活在热带中低收入发展中国家高海拔地区的严重哮喘（SA）儿童对过敏原的敏感性，包括 HDM。
对居住在海拔 2640 米高的热带中低收入发展中国家 HA 的 6-15 岁严重哮喘儿童进行观察性、分析性、横断面研究。进行皮肤点刺试验（SPT）、血清 IgE、呼出气一氧化氮分数（FE ）、肺量测定和哮喘问卷（ACT）。通过 Pearson 或 Spearman 系数探索相关性。
共纳入 61 名儿童。大多数患者为男性（61.3%），中位年龄为 10 岁（IQR：8-12），中位 BMI 为 17kg/m （IQR：16-20）；中位 SPT 阳性：2 （IQR：2-3）。88.7%的患者至少有一种 SPT 阳性，87.9%的患者至少有一种 HDM 阳性。血清 IgE：348UI/mL（IQR：154-760），FE ：22ppb（IQR：9-41）。未使用支气管扩张剂时，FVC：109.7%（±15.5%），FE ：98.4%（±16.3%）；FE /FVC：82%（±8%）。SPT 与 FEV /FVC 呈负相关（Rho：-0.34；95%CI：-0.55 a -0.09；P=0.008）。
生活在热带中低收入发展中国家高海拔地区的严重哮喘儿童对 HDM 过敏的发生率较高。造成这种情况的一个解释可能是热带条件，如温度和湿度，可能会改变海拔对哮喘的影响。
