Boston Children's Hospital, Division of Allergy and Immunology, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
Channing Laboratory, Brigham and Women's Hospital, Boston, Massachusetts.
Ann Allergy Asthma Immunol. 2019 Jun;122(6):610-615.e1. doi: 10.1016/j.anai.2019.03.011. Epub 2019 Mar 20.
Home fungus exposures may be associated with development or worsening of asthma. Little is known about the effects of school/classroom fungus exposures on asthma morbidity in students.
To evaluate the association of school-based fungus exposures on asthma symptoms in both fungus-sensitized and nonsensitized students with asthma.
In this prospective study, 280 children with asthma from 37 inner-city schools were phenotypically characterized at baseline and followed-up for 1 year. Fungal spores were collected by using a Burkard air sampler twice during the school year. Clinical outcomes were evaluated throughout the school year and linked to classroom-specific airborne spore sampling. The primary outcome was days with asthma symptoms per 2-week period.
Fungal spores were present in all classroom samples. The geometric mean of the total fungi was 316.9 spores/m and ranged from 15.0 to 59,345.7 spores/m. There was variability in total fungus quantity between schools and classrooms within the same school. Mitospores were the most commonly detected fungal grouping. Investigation of the individual mitospores revealed that exposure to Alternaria was significantly associated with asthma symptom days in students sensitized to Alternaria (OR = 3.61, CI = 1.34-9.76, P = .01), but not in children not sensitized to Alternaria (OR = 1.04, CI = 0.72-1.49, P = .85). Students sensitized to Alternaria and exposed to high levels (≥75th percentile exposure) had 3.2 more symptom days per 2-week period as compared with students sensitized but exposed to lower levels.
Children with asthma who are sensitized to Alternaria and exposed to this fungus in their classroom may have significantly more days with asthma symptoms than those who were sensitized and not exposed.
Clinicaltrials.govNCT01756391.
家庭真菌暴露可能与哮喘的发生或恶化有关。关于学校/教室真菌暴露对学生哮喘发病率的影响，人们知之甚少。
评估学校内真菌暴露对真菌致敏和非致敏哮喘学生哮喘症状的影响。
在这项前瞻性研究中，对来自 37 所城市学校的 280 名哮喘儿童进行了表型特征分析，并进行了为期 1 年的随访。在学年期间，使用 Burkard 空气采样器两次采集真菌孢子。在整个学年中评估临床结果，并将其与课堂特定的空气传播孢子采样相关联。主要结局是每两周哮喘症状天数。
所有教室样本中均存在真菌孢子。总真菌的几何平均值为 316.9 个孢子/m，范围为 15.0 至 59,345.7 个孢子/m。同一所学校内不同教室的总真菌数量存在差异。米孢子是最常见的真菌群。对单个米孢子的调查显示，暴露于交链孢霉与对交链孢霉致敏的学生哮喘症状天数显著相关（OR=3.61，95%CI=1.34-9.76，P=0.01），但与未致敏的儿童无关（OR=1.04，95%CI=0.72-1.49，P=0.85）。对交链孢霉致敏且暴露于高水平（≥第 75 百分位数暴露）的学生与暴露于较低水平但致敏的学生相比，每两周的症状天数多 3.2 天。
对交链孢霉致敏且在教室中暴露于该真菌的哮喘儿童可能比致敏但未暴露的儿童有更多的哮喘症状天数。
Clinicaltrials.govNCT01756391。
