Department of Pediatrics, Section of Allergy and Clinical Immunology, University of Manitoba, Winnipeg, Manitoba, Canada.
Department of Pediatrics, Section of Pediatric Pulmonary and Sleep Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colo.
J Allergy Clin Immunol Pract. 2019 Jul-Aug;7(6):1778-1782. doi: 10.1016/j.jaip.2019.03.004. Epub 2019 Apr 5.
Mouse allergen is endemic in the inner cities of the United States, with research predominantly in the Northeastern United States. A recent practice parameter notes the effect of mouse exposure in asthma in inner cities. However, studies are emerging that find a role of mouse allergen in non-inner cities as well. Mouse sensitization is associated with mouse allergen exposure and has been linked with adverse asthma outcomes including increased asthma symptoms, poorer lung function, and increased risk of exacerbations. There are commercially available extracts for testing for mouse sensitization although they are not standardized. Pest management studies have had varying results, but with decreased allergen exposure, there is a trend toward improved asthma outcomes. Physicians should be aware of the potential for rodent exposure and sensitization and consider screening for mouse allergy in asthmatic children, especially if they are located in the inner city, have poorly controlled asthma, or have a history of mouse infestation in their location. Evidence is emerging that this allergen should be considered in non-inner-city asthmatics as well. Finally, advocacy efforts are necessary to ensure that removal of this allergen is accomplished, when possible, in the environments of asthmatic children sensitized to mouse.
美国内陆城市普遍存在鼠过敏原，相关研究主要集中在美国东北部。最近的实践参数指出了内城环境中鼠暴露对哮喘的影响。然而，也有研究发现，鼠过敏原在内城以外地区也发挥作用。鼠致敏与鼠过敏原暴露有关，并与不良哮喘结局相关，包括哮喘症状加重、肺功能下降和恶化风险增加。有市售的提取液可用于检测鼠致敏，但尚未标准化。害虫管理研究的结果不一，但随着过敏原暴露的减少，哮喘结局改善的趋势明显。医生应意识到接触和致敏的潜在风险，并考虑在哮喘儿童中筛查鼠过敏，尤其是在他们位于内陆城市、哮喘控制不佳或其居住环境中有过鼠类侵扰的情况下。有证据表明，这种过敏原在内城区以外的哮喘患者中也应加以考虑。最后，需要采取宣传措施，确保在可能的情况下，在对鼠过敏的哮喘儿童的环境中清除这种过敏原。
