葡萄球菌肠毒素致敏与哮喘严重程度：EGEA 队列的纵向研究。

Sensitisation to staphylococcal enterotoxins and asthma severity: a longitudinal study in the EGEA cohort.

机构信息

Upper Airways Research Laboratory, Ghent University, Ghent, Belgium.

Both authors contributed equally.

出版信息

Eur Respir J. 2019 Sep 12;54(3). doi: 10.1183/13993003.00198-2019. Print 2019 Sep.

DOI:10.1183/13993003.00198-2019

PMID:31285304

Abstract

INTRODUCTION

Evidence is accumulating that plays an important role as disease modifier in upper and lower airway diseases. Sensitisation to enterotoxins (SEs) was associated with an increased risk of severe asthma in previous cross-sectional studies, but evidence from longitudinal studies is lacking. We aimed to assess associations between SE-sensitisation and the subsequent risk for asthma severity and exacerbations.

METHODS

This is a nested case-control study from the 20-year Epidemiological Study of the Genetics and Environment of Asthma (EGEA) cohort, including 225 adults (75 without asthma, 76 with mild asthma and 74 with severe asthma) in EGEA2 (2003-2007). For 173 of these individuals, SE-sensitisation was measured on samples collected 11 years earlier (EGEA1). Cross-sectional associations were conducted for EGEA1 and EGEA2. Longitudinal analyses estimated the association between SE-sensitisation in EGEA1 and the risk of severe asthma and asthma exacerbations assessed in the follow-up. Models were adjusted for sex, age, smoking, parental asthma/allergy and skin-prick test to house dust mite.

RESULTS

SE-sensitisation varied between 39% in controls to 58% and 76% in mild and severe asthma, respectively, in EGEA1. An adjusted cross-sectional association showed that SE-sensitisation was associated with an increased risk of severe, but not for mild asthma. SE-sensitisation in EGEA1 was associated with severe asthma (adjusted OR 2.69, 95% CI 1.18-6.15) and asthma exacerbations (adjusted OR 4.59, 95% CI 1.40-15.07) assessed 10-20 years later.

CONCLUSION

For the first time, this study shows that being sensitised to SEs is associated with an increased subsequent risk of severe asthma and asthma exacerbations.

摘要

简介

越来越多的证据表明，在上下呼吸道疾病中，发挥着重要的疾病修饰作用。在以前的横断面研究中，对肠毒素（SEs）的致敏与严重哮喘的风险增加有关，但缺乏来自纵向研究的证据。我们旨在评估 SE 致敏与随后哮喘严重程度和加重的风险之间的关系。

方法

这是一项来自 20 年遗传与环境对哮喘影响的流行病学研究（EGEA）队列的嵌套病例对照研究，包括 EGEA2（2003-2007 年）中的 225 名成年人（75 名无哮喘、76 名轻度哮喘和 74 名重度哮喘）。其中 173 名个体在 11 年前（EGEA1）采集的样本中测量了 SE 致敏情况。对 EGEA1 和 EGEA2 进行了横断面关联分析。纵向分析估计了 EGEA1 中 SE 致敏与随后严重哮喘和哮喘加重风险之间的关联，这些风险在随访中进行评估。模型调整了性别、年龄、吸烟、父母哮喘/过敏和皮肤点刺试验以屋尘螨。

结果

EGEA1 中 SE 致敏率在对照组为 39%，轻度和重度哮喘组分别为 58%和 76%。调整后的横断面关联表明，SE 致敏与重度哮喘的风险增加相关，但与轻度哮喘无关。EGEA1 中的 SE 致敏与重度哮喘（调整后的 OR 2.69，95%CI 1.18-6.15）和哮喘加重（调整后的 OR 4.59，95%CI 1.40-15.07）有关，这些加重在 10-20 年后进行评估。