与沙特阿拉伯西南部阿西尔地区成人哮喘相关的免疫学因素。
Immunological Factors Associated with Adult Asthma in the Aseer Region, Southwestern Saudi Arabia.
机构信息
Department of Internal Medicine, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia.
Department of Internal Medicine, College of Medicine, King Abdul Aziz University, Jeddah 21589, Saudi Arabia.
出版信息
Int J Environ Res Public Health. 2019 Jul 12;16(14):2495. doi: 10.3390/ijerph16142495.
BACKGROUND
The prevalence of asthma is on the rise in Saudi Arabia. Data regarding the immunological profile of asthma in adults in the Aseer region, in southwestern Saudi Arabia, have not been well studied.
OBJECTIVES
Our aim was to study the immunological factors associated with sensitization to asthma among adults in the Aseer region.
METHODS
A cross-sectional study with a nested case control design in a 1:1 ratio was conducted on a sample of adults attending primary health care centers in the Aseer region. The study used a validated Arabic version of the International study of asthma and allergies in childhood (ISAAC) questionnaire. The presence of wheezing in the past 12 months was used as a proxy for bronchial asthma. Matched age and sex controls were selected. Both groups were tested for complete blood count (CBC), total and differential white blood cell (WBC) count including eosinophils, total immunoglobulin E (IgE) measurement, allergen-specific immunoglobulin E (IgE), and cytokine levels.
RESULTS
The present study included 110 cases and 157 age- and sex-matched controls. Rye wheat was found to be a significant outdoor sensitizing agent ((odds ratio) OR = 5.23, 95% CI: 1.06-25.69). Indoors, house dust mites (OR = 2.04, 95% CI: 1.04-3.99) and (OR = 2.50, 95% CI: 1.09-5.75) were significant. Higher total IgE (OR = 1.84, 95% CI: 1.10-3.06) and eosinophil levels (OR = 2.85, 95% CI: 1.14-7.15) were significantly associated with adult bronchial asthma in Aseer. On the other hand, the role of cytokines was not significant.
CONCLUSIONS
In the present study, certain environmental agents were found to be important with regards to sensitization to bronchial asthma in adults. Knowledge about these sensitization agents should be disseminated to health providers and treating physicians in order to enhance preventive environmental control measures and asthma management. Asthma-treating physicians in the region should be alerted to the use of targeted biological therapies in selected asthmatics with difficult-to-control courses.
背景
沙特阿拉伯的哮喘患病率呈上升趋势。关于沙特阿拉伯西南部阿西尔地区成年人哮喘的免疫学特征的数据尚未得到充分研究。
目的
我们的目的是研究与阿西尔地区成年人哮喘致敏相关的免疫学因素。
方法
采用病例对照嵌套设计的横断面研究，对阿西尔地区初级保健中心的成年人进行抽样调查。研究使用了经过验证的阿拉伯语版国际儿童哮喘和过敏研究（ISAAC）问卷。过去 12 个月内出现喘息被用作支气管哮喘的替代指标。选择年龄和性别匹配的对照。两组均进行全血细胞计数（CBC）、总白细胞计数和白细胞分类计数（包括嗜酸性粒细胞）、总免疫球蛋白 E（IgE）测量、过敏原特异性 IgE（IgE）和细胞因子水平检测。
结果
本研究共纳入 110 例病例和 157 例年龄和性别匹配的对照。黑麦小麦被发现是一种重要的室外致敏剂（（比值比）OR=5.23，95%可信区间：1.06-25.69）。室内，尘螨（OR=2.04，95%可信区间：1.04-3.99）和（OR=2.50，95%可信区间：1.09-5.75）是显著的。较高的总 IgE（OR=1.84，95%可信区间：1.10-3.06）和嗜酸性粒细胞水平（OR=2.85，95%可信区间：1.14-7.15）与阿西尔地区成年人支气管哮喘显著相关。另一方面，细胞因子的作用并不显著。
结论
在本研究中，某些环境因素被发现与成年人对支气管哮喘的致敏有关。应该向卫生保健提供者和治疗医生传播有关这些致敏剂的知识，以加强预防环境控制措施和哮喘管理。该地区的哮喘治疗医生应注意在治疗难以控制的哮喘患者时使用有针对性的生物疗法。
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