Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia; Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia.
School of Psychology and Public Health, La Trobe University, Victoria, Australia.
Environ Res. 2019 Nov;178:108675. doi: 10.1016/j.envres.2019.108675. Epub 2019 Aug 19.
Many outdoor fungal spores are ubiquitous, respirable and possibly allergenic. They may contribute to asthma symptoms; however, little is known about their effects on respiratory function.
To investigate if outdoor fungal spore levels were associated with lung function or airway inflammation, and whether fungal sensitization or current asthma modified any associations.
Cross-sectional associations between same day (Lag0) and cumulative 3-day lagged (Lag0-3) counts of 12 outdoor fungal spore taxa and pre-bronchodilator spirometry (FEV, FVC, FEF), bronchodilator response (BDR) and airway inflammation (fractional exhaled nitric oxide (FeNO) and exhaled breath condensate (EBC) nitrogen oxides (NOx) and pH were investigated in 936 Melbourne Atopy Cohort Study participants during September 2009 to December 2011. Generalized linear models were used to quantify associations with lung function, FeNO and EBC pH; generalized estimating equations for BDR; and ordinal logistic regression for EBC NOx. Models were adjusted for age, sex, height, temperature, relative humidity, grass pollen and sample storage time. Potential effect modification by fungal sensitization and current asthma were examined using interaction terms.
Mixed associations were found. Higher levels of Ustilago/smuts were associated with lower lung function at Lag0 (FEV: 21ml [95%CI -36, -7]; FEF 39ml [-65, -13]) and Lag0-3 (FEV: 9ml [-14, -4]; FEF -18ml [-27, -9]). Positive BDR was associated with Ustilago/smuts (Lag0 OR = 1.1 [1.04, 1.2]; Lag0-3 OR = 1.04 [1.02, 1.07]), Alternaria (Lag0 OR = 1.3 [1.0, 1.6]) and Drechslera (Lag0 OR = 1.1 [1.03, 1.2]). Higher EBC NOx was associated with Cladosporium (Lag0-3 OR = 1.1 [1.0, 1.2]), Alternaria (Lag0-3 OR = 1.1 [1.0, 1.3]). No associations were found with higher FeNO. In those with fungal sensitization, Ustilago/smuts and Drechslera were associated with lower FEV and FVC; Cladosporium was associated with increased FEV, FVC and FEF but also with higher FeNO and lower EBC pH. In those with current asthma, Alternaria, Ustilago/smuts and Drechslera were associated with lower FEV, FVC, FEF and EBC pH.
Exposure to outdoor fungal spores may be associated with lower lung function and increased airway inflammation, particularly in those with fungal sensitization and/or current asthma.
许多户外真菌孢子无处不在、可吸入且可能具有致敏性。它们可能导致哮喘症状；然而，人们对它们对呼吸功能的影响知之甚少。
调查户外真菌孢子水平是否与肺功能或气道炎症有关，以及真菌致敏或当前哮喘是否改变了任何关联。
2009 年 9 月至 2011 年 12 月期间，在 936 名墨尔本过敏队列研究参与者中，使用广义线性模型调查了 12 种户外真菌孢子分类群在同一日（Lag0）和累积 3 日滞后（Lag0-3）的计数与预支气管扩张剂肺活量（FEV、FVC、FEF）、支气管扩张剂反应（BDR）和气道炎症（呼出气一氧化氮分数（FeNO）和呼气冷凝液（EBC）氮氧化物（NOx）和 pH）之间的横断面关联。使用广义估计方程对 BDR 进行量化；对 EBC NOx 使用有序逻辑回归。模型经过调整，以适应年龄、性别、身高、温度、相对湿度、草花粉和样本储存时间。使用交互项检查真菌致敏和当前哮喘的潜在效应修饰。
发现混合关联。Ustilago/smuts 水平较高与 Lag0 时的肺功能较低相关（FEV：21ml [95%CI -36，-7]；FEF 39ml [-65，-13]）和 Lag0-3 时的肺功能较低相关（FEV：9ml [-14，-4]；FEF -18ml [-27，-9]）。BDR 呈阳性与 Ustilago/smuts（Lag0 OR=1.1 [1.04，1.2]；Lag0-3 OR=1.04 [1.02，1.07]）、Alternaria（Lag0 OR=1.3 [1.0，1.6]）和 Drechslera（Lag0 OR=1.1 [1.03，1.2]）有关。较高的 EBC NOx 与 Cladosporium（Lag0-3 OR=1.1 [1.0，1.2]）、Alternaria（Lag0-3 OR=1.1 [1.0，1.3]）有关。与较高的 FeNO 无关联。在有真菌致敏的人群中，Ustilago/smuts 和 Drechslera 与较低的 FEV 和 FVC 有关；Cladosporium 与 FEV、FVC 和 FEF 增加有关，但也与较高的 FeNO 和较低的 EBC pH 有关。在当前患有哮喘的人群中，Alternaria、Ustilago/smuts 和 Drechslera 与较低的 FEV、FVC、FEF 和 EBC pH 有关。
暴露于户外真菌孢子可能与肺功能下降和气道炎症增加有关，特别是在有真菌致敏和/或当前哮喘的人群中。
