Hasunuma Hideki, Yoda Yoshiko, Tokuda Narumi, Taniguchi Naoko, Takeshima Yasuhiro, Shima Masayuki
Department of Public Health Hyogo College of Medicine Nishinomiya Japan.
Hyogo Regional Centre for the Japan Environment and Children's Study Nishinomiya Japan.
Clin Transl Allergy. 2021 Oct 13;11(8):e12071. doi: 10.1002/clt2.12071. eCollection 2021 Oct.
The effects of early-life exposure to house dust mite allergen and endotoxin on the development of asthma are unclear in the literature. We investigated the association of early-life exposure (0-36 months old) to house dust mite allergen and endotoxin with asthma incidence.
In this novel, large-scale, nationwide birth cohort study, 5017 participants were randomly selected from those who met the eligibility criteria. House dust was vacuum-sampled from the children's mattresses within homes and assayed for the presence of dust mite allergen (Der 1) and endotoxin. The participants were classified into four quartiles (Q1-Q4) according to exposure levels. We defined the incidence of asthma and wheezing using questionnaires at 12, 24, and 36 months old. Odds ratios (ORs) of the incidence of asthma and wheezing by age in Der 1 and endotoxin exposure level were estimated using logistic regression.
The cumulative incidence rates of asthma and wheezing during 0-36 months were 10.4% and 38.1%, respectively. Significant ORs were observed in asthma onset during 12-24 months old, asthma onset during 24-36 months old, and wheezing onset during 0-12 months old in the Q4 Der 1 group. In the Q4 endotoxin group, significant positive associations between endotoxin exposure and asthma (OR 2.00, 95% confidence interval [CI]: 1.03-3.85) and wheezing (OR 1.78, 95% CI: 1.01-3.12) onset during 24-36 months old were found.
Our results indicated that high levels of early-life exposure to Der 1 and endotoxin in mattresses may be involved in the development of asthma.
早年暴露于屋尘螨过敏原和内毒素对哮喘发生发展的影响在文献中尚不清楚。我们调查了早年（0至36个月大）暴露于屋尘螨过敏原和内毒素与哮喘发病率之间的关联。
在这项新颖的、大规模的全国性出生队列研究中，从符合入选标准的人群中随机选取了5017名参与者。在家中从儿童床垫上用真空法采集屋尘，检测其中尘螨过敏原（Der 1）和内毒素的存在情况。参与者根据暴露水平被分为四个四分位数组（Q1 - Q4）。我们通过12、24和36个月大时的问卷来定义哮喘和喘息的发病率。使用逻辑回归估计Der 1和内毒素暴露水平下按年龄划分的哮喘和喘息发病率的比值比（OR）。
0至36个月期间哮喘和喘息的累积发病率分别为10.4%和38.1%。在Q4 Der 1组中，观察到12至24个月大时哮喘发病、24至36个月大时哮喘发病以及0至12个月大时喘息发病的显著OR。在Q4内毒素组中，发现24至36个月大时内毒素暴露与哮喘发病（OR 2.00，95%置信区间[CI]：1.03 - 3.85）和喘息发病（OR 1.78，95% CI：1.01 - 3.12）之间存在显著正相关。
我们的结果表明，早年床垫中高水平的Der 1和内毒素暴露可能与哮喘的发生发展有关。
