Faculty of Health Sciences, University of Macau, Macau, China.
Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center of Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangdong, China.
Ann Med. 2022 Dec;54(1):2929-2940. doi: 10.1080/07853890.2022.2134584.
The relationship between childhood blood eosinophils and subtypes of allergic diseases remains understudied. This study aimed to examine the associations between childhood blood eosinophils and subtypes of asthma, rhinitis and dermatitis, as well as the modifying effect of age.
We obtained concurrent blood cell counts and serum Immunoglobulin E (IgE) test results in 5026 children (0-13, years) from First Affiliated Hospital of Guangzhou Medical University from 2014 to 2019. Generalized additive models with multivariable adjustments were utilized to model the exposure-response relationship between eosinophils and allergic symptoms. The robustness of the association was assessed in two age categories (<6, 6-13 years).
The association of eosinophils with allergic asthma/rhinitis was positively nonlinear, with a plateau at levels of Q (≥0.51, 10/L). Conversely, exposure-response curves between eosinophils and the risk of non-allergic asthma and rhinitis were negatively linear, and especially, became statistically significant when levels of eosinophils were larger than Q (≥0.30, 10/L). Compared with their counterparts, school-aged children (6-13, years) with a higher level of blood eosinophils (≥0.35, 10/L) were more likely to suffer from allergic asthma [relative excess risk due to interaction (RERI), 2.51; 95% CI, 1.24-3.78], allergic rhinitis (RERI, 2.79; 95% CI, 1.14-4.45) but not allergic dermatitis (RERI not significant).
Higher eosinophil counts were associated with the increased risk of allergic subtype symptoms and the decreased risk of non-allergic subtypes in children. Moreover, the associations between eosinophils and allergic asthma/rhinitis were accentuated in the school-aged child. These findings may contribute to providing novel insights for clinical administration relevance of allergic-related symptoms.Key messages:There was a positively nonlinear association between childhood eosinophils and allergic asthma/rhinitis.Age modified the associations between eosinophils and allergy-related outcomes. The associations of eosinophil with allergic asthma/rhinitis accentuated in the school-aged child (6-13, years).
儿童血液嗜酸性粒细胞与过敏疾病亚型之间的关系仍研究不足。本研究旨在探讨儿童血液嗜酸性粒细胞与哮喘、鼻炎和皮炎亚型之间的关系，以及年龄的修饰作用。
我们从 2014 年至 2019 年，从广州医科大学第一附属医院获得了 5026 名（0-13 岁）儿童的同期血细胞计数和血清免疫球蛋白 E（IgE）检测结果。利用多变量调整的广义加性模型，对嗜酸性粒细胞与过敏症状之间的暴露-反应关系进行建模。在<6 岁和 6-13 岁两个年龄组评估了关联的稳健性。
嗜酸性粒细胞与过敏哮喘/鼻炎的关联呈正非线性，在 Q（≥0.51，10/L）水平呈平台状。相反，嗜酸性粒细胞与非过敏性哮喘和鼻炎风险之间的暴露-反应曲线呈负线性，特别是当嗜酸性粒细胞水平大于 Q（≥0.30，10/L）时，具有统计学意义。与对照组相比，年龄较大的儿童（6-13 岁）血液嗜酸性粒细胞水平较高（≥0.35，10/L），更易患过敏性哮喘[交互相对超额风险（RERI），2.51；95%置信区间，1.24-3.78]、过敏性鼻炎（RERI，2.79；95%置信区间，1.14-4.45），但过敏性皮炎的 RERI 不显著。
较高的嗜酸性粒细胞计数与儿童过敏亚型症状的风险增加和非过敏亚型的风险降低有关。此外，嗜酸性粒细胞与过敏性哮喘/鼻炎之间的关联在学龄儿童中更为明显。这些发现可能有助于为过敏相关症状的临床管理相关性提供新的见解。
儿童嗜酸性粒细胞与过敏性哮喘/鼻炎之间存在正非线性关系。年龄改变了嗜酸性粒细胞与过敏相关结局之间的关系。嗜酸性粒细胞与过敏性哮喘/鼻炎的关联在学龄儿童（6-13 岁）中更为明显。
