The Allergy & Asthma Institute, Islamabad, Pakistan.
National University of Science and Technology, Islamabad, Pakistan.
J Glob Health. 2023 Sep 1;13:04091. doi: 10.7189/jogh.13.04091.
Although the role of airborne plant pollen in causing allergic rhinitis has been established, the association of concentrations of paper mulberry (Broussenetia papyrifera) pollens in the air and incidence of asthma exacerbations has not, despite an observed increase in the number of asthma patients attending physician clinics and hospital Accident and Emergency (A&E) Departments during the paper mulberry pollen season. We aimed to assess the association between paper mulberry pollen concentrations (typically peaking in March each year) and asthma exacerbations in the city of Islamabad.
We used three approaches to investigate the correlation of paper mulberry pollen concentration with asthma exacerbations: A retrospective analysis of historical records (2000-2019) of asthma exacerbations of patients from the Allergy and Asthma Institute, Pakistan (n = 284), an analysis of daily nebulisations in patients attending the A&E Department of the Pakistan Institute of Medical Sciences (March 2020 to July 2021), a prospective peak expiratory flow rate (PEFR) diary from participants (n = 40) with or without asthma and with or without paper mulberry sensitisation. We examined associations between pollen data and asthma exacerbations using Pearson correlation.
We found a strong positive correlation between mean paper mulberry pollen counts and clinical records of asthma exacerbations in patients sensitised to paper mulberry (Pearson correlation coefficient (r) = 0.86; P < 0.001), but not in non-sensitised patients (r = 0.32; P = 0.3). There was a moderate positive correlation between monthly nebulisation counts and pollen counts (r = 0.56; P = 0.03), and a strong negative correlation between percent predicted PEFR and pollen counts in sensitised asthma patients (r = -0.72, P < 0.001). However, these correlations were of low magnitude in the non-sensitised asthma (r = -0.16; P < 0.001) and sensitised non-asthma (r = -0.28; P < 0.001) groups.
Our three approaches to analysis all showed an association between high paper mulberry pollen concentration in Islamabad and asthma exacerbations. Predicting pollen peaks could enable alerts and mobilise strategies to proactively manage these peaks of asthma exacerbations.
虽然空气中植物花粉在引发过敏性鼻炎方面的作用已得到证实，但纸桑花粉在空气中的浓度与哮喘恶化之间的关联尚未得到证实，尽管在纸桑花粉季节，到医生诊所和医院急症室就诊的哮喘患者数量有所增加。我们旨在评估巴基斯坦伊斯兰堡市的纸桑花粉浓度（通常每年 3 月达到峰值）与哮喘恶化之间的关联。
我们使用三种方法来研究纸桑花粉浓度与哮喘恶化之间的相关性：对来自巴基斯坦过敏与哮喘研究所的哮喘恶化患者的历史记录（2000-2019 年）进行回顾性分析（n=284），对巴基斯坦医学科学院急症室就诊患者的每日雾化治疗进行分析（2020 年 3 月至 2021 年 7 月），对有或没有哮喘且对纸桑花粉有或没有致敏的 40 名参与者进行前瞻性最大呼气流量率（PEFR）日记记录。我们使用 Pearson 相关性分析来检查花粉数据与哮喘恶化之间的关联。
我们发现，对纸桑花粉过敏的患者的平均纸桑花粉计数与哮喘恶化的临床记录之间存在强烈的正相关（Pearson 相关系数（r）=0.86；P<0.001），但在非致敏患者中没有发现这种相关性（r=0.32；P=0.3）。每月雾化计数与花粉计数之间存在中度正相关（r=0.56；P=0.03），而致敏哮喘患者的预计 PEFR 百分比与花粉计数之间存在强烈的负相关（r=-0.72，P<0.001）。然而，在非致敏哮喘患者（r=-0.16；P<0.001）和致敏非哮喘患者（r=-0.28；P<0.001）中，这些相关性的幅度较低。
我们的三种分析方法都表明，在伊斯兰堡，高浓度的纸桑花粉与哮喘恶化之间存在关联。预测花粉高峰期可以发出警报，并调动策略主动管理这些哮喘恶化高峰期。
