Asmaire Program and Departamento de Investigación, Fundación Neumológica Colombiana, Bogotá, Colombia.
Universidad de La Sabana, Chía, Colombia.
J Asthma. 2024 Mar;61(3):222-231. doi: 10.1080/02770903.2023.2263072. Epub 2024 Feb 8.
There is a lack of information on house dust mite (HDM) sensitization and phenotype distribution in patients with severe asthma (SA) living permanently at high-altitude (HA) in tropical regions, which may be different.
The aim of this study was to characterize adults with SA in a tropical high altitude city (2,640 m): Bogotá, Colombia.
This observational cross-sectional study included severe asthmatic outpatients ( = 129) referred to the ASMAIRE program of the Fundación Neumológica Colombiana in Bogotá (2,640 m). Clinical history, spirometry, total IgE, blood eosinophils, and skin prick test (SPT), including HDM allergens, were performed. Phenotype definitions: Allergic/atopic (AA): IgE ≥100 IU/mL and/or at least one positive SPT; eosinophilic (EOS): blood eosinophils ≥300 cells/µL; type 2-high: AA and/or EOS phenotype; type 2-low: non-AA/non-EOS phenotype (IgE <100 IU/mL, negative SPT, and blood eosinophils <300 cells/µL).
A total of 129 adults with SA were included, 79.8% female. Phenotype distribution: AA: 61.2%; EOS: 37.2%; type 2-high: 72.1%; type 2-low: 27.9%. Among AA patients, HDM sensitization was present in 87% and 34.9% were non-eosinophilic. There was a significant overlap between the phenotypes.
In contrast to non-tropical high-altitude regions, we found a high frequency of HDM sensitization in patients with AA phenotype living in a tropical high-altitude city. We also found a discrete lower frequency of EOS phenotype with no other significant differences in the phenotypic distribution compared to that described at low altitudes. We propose that tropical location may modify the effect of high altitude on HDM concentrations and allergenicity.
在热带高海拔地区（2640 米），永久性居住的严重哮喘（SA）患者中，尘螨（HDM）致敏和表型分布的信息缺乏，可能存在差异。
本研究旨在对热带高海拔城市（2640 米）——哥伦比亚波哥大的 SA 成人患者进行特征描述。
这是一项观察性的横断面研究，纳入了 129 名转诊至哥伦比亚肺科基金会 ASMAIRE 项目的严重哮喘门诊患者（2640 米）。进行了临床病史、肺量测定、总 IgE、血嗜酸性粒细胞和皮肤点刺试验（SPT），包括 HDM 过敏原。表型定义：过敏/特应性（AA）：IgE≥100 IU/mL 和/或至少一项 SPT 阳性；嗜酸性粒细胞（EOS）：血嗜酸性粒细胞≥300 细胞/μL；2 型高：AA 和/或 EOS 表型；2 型低：非 AA/非 EOS 表型（IgE<100 IU/mL，SPT 阴性，血嗜酸性粒细胞<300 细胞/μL）。
共纳入 129 名成人 SA 患者，其中 79.8%为女性。表型分布：AA：61.2%；EOS：37.2%；2 型高：72.1%；2 型低：27.9%。在 AA 患者中，HDM 致敏率为 87%，34.9%为非嗜酸性粒细胞。各表型之间存在显著重叠。
与非热带高海拔地区不同，我们发现生活在热带高海拔城市的 AA 表型患者中，HDM 致敏率较高。与低海拔地区相比，我们还发现 EOS 表型的频率较低，但表型分布无其他显著差异。我们提出，热带位置可能会改变高海拔对 HDM 浓度和变应原性的影响。
