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热带地区10年间IgE致敏患病率及变应原暴露情况的变化

Changes in Prevalence of IgE Sensitization and Allergenic Exposition over a 10-Year Period in a Tropical Region.

作者信息

Sánchez Jorge, Diez Libia-Susana, Álvarez Leidy, Munera Marlon, Sánchez Andrés

机构信息

Group of Clinical and Experimental Allergy, Hospital "Alma mater de Antioquia", University of Antioquia, Medellín, Colombia.

Group "Ciencias de la vida y la salud, escuela de graduados" University CES, Medellín, Colombia.

出版信息

Int Arch Allergy Immunol. 2025;186(1):12-22. doi: 10.1159/000540646. Epub 2024 Sep 3.

Abstract

INTRODUCTION

Multiple antigen environmental sources have been identified as possible causes of allergies, but few studies have evaluated changes in the sensitization profiles over time. The aim of this study was to evaluate the changes in IgE sensitization and exposure to dust mites, cats, dogs, and cockroaches over a 10-year period.

METHODS

During a period of 10 years among patients with asthma, rhinitis and/or atopic dermatitis, we evaluated the annual frequency of atopy to Dermatophagoides farinae, Dermatophagoides pteronyssinus, Blomia tropicalis, Canis familiaris, Felis domesticus and cockroaches (Periplaneta americana and Blatella germanica). Exposure to sources was also assessed using questionnaires (Pets) or direct counts (House dust mites and cockroaches). The association between some risk factors and the prevalence of atopy was explored.

RESULTS

A total of 6,000 records were included. Among the patients, 82% had IgE sensitization to at least one of the six allergenic sources. Sensitization to Dermatophagoides spp. was the most frequent (>78%). Exposure and sensitization in the first decade of life to Dermatophagoides spp. seem to determine the molecular spreading to other allergenic sources. Exposure to Blomia tropical increases significantly over time (year 2015; 38% vs. year 2022; 51%, p 0.03). Exposure to dogs was higher than with cats but association between atopy and exposure was stronger with cats (OR 27.4, 95% CI: 22.3-33.6, p < 0.01).

CONCLUSION

Exposure and sensitization in the first decade of life to Dermatophagoides spp. determine the molecular spreading of IgE antibodies to other allergenic sources. Household exposure to dogs and cats seems to be important for the subsequent development of atopy. Sensitization to B. tropicalis and cockroach appears to be mostly from cross-reactivity rather than direct exposure.

摘要

引言

多种抗原环境来源已被确定为过敏的可能原因,但很少有研究评估随时间推移致敏谱的变化。本研究的目的是评估10年间IgE致敏情况以及对尘螨、猫、狗和蟑螂的暴露情况的变化。

方法

在10年期间,对哮喘、鼻炎和/或特应性皮炎患者,我们评估了对粉尘螨、户尘螨、热带无爪螨、犬、猫和蟑螂(美洲大蠊和德国小蠊)的特应性年发生率。还通过问卷(宠物)或直接计数(屋尘螨和蟑螂)评估了对这些来源的暴露情况。探讨了一些危险因素与特应性患病率之间的关联。

结果

共纳入6000份记录。在这些患者中,82%对六种变应原来源中的至少一种有IgE致敏。对尘螨属的致敏最为常见(>78%)。生命最初十年对尘螨属的暴露和致敏似乎决定了向其他变应原来源的分子扩散。随着时间的推移,对热带无爪螨的暴露显著增加(2015年为38%,2022年为51%,p<0.03)。对狗的暴露高于对猫的暴露,但特应性与暴露之间的关联在猫中更强(比值比27.4,95%置信区间:22.3 - 33.6,p<0.01)。

结论

生命最初十年对尘螨属的暴露和致敏决定了IgE抗体向其他变应原来源的分子扩散。家庭中对狗和猫的暴露似乎对随后特应性的发展很重要。对热带无爪螨和蟑螂的致敏似乎主要来自交叉反应而非直接暴露。

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