Beheshti Ramin, Phipatanakul Wanda, DiMango Emily, Grant Torie L
Division of Pediatric Allergy, Immunology, and Rheumatology, Johns Hopkins University School of Medicine, Baltimore, Md.
Division of Allergy and Immunology, Boston Children's Hospital, Harvard Medical School, Boston, Mass.
J Allergy Clin Immunol Pract. 2025 Jun;13(6):1256-1265. doi: 10.1016/j.jaip.2025.04.027. Epub 2025 Apr 25.
Asthma remains a prevalent and burdensome chronic disease in the United States, disproportionately affecting low-income populations and placing a significant strain on the health care system. Environmental allergen exposure, particularly in urban areas, has been extensively linked to asthma development and exacerbations. Identifying effective strategies for reducing allergen exposure could help mitigate asthma morbidity, decrease health care utilization, and improve patients' quality of life. Studies evaluating environmental interventions, including home- and school-based allergen reduction strategies, have reported mixed results. Although some interventions, such as targeted allergen reduction, pest management, and air filtration, demonstrate improvements in asthma symptoms and health care utilization, others show limited impact on long-term asthma control and controller medication use. In this review, we assess the impact of environmental allergens on asthma prevalence, morbidity, and health care burden in the United States. We also examine the effectiveness of various allergen-reduction strategies in achieving sustained clinical benefits for asthma management and make practical recommendations for patient care.
在美国,哮喘仍然是一种普遍且负担沉重的慢性疾病,对低收入人群的影响尤为严重,并给医疗保健系统带来了巨大压力。环境过敏原暴露,尤其是在城市地区,已被广泛认为与哮喘的发生和加重有关。确定减少过敏原暴露的有效策略有助于减轻哮喘发病率,降低医疗保健利用率,并改善患者的生活质量。评估环境干预措施(包括基于家庭和学校的过敏原减少策略)的研究结果不一。尽管一些干预措施,如针对性的过敏原减少、害虫管理和空气过滤,显示出哮喘症状和医疗保健利用率有所改善,但其他措施对长期哮喘控制和控制药物使用的影响有限。在本综述中,我们评估了环境过敏原对美国哮喘患病率、发病率和医疗保健负担的影响。我们还研究了各种过敏原减少策略在实现哮喘管理持续临床益处方面的有效性,并为患者护理提出实用建议。