Frederick J M, Warner J O, Jessop W J, Enander I, Warner J A
Child Health, University of Southampton, UK.
Eur Respir J. 1997 Feb;10(2):361-6. doi: 10.1183/09031936.97.10020361.
Allergen avoidance is regarded as an important approach to management of atopic asthma. The effect of Intervent bed covering systems on house dust mite (HDM) allergen exposure, asthma symptoms and markers of inflammation was investigated in 31 HDM sensitive asthmatic children. Dust concentrations of Dermatophagoides pteronyssinus allergen 1 (Der p 1) were monitored before and after covering the mattress, duvet and pillow with active and placebo covers for 3 months, in a single-blind, cross-over trial. Twice daily peak expiratory flow rate (PEFR), daily symptom scores and treatment schedule were recorded. Bronchial hyperresponsiveness was monitored by histamine challenge (provocative concentration of histamine causing a 20% fall in forced expiratory volume in one second (PC20)), and inflammation by measuring eosinophil cationic protein (ECP), eosinophil protein X (EPX), eosinophil peroxidase (EPO), and soluble interleukin-2 receptor (sIL-2R) in serum. There was a significant reduction in Der p 1 when the mattress, duvet and pillow were covered with the active bedding. There was no significant improvement in symptoms of asthma, PEFR, bronchodilator usage of PC20. Also, ECP, EPX, sIL-2R concentrations did not change for either treatment. EPO concentrations were significantly lower in the active compared to the placebo period. The active bed covers reduced retrievable Dermatophagoides pteronyssinus allergen 1 (Der p 1) from the bedding, with short term clinical benefit.
避免接触过敏原被视为治疗过敏性哮喘的重要方法。在31名对屋尘螨(HDM)敏感的哮喘儿童中,研究了干预性床罩系统对屋尘螨过敏原暴露、哮喘症状及炎症标志物的影响。在一项单盲交叉试验中,用活性床罩和安慰剂床罩分别覆盖床垫、羽绒被和枕头3个月,监测覆盖前后粉尘中粉尘螨过敏原1(Der p 1)的浓度。记录每日两次的呼气峰值流速(PEFR)、每日症状评分及治疗方案。通过组胺激发试验(使一秒用力呼气容积下降20%的组胺激发浓度(PC20))监测支气管高反应性,通过检测血清中的嗜酸性粒细胞阳离子蛋白(ECP)、嗜酸性粒细胞蛋白X(EPX)、嗜酸性粒细胞过氧化物酶(EPO)和可溶性白细胞介素-2受体(sIL-2R)监测炎症。当用活性床罩覆盖床垫、羽绒被和枕头时,Der p 1显著降低。哮喘症状、PEFR、PC20的支气管扩张剂使用情况均无显著改善。此外,两种治疗方法的ECP、EPX、sIL-2R浓度均未改变。与安慰剂期相比,活性期的EPO浓度显著降低。活性床罩可减少床垫中可检测到的粉尘螨过敏原1(Der p 1),具有短期临床益处。