Smith J M, Cadoret R J, Burns T L, Troughton E P
Department of Internal Medicine, University of Iowa Hospitals & Clinics, Iowa City 52242-1081, USA.
Ann Allergy Asthma Immunol. 1998 Aug;81(2):135-9. doi: 10.1016/S1081-1206(10)62799-8.
Since the highest risk for the development of atopic disease is in early life, environmental risk factors need to be separated from the genetic component in this high risk period. Adoptees removed at birth and placed in adoptive families present a way to separate environmental and genetic factors at this early susceptible age.
An opportunity for a pilot study of asthma and allergic rhinitis in adoptive families was presented when a psychiatrist (RC) was planning a behavioral study of young adult adoptees and their adoptive parents. A detailed questionnaire about allergic rhinitis and asthma was added after the psychiatrists' interview. Placement was not influenced by a history of allergy in adoptive or natural parents. The adoptee and at least one adoptive parent completed questionnaires in 367 families. The adoptees had been removed at birth and placed in the adoptive family within 3 months (83% within 1 month).
Compared with adoptive families without asthma or allergic rhinitis, an adoptive mother with asthma or rhinitis, when the adoptive father was not affected, increased the risk for asthma in the adoptee (OR = 3.2, P < .0005). Asthma in the adoptive mother alone (OR = 3.2, P < .005) and allergic rhinitis alone (OR = 3.4, P < .005) increased the risk for asthma in the adoptee. Adoptive father asthma or allergic rhinitis showed a trend toward increased asthma in the adoptee (OR = 1.9, P < .1).
This should be considered a pilot or feasibility study since subjects could not be examined or tested. Finding a risk for atopic respiratory disease or asthma associated with adoption by parents with asthma or allergic rhinitis suggests that further well planned adoptee studies should be made.
由于特应性疾病发病的最高风险期在生命早期，因此需要在这一高风险时期将环境风险因素与遗传因素区分开来。出生时即被领养并安置在领养家庭中的儿童提供了一种在这个早期易感阶段区分环境因素和遗传因素的方法。
一位精神科医生（RC）计划对年轻成年领养者及其领养父母进行行为研究时，出现了对领养家庭中的哮喘和过敏性鼻炎进行试点研究的机会。在精神科医生的访谈之后，增加了一份关于过敏性鼻炎和哮喘的详细问卷。安置情况不受领养父母或亲生父母过敏史的影响。367个家庭中的领养者和至少一位领养父母完成了问卷。领养者出生时即被带走，并在3个月内安置在领养家庭中（83%在1个月内）。
与没有哮喘或过敏性鼻炎的领养家庭相比，当领养父亲未受影响时，领养母亲患有哮喘或鼻炎会增加领养者患哮喘的风险（比值比=3.2，P<.0005）。仅领养母亲患有哮喘（比值比=3.2，P<.005）和仅患有过敏性鼻炎（比值比=3.4，P<.005）都会增加领养者患哮喘的风险。领养父亲患有哮喘或过敏性鼻炎显示出领养者患哮喘风险增加的趋势（比值比=1.9，P<.1）。
由于无法对受试者进行检查或测试，因此应将此视为一项试点或可行性研究。发现患有哮喘或过敏性鼻炎的父母领养的孩子患特应性呼吸道疾病或哮喘存在风险，这表明应该进一步开展精心规划的领养者研究。
