Eggleston P A, Rosenstreich D, Lynn H, Gergen P, Baker D, Kattan M, Mortimer K M, Mitchell H, Ownby D, Slavin R, Malveaux F
Department of Pediatrics, Johns Hopkins University, Baltimore, MD 21287, USA.
J Allergy Clin Immunol. 1998 Oct;102(4 Pt 1):563-70. doi: 10.1016/s0091-6749(98)70272-6.
It is important to understand the relationship between environmental allergen exposure dose and the risk of atopic individuals becoming sensitized to that allergen if we are to change the risk of sensitization and morbidity from allergic disease.
The objective of these studies was to determine whether there was a dose response between current exposure to mite, cockroach, and cat allergen in inner-city children and to determine the prevalence of sensitization to these allergens.
A sample of 500 children was selected from the 1528 children enrolled in the National Cooperative Inner City Asthma Study. Children were selected who had a sample of home dust and valid skin test responses performed with a MultiTest skin test device. The samples of home dust were collected from the floor and furniture in the kitchen, bedroom, and television/living room and were assayed for Der p 1, Der f 1, Bla g 1, and Fel d 1 allergens.
Each allergen level correlated significantly between rooms in individual homes. Mite (Der p 1 and Der f 1) and cat (Fel d 1) allergen levels were frequently below the detection limit of the assay. Cockroach allergen (Bla g 1) concentrations in the child's bedroom were related to the prevalence of positive skin test responses to cockroach allergen extract among the children, with an odds ratio for sensitization of 1.45 (1.11-1.92). Positive skin test responses to cockroach allergen were seen in 15% of children exposed to bedroom dust with a Bla g 1 concentration below the level of detection compared with a rate of 32% in bedrooms with Bla g 1 levels of 1 to 2 U/g and 40% to 44% among those in rooms with 4 U/g or greater. The relationship between exposure and positive skin test responses was clearly stronger among atopic children with a greater number of positive skin test responses.
Despite widespread exposure to household allergens, the strongest relationship between exposure and sensitization was seen in the bedroom. The dose response between exposure to cockroach allergen and sensitization suggested that exposure to low doses of allergen, 2 U/g or less, was a risk factor and that the risk plateaus above 4 U/g. Atopy modified the relationship of exposure to sensitization.
如果我们想要改变过敏性疾病致敏和发病的风险，了解环境过敏原暴露剂量与特应性个体对该过敏原致敏风险之间的关系就很重要。
这些研究的目的是确定市中心儿童当前接触螨虫、蟑螂和猫过敏原之间是否存在剂量反应关系，并确定对这些过敏原致敏的患病率。
从参加全国城市内哮喘合作研究的1528名儿童中选取500名儿童作为样本。选取的儿童有家庭灰尘样本，并使用MultiTest皮肤测试装置进行了有效的皮肤测试反应。家庭灰尘样本从厨房、卧室和电视/客厅的地板和家具上收集，并检测其中的Der p 1、Der f 1、Bla g 1和Fel d 1过敏原。
各个家庭中不同房间的每种过敏原水平之间均存在显著相关性。螨虫（Der p 1和Der f 1）和猫（Fel d 1）过敏原水平经常低于检测限。儿童卧室中的蟑螂过敏原（Bla g 1）浓度与儿童对蟑螂过敏原提取物皮肤测试阳性反应的患病率相关，致敏比值比为1.45（1.11 - 1.92）。在卧室灰尘中Bla g 1浓度低于检测水平的儿童中，15%对蟑螂过敏原皮肤测试呈阳性反应；而在Bla g 1水平为1至2 U/g的卧室中，这一比例为32%；在Bla g 1水平为4 U/g或更高的房间中，这一比例为40%至44%。在皮肤测试阳性反应较多的特应性儿童中，暴露与皮肤测试阳性反应之间的关系明显更强。
尽管普遍接触家庭过敏原，但暴露与致敏之间最强的关系出现在卧室。接触蟑螂过敏原与致敏之间的剂量反应表明，接触低剂量（2 U/g或更低）过敏原是一个风险因素，而在4 U/g以上风险趋于平稳。特应性改变了暴露与致敏之间的关系。
