Comparative degree and type of sensitization to common indoor and outdoor allergens in subjects with allergic rhinitis and/or asthma
Comparative degree and type of sensitization to common indoor and outdoor allergens in subjects with allergic rhinitis and/or asthma
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DOI：
10.1111/j.1365-2222.1997.tb00672.x
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发表时间：
1997-01-01
影响因子：
6.1
通讯作者：
Hebert, J
中科院分区：
文献类型：
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作者：
Boulet, LP;Turcotte, H;Hebert, J
背景和目的特应性临床表现变异性的决定因素仍有待研究。本研究的目的是通过观察不同年龄和性别对这些过敏原的流行程度和致敏程度，确定临床诊断为有症状的哮喘或鼻炎的受试者，不同类型的室内和室外过敏原对其疾病发展的可能贡献。研究对象和方法我们分析了3371例连续患者对室内和室外常见空气传播过敏原的过敏皮肤点刺试验，根据诊断为过敏性哮喘、鼻炎或两者同时进行分组。对于这三组中的每一组，我们计算了对室内和室外过敏原的致敏率、特应性指数（AI）、过敏皮肤点刺试验阳性反应的数量以及这些反应的平均轮径（MWD）。结果16 ~ 25岁人群的特应性患病率及AI、MWD值最高，随后下降；在大于或等于18岁的受试者中，男性的特应性指数略高于女性。在特应性人群中，致敏率依次为屋尘（84.2%）、猫毛上皮（76.5%）、狗毛皮屑（63.0%）、屋尘螨（54.2%）、草（51.9%）、树（47.2%）、豚草花粉（44.9%），最后是霉菌（25.4%）。在仅对室外过敏原敏感的受试者中（n = 195）， 73.8%患有鼻炎，11.8%患有哮喘，14.4%患有两种诊断；对于仅对室内过敏原致敏的患者（n = 710），这些值分别为48.6%、24.5%和26.9%，对于室内和室外过敏原均致敏的患者（n = 1793），这些值分别为55.5%、14.6%和29.9%。结论这些数据表明，在有呼吸道过敏症状的人群中，室内变应原致敏与哮喘密切相关，而对花粉的纯致敏主要与鼻炎相关。根据诊断或年龄确定的所有组中，室内过敏原致敏率高于室外过敏原。18岁以上年龄组男性的特异反应指数较高。患病率和致敏程度在年轻人中达到峰值，与过敏原无关，并随着年龄的增长而减少。本研究强调室内过敏原在哮喘发展中的作用，并根据致敏类型显示过敏表现的变异性。
Background and objectives The determinants of variability in the clinical expression of atopy are still to be documented. The goals of this study were to determine, in subjects with a clinical diagnosis of symptomatic asthma or rhinitis, what is the possible contribution of different types of indoor and outdoor allergens to the development of their disease, by looking at the prevalence and degree of sensitization to these allergens according to age and gender.Subjects and methods We analysed allergy skin prick tests to common airborne indoor and outdoor allergens in 3371 consecutive patients, grouped according to diagnosis of allergic asthma, rhinitis, or both. For each of these three groups, we calculated the prevalence of sensitization to indoor:outdoor allergens, the atopic index (AI), the number of positive responses to allergy skin prick test and the mean wheal diameter (MWD) of these responses.Results The prevalence of atopy and the values of AI and MWD peaked in subjects aged 16 to 25 years, declining afterwards; in subjects greater than or equal to 18 years old, atopic indices were slightly higher in men than in women. In atopic subjects, the prevalence of sensitization was, in decreasing order: housedust (84.2%), cat hair-epithelium (76.5%), dog hair-dander (63.0%), house dust mite (54.2%), grasses (51.9%), trees (47.2%) and ragweed pollens (44.9%) and finally, moulds (25.4%). Among subjects sensitized only to outdoor allergens (n = 195), 73.8% had a rhinitis, 11.8% had asthma and 14.4% had both diagnoses; for those sensitized only to indoor allergens (n = 710), these values were respectively 48.6, 24.5 and 26.9%, and for those sensitized to both indoor and outdoor allergens (n = 1793), the comparable values were 55.5, 14.6 and 29.9%.Conclusion These data show that in our population of subjects with respiratory allergic symptoms, indoor allergen sensitization is strongly associated with asthma, while exclusive sensitization to pollens is associated primarily with rhinitis. Sensitization was more prevalent for indoor allergens than for outdoor allergens in all groups determined according to diagnosis or age. Indices of atopy were higher in men in the group greater than or equal to 18 years old. Prevalence and degree of sensitization were shown to peak in young adults, regardless of the allergen, and to diminish with age. This study stresses the role of indoor allergens in the development of asthma and shows the variability of allergic manifestations according to the type of sensitization.