Relationship of house-dust mite allergen exposure in children's bedrooms in infancy to bronchial hyperresponsiveness and asthma diagnosis by age 6 to 7
Relationship of house-dust mite allergen exposure in children's bedrooms in infancy to bronchial hyperresponsiveness and asthma diagnosis by age 6 to 7
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DOI：
10.1016/s1081-1206(10)63612-5
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发表时间：
2003-01-01
影响因子：
5.9
通讯作者：
Johnson, CC
中科院分区：
文献类型：
--
作者：
Carter, PM;Peterson, EL;Johnson, CC
背景资料：几项研究表明，婴儿期暴露于屋尘螨（HDM）过敏原会增加患哮喘的风险。目的：确定婴儿期暴露于较高水平的尘螨是否会增加6至7岁时患支气管高反应性（BHR）或医生诊断的哮喘的风险。方法：一项基于健康维护组织的队列研究，包括97名出生于1987年至1989年的中产阶级郊区儿童，他们具有高脐带血免疫球蛋白E，定义为大于或等于0.56 IU/mL，作为儿童过敏研究的一部分。在头2年的生活，每月的卧室灰尘样本收集和分析的Der f 1和Der p 1。在6至7岁之间，原始队列中的64人回答了用于确定医生诊断的哮喘的存在的问卷，接受了临床检查、皮肤点刺试验和乙酰甲胆碱吸入激发。采用Mann-Whitney检验比较BHR儿童和非BHR儿童以及医生诊断为哮喘和非哮喘儿童家中的Der f 1和Der p 1水平。无论是平均值，最大值，或最小尘螨过敏原水平在家中的儿童与无BHR，或儿童与无哮喘没有显着差异。然而，致敏HDM与医生诊断的哮喘（P < 0.05）。结论：与其他研究相比，我们能够更准确地估计尘螨过敏原暴露水平，通过重复采样在一个相对较长的时间，结合季节性变化。虽然HDM致敏和哮喘同时相关，但我们无法发现儿童早期卧室HDM过敏原暴露水平与6至7岁时BHR或医生诊断的哮喘的发展之间存在任何关系。
Background: Several studies have suggested that exposure to house-dust mite (HDM) allergen in infancy increases the risk of developing asthma.Objective: To determine whether exposure to higher levels of dust mite in infants increased the risk of developing bronchial hyperresponsiveness (BHR) or physician-diagnosed asthma by age 6 to 7 years.Methods: A health maintenance organization-based cohort of 97 middle class suburban children born from 1987 to 1989 with a high cord blood immunoglobulin E, defined as greater than or equal to0.56 IU/mL, was followed as a part of the Childhood Allergy Study. During the first 2 years of life, monthly bedroom dust samples were collected and analyzed for Der f 1 and Der p 1. Between 6 and 7 years of age, 64 of the original cohort answered a questionnaire used to determine the presence of physician-diagnosed asthma, underwent clinical examination, skin prick testing, and methacholine inhalation challenge. Mann-Whitney tests were used to compare Der f 1 and Der p 1 levels in homes of children with and without BHR, and those with and without physician-diagnosed asthma.Results: In all, 1,421 dust samples were collected and assayed. No significant differences were seen in either the mean, maximum, or minimum dust mite allergen levels in homes of children with versus without BHR, or children with versus without asthma. However, sensitization to HDM was associated with physician-diagnosed asthma (P < 0.05).Conclusions: When compared with other studies, we were able to more accurately estimate the level of dust mite allergen exposure through repeated sampling over a relatively long period, incorporating seasonal variations. Although HDM sensitization and asthma were concurrently related, we were unable to find any relationship between level of HDM allergen exposure in children's bedrooms in early childhood and development of BHR or physician-diagnosed asthma by age 6 to 7 years.