Mold sensitization is common amongst patients with severe asthma requiring multiple hospital admissions.
Mold sensitization is common amongst patients with severe asthma requiring multiple hospital admissions.
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DOI：
10.1186/1471-2466-5-4
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发表时间：
2005-02-18
影响因子：
3.1
通讯作者：
Denning DW
中科院分区：
文献类型：
--
作者：
O'Driscoll BR;Hopkinson LC;Denning DW
多项研究将真菌暴露与哮喘联系起来，但与严重哮喘的联系存在争议。我们在181名哮喘受试者中研究了哮喘严重程度与对霉菌（真菌）和非霉菌过敏原的速发型超敏反应之间的关系。我们在一所大学医院和附近的一家全科医院招募了16至60岁的哮喘患者。患者根据一生中因哮喘入院的次数进行分类（82例从未入院，53例一次入院，46例多次入院）。所有受试者都进行了5种霉菌过敏原（曲霉菌、链格孢菌、枝孢菌、青霉菌和念珠菌）和4种其他常见吸入性过敏原（D。pteronyssinus、草花粉、猫和狗）。皮肤对所有过敏原的反应性在多次入院组中最常见。霉菌过敏原和狗过敏原的这种趋势最强，而D. pteronyssinus。76%的多次入院患者至少有一次霉菌皮肤试验阳性，而其他哮喘患者为16%-19%（卡方p < 0.0001）。多个霉菌反应在多次入院组中也更常见（50%、5%和6%; p < 0.0001）。哮喘患者的入院人数与霉菌皮肤过敏试验阳性的人数和规模相关（斯皮尔曼相关系数r = 0.60，p < 0.0001），与非霉菌过敏试验的人数和规模相关性较弱（r = 0.34，p = 0.0005）。16-40岁的哮喘患者在霉菌孢子季节（7月至10月）最常见，而40岁以上的患者在11月至2月达到高峰（卡方，p < 0.02）。这些发现支持了以前的建议，霉菌致敏可能与严重的哮喘发作需要住院治疗。
Multiple studies have linked fungal exposure to asthma, but the link to severe asthma is controversial. We studied the relationship between asthma severity and immediate type hypersensitivity to mold (fungal) and non-mold allergens in 181 asthmatic subjects. We recruited asthma patients aged 16 to 60 years at a University hospital and a nearby General Practice. Patients were categorized according to the lifetime number of hospital admissions for asthma (82 never admitted, 53 one admission, 46 multiple admissions). All subjects had allergy skin prick tests performed for 5 mold allergens (Aspergillus, Alternaria, Cladosporium, Penicillium and Candida) and 4 other common inhalant allergens (D. pteronyssinus, Grass Pollen, Cat and Dog). Skin reactivity to all allergens was commonest in the group with multiple admissions. This trend was strongest for mold allergens and dog allergen and weakest for D. pteronyssinus. 76% of patients with multiple admissions had at least one positive mold skin test compared with 16%-19% of other asthma patients; (Chi squared p < 0.0001). Multiple mold reactions were also much commoner in the group with multiple admissions (50% V 5% and 6%; p < 0.0001). The number of asthma admissions was related to the number and size of positive mold skin allergy tests (Spearman Correlation Coefficient r = 0.60, p < 0.0001) and less strongly correlated to the number and size of non-mold allergy tests (r = 0.34, p = 0.0005). Hospital admissions for asthma patients aged 16–40 were commonest during the mold spore season (July to October) whereas admissions of patients aged above 40 peaked in November-February (Chi Squared, p < 0.02). These findings support previous suggestions that mold sensitization may be associated with severe asthma attacks requiring hospital admission.