Inner City Asthma Study: Relationships among sensitivity, allergen exposure, and asthma morbidity
Inner City Asthma Study: Relationships among sensitivity, allergen exposure, and asthma morbidity
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DOI：
10.1016/j.jaci.2004.12.006
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发表时间：
2005-03-01
影响因子：
14.2
通讯作者：
Mitchell, H
中科院分区：
文献类型：
--
作者：
Gruchalla, RS;Pongracic, J;Mitchell, H
背景：哮喘相关发病率正在上升，特别是在内城儿童中。目的：我们评估了内城哮喘研究参与者的过敏原敏感性、过敏原暴露和相关发病率。我们还确定了室内变应原水平的地理变异。方法：对937名患有中重度哮喘的市中心5~11岁儿童进行变应原皮肤试验。结果：皮肤试验对蟑螂(69%)、尘螨(62%)和霉菌(50%)的敏感度较高，有显著的研究地点差异。蟑螂敏感度在布朗克斯、纽约和达拉斯最高(分别为81.2%、78.7%和78.5%)，尘螨敏感度最高在达拉斯和西雅图(分别为83.7%和78.0%)。芝加哥、纽约和布朗克斯的大多数家庭的蟑螂过敏原水平超过2微克/克，达拉斯和西雅图的大多数家庭的尘螨过敏原水平超过2微克/克。这两种过敏原的水平都受到房屋类型的影响。蟑螂过敏原水平在高层公寓中最高，而尘螨过敏原水平在独立住宅中最高。同时对蟑螂变应原敏感且暴露于蟑螂变应原的儿童出现哮喘症状的天数明显多于不敏感或暴露于蟑螂变应原的儿童。结论：城区儿童的过敏原暴露和敏感度存在地域差异。蟑螂暴露量和敏感度在东北部占主导地位，而尘螨暴露量和敏感度在南部和西北部最高。在这些儿童中，蟑螂过敏原似乎比尘螨或宠物过敏原对哮喘发病率有更大的影响。
Background: Asthma-associated morbidity is rising, especially in inner city children.Objective: We evaluated the allergen sensitivities, allergen exposures, and associated morbidity for participants in the Inner City Asthma Study. We also determined geographic variations of indoor allergen levels.Methods: Nine hundred thirty-seven inner city children 5 to 11 years old with moderate to severe asthma underwent allergen skin testing. Bedroom dust samples were evaluated for Der p 1, Der f 1, Bla g 1, Fel d 1, and Can f 1.Results: Skin test sensitivities to cockroach (69%), dust mites (62%), and molds (50%) predominated, with marked study site-specific differences. Cockroach sensitivity was highest in the Bronx, New York, and Dallas (81.2%, 78.7%, and 78.5%, respectively), and dust mite sensitivity was highest in Dallas and Seattle (83.7% and 78.0%, respectively). A majority of homes in Chicago, New York, and the Bronx had cockroach allergen levels greater than 2 U/g, and a majority of those in Dallas and Seattle had dust mite allergen levels greater than 2 mu g/g. Levels of both of these allergens were influenced by housing type. Cockroach allergen levels were highest in high-rise apartments, whereas dust mite allergen levels were highest in detached homes. Children who were both sensitive and exposed to cockroach allergen had significantly more asthma symptom days, more caretaker interrupted sleep, and more school days missed than children who were not sensitive or exposed.Conclusion: Geographic differences in allergen exposure and sensitivity exist among inner city children. Cockroach exposure and sensitivity predominate in the Northeast, whereas dust mite exposure and sensitivity are highest in the South and Northwest. Cockroach allergen appears to have a greater effect on asthma morbidity than dust mite or pet allergen in these children.