The role of cockroach allergy and exposure to cockroach allergen in causing morbidity among inner-city children with asthma
The role of cockroach allergy and exposure to cockroach allergen in causing morbidity among inner-city children with asthma
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DOI：
10.1056/nejm199705083361904
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发表时间：
1997-05-08
影响因子：
158.5
通讯作者：
Malveaux, F
中科院分区：
文献类型：
--
作者：
Rosenstreich, DL;Eggleston, P;Malveaux, F
据推测，与哮喘相关的健康问题在市中心地区的儿童中最为严重，这些儿童对特定的过敏原过敏，并且在卧室灰尘中暴露于高水平的过敏原。方法从1992年11月到1993年10月，我们从美国8个市中心地区招募了476名哮喘儿童（年龄，4至9岁）。对蟑螂、屋尘螨和猫过敏原的立即过敏反应通过皮肤试验进行测量。然后，我们使用基于单克隆抗体的酶联免疫吸附法测定了家用粉尘中蟑螂（Bla g1）、尘螨（Der p1和Der f1）和猫皮屑（Fel d1）的主要过敏原。根据建议的致病阈值确定高暴露水平。在基线和一年的时间内收集哮喘发病率的数据。结果儿童对蟑螂过敏原过敏的比例为36.8%，对尘螨过敏的比例为34.9%，对猫过敏原过敏的比例为22.7%。在儿童卧室中，50.2%的灰尘中含有高浓度的蟑螂过敏原，9.7%的灰尘中含有高浓度的尘螨过敏原，12.6%的灰尘中含有高浓度的猫过敏原。在我们调整了性别、儿童行为检查表得分和哮喘家族史后，我们发现对蟑螂过敏原过敏并暴露于高水平过敏原的儿童每年住院0.37次，而其他儿童为0.11次（P=0.001），每年因哮喘非计划就诊2.56次，而其他儿童为1.43次（P=0.001）
Background It has been hypothesized that asthma-related health problems are most severe among children in inner-city areas who are allergic to a specific allergen and also exposed to high levels of that allergen in bedroom dust.Methods From November 1992 through October 1993, we recruited 476 children with asthma (age, four to nine years) from eight inner-city areas in the United States. Immediate hypersensitivity to cockroach, house-dust-mite, and cat allergens was measured by skin testing. We then measured major allergens of cockroach (Bla g 1), dust mites (Der p 1 and Der f 1), and cat dander (Fel d 1) in household dust using monoclonal-antibody-based enzyme-linked immunosorbent assays. High levels of exposure were defined according to proposed thresholds for causing disease. Data on morbidity due to asthma were collected at base line and over a one-year period.Results Of the children, 36.8 percent were allergic to cockroach allergen, 34.9 percent to dust-mite allergen, and 22.7 percent to cat allergen. Among the children's bedrooms, 50.2 percent had high levels of cockroach allergen in dust, 9.7 percent had high levels of dust-mite allergen, and 12.6 percent had high levels of cat allergen. After we adjusted for sex, score on the Child Behavior Checklist, and family history of asthma, we found that children who were both allergic to cockroach allergen and exposed to high levels of this allergen had 0.37 hospitalization a year, as compared with 0.11 for the other children (P=0.001), and 2.56 unscheduled medical visits for asthma per year, as compared with 1.43 (P