EXPOSURE TO HOUSE-DUST MITE ALLERGEN (DER-P-I) AND THE DEVELOPMENT OF ASTHMA IN CHILDHOOD - A PROSPECTIVE-STUDY
EXPOSURE TO HOUSE-DUST MITE ALLERGEN (DER-P-I) AND THE DEVELOPMENT OF ASTHMA IN CHILDHOOD - A PROSPECTIVE-STUDY
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DOI：
10.1056/nejm199008233230802
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发表时间：
1990-08-23
影响因子：
158.5
通讯作者：
COGSWELL, JJ
中科院分区：
文献类型：
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作者：
SPORIK, R;HOLGATE, ST;COGSWELL, JJ
背景和方法：患有哮喘的儿童通常对吸入过敏原进行皮试呈阳性，在英国，大多数年龄较大的哮喘儿童对屋尘螨过敏。在一群因家族史而面临过敏性疾病风险的英国儿童中，我们从 1978 年到 1989 年前瞻性地调查了接触屋尘螨过敏原 (Der p I) 与过敏和哮喘发生之间的关系。结果：1989 年研究的 67 名儿童中，35 名患有特应性（皮试呈阳性），32 名非特应性。在 17 名活动性哮喘患者中，有 16 名患有特应性（P < 0.005），根据阳性皮肤测试和特异性 IgE 抗体水平判断，所有这些人都对屋尘螨过敏（P < 0.001）。 1979 年从 59 名儿童的家中和 1989 年从 65 名儿童的家中收集了四个室内灰尘样本，最高 Der p I 暴露的几何平均值分别为每克筛分灰尘 16.1 和 16.8 微克。 11 岁时敏化程度呈增加趋势，1 岁时暴露程度更高（P = 0.062）。除一名 11 岁哮喘儿童外，所有儿童在 1 岁时均接触过每克粉尘超过 10 微克的 Der p I；对于本次曝光；哮喘的相对风险为 4.8 (P = 0.05)。对于所有儿童，第一次喘息发生的年龄与 1 岁时的暴露水平呈负相关（P = 0.015），尤其是特应性儿童（r = -0.66，P = 0.001）。结论：除了遗传因素外，儿童早期接触屋尘螨过敏原是随后发生哮喘的重要决定因素。
Backgroud and Methods: Children with asthma commonly have positive skin tests for inhaled allergens, and in the United Kingdom the majority of older children with asthma are sensitized to the house-dust mite. In a cohort of British children at risk for allergic disease because of family history, we investigated prospectively from 1978 to 1989 the relation between exposure to the house-dust mite allergen (Der p I) and the development of sensitization and asthma. Results: Of the 67 children studied in 1989, 35 were atopic (positive skin tests), and 32 were nonatopic. Of the 17 with active asthma, 16 were atopic (P < 0.005), all of whom were sensitized to the house-dust mite, as judged by positive skin tests and levels of specific IgE antibodies (P < 0.001). Four house-dust samples collected from the homes of 59 of the children in 1979 and from 65 homes in 1989, the geometric means for the highest Der p I exposure were, respectively, 16.1 and 16.8 .mu.g per gram of sieved dust. There was a trend toward an increasing degree of sensitization at the age of 11 with greater exposure at the age of 1 (P = 0.062). All but one of the children with asthma at the age of 11 had been exposed at 1 year of age to more than 10 .mu.g of Der p I per gram of dust; for this exposure; the relative risk of asthma was 4.8 (P = 0.05). The age at which the first episode of wheezing occurred was inversely related to the level of exposure at the age of 1 for all children (P = 0.015), but especially for the atopic children (r = -0.66, P = 0.001). Conclusions: In addition to genetic factors, exposure in early childhood to house-dust mite allergens is an important determinant of the subsequent development of asthma.