Specific IgE Response to Trichophyton and Asthma Severity
Specific IgE Response to Trichophyton and Asthma Severity
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DOI：
10.1378/chest.08-1783
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发表时间：
2009-04-01
期刊：
影响因子：
9.6
通讯作者：
Mishima, Michiaki
中科院分区：
文献类型：
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作者：
Matsuoka, Hirofumi;Niimi, Akio;Mishima, Michiaki
背景：毛癣菌是一种主要的皮肤真菌，其致敏性与哮喘有关。这种致敏作用是否与哮喘的严重程度有关，就像其他霉菌如链格孢菌一样，尚不清楚。我们比较了258例哮喘患者，根据严重程度分为轻度（n = 123），中度（101）或重度（34），以及114例健康对照受试者，针对红色毛癣菌和其他常见过敏原如混合霉菌、屋尘螨、猫皮屑、狗皮屑、日本雪松花粉、混合禾本科花粉和混合杂草花粉的特异性IgE滴度。中度哮喘患者毛癣菌特异性IgE阳性率较高（15.8%）高于对照组（7.0%，p = 0.04）和轻度哮喘患者（4.9%，P < 0.006），且重度哮喘组也明显高于对照组（32.4%）高于对照组（p = 0.0001）、轻度哮喘组（p < 0.0001）和中度哮喘组（p = 0.04），但对照组与轻度哮喘组之间无差异。混合霉菌、猫皮屑和狗皮屑的阳性率在所有哮喘亚组中几乎总是高于对照组，但在三个哮喘亚组中没有差异。其他过敏原阳性率各组间无差异。排除52例混合霉菌阳性结果的受试者后，对毛癣菌特异性IgE阳性率进行再分析，结果显示与原始队列相似的统计学趋势。这可能会抵消对这些霉菌的交叉反应性的潜在影响。哮喘亚组的多变量分析确定阳性IgE结果毛癣菌作为一个独立的决定因素哮喘severity.Conclusions：特异性IgE反应毛癣菌可能与更严重的哮喘。
Background: Sensitization to Trichophyton, a major dermatophyte, has been associated with asthma. Whether such sensitization is generally associated with the severity of asthma, like other molds such as Alternaria, is unknown.Methods: We compared 258 patients with asthma, which was classified by severity as mild (n = 123), moderate (101), or severe (34), and 114 healthy control subjects, with regard to specific IgE titers against Trichophyton rubrum and other common allergens such as mixed molds, house-dust mite, cat dander, dog dander, Japanese cedar pollen, mixed Graminea pollens and mixed weed pollens.Results: Positive rate of Trichophyton-specific IgE was higher in the patients with moderate asthma (15.8%) than in the-control subjects (7.0%, p = 0.04) and patients with mild asthma (4.9%, p < 0.006), and it was also higher in the patients with severe asthma (32.4%) than in control subjects (p = 0.0001), and patients with mild asthma (p < 0.0001) and moderate asthma (p = 0.04), but it did not differ between the control subjects and patients with mild asthma. The positive rates of mixed molds, cat dander, and dog dander were almost invariably higher in patients in all asthma subgroups than in the control subjects but did not differ among patients in the three asthma subgroups. The positive rates of other allergens were not different in all groups. Reanalysis of positive rate of Trichophyton-specific IgE after excluding 52 subjects with positive results for mixed molds showed a similar statistical trend to that of the original cohort. This may negate the potential effect of cross-reactivity to these molds. Multivariate analysis of asthma subgroups identified positive IgE results for Trichophyton as an independent determinant of asthma severity.Conclusions: Specific IgE response to Trichophyton may be associated with more severe asthma.