Differential effects of outdoor versus indoor fungal spores on asthma morbidity in inner-city children.
Differential effects of outdoor versus indoor fungal spores on asthma morbidity in inner-city children.
复制标题
室外与室内真菌孢子对内城儿童哮喘发病率的差异影响。
DOI：
10.1016/j.jaci.2009.10.036
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发表时间：
2010-03
期刊：
影响因子：
--
通讯作者：
Mitchell HE
中科院分区：
文献类型：
--
作者：
Pongracic JA;O'Connor GT;Muilenberg ML;Vaughn B;Gold DR;Kattan M;Morgan WJ;Gruchalla RS;Smartt E;Mitchell HE
虽然对真菌过敏原的敏感性在市中心哮喘儿童中很普遍，但真菌暴露与发病率之间的关系知之甚少。我们研究了城市儿童真菌致敏、暴露和哮喘发病率之间的关系。参与者年龄在5-11岁之间，参加了内城哮喘研究。本报告包括至少有1次真菌过敏原提取物皮肤试验阳性的儿童亚组;对于这些儿童，在基线和整个2年研究期间测量室内和室外空气中可培养真菌。前瞻性收集哮喘发病率指标。主要结局为每2周的症状天数。在基线时，与那些没有对任何真菌过敏原提取物进行阳性皮肤试验的儿童相比，对真菌过敏原提取物进行阳性皮肤试验的儿童具有显着更多的症状天数（每2周6.3 vs 5.7天，p=0.04）。在研究期间，真菌总暴露量和室内青霉菌暴露量的升高与症状天数和哮喘计划外访视的增加相关。室内暴露于总真菌和青霉菌与计划外访问的显着增加，即使在控制室外真菌水平。与暴露于特定真菌相关的不良反应在对该真菌过敏原提取物皮肤试验阳性的儿童中比皮肤试验阴性的儿童更强。户外真菌暴露主要与该人群哮喘症状增加和加重风险增加相关。
While sensitization to fungal allergens is prevalent in inner-city children with asthma, the relationship between fungal exposure and morbidity is poorly understood. We examined relationships between fungal sensitization, exposure and asthma morbidity in inner-city children. Participants were 5–11 years old and enrolled in the Inner-City Asthma Study. This report includes the subset of children with at least 1 positive skin test to a fungal allergen extract; for these children, indoor and outdoor airborne culturable fungi were measured at baseline and throughout the 2 year study. Asthma morbidity measures were collected prospectively. The primary outcome was symptom days per 2 weeks. At baseline, children with a positive skin test to a fungal allergen extract had significantly more symptom days compared to those without positive skin test to any fungal allergen extract (6.3 vs 5.7 days per 2 weeks, p=0.04). During the study, elevations in total fungal exposure and indoor Penicillium exposure were associated with increases in symptom days and asthma unscheduled visits. Indoor exposures to total fungi and to Penicillium were associated with significant increases in unscheduled visits, even after controlling for outdoor fungal levels. Adverse effects associated with exposure to a specific fungus were stronger among children with positive skin test to that fungal allergen extract compared to skin test negative children. Outdoor fungal exposure is primarily associated with increased asthma symptoms and increased risk of exacerbations in this population.