The association between persistent eosinophilia and asthma in childhood is independent of atopic status
The association between persistent eosinophilia and asthma in childhood is independent of atopic status
复制标题
DOI：
10.1046/j.0022-0477.2001.01273.x
复制
发表时间：
2002-01-01
影响因子：
6.1
通讯作者：
Wright, AL
中科院分区：
文献类型：
--
作者：
Karakoc, F;Remes, ST;Wright, AL
背景 虽然外周血嗜酸性粒细胞增多与哮喘风险相关，但与特应性的关系尚未确定。 目的 评估嗜酸性粒细胞与儿童期慢性哮喘之间的关系，并确定随时间推移与嗜酸性粒细胞水平相关的因素。 方法 在受试者 9 个月、6 岁和 11 岁时测量嗜酸性粒细胞/300 个白细胞 (WBC) 计数 ('eos') 的百分比 参加前瞻性图森儿童呼吸研究。根据嗜酸性粒细胞低（小于或等于 2%）或高（> 5%）的测量次数对儿童进行分类，如下：（1）持续低 Cos（n = 130）； (2) 低 Cos（间歇性低或持续中等，但从不高，n = 317）； (3) Cos 间歇性偏高 (n = 192)； (4) 持续高 Cos (n = 17)。仅将 eos 测量值大于或等于 2 的儿童纳入分析。慢性哮喘被定义为医生 (MD) 诊断哮喘，并在 2 至 13 岁之间完成 3 份以上的调查问卷，并在前一年报告有喘息。 6 岁或 11 岁时至少有一次皮肤点刺试验（SPT；大于或等于 3 mm）呈阳性的儿童被认为是“特应性”。 结果 慢性哮喘与纵向确定的嗜酸性粒细胞呈线性相关（趋势 chi(2) P < 0.001），患病率范围为持续低 Cos 儿童的 5.8% 到持续高 Cos 儿童的 37.5%。这种关系独立于 特应性。父母哮喘病史与慢性哮喘（P < 0.001）和纵向嗜酸性粒细胞状态（P < 0.001）相关。调整特应性和性别后，纵向嗜酸性粒细胞水平每增加一次，哮喘风险就会增加 70%。当将父母哮喘添加到模型中时，这种逐步增加减少到 48%。 结论 纵向嗜酸性粒细胞水平与儿童期慢性哮喘线性相关，与特应性无关。父母哮喘与嗜酸性粒细胞状态之间的密切相关表明遗传背景可能是嗜酸性粒细胞反应的重要决定因素。
Background Although peripheral blood eosinophilia is associated with risk of asthma, the relation with atopy has not been established.Objective To assess the relationship between eosinophils and chronic asthma in childhood, and to determine the factors associated with eosinophil levels over time.Methods Percent eosinophils/300 white blood cell (WBC) count ('eos') was measured at 9 months, 6 years and 11 years in subjects participating in the prospective Tucson Children's Respiratory Study. Children were classified based on the number of measurements in which they had low (less than or equal to 2%) or high (> 5%) eosinophils, as follows: (1) Persistently low Cos (n = 130); (2) Low Cos (intermittently low or consistently moderate, but never high, n = 317); (3) Intermittently high Cos (n = 192); and (4) Persistently high Cos (n = 17). Only children with greater than or equal to 2 eos measurements were included in the analysis. Chronic asthma was defined as medical doctor (MD)-diagnosed asthma with reports of wheezing during the previous year, on > 3 questionnaires completed between 2 and 13 years of age. Children with at least one positive skin prick test (SPT; greater than or equal to 3 mm) at age 6 or 11 were considered 'atopic'.Results Chronic asthma was linearly related to longitudinally ascertained eosinophils (trend chi(2) P < 0.001) with prevalence ranging from 5.8% among children with persistently low Cos to 37.5% among children with persistently high Cos. This relation was independent of atopy. Parental history of asthma was associated with both chronic asthma (P < 0.001) and with longitudinal eosinophil status (P < 0.001). After adjusting for atopy and gender, there was a 70% increase in asthma risk with each increase in longitudinal eosinophil level. This stepwise increase was reduced to 48% when parental asthma was added to the model.Conclusion Longitudinal eosinophil levels are linearly associated with chronic asthma in childhood, independent of atopy. The strong association between parental asthma and eosinophil status suggests that genetic background may be an important determinant of eosinophilic response.