Sensitization to Ascaris lumbricoides and severity of childhood asthma in Costa Rica
Sensitization to Ascaris lumbricoides and severity of childhood asthma in Costa Rica
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DOI：
10.1016/j.jaci.2006.12.609
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发表时间：
2007-03-01
影响因子：
14.2
通讯作者：
Celedon, Juan C.
中科院分区：
文献类型：
--
作者：
Hunninghake, Gary M.;Soto-Quiros, Manuel E.;Celedon, Juan C.
背景：哮喘患者对蠕虫的致敏性（定义为IgE阳性）和疾病严重程度知之甚少。目的：研究哥斯达黎加人群中蛔虫致敏（定义为IgE阳性）与哮喘发病率和严重程度之间的关系，该人群寄生虫感染患病率低，但寄生虫暴露患病率高。方法：对439例哮喘患儿（6 ~ 14岁）进行横断面研究。多元统计分析采用线性回归和逻辑回归。结果：在调整父母教育和其他协变量后，对类蛔虫致敏与以下因素相关：对过敏原进行至少1次皮肤试验阳性（优势比为5.15；95% CI为2.36-11.21;P < .001）、外周血总血清IgE和酸性粒细胞升高、FEV1和FEV1/用力肺活量降低、气道反应性和支气管扩张剂反应性升高、前一年因哮喘住院(优势比为3.08；95% Cl, 1.23-7.68；P = .02)。结论：哥斯达黎加儿童对类蛔虫致敏与哮喘严重程度和发病率增加有关。这种关联可能是由对Asearis敏感的哮喘儿童的特应性程度增加所介导的。临床意义：在哥斯达黎加等蛔虫病患病率较低的地区，蛔虫致敏可能是哮喘儿童严重特应性和疾病发病率的重要标志。
Background: Little is known about sensitization (defined as a positive IgE) to helminths and disease severity in patients with asthma.Objectives: To examine the relationship between sensitization (defined as a positive IgE) to Ascaris lumbricoides and measures of asthma morbidity and severity in a Costa Rican population with low prevalence of parasitic infection but high prevalence of parasitic exposure.Methods: Cross-sectional study of 439 children (ages 6 to 14 years) with asthma. Linear regression and logistic regression were used for the multivariate statistical analysis.Results: After adjustment for parental education and other covariates, sensitization to Ascaris lumbricoides was associated with having at least 1 positive skin test to allergens (odds ratio, 5.15; 95% CI, 2.36-11.21; P < .001), increased total serum IgE and eosinophils in peripheral blood, reductions in FEV1 and FEV1/forced vital capacity, increased airway responsiveness and bronchodilator responsiveness, and hospitalizations for asthma in the previous year (odds ratio, 3.08; 95% Cl, 1.23-7.68; P = .02).Conclusion: Sensitization to Ascaris lumbricoides is associated with increased severity and morbidity of asthma among children in Costa Rica. This association is likely mediated by an increased degree of atopy among children with asthma who are sensitized to Asearis.Clinical implications: In areas with a low prevalence of helminthiasis such as Costa Rica, Ascaris sensitization may be an important marker of severe atopy and disease morbidity in children with asthma.