Relationship between exposure to domestic allergens and bronchial hyperresponsiveness in non-sensitised, atopic asthmatic subjects
Relationship between exposure to domestic allergens and bronchial hyperresponsiveness in non-sensitised, atopic asthmatic subjects
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DOI：
10.1136/thx.2004.027839
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发表时间：
2005-01-01
期刊：
影响因子：
10
通讯作者：
Custovic, A
中科院分区：
文献类型：
--
作者：
Langley, SJ;Goldthorpe, S;Custovic, A
背景：此前尚未研究过接触过敏原但不会引起特应性哮喘受试者过敏的影响。一项研究旨在评估对所接触的国内过敏原不敏感的特应性哮喘患者的哮喘严重程度（通过肺活量测定、气道反应性和呼出一氧化氮进行测量）。方法：从 248 名受试者家中的客厅地毯和床垫上收集灰尘样本，并测量尘螨、猫和狗过敏原的浓度。测定肺活量、非特异性支气管反应性（BR）和呼出一氧化氮（eNO）。通过皮肤点刺试验评估患者的致敏状态。 结果：对螨不敏感但暴露于高水平螨过敏原的成人特应性哮喘患者的 BR 明显比未暴露于高水平螨的受试者严重 (PD20，几何平均值 (GM) 0.21 mg (95% CI 0.09 to 0.47) v 0.86 mg (95% CI 0.44 to 1.67)，平均比率差异 4.1（95% CI 1.5 至 11.4），p = 0.008）。未致敏但暴露于高水平狗过敏原的受试者也比未暴露的受试者具有更严重的 BR（PD20 GM 0.16 vs 0.52 mg，平均比差 3.3（95% CI 1.2 至 9.2），p = 0.01）。调整混杂因素后，这些组之间的 BR 差异仍然显着。在暴露于猫过敏原但不敏感的受试者中，没有观察到气道反应性增加的这种影响。 结论：暴露于高水平尘螨或狗过敏原但对这些过敏原不敏感的特应性哮喘受试者有气道反应性增加的证据。
Background: The effect of exposure to allergens not causing sensitisation in atopic asthmatic subjects has not previously been studied. A study was undertaken to assess the degree of asthma severity ( measured by spirometry, airway reactivity and exhaled nitric oxide) in atopic asthmatic patients not sensitised to the domestic allergen to which they were exposed.Methods: Dust samples were collected from the living room carpet and mattress in the homes of 248 subjects and dust mite, cat and dog allergen concentrations were measured. Spirometry, non-specific bronchial reactivity ( BR), and exhaled nitric oxide (eNO) were ascertained. Patients' sensitisation status was assessed by skin prick testing.Results: Adult atopic asthmatics not sensitised to mite but exposed to high levels of mite allergen had significantly more severe BR than subjects not exposed to high levels of mite (PD20, geometric mean (GM) 0.21 mg (95% CI 0.09 to 0.47) v 0.86 mg ( 95% CI 0.44 to 1.67), mean ratio difference 4.1 ( 95% CI 1.5 to 11.4), p = 0.008). Subjects not sensitised but exposed to high levels of dog allergen also had significantly more severe BR than subjects not exposed ( PD20 GM 0.16 v 0.52 mg, mean ratio difference 3.3 ( 95% CI 1.2 to 9.2), p = 0.01). The differences in BR between these groups were still significant after adjusting for confounding factors. This effect of greater airway reactivity was not seen in subjects exposed but not sensitised to cat allergens.Conclusion: Atopic asthmatic subjects who are exposed to high levels of dust mite or dog allergens but not sensitised to these allergens have evidence of increased airway reactivity.