Childhood eczema and rhinitis predict atopic but not nonatopic adult asthma: A prospective cohort study over 4 decades
Childhood eczema and rhinitis predict atopic but not nonatopic adult asthma: A prospective cohort study over 4 decades
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DOI：
10.1016/j.jaci.2011.02.041
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发表时间：
2011-06-01
影响因子：
14.2
通讯作者：
Dharmage, Shyamali C.
中科院分区：
文献类型：
--
作者：
Martin, Pamela E.;Matheson, Melanie C.;Dharmage, Shyamali C.
背景：关于儿童时期观察到的特应性进展（即从湿疹到变应性鼻炎和哮喘的进展）是否延伸到成年期的证据很少，并且没有证据表明该进展是否导致哮喘的特定表型。目的：我们试图评估儿童湿疹和鼻炎是否是成人哮喘特定表型的危险因素。方法：对1968年塔斯马尼亚纵向健康研究招募的参与者（年龄范围6.0-7.0岁）进行随访，随访年龄为44岁。当前特应性或非特应性中年哮喘的风险以儿童湿疹、鼻炎或两者兼有的空气过敏原致敏为特征，通过多项logistic回归计算。结果：儿童湿疹、鼻炎与成人非特应性哮喘无相关性。相比之下，儿童湿疹和鼻炎合并预测中年新发特应性哮喘（调整多项优势比[aMOR]， 6.3; 95% CI, 1.7-23.2）和儿童哮喘到成人特应性哮喘的持续性（aMOR, 11.7; 95% CI, 3.6-37.9）。单独患有儿童湿疹的参与者新发特应性哮喘的风险增加（aMOR, 4.1; 95% CI, 1.9-8.8），而单独患有鼻炎的参与者预测儿童哮喘持续发展为特应性哮喘（aMOR, 2.7; 95% CI, 1.3-5.6）。在所有哮喘中，29.7%的持续性特应性哮喘和18.1%的新发特应性哮喘可归因于儿童期湿疹和鼻炎。结论：儿童湿疹和鼻炎与成人特应性哮喘的发病率和持续性密切相关。[J] .过敏症临床与免疫杂志，2011;127:1473-9。
Background: The evidence on whether the atopic march observed in childhood (ie, the progression from eczema to allergic rhinitis and asthma) extends to adulthood is sparse, and there is no evidence on whether the progression leads to a specific phenotype of asthma.Objective: We sought to assess whether childhood eczema and rhinitis are risk factors for specific phenotypes of adult asthma.Methods: Participants of the Tasmanian Longitudinal Health Study recruited in 1968 (age range, 6.0-7.0 years) were followed up at age 44 years. The risk of current atopic or nonatopic asthma in middle age characterized by sensitization to aeroallergens given childhood eczema, rhinitis, or both was calculated by using multinomial logistic regression.Results: No association was found between childhood eczema or rhinitis and nonatopic adult asthma. In contrast, childhood eczema and rhinitis in combination predicted both new-onset atopic asthma by middle age (adjusted multinomial odds ratio [aMOR], 6.3; 95% CI, 1.7-23.2) and the persistence of childhood asthma to adult atopic asthma (aMOR, 11.7; 95% CI, 3.6-37.9). Participants with childhood eczema alone were at increased risk of new-onset atopic asthma (aMOR, 4.1; 95% CI, 1.9-8.8), whereas rhinitis alone predicted the persistence of childhood asthma to atopic asthma (aMOR, 2.7; 95% CI, 1.3-5.6). Of all asthma, 29.7% of persistent atopic asthma and 18.1% of new-onset atopic asthma could be attributed to having childhood eczema and rhinitis.Conclusion: Childhood eczema and rhinitis are strongly associated with the incidence and persistence of adult atopic asthma. (J Allergy Clin Immunol 2011;127:1473-9.)