Severity of asthma is related to endotoxin in house rust
Severity of asthma is related to endotoxin in house rust
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DOI：
10.1164/ajrccm.154.6.8970348
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发表时间：
1996-12-01
影响因子：
24.7
通讯作者：
Sergysels, R
中科院分区：
文献类型：
--
作者：
Michel, O;Kips, J;Sergysels, R
在致敏对象中，暴露于螨过敏原似乎只是导致哮喘的几个因素之一。我们假设，与过敏原暴露有关，内毒素，一种存在于室内灰尘（HD）中的促炎剂，影响哮喘的严重程度。采用横断面研究设计，我们调查了69名连续尘螨（HDM）致敏的受试者，定义为患有鼻炎（n = 20）或哮喘（n = 49）；后者通过三个不同的分数和他们对日常药物的需求来评估功能和临床。在每个受试者家中的床垫和地板上采集一式两份的HD，测量翼状棘球绦虫I过敏原（Der p I）（通过双位点单克隆抗体酶联免疫吸附法[ELISA]）、鸟嘌呤（通过高压液相色谱法[H PLC]）和内毒素（通过改良鲎试剂裂解法）的浓度。哮喘组床垫HD中Der p I和鸟嘌呤浓度显著高于鼻炎组（p < 0.05和< 0.04）。在暴露于高水平HDM过敏原（即Der p I大于等于10 μ g/g HD和/或鸟嘌呤大于等于0.10 mg/100 mg HD）的受试者（n = 37）中，哮喘的严重程度与HDM尘螨过敏原浓度无关。相反，哮喘的严重程度与HD患者同时暴露于内毒素有关，因为HD内毒素浓度与FEV(1) （p < 0.05）、FEV(1)/FVC （p < 0.02）、每日口服（p < 0.01）和吸入（p < 0.01）皮质类固醇、每日β(2)激动剂（p < 0.001）和黄嘌呤（p < 0.01）以及临床评分如改良Aas评分（p < 0.01）呈显著负相关。在暴露于高水平过敏原的hum致敏受试者中，HD测量的内毒素浓度是哮喘严重程度的重要决定因素。
In sensitized subjects, exposure to the mite allergen appears to be only one of several factors leading to asthma. We hypothesized that in association with allergen exposure, endotoxin, a proinflammatory agent present in house dust (HD), influences the severity of asthma. Using a cross-sectional study design, we investigated a group of 69 consecutive dust mite (HDM)-sensitized subjects defined as having rhinitis (n = 20) or asthma (n = 49); the latter were evaluated functionally and clinically by three different scores and by their need for daily medication. Concentrations of Dermatophagoides pteronyssinus p I allergen (Der p I)(by two-site monoclonal antibody enzyme-linked immunosorbent assay [ELISA]), guanine (by high-pressure liquid chromatography [H PLC]), and endotoxin (by modified Limulus amebocyte lysate assay) were measured in HD collected in duplicate from the mattresses and floors in each subject's home. The concentrations of Der p I and of guanine in HD collected from mattresses were significantly higher in asthmatic subjects than in those with rhinitis (p < 0.05 and < 0.04, respectively). In subjects (n = 37) exposed to a high level of HDM allergen (i.e., Der p I greater than or equal to 10 mu g/g HD and/or guanine greater than or equal to 0.10 mg/100 mg HD), the severity of asthma was unrelated to mite allergen concentration in HD. On the contrary, the severity of asthma was related to concomitant exposure to endotoxin in HD, since the concentration of HD endotoxin was significantly and inversely correlated with FEV(1) (p < 0.05), FEV(1)/FVC (p < 0.02), daily need for oral (p < 0.01) and inhaled (p < 0.01) corticosteroids, daily need for beta(2) agonists (p < 0.001) and xanthines (p < 0.01), and clinical scores such as the modified Aas score (p < 0.01). In HUM-sensitized subjects exposed to a high level of allergen, the concentration of endotoxin measured in HD is an important determinant of asthma severity.