Relationship of indoor allergen exposure to skin test sensitivity in inner-city children with asthma
Relationship of indoor allergen exposure to skin test sensitivity in inner-city children with asthma
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DOI：
10.1016/s0091-6749(98)70272-6
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发表时间：
1998-10-01
影响因子：
14.2
通讯作者：
Malveaux, F
中科院分区：
文献类型：
--
作者：
Eggleston, PA;Rosenstreich, D;Malveaux, F
背景：如果我们要改变过敏性疾病的致敏风险和发病率，了解环境过敏原暴露剂量和特应性个体对该过敏原致敏的风险之间的关系是很重要的。目的：这些研究的目的是确定市中心儿童当前暴露于尘螨、蟑螂和猫变应原之间是否存在剂量反应，并确定对这些过敏原的致敏流行率。方法：从参加全国合作内城哮喘研究的1528名儿童中选取500名儿童作为样本。孩子们被选中，他们的家庭灰尘样本和有效的皮肤测试反应是用多项皮肤测试设备进行的。从厨房、卧室和电视/起居室的地板和家具上采集粉尘样本，检测Der p 1、Der f 1、B la g 1和Eel dl过敏原。结果：各过敏原水平在不同房间之间存在显著相关性。尘螨(Der p 1和Der f 1)和猫(Fel D 1)变应原水平经常低于该分析的检测下限。儿童卧室中的蟑螂变应原(BLA G 1)浓度与儿童对蟑螂变应原提取物的皮肤试验阳性率有关，致敏的优势比为1.45(1.11~1.92)。暴露在Bla g 1浓度低于检测水平的卧室粉尘中，15%的儿童对蟑螂变应原有阳性反应，相比之下，Bla g 1水平为1至2 U/g的卧室儿童的阳性率为32%，Bla g 1水平为4 U/g或更高的房间的儿童为40%至44%。皮肤试验阳性的特应性儿童中，暴露与皮肤试验阳性反应之间的关系明显更强。结论：尽管广泛暴露于家庭变应原，但暴露与致敏之间的关系最强的是卧室。蟑螂变应原暴露与致敏之间的剂量反应表明，暴露于2U/g或更低剂量的过敏原是一个危险因素，风险平台高于4U/g。特应性改变了暴露与致敏的关系。
Background: It is important to understand the relationship between environmental allergen exposure dose and the risk of atopic individuals becoming sensitized to that allergen if we are to change the risk of sensitization and morbidity from allergic disease.Objective: The objective of these studies was to determine whether there was a dose response between current exposure to mite, cockroach, and cat allergen in inner-city children and to determine the prevalence of sensitization to these allergens. Methods: A sample of 500 children was selected from the 1528 children enrolled in the National Cooperative Inner City Asthma Study. Children were selected who had a sample of home dust and valid skin test responses performed with a MultiTest skin test device. The samples of home dust were collected from the floor and furniture in the kitchen, bedroom, and television/living room and were assayed for Der p 1, Der f 1, Bla g 1, and Eel dl allergens.Results: Each allergen level correlated significantly between rooms in individual homes. Mite (Der p 1 and Der f 1) and cat (Fel d 1) allergen levels were frequently below the detection limit of the assay. Cockroach allergen (BLa g 1) concentrations in the child's bedroom were related to the prevalence of positive skin test responses to cockroach allergen extract among the children, with an odds ratio for sensitization of 1.45 (1.11-1.92). Positive skin test responses to cockroach allergen were seen in 15% of children exposed to bedroom dust with a Bla g 1 concentration below the level of detection compared with a rate of 32% in bedrooms with Bla g 1 levels of 1 to 2 U/g and 40% to 44% among those in rooms with 4 U/g or greater. The relationship between exposure and positive skin test responses was clearly stronger among atopic children with a greater number of positive skin test responses.Conclusions: Despite widespread exposure to household allergens, the strongest relationship between exposure and sensitization was seen in the bedroom. The dose response between exposure to cockroach allergen and sensitization suggested that exposure to low doses of allergen, 2 U/g or less, was a risk factor and that the risk plateaus above 4 U/g. Atopy modified the relationship of exposure to sensitization.