The role of atopy in the clinical course of pulmonary sarcoidosis in the Japanese population
The role of atopy in the clinical course of pulmonary sarcoidosis in the Japanese population
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DOI：
10.2500/aap.2010.31.3336
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发表时间：
2010-05-01
影响因子：
2.8
通讯作者：
Nishimura, Masaharu
中科院分区：
文献类型：
--
作者：
Hattori, Takeshi;Konno, Satoshi;Nishimura, Masaharu
结节病是一种多系统疾病，其特征是辅助性T细胞1（Th 1）介导的免疫反应。相反，特应性的特征在于存在与Th 2型免疫应答相关的特异性免疫球蛋白E（IgE）E应答。一些流行病学研究表明，特应性状态影响疾病的活动和临床过程中的几个Th 1介导的疾病。本研究的目的是评估特应性状态与结节病临床表现之间的关系。我们进一步评估了特应性状态对肺结节病临床病程的影响。我们将特应性定义为对至少一种常见吸入性过敏原的特异性IgE反应阳性（多抗原同时试验评分，Lumicount>1.01）。受试者包括134例2000年至2006年诊断为结节病的患者，分为特应性和非特应性组。比较两组患者的临床表现。此外，100例受试者诊断后2年观察分为解决和持续的临床过程组根据胸部X线片和特应性状态的关联进行了评估。特应性在男性中的患病率高于女性（p = 0.009），与无特应性的受试者相比，特应性受试者更年轻（p = 0.002），肺实质病变（II期和III期; p = 0.018）的发生率更低。缓解期临床病程组的特应性患病率高于持续期临床病程组（p = 0.002），这种相关性与性别、年龄、肺实质病变和肺外病变无关（p = 0.037）。根据特应性状态对结节病进行分类可能有助于预测肺结节病的临床病程。（Allergy Asthma Proc 31：238-243，2010; doi：10.2500/aap.2010.31.3336）
Sarcoidosis is a multisystem disorder characterized by a T-helper 1 (Th1)-mediated immune response. Conversely, atopy is characterized by the presence of a specific immunoglobulin E (IgE) E response in association with a Th2-type immune response. Several epidemiological studies have shown that atopic status influences disease activity and clinical course for several Th1-mediated diseases. The aim of this study was to evaluate associations between atopic status and clinical findings of sarcoidosis. We further evaluated the impact of atopic status on the clinical course of pulmonary sarcoidosis. We defined atopy as a positive specific IgE response to at least one common inhaled allergen (multiple antigen simultaneous test scores, lumicount of >1.01). Subjects comprised 134 patients given a diagnosis of sarcoidosis between 2000 and 2006, divided into atopic and nonatopic groups. Several clinical findings were compared between the two groups. Furthermore, 100 subjects observed 2 years after diagnosis were divided into resolving and persistent clinical course groups according to chest radiography and associations with atopic status were evaluated. Atopy was more prevalent among men than women (p = 0.009) and subjects with atopy were younger (p = 0.002) and showed less frequent lung parenchymal lesions (stages II and III; p = 0.018) compared with subjects without atopy. The prevalence of atopy was higher in the resolving clinical course group than in the persistent clinical course group (p = 0.002) and this association was independent of sex, age, presence of lung parenchymal lesions, and presence of extra pulmonary lesions (p = 0.037). Classification of sarcoidosis based on atopic status might be useful for predicting the clinical course of pulmonary sarcoidosis. (Allergy Asthma Proc 31:238-243, 2010; doi: 10.2500/aap.2010.31.3336)