High prevalence of skin test positivity in severe or difficult-to-treat asthma
High prevalence of skin test positivity in severe or difficult-to-treat asthma
复制标题
DOI：
10.1080/02770900601031540
复制
发表时间：
2006-12-01
影响因子：
1.9
通讯作者：
Wong, Dennis A.
中科院分区：
文献类型：
--
作者：
Haselkorn, Tmirah;Borish, Larry;Wong, Dennis A.
背景：皮肤测试被认为是临床环境中检测过敏原特异性免疫球蛋白 E (IgE) 的金标准，也是诊断和治疗过敏性哮喘的重要工具。目的：评估参加哮喘流行病学和自然史：结果和治疗方案 (TENOR) 研究的 12 岁以上患者的皮肤测试流行率。方法：询问患者是否曾经做过皮肤测试，如果做过，则要求他们提供测试结果。使用临床特征来比较阳性（ST+）、阴性（ST-）和未进行皮试（STND）患者。结果：在 2,985 名符合条件的患者中，85.8% 的患者回忆起接受过皮肤测试。在接受检测的人中，93.5% 呈阳性（过敏科医生 95.7%，肺科医生 87.3%）。高比例的白人 (93.5%) 和非白人 (94.0%) 为 ST+；然而，更多的非白人从未进行过皮肤测试（分别为 21.7% 和 12.3%；p < 0.0001）。 ST+患者的血清总IgE为104.6 IU/mL，STND患者为87.1 IU/mL，ST-患者为32.4 IU/mL。哮喘发病年龄、哮喘持续时间以及特应性疾病和哮喘触发因素的患病率将 ST+ 组与 ST- 组区分开来。两组之间的疾病严重程度相似。一般来说，STND 患者的值更接近 ST+ 组，这表明那些未测试的患者如果进行测试，也会是 ST+。结论：ST+ 患者在过敏和肺科实践中以及白人和非白人患者中的患病率较高。这些数据支持对严重哮喘患者进行更完整的过敏评估的实用性。皮肤测试似乎与哮喘的疾病病理生理学相关。
Background: Skin tests are considered the gold standard for detecting allergen-specific immunoglobulin E (IgE) in the clinical setting and are an important tool for diagnosing and managing allergic asthma. Objective: To assess the prevalence of skin testing in patients >= 12 years enrolled in The Epidemiology and Natural History of Asthma: Outcomes and Treatment Regimens ( TENOR) study. Methods: Patients were asked whether they had ever been skin tested and, if so, they were asked to provide the test results. Clinical characteristics were used to compare positive (ST+), negative (ST-), and skin test not done (STND) patients. Results: Of 2,985 patients eligible, 85.8% recalled being skin tested. Of those tested, 93.5% were positive ( allergist 95.7%, pulmonologist 87.3%). A high proportion of Whites ( 93.5%) and non-Whites (94.0%) were ST+; however, more non-Whites had never been skin tested (21.7% vs. 12.3%, respectively; p < 0.0001). Total serum IgE was 104.6 IU/mL for ST+ patients, 87.1 IU/mL for STND patients, and 32.4 IU/mL for ST- patients. Age at asthma onset, duration of asthma, and the prevalence of atopic disorders and asthma triggers differentiated the ST+ from the ST- group. Disease severity appeared similar between the two groups. In general, values for STND patients were closer to the ST+ group, suggesting that those not tested would have been ST+ if administered a test. Conclusions: The prevalence of ST+ patients was high in allergy and pulmonology practices, and in White and non-White patients. These data support the utility of a more complete allergic evaluation in severe asthmatics. Skin testing appears associated with disease pathophysiologies in asthma.