THE EFFECT OF COCKROACH ALLERGIES IN CHILDREN WITH ASTHMA

蟑螂过敏对哮喘儿童的影响

• 批准号: 6235393
• 负责人: LARRY W WILLIAMS
• 金额: $ 14.15万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1997
• 资助国家: 美国
• 起止时间: 1997-08-01 至 1998-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6235393
• 关键词: allergens; arthropod nonpollutant control; asthma; child (0-11); cockroach; cooperative study; dust; enzyme linked immunosorbent assay; housing; human subject; human therapy evaluation; immunopathology therapy; insect control; insecticides

Asthma is a problem of increasing importance in the United States, especially among minority and inner-city groups. Causes for this increase in asthma are poorly defined; however, studies from many areas of the United States point to a high prevalence of sensitization to cockroach among asthmatics, especially in inner cities, but also among rural and small town residents. Skin test surveys, bronchial challenge studies, and evidence of occupational illness demonstrate the relevance of cockroach allergen to asthma. Cockroach allergen may be found in vacuumed dust from households, but a critical level beyond which sensitization or symptoms are expected is not known. The amount and nature of any cockroach allergen suspended in household air is not known. The effect of suggested cockroach control measures on allergen in household dust and air is not known. Similarly, it is not known if reduction of exposure to cockroach allergen will have an effect on lung function in cockroach-sensitive asthmatics. This proposed study will investigate several of these gaps in knowledge of cockroach allergens and their relation to asthma. Hypotheses to be tested are: (1). Simple control of cockroach population in a detached dwelling will lead to a decrease in cockroach allergen in vacuumed dust. (2). This reduction in cockroach allergen will have a detectable beneficial effect on the status of asthma in patients living in the home. A parallel group, placebo-controlled trial of the use of hydramethylnon bait stations will be used to confirm, firstly, that this intervention reduces cockroach population (as expected from the literature), and, secondly, that cockroach allergen in vacuumed dust as measured by specific monoclonal antibodies also decreases. The effect on asthma will subsequently be determined by treating, also in a parallel group, double- blinded, placebo-controlled fashion, the homes of patients with asthma and cockroach sensitivity, attempting to control for the important confounding variables, especially other indoor allergens. Sample size calculation suggests that, with methacholine reactivity as the outcome indicator, sufficient power can be achieved with a realistic sample size to detect a clinically important improvement in asthma. Proof of the efficacy of this inexpensive intervention in reducing asthma severity could have major public health implications.

哮喘在美国是一个日益重要的问题， 尤其是在少数民族和市中心群体中。造成这一增长的原因 对哮喘的定义很模糊；然而，来自许多领域的研究 美国指出蟑螂敏感率很高 在哮喘患者中，特别是在市中心，但也在农村和 小镇居民。皮肤测试调查，支气管挑战研究，以及 职业病证据表明蟑螂的相关性 哮喘的过敏原。蟑螂过敏原可能在吸尘后的粉尘中发现 家庭，但超过敏感度或症状的临界水平 预计会发生什么还不得而知。任何蟑螂过敏原的数量和性质 悬浮在室内空气中的情况尚不清楚。建议使用蟑螂的效果 对家庭粉尘和空气中的过敏原的控制措施尚不清楚。 同样，目前尚不清楚是否减少接触蟑螂变应原 会对蟑螂敏感型哮喘患者的肺功能产生影响。 这项拟议的研究将调查这些知识中的几个差距 蟑螂过敏原及其与哮喘的关系。有待检验的假设 包括： (1)。独立住宅中蟑螂种群的简易控制 导致吸尘后蟑螂过敏原的减少。 (2)。蟑螂过敏原的减少将有一个可检测到的 对居家哮喘患者的病情有一定的改善作用。 使用水合甲基农的平行组、安慰剂对照试验 首先，诱饵站将被用来确认这种干预 减少蟑螂数量(正如文献中预期的那样)，并且， 其次，吸尘器灰尘中的蟑螂过敏原是由特定的 单抗也减少了。对哮喘的影响将 随后，也是在平行的组中，通过治疗双重- 盲目的，安慰剂控制的时尚，哮喘患者和 蟑螂敏感，试图控制为重要的混杂 变数，尤其是其他室内过敏原。样本量计算 这表明，以乙酰甲胆碱反应性为结果指标， 通过实际的样本大小可以获得足够的功率来检测 哮喘的临床重要改善。证明这一方法的有效性 降低哮喘严重程度的廉价干预措施可能会产生重大影响 对公共健康的影响。