EPIDEMIOLOGY OF AIRWAYS RESPONSIVENESS

哮喘和慢性阻塞性肺病是中老年人群中最常见的两种慢性病 老年人和老年美国人分别有3%和11%的人 这些年龄段的人。这些情况经常并存。慢性阻塞性肺病是第四种 头号死因，第三大致病原因，也是 65岁以上人群的死因迅速上升。的总目标是 这项正在进行的研究旨在前瞻性地确定影响 肺功能下降的速度和识别预测因素 人群样本中的慢性阻塞性肺疾病(感冒)和哮喘 年长的成年人。我们假设加速的发展 FEV1下降与老年人呼吸道症状的发生 是由两种环境暴露决定的：烟草烟雾诱导 吸入性空气变应原的损伤和IgE介导的超敏反应。这个 过敏原暴露和呼吸道反应性导致固定的程度 老年人的气流阻塞是未知的。的主要过敏原 兴趣包括：屋尘螨(Der p i，Der fi)，蟑螂(Bla g i， Bla g II)、CAT(Fel D I)和真菌。呼吸道高反应性 支气管收缩刺激是一种生理特征，可能是 认为既是呼吸道疾病的一种表现，也是一种内在的 易患呼吸道疾病的宿主特征 并决定了它的临床模式。我们建议使用广泛的 关于呼吸道症状和疾病的纵向信息，香烟 吸烟、肺功能、呼吸道反应性、特应性指数(皮肤 检测、总IgE和抗原特异性IgE)、炎症指标(嗜酸性粒细胞 和外周血中的白细胞计数)，以及粉尘和 NAS参与者和他们的妻子在AIR中解决以下问题 假设。我们假设呼吸道增加的关联 肺功能纵向加速下降的反应性 受性别、吸烟、FEV1水平和皮肤测试反应性的影响。 我们假设接触常见室内过敏原的水平 影响肺功能纵向下降率。我们 假设高水平暴露于常见室内过敏原会导致 到随着时间的推移，呼吸道反应性纵向增加。最后，我们 确定真菌尘埃水平(可培养和可计数)的假设 生物)和抗原，蟑螂(Bla g L，Bla g II)和猫(Fel D I) 与空气中这些毒剂的水平有关。这项提案将是 首次将室内过敏原暴露与呼吸道反应性和 肺功能的下降，应该会为 青海省阻塞性呼吸道疾病的危险因素和自然病史 成年人。

Asthma and COPD, two of the most prevalent chronic diseases among middle- aged and older Americans, afflict 3% and 11%, respectively, of persons in these age groups. These conditions frequently coexist. COPD is the fourth leading cause of death, the third leading cause of morbidity, and the most rapidly rising cause of death in individuals over 65. The overall goal of this ongoing study is to prospectively identify factors that influence the rate of decline in pulmonary function and to identify predictors of chronic obstructive lung disease (COLD) and asthma in a population sample of older adults. We hypothesize that the development of accelerated decline in FEV1 and the occurrence of respiratory symptoms in older adults are determined by two environmental exposures: tobacco smoke-induced injury and IgE-mediated hypersensitivity to inhaled aeroallergens. The extent to which allergen exposure and airway responsiveness lead to fixed airflow obstruction in older adults is unknown. The primary allergens of interest include: house dust mite (Der p I, Der fI), cockroach (Bla g I, Bla g II), cat (Fel d I), and fungi. Airway hyperresponsiveness to bronchoconstricting stimuli is a physiologic characteristic that may be thought of both as a manifestation of airway disease and as an intrinsic host characteristic which predisposes to the development of airway disease and determines its clinical pattern. We propose to use the extensive longitudinal information on respiratory symptoms and illnesses, cigarette smoking, pulmonary function, airway responsiveness, indices of atopy (skin test, total and antigen-specific IgE), indices of inflammation (eosinophil and leukocyte counts in peripheral blood), and allergen levels in dust and air in NAS participants and their wives to address the following hypotheses. We hypothesize that the association of increased airway responsiveness with accelerated longitudinal decline in pulmonary function is modified by gender, smoking, level of FEV1, and skin test reactivity. We hypothesize that the level of exposure to common indoor allergens affects the rate of longitudinal decline of pulmonary function. We hypothesize that high levels of exposure to common indoor allergens leads to longitudinal increases in airway responsiveness over time. Finally, we hypothesize that settled dust levels of fungi (culturable and countable organisms) and antigens, cockroach (Bla g l, Bla g II], and cat (Fel d I) are correlated with airborne levels of these agents. This proposal will be the first to relate indoor allergen exposure to airway responsiveness and decline in lung function, and should provide important insights into the risk factors and natural history of obstructive airways diseases in adults.