背景:某些环境过敏原暴露在弱势社区中更为常见,并且可能导致对上呼吸道感染(URI)的易感性差异。
目的:检查室内过敏原与:1)URI;2)URI+感冒症状;3)URI+感冒症状+肺嗜酸性粒细胞性炎症(FENO≥20ppb);和4)URI+感冒症状+肺功能降低(预测FEV1百分比<80%)之间的关联。
方法:我们使用来自环境对照的数据作为儿童哮喘研究的附加疗法。在空气(小鼠)和沉降的灰尘(小鼠,蟑螂,狗,和猫)。URI是通过测试鼻腔粘液的上呼吸道病毒来确定的。我们评估了过敏原浓度和URI相关结果之间的关联,包括年龄,性别,研究月,季节,健康保险,和家庭大小。
结果:90名参与者(92%是黑人,92%的公共保险)包括192个观察结果;52(27%)的观察结果对URI呈阳性。蟑螂过敏原浓度的加倍使URI出现感冒症状的几率增加了18%(优势比(OR)=1.18,95%CI,0.99-1.40),URI+感冒症状+肺嗜酸性粒细胞炎症的几率为31%(OR=1.31,95%CI,1.10-1.57),URI+感冒症状+肺功能降低的几率为45%(OR=1.45,95%CI,1.13-1.85)。小鼠过敏原浓度与所有结果呈正相关。暗示对害虫过敏原敏感的儿童之间的关联更强。
结论:蟑螂和老鼠,但不是狗或猫,过敏原暴露可能会使哮喘患儿易患URI并伴有感冒和下呼吸道转归。
BACKGROUND: Certain environmental allergen exposures are more common in disadvantaged communities and may contribute to differences in susceptibility to upper respiratory infections (URI).
OBJECTIVE: To examine associations between indoor allergens and: 1) URI; 2) URI +
cold symptoms; 3) URI +
cold symptoms + pulmonary eosinophilic inflammation (FENO≥20 ppb); and 4) URI +
cold symptoms + reduced lung function (percent predicted FEV1<80%).
METHODS: We used data from the Environmental Control as Add-on Therapy for Childhood Asthma study. Allergen concentrations were measured in air (mouse) and settled dust (mouse, cockroach, dog, and cat). URI was determined by testing nasal mucus for upper respiratory viruses. We evaluated associations between allergen concentrations and URI-associated outcomes accounting for age, sex, study month, season, health insurance, and household size.
RESULTS: 90 participants (92% Black, 92% public insurance) with 192 observations were included; 52 (27%) of observations were positive for URI. A doubling in cockroach allergen concentration increased the odds of a URI with
cold symptoms by 18% (odds ratios (OR) =1.18, 95% CI, 0.99-1.40), the odds of a URI +
cold symptoms + pulmonary eosinophilic inflammation by 31% (OR=1.31, 95% CI, 1.10-1.57), and the odds of a URI +
cold symptoms + reduced lung function by 45% (OR = 1.45, 95% CI, 1.13-1.85). Mouse allergen concentrations were positively associated with all outcomes. Associations were suggestively stronger among children sensitized to pest allergens.
CONCLUSIONS: Cockroach and mouse, but not dog or cat, allergen exposure may predispose children with asthma to URIs with colds and lower respiratory outcomes.